Exposure of operating room surgical staff to surgical smoke under different ventilation schemes

Abstract

In operating rooms (ORs), surgical smoke is released during electro and laser surgery as well as in ultrasound applications, which poses a health risk to the surgical personnel. In this experimental study, a surgical smoke substitute was developed. The particle concentration near the facial region of different OR staff members and the extract concentration were measured while varying the airflow (unidirectional air flow (UDAF), turbulent mixing ventilation (TMV), and displacement ventilation (DV)) as well as the OR light configuration (lamp positions and shapes). The lowest exposure was observed with DV due to the upward flow motion of contaminants toward the extract openings in the ceiling. UDAF was the only airflow scheme in which the presence of surgical lights affected personnel exposure to surgical smoke; where the presence of OR lights greatly increased surgical smoke exposure due to the wake below the lights. In summary, it was found that the highest exposure to surgical smoke occurred in UDAF and the surgeons were exposed to a significantly higher concentration of surgical smoke than the assistant and anesthesiologist.

Keywords: displacement ventilation; operating room; surgical smoke; turbulent mixing ventilation; unidirectional air flow.