Use of TKR cement with a pregnant circulating nurse

IsseyM · Jan 24, 2007

I was observing a total knee the other day, both the circulator and scrub asked if i was pregnant. I told them no and asked why. They told me that it is dangerous for pregnant women and they should not be in the room while the cement is being mixed. I was curious and did a little bit of research. Anyways this is what i found.

Bone cement (PMMA) as you already know comes with the powder and the liquid to mix. This liquid methylmethacrylate or MMA is known to be toxic, irritating and a possible carcinogen but evidence is limited.

I did read the hazard sheet for MMA and it stated that, it may affect the ability to have children (both men and women childbearing age are at high risk), it may harm the developing fetus. It may affect liver and kidneys. May damage nervous system by causing numbness "pins and needles" and/or weakness in hands and feet. May cause skin allergies. Note: This is chronic health effects. BUT for acute health effects it stated that it can irritate eyes, nose, throat and lungs. Can also make you dizzy, irritable, difficulty with memory or concentration. A surgical tech. tried to sue stating that she got asthma from long term exposure to mixing bone cement in orthopedic cases. Not sure if she won or not. OSHA has a permissable exposure limit (PEL) for an 8 hour shift (100PPM) and they recommend employees wear respirators if there isn't adequate local exhaust ventilation at the site of chemical release.

What is also interesting is they do not recommend wearing contact lenses while mixing the cement. I read on another site the vapors may damage soft contact lens. Can you imagine if you splash this liquid in your eye! Ouch! Not good. Now once it becomes PMMA its supposed to be safe for the human body. Chemistry is wierd isn't it?

ewattsjt · Jan 24, 2007

Good reply. No.... GREAT REPLY. Our facility doesn't assign totals to pregnant women because of this.

Marie_LPN, RN, LPN, RN · Jan 29, 2007

No pregnant women in any total joint room, unless the total joint being put in doesn't use cement (ex. the metal-on-metal Depuy hip)

debbieuk · Jan 29, 2007

hi,

in the UK we also don't have pregnant women anywhere near cement

debbie

ewattsjt · Jan 31, 2007

I forgot to mention that here, if a couple is trying to get pregnant, the person is ban from where bone cement is used.

Marie_LPN, RN, LPN, RN · Jan 31, 2007

I forgot to mention that here, if a couple is trying to get pregnant, the person is ban from where bone cement is used.

That's sort of the way it is where i work, except that the person who is trying to get pregnant just requests not to be put in cement (or X-ray) cases, and the coordinator complies with it.

Zillie · Feb 8, 2007

I know a lot of people on here will disagree with me on this but I will tell you that I worked around cement throughout my pregnancy. At the hospital where I work we have laminar flow rooms and vacuum mixers that minimize the exposure to the fumes. I also did research on the effects of the cement and the levels that are being discussed here are much higher than what we are exposed to in the operating suite. During my first trimester when the doctor did not use the vacuum mixer I would use a fumevac bowl with suction. I also worked around x-ray during this time as well, always wearing wrap around lead. The point of lead is to protect you, which doesn't change even when you are pregnant. The most important thing to remember is to try to double the lead up in the front where you have the most exposure.

I am very comfortable with the decisions I made during my pregnancy. My daughter was born very healthy and 3 days overdue and I worked right up until my due date. I am no way telling you what choice to make. You must do what you are comfortable with because ultimately you must live with your decision. Best of luck to you and have fun making a baby! It will change your life in the best way possible!!