Air pollution in the operating room: A case study of characteristics of airborne particles, PAHs and environmentally persistent free radicals

Abstract Air quality in the microenvironment of operating rooms (ORs) has attracted much attention as surgical smoke may pose health risks. We investigated air pollution in the operating room with a laminar flow system by examining the number and size distribution of airborne particles, the chemical composition and morphology of single particles, and polycyclic aromatic hydrocarbons (PAHs). In addition, environmentally persistent free radicals (EPFRs) in ORs are reported for the first time. The results showed that there were high levels of fine particles, EPFRs, and PAHs in laminar flow operating rooms during surgical procedures. PM2.5 is the dominant particle in ORs (accounting for >90%), consisting mainly of calcareous and metal-related particles based on the morphology and chemical analysis of single particles. In addition, anesthetic gas-related particles were found in the fine particles, and their toxicology requires more attention. EPFRs in the ORs were mainly carbon-centered radicals that may be reactive to cells. The concentrations of EPFRs and PAHs in ORs were higher than in the outside environment and present a potential health risk to surgeons and anesthetists. Hence, effective filtration and evacuation of surgical smoke are necessary.