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- Camille L Stewart, Mustafa Raoof, Robert Lingeman, Linda Malkas, Viviana Flores, Kerry Caldwell, Yuman Fong, and Kurt Melstrom.
- Department of Surgery, City of Hope National Medical Center, Duarte, California.
- Ann. Surg. 2021 Aug 1; 274 (2): 306311306-311.
ObjectiveWe hypothesized that OR airborne PM was different in quantity and mutagenic potential than office air and cigarette smoke.Summary Of Background DataExposure to surgical smoke has been equated to cigarette smoking and thought to be hazardous to health care workers despite limited data.MethodsPM was measured during 15 operations in ORs with 24.8 ± 2.0 air changes/h, and in controls (cigarettes, office air with 1.9-2.9 air changes/h). Mutagenic potential was assessed by gamma Histone 2A family member X staining of DNA damage in small airway epithelial cells co-cultured with PM.ResultsAverage PM concentration during surgery was 0.002 ± 0.002 mg/m3 with maximum values at 1.08 ± 1.30 mg/m3. Greater PM correlated with more diathermy (ρ = 0.69, P = 0.006). Values were most often near zero, resulting in OR average values similar to office air (0.002 ± 0.001 mg/m3) (P = 0.32). Cigarette smoke average PM concentration was significantly higher, 4.8 ± 5.6 mg/m3 (P < 0.001). PM collected from 14 days of OR air caused DNA damage to 1.6% ± 2.7% of cultured cells, significantly less than that from office air (27.7% ± 11.7%, P = 0.02), and cigarette smoke (61.3% ± 14.3%, P < 0.001).ConclusionsThe air we breathe during surgery has negligible quantities of PM and mutagenic potential, likely due to low frequency of diathermy use coupled with high airflow. This suggests that exposure to surgical smoke is associated with minimal occupational risk.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
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