Systematic Review of Occupational and Environmental Exposure to Anesthetic Gases in Operating Rooms: Pregnancy Outcomes in Iranian Healthcare Professionals

Mahrokh  Jalili; Faezeh Mazidi  Sharaf abadi; Zahra  Soltanianzadeh; Amin  Ghasemi

doi:10.18502/jehsd.v10i4.20653

Mahrokh Jalili Department of Environmental Health Engineering, Genetics and Environmental Hazards Research Center, Abarkouh School of Medical Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Faezeh Mazidi Sharaf abadi Department of Operating Room and Anesthesia, Faculty of Paramedical Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Zahra Soltanianzadeh Environmental Science and Technology Research Center, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Amin Ghasemi Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

DOI: https://doi.org/10.18502/jehsd.v10i4.20653

Keywords: Environmental Exposure; Occupational Exposure; Anesthetics; Operating Rooms; Pregnancy Outcome.

Abstract

Introduction: Operating room personnel are exposed to various occupational hazards that may pose health risks. Advances in anesthetic techniques and ventilation have reduced waste anesthetic gas exposure; however, concerns regarding potential reproductive risks persist. This review aims to summarize the current evidence on occupational exposure to anesthetic gases in operating rooms, focusing on their impact on pregnancy outcomes among healthcare professionals in Iran.

Materials and Methods: A systematic review was conducted on studies published between January 2000 and May 2025, identified through international and Iranian scientific databases, including the Web of Science, PubMed, Scopus, ScienceDirect, SID, Magiran, and IranDoc. Relevant studies were retrieved using keywords such as “Environmental exposure,” “Occupational exposure,” “Anesthetics,” “Operating room,” and “Pregnancy outcome” in both Persian and English languages. Finally, five articles were selected for the final analysis.

Results: The reviewed evidence showed mixed results regarding spontaneous abortion and preterm birth rates. Some studies have found a significant association between anesthetic gas exposure and these outcomes, while others have not reported any such association. Two studies have reported a significant association between anesthetic gas exposure and infertility. No significant relationship between anesthetic gas exposure and low birth weight was observed in the studies reviewed.

Conclusion: These findings suggest a potential association between occupational exposure to anesthetic gases and adverse pregnancy outcomes. Given the limited and methodologically limited studies in Iran, further well-designed prospective research and improved workplace safety measures are needed to clarify these associations and minimize the potential risks for operating room personnel.