Assessment of air quality during mastoidectomy

The Occupational Health and Safety Administration (OSHA) outlines specific requirements governing the use of respiratory protection for workers dealing with dust or other aerosolized compounds. Health care workers may be exposed to bone dust produced during otologic procedures, creating an occupational hazard. The purpose of this research was to quantify the total suspended particulate matter (TSPM) and respirable particulate matter (PM(5)) created during cortical mastoidectomy and investigate whether the concentration of aerosolized dust during mastoidectomy would require the use of a particulate respirator.

Cadaveric study to assess air quality during cortical mastoidectomy.

Temporal bone laboratory.

A simple mastoidectomy was performed on 3 cadaveric temporal bones. Suspended particulate concentration was measured using gravimetric filter methodology for TSPM and PM(5). Concentration of particulate exposure was compared between mannequins positioned near the surgical field with a standard surgical mask, surgical respirator, or controls.

The average total particulate matter concentration during cortical mastoidectomy was 1.89 mg/m(3). The average quantity of respirable particles was below detection levels. The calculated particulate exposure concentrations for TSPM and PM(5) did not exceed OSHA's requirement for respirator use. The particulate respirator prevented exposure to bone particulates compared with controls (P = .028).

The concentration of bone dust produced during cortical mastoidectomy is below regulatory guidelines for use of particulate respirators. However, experimental studies show the use of a surgical respirator may decrease particulate exposure.