You Can Mitigate Exposure to Methyl Methacrylate Fumes

An alternative cement mixing system reduces surgeon exposure to potentially harmful MMA emissions in the operating room.

Smart Practice: If you’re risk-averse, consider a cement-mixing system that is “entirely closed” to decrease exposure to potentially harmful methyl methacrylate (MMA) monomer fumes during cemented arthroplasty surgery — but you have other choices, too.

What’s the Claim?

An experimental study found ambient fumes from methyl methacrylate (MMA) differ widely when cement is mixed using any of five commercially available and commonly used cement mixing systems, with one “entirely closed” system (PALACOS Pro All-in-One Fixation System, Heraeus Medical) resulting in consistently lower MMA emissions. That system performed well both in laminar flow and conventional ventilation settings, a feature not achieved by any of the other systems. MMA fumes are substantially reduced in operating rooms with laminar airflow compared to conventional ventilation, but this isn’t something you’re likely to be able to change about your setting.

It’s likely that all of the mixing systems tested kept MMA fumes below the US Occupational Safety and Health Administration (OSHA) standard when extrapolated to their 8-hour standard exposure, but if you’re sensitive, cautious, or pregnant or lactating (groups for whom greater concerns have been raised, though MMA is not a known teratogen), this study can help you to choose the mixing system that suits your preference.

How’s It Stack Up?