Table 2 Potentially hazardous substances found in the ICU

The evidence that waste anesthetic gases used for sedation significantly affect staff is equivocal. Effects may include an increased risk of spontaneous abortion

(Buring..efa/ 1985) and alteration of DNA synthesis by nitrous oxide. Actively replicating cells are most affected, as folic acid metabolism is altered and the synthesis of vitamin B12 and DNA is impaired. Long-term exposure may result in several disabilities including megaloblastic anemia, leukopenia, peripheral neuropathy, and possibly fetal damage. ICUs should be properly ventilated and be equipped with scavenging systems. However, given the paucity of evidence linking such agents with staff ill health, these protective measures should not increase patient risk in any way.

Controlled-airflow cupboards may be employed as a means of both protecting staff from harmful fluid splashes and vapors and providing a sterile field. Musculoskeletal injury

Back injury is a major cause of morbidity among health workers and therefore has implications for financial planning within the establishment of the health provider. Although nurses take fewer days leave through sickness than the general population, they have 30 per cent more absences per year through back pain. The consensus of opinion is that these back injuries result from stresses during patient lifting and transfer (Laflin and Aja 1995). Several factors have been implicated in back injury (Table. .3)

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