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Operating Theatre Ventilation Systems and Their Performance in Contamination Control: “At Rest” and “In Operation” Particle and Microbial Measurements Made in an Italian Large and Multi-Year Inspection Campaign

Author

Listed:
  • Francesco Romano

    (Dipartimento di Energia, Politecnico di Milano, 20156 Milan, Italy)

  • Samanta Milani

    (Dipartimento di Energia, Politecnico di Milano, 20156 Milan, Italy)

  • Roberto Ricci

    (Biologist–OT Validation Specialist, 60035 Jesi, Italy)

  • Cesare Maria Joppolo

    (Dipartimento di Energia, Politecnico di Milano, 20156 Milan, Italy)

Abstract

In Operating Theatres (OT), the ventilation system plays an important role in controlling airborne contamination and reducing the risks of Surgical Site Infections (SSIs). The air cleanliness is really crucial in this field and different measurements are used in order to characterize the situation in terms of both airborne microbiological pollutants and particle size and concentration. Although the ventilation systems and airborne contamination are strictly linked, different air diffusion schemes (in particular, the Partial Unidirectional Airflow, P-UDAF, and the Mixing Airflow, MAF) and various design parameters are used, and there is still no consensus on real performance and optimum solutions. This study presents measurements procedures and results obtained during Inspection and Periodic Performance Testing (1228 observations) in a large sample of Italian OTs (175 OTs in 31 Italian hospitals) in their operative life (period from 2010 to 2018). The inspections were made after a cleaning procedure, both in “at-rest” conditions and “in operation” state. Inert and microbial contamination data (in air and on surfaces) are analyzed and commented according to four relevant air diffusion schemes and design classes. Related data on Recovery Time (RT) and personnel presence were picked up and are commented. The results confirm that the ventilation systems are able to maintain the targeted performance levels in the OT operative life. However, they attest that significant differences in real OT contamination control capabilities do exist and could be ascribed to various design choices and to different operation and maintenance practices. The study shows and confirms that the air diffusion scheme and the design airflow rate are critical factors. Beside large variations in measurements, the performance values, in terms of control of airborne particle and microbial contamination (in air and on surfaces), for P-UDAF systems are better than those that were assessed for the MAF air diffusion solution. The average performances do increase with increasing airflows, and the results offer a better insight on this relationship leading to some possible optimization.

Suggested Citation

  • Francesco Romano & Samanta Milani & Roberto Ricci & Cesare Maria Joppolo, 2020. "Operating Theatre Ventilation Systems and Their Performance in Contamination Control: “At Rest” and “In Operation” Particle and Microbial Measurements Made in an Italian Large and Multi-Year Inspectio," IJERPH, MDPI, vol. 17(19), pages 1-16, October.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:19:p:7275-:d:423905
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    References listed on IDEAS

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    1. Maria Teresa Montagna & Serafina Rutigliano & Paolo Trerotoli & Christian Napoli & Francesca Apollonio & Alessandro D’Amico & Osvalda De Giglio & Giusy Diella & Marco Lopuzzo & Angelo Marzella & Simon, 2019. "Evaluation of Air Contamination in Orthopaedic Operating Theatres in Hospitals in Southern Italy: The IMPACT Project," IJERPH, MDPI, vol. 16(19), pages 1-11, September.
    2. Francesco Romano & Jan Gustén & Stefano De Antonellis & Cesare M. Joppolo, 2017. "Electrosurgical Smoke: Ultrafine Particle Measurements and Work Environment Quality in Different Operating Theatres," IJERPH, MDPI, vol. 14(2), pages 1-13, January.
    3. Laura Dallolio & Alessandra Raggi & Tiziana Sanna & Magda Mazzetti & Alessandra Orsi & Angela Zanni & Patrizia Farruggia & Erica Leoni, 2017. "Surveillance of Environmental and Procedural Measures of Infection Control in the Operating Theatre Setting," IJERPH, MDPI, vol. 15(1), pages 1-10, December.
    4. Francesco Romano & Samanta Milani & Jan Gustén & Cesare Maria Joppolo, 2020. "Surgical Smoke and Airborne Microbial Contamination in Operating Theatres: Influence of Ventilation and Surgical Phases," IJERPH, MDPI, vol. 17(15), pages 1-13, July.
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