Air Quality Monitoring of the Post-Operative Recovery Room and Locations Surrounding Operating Theaters in a Medical Center in Taiwan

Chin-Sheng Tang,Gwo-Hwa Wan,John Conly

doi:10.1371/journal.pone.0061093

Chin-Sheng Tang, Gwo-Hwa Wan + Show 1 more

Open Access

https://doi.org/10.1371/journal.pone.0061093

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Journal: PloS one	Publication Date: Apr 3, 2013
Citations: 63	License type: CC BY 4.0

Affiliation: Fu Jen Catholic University, Chang Gung University

Abstract

To prevent surgical site infection (SSI), the airborne microbial concentration in operating theaters must be reduced. The air quality in operating theaters and nearby areas is also important to healthcare workers. Therefore, this study assessed air quality in the post-operative recovery room, locations surrounding the operating theater area, and operating theaters in a medical center. Temperature, relative humidity (RH), and carbon dioxide (CO2), suspended particulate matter (PM), and bacterial concentrations were monitored weekly over one year. Measurement results reveal clear differences in air quality in different operating theater areas. The post-operative recovery room had significantly higher CO2 and bacterial concentrations than other locations. Bacillus spp., Micrococcus spp., and Staphylococcus spp. bacteria often existed in the operating theater area. Furthermore, Acinetobacter spp. was the main pathogen in the post-operative recovery room (18%) and traumatic surgery room (8%). The mixed effect models reveal a strong correlation between number of people in a space and high CO2 concentration after adjusting for sampling locations. In conclusion, air quality in the post-operative recovery room and operating theaters warrants attention, and merits long-term surveillance to protect both surgical patients and healthcare workers.

Highlights

Hospital indoor air pollution is associated with inadequate building environments, including building materials, air conditioning systems, ventilation rates, and human factors, such as overcrowding in constrained spaces [1,2,3]
The bacterial concentration in the supply washing room significantly exceeded that in the office, after adjusting for air temperature, relative humidity (RH), and number of people in the space (p = 0.04). This is the first study in Taiwan to apply air quality indices to an operating theater area, including the post-operative recovery room and surrounding areas in a medical center, to document differences in air quality
No international consensus existed regarding the best method and frequency of air sampling, and the tolerable bioburden in operating theater areas

Summary

Introduction

Hospital indoor air pollution is associated with inadequate building environments, including building materials, air conditioning systems, ventilation rates, and human factors, such as overcrowding in constrained spaces [1,2,3]. Patients, and visitors are significant sources of airborne microbes in hospitals. The airborne microbial concentration is correlated with suspended PM sized 5–7mm [3], human activity, number of people in a space, and apparel worn by personnel in operating theaters [6]. The airborne microbial concentration must be reduced to prevent surgical site infection (SSI). Safe airborne bacterial limits, such as 10 CFU/m3 [14] and 180 CFU/m3 [10], have been proposed, no international consensus exists regarding tolerable microbial levels in operating theaters

Methods

Results

Conclusion