Background: Although pregnant personnel are commonly encouraged to
leave the operating room during the mixing and application of
polymethylmethacrylate, we are not aware of any information regarding the
safety of exposure to methylmethacrylate fumes for breastfeeding women. The
present study was performed to investigate the concentrations of
methylmethacrylate in serum and breast milk following exposure during total
Methods: A survey designed to determine present-day attitudes to
polymethylmethacrylate exposure during pregnancy and lactation was sent to
members of the Ruth Jackson Orthopaedic Society and the National Association
of Orthopaedic Nurses. To define the presence or absence of a scientific basis
for this behavior, serum and breast milk samples were collected from two
lactating surgeons at selected intervals after exposure to methylmethacrylate
during eight total joint arthroplasty procedures. Two healthy breastfeeding
women without exposure to methylmethacrylate served as controls. All
twenty-five samples were analyzed for methylmethacrylate with use of a
previously published headspace gas chromatography protocol.
Results: The gas chromatography protocol detected methylmethacrylate
at levels as low as 0.5 part per million. No serum or breast milk sample
demonstrated evidence of methylmethacrylate at that level, nor did any surgeon
sample test at a higher level than the control specimens. Serum and milk
samples spiked with methylmethacrylate yielded the analyte peak as expected,
evidencing no interference from either matrix.
Conclusions: Methylmethacrylate was not detectable at the
0.5-part-per-million level in serum or breast milk following inhalational
exposure during total joint arthroplasty. Although a controlled longitudinal
relative risk analysis was not performed and the sample size was relatively
small, pregnant or breastfeeding women may use this information to make an
informed decision regarding such exposure.
Level of Evidence: Therapeutic Level II. See Instructions
to Authors for a complete description of levels of evidence.