Nitrous Oxide in the NHS – Risks, Plans, and Targets

For years, the NHS made extensive use of nitrous oxide as an anaesthetic gas. Yet there are concerns that prolonged exposure to nitrous oxide could pose certain health risks. Practitioners are also becoming increasingly aware of the possible environmental impact of using anaesthetic gases.

How is Nitrous Oxide Used in Healthcare

Nitrous oxide is an odourless and colourless gas. In sub-anaesthetic concentrations it acts as a powerful analgesic. It is most commonly used in a 50:50 mix with oxygen. This mixture is otherwise known as “gas and air”, or Entonox.

Nitrous Oxide Health Risks

Short-term exposure to Entonox can cause dizziness, fatigue, and nausea. Long-term exposure can affect the body’s capacity to absorb vitamin B12. This can damage the body’s nervous system and red blood cells, which can lead to a number of neurological conditions.

Prolonged exposure to nitrous oxide may also increase the risk of developing certain liver and kidney diseases.

The exposure risks for patients are low, as patients inhale the gas through a demand valve. However, when they breathe out, they can release some of the nitrous oxide back into the room. Over time, this can create an exposure risk for medical personnel. The risk will be greater if there are ever any gas leaks, or if staff routinely administer the gas in a poorly ventilated area.

This is why it’s essential to monitor the levels of nitrous oxide in hospitals. Our workplace exposure monitoring servicecan help you address your staff’s exposure to nitrous oxide and other potentially harmful substances.

Nitrous Oxide Environmental Risks – And The Solution

In a 2022 report, the NHS discussed the environmental impact of using certain anaesthetic gases. They revealed that emissions from one bottle can produce the same amount of carbon as burning 440kg of coal.

The NHS’s long-term plan is to reduce the carbon footprint associated with anaesthetic gases by 40%. Part of this strategy involves switching to lower carbon alternatives, such as sevoflurane.

The NHS is also exploring techniques for capturing, destroying, or reusing anaesthetic gases. They estimate that capturing and destroying nitrous oxide could cut over 33% of their total anaesthetic emissions.

There’s also a focus on cutting down on nitrous oxide wastage. Up to 30% of nitrous oxide may remain in cannisters after use. This residual gas can carry an environmental risk if it leaks, and recycling or reusing it can prove difficult.

We Can Help You Address The Risks of Nitrous Oxide in Your Hospital

Nitrous oxide leaks in your hospital contribute to your overall carbon footprint, and they may also present long-term workplace exposure risks for your personnel.

Keeping on top of equipment maintenance can help prevent leaks. It’s also important to ensure that any area of your hospital where nitrous oxide or other anaesthetic gases are administered is as well-ventilated as possible.

Yet if you want to address the exposure risks in your hospital, first you will need to understand the risks. This is where we can help. Our workplace exposure monitoring service can help you address your staff’s exposure to nitrous oxide and other potentially harmful substances.

We can provide a comprehensive report including discussions and recommendations based upon our findings. In this way, we can help you meet your COSHH obligations wherever your staff are exposed to hazardous substances in your hospital.

For information on our workplace exposure monitoring services, give us a call on 0845 226 0185 email us at