Nitrous oxide in blood and urine of operating theatre personnel and the general population

Nitrous oxide (N₂O) was assayed in 676 urine samples and 101 blood samples provided after exposure by operating theatre personnel from nine hospitals. The blood and urine assays were repeated in 25 subjects 18 h after the end of exposure. For 80 subjects, environmental N₂O was also measured during intraoperative exposure. Mean urinary N₂O in the 676 subjects at the end of exposure was 40 g/l (range 1–3805 g/l); in 10 of the 676 subjects, urinary N₂O was in the range 279–3805 g/l (mean 1202 /l). The 98^th percentile was 120 g/l. Mean blood N₂O at the end of exposure, measured in 101 subjects, was 21 g/l (median 16 g/l, range 1–75 g/l). Blood and urine N₂O (1.5 g/l and 4.9 g/l, respectively) in 25 subjects, 18 h after exposure, was significantly higher than in occupationally non-exposed subjects (blood 0.91 g/l, urine 1 g/l). Environmental exposure was significantly related to blood and urinary N₂O (r = 0.59 andr = 0.64, respectively). Blood and urinary N₂O were significantly related to each other (r = 0.71), and were equivalent to about 25% of the environmental exposure level. The mean urinary N₂O of 1202 g/l in 10/676 subjects was not related to environmental exposure in the operating theatre. The highest urinary N₂O levels measured in these 10/676 subjects could be explained by an asymptomatic urinary infection.