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Risk factors for particulate and microbial contamination of air in operating theatres
Journal of Hospital Infection
Volume 66, Issue 4, August 2007, Pages 320-326
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WJP-4P8H83J-4&_user=10&_coverDate=08%2F31%2F2007&_rdoc=5&_fmt=summary&_orig=browse&_srch=doc-info(%23toc%236884%232007%23999339995%23665802%23FLA%23display%23Volume)&_cdi=6884&_sort=d&_docanchor=&_ct=27&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=89d5c1d843f895b8c96265be504dd580
Summary
This study was designed to standardize dust collection in recently built operating theatres equipped with a continuous monitoring system. The objectives were to establish the relationship between microbiological and dust contamination, and then to compare those parameters with the main indicators of surgical activity in order to better define risk factors affecting air quality. The air quality during 23 surgical operations was studied in three conventionally ventilated operating theatres. Microbiological air counts were taken using both passive and active sampling methods. Air dust particles, ≥0.5 and ≥5 μm in size, were measured using a light-scattering particle analyser. The overall dust load was mainly (98%) composed of fine particulate matter, most probably due to its longer suspension time before settlement. These particles positively correlated with operation length, but not with surgical technique, suggesting that fine particles may be a good tracer of operation complexity. In contrast, the surgical technique was the main predictor for the concentration of particles ≥5 μm, with a higher risk from general conventional surgery compared with scope surgery. The frequency of door-opening, taken as an index of staff and visitor movement, was the main negative predictor of over-threshold values of both fine and larger dust particles but, conversely, was a positive predictor of raised bacterial counts.
Keywords: Environmental monitoring; Operating theatre; Air quality; Microbial contamination; Particle contamination; Risk factors
手术室中空气尘埃和微生物污染的危险因素
这项研究是为最近建成的配备了连续监测系统的手术室设定除尘标准,目的是探讨微生物与尘埃污染的联系,然后用这些参数来比较手术活动的一些主要情况,以便更好地界定影响空气质量的危险因素。对在三个常规通风手术室中的23台手术的空气质量进行了研究。空气中菌落数采用被动和主动采样方法。用光散射尘埃粒子分析器来测量空气中的≥ 0.5和≥ 5 μ m的尺寸的尘埃粒子。空气中的粉尘98%是由细小粒物组成,在处理前它们长期悬浮在空气中。这些颗粒浓度与手术时间呈正相关,但与外科技术无关,表明微粒可能是一个很好的反映手术复杂性的指标,相反,而外科技术是评价≥ 5 μ m尘埃粒子浓度的主要指标,开展大面积的常规手术要比局部手术危险性高。频繁开关手术室门、室内人员数量和探视人员流动,是微粒和较大的尘埃超标的主要危险因素,也预示着细菌浓度超标。 |