Report on BeaconMedaes' Weighted Time Average Test Using Personal Nitrous Oxide Detectors for Nitrous Oxide & Entonox Exposure

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Introduction

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The utilisation of Entonox, a 50/50 mix of Oxygen and Nitrous Oxide, in medical settings, poses potential occupational exposure risks to nursing and midwifery staff. The adverse health effects due to prolonged exposure necessitate reliable detection and monitoring methods to ensure staff safety.

Overexposure to nitrous oxide / Entonox can potentially pose several risks to midwives, nursing and clinical teams:

1. Neurological Effects: Chronic exposure to nitrous oxide can lead to a depletion of vitamin B12, an essential nutrient for nerve health. This can cause neurological symptoms like tingling, numbness, and in severe cases, nerve damage.
2. Hematological Issues: A decrease in vitamin B12 levels can also lead to hematological problems, including megaloblastic anemia.
3. Reproductive Risks: Prolonged exposure has been linked to reproductive issues, including decreased fertility and potential harm to a developing fetus.
4. Respiratory Impact: Although Entonox is less likely to cause respiratory depression, in high concentrations or with prolonged use, nitrous oxide can depress respiration.
5. Mental Health Effects: Overuse can lead to psychological issues such as depression, anxiety, and in some cases, addiction.
6. Dental Issues: Frequent inhalation can lead to oral health problems, including dental decay and mouth infections.
7. Occupational Hazards: Healthcare workers who are frequently exposed to nitrous oxide in a medical setting, without proper ventilation, may be at a higher risk of these side effects.
8. Diffuse Hypoxia: In cases where nitrous oxide is used without adequate oxygen (as in the misuse of pure nitrous oxide), there is a risk of hypoxia, where the body is deprived of adequate oxygen supply.

?Rationale for BeaconMedaes' Approach

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BeaconMedaes, in its pursuit of ensuring the highest standards of safety in healthcare environments, advocates for the adoption of a weighted time average test using personal Nitrous Oxide Detectors (NOD) from Medclair AB. This method aligns with the established workplace exposure limits (WEL) for Entonox, which are set to protect worker health by averaging hazardous substance concentrations over a specified time. The current limit is set at 100ppm (parts per million) over an 8 hour shift.

"Workplace exposure limits (WEL) are set in order to help protect the health of workers. WELs are concentrations of hazardous substances in the air, averaged over a specified period of time, referred to as a time-weighted average (TWA). Entonox has a long-term workplace exposure limit (WEL) in EH40 of 100 parts per million (ppm). Employers must ensure that nursing and midwifery staff are not exposed to levels exceeding this." - Quote from Royal College of Nursing document - Risks of exposure to Entonox to nursing and midwifery staff

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Superiority of the Weighted Time Average Test

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The weighted time average test offers a comprehensive assessment of exposure levels over time, providing a more accurate reflection of the actual risk to staff. This method surpasses traditional spot-check approaches by accounting for fluctuations in exposure levels, thus offering a more robust and reliable monitoring mechanism.

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Integration with Medclair AB's NOD

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Medclair AB's NOD is specifically engineered for precision in detecting Nitrous Oxide levels. When integrated with BeaconMedaes' weighted time average testing methodology, these detectors become an indispensable tool in accurately assessing occupational exposure. Their portability and ease of use make them ideal for continuous monitoring in various healthcare settings, including areas with potential for higher Entonox usage.

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Conclusion

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BeaconMedaes, with its commitment to sustainability and safety in healthcare, recommends the weighted time average test using Medclair AB's NOD as the primary method for detecting overexposure to Nitrous Oxide and Entonox. This approach ensures a safer working environment for nursing and midwifery staff, aligning with both regulatory standards and BeaconMedaes' ethos of advancing healthcare through innovative and reliable solutions.

Once this assessment has taken place the affected sites should look at installation of the Central Destruction Unit to provide a safe working environment for staff and to aid the NHS in their drive towards Net Zero under their carbon reduction policy.

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