Francesco Romano

Electrosurgical Smoke: Ultrafine Particle Measurements and Work Environment Quality in Different Operating Theatres

Air cleanliness in operating theatres (OTs) is an important factor for preserving the health of both the patient and the medical staff. Particle contamination in OTs depends mainly on the surgery process, ventilation principle, personnel clothing systems and working routines. In many open surgical operations, electrosurgical tools (ESTs) are used for tissue cauterization. ESTs generate a significant airborne contamination, as surgical smoke. Surgical smoke is a work environment quality problem. Ordinary surgical masks and OT ventilation systems are inadequate to control this problem. This research work is based on numerous monitoring campaigns of ultrafine particle concentrations in OTs, equipped with upward displacement ventilation or with a downward unidirectional airflow system. Measurements performed during ten real surgeries highlight that the use of ESTs generates a quite sharp and relevant increase of particle concentration in the surgical area as well within the entire OT area. The measured contamination level in the OTs are linked to surgical operation, ventilation principle, and ESTs used. A better knowledge of airborne contamination is crucial for limiting the personnel’s exposure to surgical smoke. Research results highlight that downward unidirectional OTs can give better conditions for adequate ventilation and contaminant removal performances than OTs equipped with upward displacement ventilation systems.

HVAC System Design in Healthcare Facilities and Control of Aerosol Contaminants: Issues, Tools, and Experiments

Ventilation design greatly affects disease transmission by aerosols in healthcare buildings and is necessary to protect patients and healthcare workers against Hospital Acquired Infections (HAI). The rising concerns for antibiotic resistance and the strong push to save energy are motivating an assessment of current situation and are supporting a multidisciplinary effort to use novel approaches and tools. The paper is suggesting a shift to performance-based concepts, made possible by a wider use of IAQ sensors and of CFD simulation tools. The paper highlights the key role of particles and Microbe-Carrying Particles, how they are generated and spread by people and can be controlled by dilution and filtration. The viable and non-viable particle measurement techniques are described and OPC emerge as a widely usable tool to quantitatively assess, monitor and control hospital ventilation. Being people the most relevant indoor particle source, it is shown how aerosol dispersion from people can be reduced using occlusive clothing and how different garments are performing in Test Chamber and in OT. The simulation and experimental study of a high-performance OT ventilation system is used in order to show potential benefits of OPC and CFD tools.