CHARACTERIZATION OF SURGICAL PLUME AEROSOLS AND ASSESSMENT OF OCCUPATIONAL EXPOSURES AMONG OPERATING ROOM PERSONNEL

surgical plume aerosols;not listed

King, Bradley StevenCelentano, David D. ;

Johns Hopkins University

关键词: surgical plume aerosols;    not listed;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/40192/KING-DISSERTATION-2014.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

These studies were undertaken to increase the knowledge of characteristics of plume particles produced by surgical cutting and cauterizing instruments and to assess occupational exposure to these surgical plume particles.Surgical plume particle characteristics measured included particle size distribution and particle number, respirable mass, active surface area, and particle-bound polycyclic aromatic hydrocarbon (pPAH) concentrations. The four surgical instruments used were an electrocautery knife, a carbon dioxide laser, a harmonic scalpel, and a neutral plasma coagulator system (i.e., Plasma JetTM). At the point of generation, geometric mean (GM) particle number concentrations ranged from 7.11E+05 particles per cubic centimeter (particles/cm^3) (geometric standard deviation (GSD): 5.68) to 7.69E+07 particles/cm^3 (GSD: 2.73). Count median diameters (CMDs) ranged from 0.034 micrometers (μm) (GSD: 1.48) to 0.095 μm (GSD: 7.99). The use of a local exhaust ventilation (LEV) control built into the electrocautery knife produced significant reductions in particle number and respirable mass concentrations. The electrocautery knife produced particles with the largest quantity of pPAHs per active surface area.Trials using both dermal and adipose tissues were conducted to determine particle size distributions and number concentrations at the personal breathing zone (PBZ) level of a worker at the surgical table. CMDs ranged from 0.028 μm (GSD: 2.0) to 0.190 μm (GSD: 2.2). GM particle number concentrations were considerably diluted compared to the point of generation by the time they reached the PBZ, ranging from 220 particles/cm^3 (GSD: 1.9) to 108,632 particles/cm^3 (GSD: 1.33).Exposure assessments were conducted during several surgical procedures with varying degrees of surgical plume produced through the use of an electrocautery knife or plasma jet. CMDs of particles ranged from 0.091 μm (GSD: 2.3) to 0.105 μm (GSD: 1.8) across the multiple surgeries measured. However, when the plasma jet was used for antibacterial purposes rather than cutting, particles of a smaller CMD, approximately 0.03 μm (GSD: 2.0), were measured. Peak particle number concentrations for the procedures with the greatest surgical plume concentrations produced between 96,000-134,000 particles/cm^3 at the measurement location located closest to the surgical table. LEV use dramatically decreased operating room concentrations compared to similar procedures when LEV was not used.