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Trial registered on ANZCTR
Registration number
ACTRN12617001334392
Ethics application status
Approved
Date submitted
11/09/2017
Date registered
19/09/2017
Date last updated
22/10/2021
Date data sharing statement initially provided
22/05/2020
Date results provided
22/10/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
Methoxyflurane metabolite (fluoride) presence in ambulance staff
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Scientific title
Change in methoxyflurane metabolite (fluoride) presence in ambulance staff
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Secondary ID [1]
292778
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Fluoride accumulation
304577
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Condition category
Condition code
Public Health
303909
303909
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0
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Health service research
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Emergency Medical Technicians in a metropolitan ambulance service will be using Penthrox (methoxyflurane) following newly introduced operational guidelines, occasionally administering up to 6mL to each patient as needed for pain relief. We expect they will be exposed to trace vapour (quantity not known) and that this may result in elevated serum fluoride in those staff. We will observe their serum fluoride over the course of 24 months to identify whether there is any evidence of fluoride accumulation.
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Intervention code [1]
299012
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Early Detection / Screening
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Statistically significant changes in serum fluoride concentration.
Serum fluoride will be measured by ion specific electrode in buffered venous sample.
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Assessment method [1]
303241
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Timepoint [1]
303241
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Methoxyflurane administration by ambulance staff will commence from June 2017, following an organisational implementation plan. We will measure staff serum fluoride at 0 months after introduction (during June 2017) to establish a baseline, and at 1, 4, 8, 12, 18 and 24 (primary endpoint) months after introduction of methoxyflurane into clinical practice.
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Secondary outcome [1]
338336
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Rate of change in serum fluoride concentration recorded over safe levels (<= 40 µmol/L).
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Assessment method [1]
338336
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Timepoint [1]
338336
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0, 1, 4, 8, 12, 18 and 24 months following introduction of methoxyflurane into clinical practice, as described for the primary endpoint.
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Eligibility
Key inclusion criteria
Ambulance officers rostered in full time patient contact role. Preferential recruitment of Emergency Medical Technicians over other qualifications.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Staff members expected to leave the ambulance service in the course of the trial.
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Convenience sample
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Timing
Prospective
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Statistical methods / analysis
Sample size 12 chosen to achieve 95% power to detect a 1 µmol/L difference in serum fluoride with p < 0.01, with up to 30% attrition due to change in role/injury or illness/cessation of employment/opting out.
Measures of change in blood fluoride over time will be calculated, including 95% confidence intervals of mean at each month tested, a series of one-sample t-tests of change in group mean vs. initial and vs. previous month (considering p < 0.05 as statistically significant), and regression models for change in blood fluoride over time.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/06/2017
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Date of last participant enrolment
Anticipated
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Actual
1/07/2017
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Date of last data collection
Anticipated
30/06/2019
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Actual
24/07/2019
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Sample size
Target
12
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Accrual to date
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Final
12
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Recruitment outside Australia
Country [1]
9174
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New Zealand
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State/province [1]
9174
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Wellington
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Funding & Sponsors
Funding source category [1]
297408
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Government body
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Name [1]
297408
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National Science Challenge funding (MBIE)
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Address [1]
297408
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Callaghan Innovation campus
69 Gracefield Rd
Gracefield
Wellington 5010
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Country [1]
297408
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New Zealand
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Funding source category [2]
297411
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Other Collaborative groups
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Name [2]
297411
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Medtec CORE (TEC)
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Address [2]
297411
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The University of Auckland
Private Bag 92019
Auckland 1142
New Zealand
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Country [2]
297411
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New Zealand
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Primary sponsor type
Individual
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Name
Dr. Paul Docherty
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Address
University of Canterbury
Private Bag 4800
Christchurch 8140
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Country
New Zealand
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Secondary sponsor category [1]
296402
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Individual
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Name [1]
296402
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Serah Allison
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Address [1]
296402
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c/o Wellington Free Ambulance
PO Box 601
Wellington 6140
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Country [1]
296402
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New Zealand
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Other collaborator category [1]
279691
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Individual
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Name [1]
279691
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Dr. Dirk Pons
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Address [1]
279691
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University of Canterbury
Private Bag 4800
Christchurch 8140
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Country [1]
279691
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New Zealand
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Other collaborator category [2]
279692
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Individual
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Name [2]
279692
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Dr. J Geoffrey Chase
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Address [2]
279692
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University of Canterbury
Private Bag 4800
Christchurch 8140
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Country [2]
279692
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
298513
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University of Canterbury Human Ethics Committee
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Ethics committee address [1]
298513
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University of Canterbury Private Bag 4800 Christchurch 8140
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Ethics committee country [1]
298513
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New Zealand
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Date submitted for ethics approval [1]
298513
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24/04/2017
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Approval date [1]
298513
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23/05/2017
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Ethics approval number [1]
298513
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HEC 2017/23/LR
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Summary
Brief summary
One option that ambulance staff have at their disposal for managing patient pain is Penthrox (methoxyflurane), which produces a vapour that the patient inhales. Research of one-off Penthrox doses indicate that the drug is safe. However ambulance staff will be repeatedly exposed to trace quantities of vapour over months and years of treating patients. Methoxyflurane can cause raised blood fluoride level, and if these levels become high enough it can be toxic. We are observing ambulance staff over a prolonged period to determine whether or not their blood fluoride level increases to dangerous levels over time.
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Trial website
None
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
77318
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Ms Serah Allison
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Address
77318
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Wellington Free Ambulance
PO Box 601
Wellington 6140
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Country
77318
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New Zealand
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Phone
77318
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+64 27 486 6707
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Fax
77318
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Email
77318
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[email protected]
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Contact person for public queries
Name
77319
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Serah Allison
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Address
77319
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Wellington Free Ambulance
PO Box 601
Wellington 6140
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Country
77319
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New Zealand
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Phone
77319
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+64 27 486 6707
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Fax
77319
0
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Email
77319
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[email protected]
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Contact person for scientific queries
Name
77320
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Serah Allison
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Address
77320
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Wellington Free Ambulance
PO Box 601
Wellington 6140
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Country
77320
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New Zealand
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Phone
77320
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+64 27 486 6707
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Fax
77320
0
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Email
77320
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
For each participant: de-identification by assigning a "participant number"; blood test dates; blood fluoride results.
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When will data be available (start and end dates)?
Personal data has already been provided to participants who requested their data.
Analysis is currently being undertaken, with a goal to publish in a peer-reviewed scientific journal before the end of 2020.
Aggregated data and analysis will be provided to participants when the paper has been accepted for publication.
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Available to whom?
Tabulated anonymised blood fluoride results will be published in the journal article and PhD thesis, and thus available to the scientific community.
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Available for what types of analyses?
Published blood fluoride results may be subsequently analysed by the scientific community however needed.
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How or where can data be obtained?
Anonymised data will be incorporated into the published journal article and PhD thesis.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
8049
Study protocol
[email protected]
8050
Statistical analysis plan
[email protected]
8051
Analytic code
[email protected]
8052
Ethical approval
[email protected]
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Serum fluoride levels in ambulance staff after commencement of methoxyflurane administration compared to meta-analysis results for the general public
2021
https://doi.org/10.13075/ijomeh.1896.01704
N.B. These documents automatically identified may not have been verified by the study sponsor.
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