Utilização do metilmetacrilato

: risco de exposição ocupacional

Abstract

Methyl methacrylate (MMA) is the basic substance of the acrylic bone cement, chemical synthesis which was first defined in 1902 by German chemist Röhm. In 1943 it was established the protocol for the chemical production of acrylic bone cement. However, the big push of the use of acrylic bone cement in medicine was given by Charnley in 1958 during its use in hip arthroplasty. The acrylic bone cement is a composite consisting essentially of a homopolymer of polymethylmethacrylate with a methylmethacrylate monomer. Though, there are various commercial forms, its chemical formula has as basic substance the MMA associated with other compounds, varying in some appropriate compound specific to any given clinical situation. In recent decades, and as a result of its widespread use, there is urgent need for development of cementing techniques in particular in relation to the techniques of preparation and application of acrylic bone cement in order to optimise their properties and minimise the risks inherent in their use. An important focus in the development of systems of cementation was controlling the level of exposure to MMA in order to create a safe work environment, because although there isn’t yet evidence of their possible carcinogenic potential, several studies show its toxicity mainly in the pulmonary system, liver and skin. Thus currently there are exposure limits for the concentration and time of exposure to MMA, which are defined by IARC in collaboration with other institutions and also defines a set of good practice for guidelines handling the acrylic bone cement This paper aims to analyse the risk of occupational exposure related to the toxicity of methylmethacrylate faced by scourb nurses in ten hospitals, in the Northern region of the country. In their professional practice, these nurses use bone cement daily. This research used, as an instrument of data collection, a questionnaire to assess information related to the levels and times of exposure, preparation practices, level of knowledge about the norms prescribed for their use, physiological manifestations during the handling and analytical control performed by these professionals in order to discourage any kind of inherent consequence of exposure to MMA monomer. The results showed that most of these professionals use the technique of manual preparation, which is the technique that exposes them the most to vapours from MMA. The majority of them have no previous information about the rules for using acrylic bone cement. Beyond the deficiency of staff knowledge, the data showed a lack of resources in the department that will allow for the proper preparation technique in order to reduce the risk of exposure. Of the 143 nurses surveyed only 14% of scourb nurses are exposed to a level superior to the recommended concentration. These situations occur when professionals participate in more than two procedures/surgeries per day using acrylic bone cement. However, more than half of respondents had symptoms during the handling of this compound. Although only 44 (23%) of respondents conduct regular analytical control in the liver and kidney function, it has been established that, out of this number, 14 people have shown changes of both liver and kidney function. This is the group that performs a greater number of surgeries per day and has more than 13 years of service. The conclusion is thus that there is a need for more training for these Health Care practitioners (providers) to the standards recommended for the handling of acrylic bone cement, exposure limits and raising a regular analytical control, so in order to minimize the risk of occupational exposure.

Date of Award	Jun 2011
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Manuel Gutierres (Supervisor)