`The air that we breathe¿: assessment of laser and electrosurgical dissection devices on operating theater air quality

Abstract

Objectives: To measure changes in air quality during surgery.Methods: Operating room (OR) and hallway air quality was continuously monitored over a 3-month period. Rooftop monitoring was used to control for environmental changes and to account for the infiltration of outdoor air pollutants. Air quality measurements were correlated with operative times and electro-dissection equipment used.Results: OR air is cooler and drier compared to the adjacent hallway. Volatile organic compounds and other gases are below indoor air exposure limit guidelines. Lasers create greater 2.5 μm particulate matter (PM 2.5 ) mass concentration, and greater fine and coarse particle number than cautery or cold tissue dissection. Cautery produces more ultrafine particles (UFP) than other dissection techniques. OR air has lower particle counts than outdoor environmental air by virtue of air conditioning HEPA filtration. Conclusion:Compared to the outside air, operating room air has lower particle counts. Lasers produce higher concentrations of PM 2.5 mass and, fine and coarse particle number counts. Cautery produces higher concentrations of UFP number counts than other modalities and warrants consideration of the use of masks with ultrafine particle filtration capacity. Operating room air is consistently cooler with decreased humidity, which may cause airway irritation.

Response to the Comment on “Feasibility and Safety of Laparoscopic Complete Mesocolic Excision (CME) for Right-sided Colon Cancer: Short-term Outcomes. A Randomized Clinical Study”

“…In addition, the filter can only filter particles larger than dozens of nanometers in diameter, 1 but it has no effect on the gas composed of molecules, which may lead to the pollution of carbon monoxide, acrylonitrile, hydrogen cyanide, formaldehyde, benzene, and other substances to the operating room. 4,5 Working in such an environment, surgical staff may have cough, headache, dizziness, fatigue, and other symptoms caused by the smoke. Long-term exposure to this environment also increases the risk of cancer, coronary artery disease, congestive heart failure, asthma, chronic obstructive pulmonary disease and so on.…”

Comment on: A Low-cost, Safe, and Effective Method for Smoke Evacuation in Laparoscopic Surgery for Suspected Coronavirus Patients

“…In addition, the filter can only filter particles larger than dozens of nanometers in diameter, 1 but it has no effect on the gas composed of molecules, which may lead to the pollution of carbon monoxide, acrylonitrile, hydrogen cyanide, formaldehyde, benzene, and other substances to the operating room. 4,5 Working in such an environment, surgical staff may have cough, headache, dizziness, fatigue, and other symptoms caused by the smoke. Long-term exposure to this environment also increases the risk of cancer, coronary artery disease, congestive heart failure, asthma, chronic obstructive pulmonary disease and so on.…”

Safety considerations for Health care Workers involved in Cytoreductive Surgery and Perioperative chemotherapy

“…These compounds are also known to cause ischemic heart disease, increased mortality from non-malignant lung diseases [30,31]. Despite this body of evidence, the actual mutagenic risk to the healthcare personnel is not known [32].…”