Comparison of generation of particles and bacteria in endoscopic surgery and thoracotomy

• Published in: Building and environment 2021-04, Vol.193, p.107664, Article 107664
• Main Authors: Odagiri, Akane, Yanagi, U., Kato, Shinsuke
• Format: Article
• Language: English
• Subjects: Air intakes; Air quality; Airborne sensing; Bacteria; Diameters; Endoscopy; Health risks; Hospital costs; In situ measurement; Infections; Microbiome; Microbiomes; Operating room; Ostomy; Outdoor air quality; Particle; Risk analysis; Risk factors; rRNA 16S; Streptococcus infections; Surgery; Surgical operation; Viruses
• ISSN: 0360-1323; 1873-684X
• DOI: 10.1016/j.buildenv.2021.107664

Maintaining air quality in operating rooms is import to prevent surgical site infections. Surgical smoke is a risk factor for infections that can be caused by bacteria or viruses. In this study, in situ measurements were conducted to understand the characteristics of airborne particles based on particle size, viable bacteria, and microbiome generated during an endoscopic surgery and a thoracotomy performed in the same operating room on a single day. During thoracotomy, a sharp rise was observed in the concentration of airborne particles (≥0.3 μm, ≥0.5 μm, and ≥1.0 μm in diameter) at the beginning of the use of electrosurgical tools. Furthermore, the concentration of airborne particles was higher during thoracotomy than during endoscopic surgery. Additionally, the mean values of airborne particles during both endoscopic surgery and thoracotomy significantly exceeded the ISO 14644-1 standard. The level of exposure to airborne particles during thoracotomy was found to be 4–27 times higher than that during endoscopic surgery. During endoscopic surgery, the concentration of bacteria near the operating table and at the air inlet was 56 CFU/m3 and undetected, respectively. In comparison, during thoracotomy, the concentration of airborne near the operating table and at the air inlet was 533 CFU/m3 and 11 CFU/m3, respectively, indicating that more bacteria were generated during thoracotomy than during endoscopic surgery. Based on 16S rRNA analysis, the top four genera of each sample, that is, Streptococcus, Acinetobacter, Neisseria, and Staphylococcus, were bacteria of human origin. •This is the first study to measure airborne particles and microbes during an endoscopic surgery and a thoracotomy on a single day in the same operating room.•During both surgeries, maximum values and mean values of airborne concentrations significantly exceeded the ISO 14644-1 standard.•The level of exposure to airborne particles during the thoracotomy was found to be 4–27 times higher than that during the endoscopic surgery.•16S rRNA analysis shows the top four genera of each sample were Streptococcus, Acinetobacter, Neisseria, and Staphylococcus.