Assessment of medical personnel exposure to nitrogen oxides during inhalednitric oxide treatment of neonatal and pediatric patients

Objective. This study was an assessment of potential exposures of medical p ersonnel to nitrogen oxides during simulated and actual inhaled nitric oxid e treatment of newborn and pediatric patients. Design. Breathing zone exposures to nitric oxide (NO) and nitrogen dioxide (NO2) were monitored using data-logging personal dosimeters during simulate d and actual administration of NO gas to patients in an intensive care sett ing. Sample. A total of 28 bedside nurses and 18 respiratory therapists were mon itored during 6 different patient treatments. Analysis. The highest measured concentrations of NO and NO2 in the personal breathing zones of the nurses and respiratory therapists were peak reading s (<1 minute in duration) of 6.7 parts per million (ppm) NO and 3.1 ppm NO2 . Exposures averaged throughout 15 minutes and throughout the work shift we re below the limit of detection (0.8-ppm NO and 0.5-ppm NO2). Conclusion. Detectable exposures to NO and NO2 were brief, infrequent, and well below Occupational Safety and Health Administration permissible exposu re limits or any other exposure guideline, eg, American Conference of Gover nmental Hygienists Threshold Limit Values.