Surgical applications of methyl methacrylate: a review of toxicity.

Methyl methacrylate (MMA) is a monomer of acrylic resin widely used in a variety of medical, dental, and industrial applications. Its extensive use in surgery, particularly for arthroplasties, has often raised concerns regarding potential human toxicity for orthopaedic surgeons, surgical nurses, and other operating-room staff who are occupationally exposed to the compound. The main toxic effects of MMA exposure appear to involve the cardiovascular system. When exposed to MMA in the work environment, surgical staff have been reported to suffer from hypersensitivity, asthmatic reactions, local neurological symptoms, irritations and local dermatological reactions. The integrity of latex gloves may also be compromised following exposure to MMA during surgical procedures. At present, MMA is not thought to be carcinogenic to humans under normal conditions of use. Nevertheless, sound occupational hygiene practices should still be used to help reduce workplace exposure to MMA during orthopaedic and other medical procedures. Surgical staff should avoid direct contact with MMA mixtures wherever possible, and room ventilation and adequate airflow should also be optimized. In the present article, the authors review studies relating to MMA toxicity in surgical practice, updating in part a previous literature review and expanding on the toxicity of MMA within the surgical setting.