Influence of Surgical Smoke on Indoor Air Quality in Hospital Operating Rooms

Abstract

The objective of this study is to analyze the volatile organic compounds (VOCs) in the surgical smoke generated during laparoscopic surgery, and determine their influence on the indoor air quality in hospital operating rooms (ORs). Field measurements were carried out during eight surgeries in conventional and robotic ORs in which an electrosurgery system was being used, thus continuously generating surgical smoke. The VOCs were measured at three different locations, in the patients' abdominal cavities, beside the surgical table, and at the exhaust vent. Other indoor pollutants including carbon monoxide (CO), carbon dioxide (CO 2 ), and total airborne bacteria (TAB) in the indoor air were measured at the exhaust to assess the general indoor air quality in the ORs. The results from the patients' abdominal cavities confirmed that the surgical smoke contained abundant VOCs, with the levels of benzene and toluene exceeding the health guidelines. Compared to the results obtained in the abdominal cavity, the measurements obtained at the surgical table and exhaust vent exhibited low levels of VOCs, indicating that the actual exposure to these compounds was minimized in a highlyventilated operating room. However, the benzene concentration in the operating room approached a level that threatens the health of the occupants. Therefore, the results of this study suggest that there is a potential health risk to the surgeon who is closest to the point of origin of the surgical gas, as well as a need for further attention to identify the local pollutant dispersion near the surgical table while the ventilation system is operating.

Particle and Carbon Dioxide Concentration Levels in a Surgical Room Conditioned with a Window/Wall Air-Conditioning System

“…In these rooms, contaminant agents such as biological (microorganisms-fungi, bacteria and viruses), chemical (waste anaesthetic gases, carbon dioxide, etc.) and particulate matter can easily be dispersed by draughts or can remain in suspension in the air for several hours [4][5][6][7]. Additionally, depending on their size, airborne infectious particles in the operating rooms can be broadly classified as follows: bacterial cells and spores (from 0.3 to 10 µm in diameter); fungal spores (from 2.0 to 5.0 µm); viruses (from 0.02 to 0.30 µm in diameter) [8][9][10].…”

Smoke Evacuation During Laparoscopic Surgery: A Problem Beyond the COVID-19 Period. A Quantitative Analysis of CO2 Environmental Dispersion Using Different Devices

“…Quantitative analysis of CO 2 environmental dispersion, expressed in parts per million (ppm), was carried out in the empty OR ("at rest condition") and during the procedure ("operational conditions") in the presence of patient and exposed staff (8÷10 operators). 9,10 The analysis has been carried out into two OR of University Federico II of Naples. The characteristics of OR and air flow systems are illustrated in Table 1.…”

Anesthetic toxic isoflurane and health risk assessment in the operation room in Abadan, Iran during 2018

“…12 samples were taken from operating rooms in the hospitals of study. The time weighted average concentrations (TWA ± SD) in two main educational hospitals were calculated using equation (1). The standard of isoflurane according to US NIOSH and California OSHA (OSHA 5155 Table AC-1) permissible exposure limits for chemical contaminants is 2 ppm (2000 mg/m 3 ).…”

“…Anesthetic gases (AG) is one of the most important indoor air quality (IAQ) that increase the risk of genetic damage, respiratory and renal disease among exposed health care worker (HCWs) and patients in operating rooms (ORs). [1][2][3][4][5][6][7][8] The main please that used to anesthetics are dental offices, veterinary hospitals and operating rooms. [9][10][11] Based on report International Agency for Research on Cancer (IARC) states in humans there is inadequate evidence for the carcinogenicity of isoflurane, sevoflurane, nitrous oxide and halothane.…”

“…4,11,12,21,22 One of the most important methods in contributing to infection control (reducing the number of surgical site infections (SSIs)) on patients and surgical staff safety and treatment anesthetic gases is Air conditioning systems.1-3 ,11, 23-25 Standards and guidelines for the air quality in ORs have been proposed, focusing on general OR ventilation requirements. 1,26,27 In 2015 Joksovic et al studied the early exposure to general anesthesia with isoflurane. 9 An investigation Chaoul et al measurement the concentration of anesthetic gases in operating rooms.…”