Effect of environmental and behavioural factors on microbiological air quality of operating rooms

Authors

  • Gurmail Singh Himachal State Health Services, Himachal Pradesh, India
  • Manisha Biswal Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  • Vipin Koushal Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  • Navneet Dhaliwal Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India

DOI:

https://doi.org/10.3396/ijic.v18.21204

Keywords:

operating room, air quality, bacteria, fungi, environment, behaviour, India

Abstract

Introduction: An operating theatre (OT) is a very complex setup, which presents numerous challenges for both patients and health care providers. A safe OT environment decreases the susceptibility of patients to postoperative infections. Therefore, a study was conducted to determine microbiological air quality for establishing baseline values and to assess concurrently the effect of environment and behavioural factors in 46 OTs of a tertiary care hospital.

Materials & Methods: The OTs were divided into two groups based on the type of air flow: laminar diffuser (Group I) or conventional diffuser (Group II). Two hundred and thirty-eight samples were collected with an active technique using a sieve impactor, sampling at 100 L/minute. Statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) Version 20 (IBM Corp., Armonk, NY).

Results: In Group I OTs with the laminar diffuser, bacterial and fungal values during the lean period for environmental and behavioural factors were 47.78 colony forming units (CFM)/m3 and 0.24 CFU/m3, respectively. The bacterial and fungal values during the surgical period were 98.01 CFU/m3 and 0.40 CFU/m3, respectively. The same values for Group II OTs with the conventional diffuser were 52.83 CFU/m3 and 0.39 CFU/m3 during the lean period, and 80.06 CFU/m3 and 0.40 CFU/m3 during the surgical period.

Discussion: Both environmental and behavioural factors – temperature, humidity, percentage of fresh air in circulation, door type, controlled entry, minimal door opening and proper OT attire – were seen to contribute concurrently to maintaining air quality in operating units.

Downloads

Download data is not yet available.

References

Ajaz M, Qadri GJ, Tabish SA, Kakru K, Bukhari IA. Incidence of nosocomial infection in postoperative patients at a teaching hospital at Kashmir. JK Pract 2004; 11(1): 38–40.

Meers PD, Ayliffe GAJ, Emmerson AM, Leigh DA, Mayon-White RT, Mackintosh CA. Report on the national survey of infection in hospitals, 1980. J Hosp Infect 1981; 2: 1–53. doi: 10.1016/S0195-6701(81)80003-5

Raymond DP, Pelletier SJ, Crabtree TD, Schulman AM, Pruett TL, Sawyer RG. Intraoperative infection and the aging population. Am Surg 2001; 67(9): 827–32.

Spagnolo AM, Ottria G, Amicizia D, Perdelli F, Cristina ML. Operating theatre quality and prevention of surgical site infections. J Prev Med Hyg 2013; 54(3): 131–7.

Knobben BAS, van Horn JR, van der Mei HC, Busscher HJ. Evaluation of measures to decrease intraoperative bacterial contamination in orthopaedic implant surgery. J Hosp Infect 2006; 62(2): 174–80. doi: 10.1016/j.jhin.2005.08.007

Pasquarella C, Vitali P, Saccani E, Manotti P, Boccuni C, Ugolotti M, et al. Microbial air monitoring in operating theatres: experience at the University Hospital of Parma. J Hosp Infect 2012; 81(1): 50–7. doi: 10.1016/j.jhin.2012.01.007

Dharan S, Pittet D. Environmental controls in operating theatres. J Hosp Infect 2002; 51(2): 79–84. doi: 10.1053/jhin.2002.1217

Pasquarella C, Pitzurra O, Herren T, Poletti L, Savino A. Lack of influence of body exhaust gowns on aerobic bacterial surface counts in a mixed-ventilation operating theatre. A study of 62 hip arthroplasties. J Hosp Infect 2003; 54(1): 2–9. doi: 10.1016/S0195-6701(03)00077-X

Scaltriti S, Cencetti S, Rovesti S, Marchesi I, Bargellini A, Borella P. Risk factors for particulate and microbial contamination of air in operating theatres. J Hosp Infect 2007; 66(4): 320–6. doi: 10.1016/j.jhin.2007.05.019

Gosden PE, Mac Gowan AP, Bannister GC. Importance of air quality and related factors in the prevention of infection in orthopedic implant surgery. J Hosp Infect 1998; 39(3): 173–80. doi: 10.1016/S0195-6701(98)90255-9

Dai C, Zhang Y, Ma X, Yin M, Zheng H, Gu X, et al. Real-time measurements of airborne biologic particles using fluorescent particle counter to evaluate microbial contamination: results of a comparative study in an operating theatre. Am J Infect Control 2015; 43(1): 78–81. doi: 10.1016/j.ajic.2014.10.004

Arrowsmith LW. Air sampling in operating theatres. J Hosp Infect 1985; 6(3): 352–3. doi: 10.1016/S0195-6701(85)80143-2

Fernstrom A, Goldblatt M. Aerobiology and its role in the transmission of infectious diseases. J Pathog 2013; 2013: 1–13. doi: 10.1155/2013/493960

Cole EC, Cook CE. Characterization of infectious aerosols in health care facilities: an aid to effective engineering controls and preventive strategies. Am J Infect Control 1998; 26(4): 453–64. doi: 10.1016/S0196-6553(98)70046-X

Wan GH, Chung FF, Tang CS. Long-term surveillance of air quality in medical center operating rooms. Am J Infect Control 2011; 39(4): 302–8. doi: 10.1016/j.ajic.2010.07.006

Harsoor S, Bhaskar SB. Designing an ideal operating room complex. Indian J Anaesth 2007; 51(3): 193–9.

Jutte PC, Traversari R, Walenkamp G. Laminar flow: the better choice in orthopedic implants. Lancet Infect Dis 2017; 17(7): 695–6. doi: 10.1016/S1473-3099(17)30342-0

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of intraoperative site infection. Infect Control Hosp Epidemiol 1999; 20(4): 250–78. doi: 10.1086/501620

Savage JW, Anderson PA. An update on modifiable factors to reduce the risk of intraoperative site infections. Spine J 2013; 13: 1017–29. doi: 10.1016/j.spinee.2013.03.051

Tang C-S, Wan G-H. Air quality monitoring of the post-operative recovery room and locations surrounding operating theaters in a medical center in Taiwan. PLoS One 2013; 8(4): e61093. doi: 10.1371/journal.pone.0061093

Edmiston CE Jr, Sinski S, Seabrook GR, Simons D, Goheen MP. Airborne particulates in the OR environment. AORN J 1999; 69(6): 1169–72. doi: 10.1016/S0001-2092(06)61884-X

Panahi P, Stroh M, Casper DS, Parvizi J, Austin MS. Operating room traffic is a major concern during total joint arthroplasty. Clin Orthop Relat Re 2012; 470(10): 2690–4. doi: 10.1007/s11999-012-2252-4

Published

2022-01-19

How to Cite

Singh, G., Biswal, M., Koushal, V., & Dhaliwal, N. (2022). Effect of environmental and behavioural factors on microbiological air quality of operating rooms. International Journal of Infection Control, 18. https://doi.org/10.3396/ijic.v18.21204

Issue

Section

Original Articles

Similar Articles

<< < > >> 

You may also start an advanced similarity search for this article.