Estimating Air Pollution in Operation Rooms Generated from Cautery, Drills, and Other Equipment, Utilizing a Particulate Counter and Gas Analyzer

Abstract

Background: Air pollution, especially indoor air pollution, is increasingly recognized as a worldwide hazard that reduces life expectancy. Pollution caused by equipment such as surgical cautery is not just a nuisance but a workplace hazard that exposes the staff to respirable particulate matter and toxic chemical agents. It has not yet received much recognition in India, nor have mitigating measures like smoke evacuators and dedicated scavenging systems become prevalent. Methods: We aimed to do a prospective observational study of the extent of this hazard in the operation rooms in our tertiary care, Government-run hospital using a consumer-grade pollution measuring equipment (CAIR +™, Prana Air, New Delhi). We measured and compared the particulate pollutant matter (PM) levels, Total Volatile Organic Compounds (TVOC), formaldehyde, and carbon dioxide at multiple areas of interest at different time points. Results: The particulate pollution level in PM 1.0, PM 2.5, and PM 10 and TVOCs rose many times the baseline near the surgical team during cautery use. It remained high near the anesthesia workstation. The median PM 2.5 level in µg/m3(micrograms/cubic meter) was 181 near the surgical team during cautery use, and it was 25 at the anesthesia workstation. This peak level was 30 times the basal level of 6 µg/m3 at the start of the day and was above the annual population-weighted mean PM 2·5 breakpoint of 40 μg/m3 recommended by the National Ambient Air Quality Standards in India. Conclusions: The pollution levels increase dramatically when surgical cautery is used, potentially exposing the team to large peak elevations in particulate matter and TVOCs. We recommend the mandatory use of smoke evacuators and optimization of the air conditioning.