Floating aerial blood mists in the operating room

Area of Science:

• Environmental Health
• Surgical Safety
• Aerosol Science

Background:

• Surgical instruments, including high-speed devices and electric coagulators, generate aerosols.
• Operating rooms require stringent air quality control to prevent contamination.

Purpose of the Study:

• To detect and quantify blood-contaminated aerosols in an operating room environment (ISO class 6 and 7).
• To assess the contribution of specific surgical devices to aerosol contamination.

Main Methods:

• Test filters were installed in air conditioning extract ducts for 1, 2, or 4 weeks.
• Filters were changed after each surgery in a separate experiment.
• The leucomalachite green method was used to detect blood contamination.

Main Results:

• Blood aerosol accumulation increased with filter exposure time (26, 60, and 143 positive dots at 1, 2, and 4 weeks).
• Positive filters were detected in 90% of surgeries using high-speed instruments and 94% using electric coagulators.
• Contamination was detected at distances of 3.8–4.6m from the surgical field.

Conclusions:

• Surgical procedures using high-speed instruments and electric coagulators release aerosolized blood into the operating room air.
• Perioperative staff, including surgeons, anaesthetists, and assistants, are potentially exposed to these contaminated aerosols.
• Enhanced precautions are necessary to mitigate exposure risks in the operating room environment.