Study Shows Perioperative Nurses Continue to Report Respiratory Issues from Surgical Smoke

Hospitals now encouraged to leverage data to improve OR environments

(Miamisburg, OH) - The environmental risks from contaminated air in operating rooms are well documented. Nurses represent twice the incidence of respiratory problems as compared to the general population largely due to their exposure to surgical smoke.1 While this workplace safety issue has been known for years, a new study now shows that nurses continue to report the same symptoms and conditions that were reported ten years ago.2

Kay Ball and Richard E. Gilder authored “A Mixed Method Survey on the Impact of Exposure to Surgical Smoke on Perioperative Nurses2”. Ball says education on surgical smoke hazards is helpful, but hospitals can do more to reduce this risk to nurses.

“Nurses have difficult jobs. The air we breathe shouldn’t be making our jobs harder,” Ball said.

Ball has been a perioperative nurse for more than 47 years and has experienced respiratory issues from exposure to surgical smoke and other airborne contaminants in the OR. She says hospitals need to understand the root cause of what is impacting their environmental quality. “The good news is technology exists to make the invisible visible,” Ball explained. “We can now identify what’s in our air and then takes steps to improve the environment for staff and patients.”

Aerobiotix has introduced the latest version of Illuvia Sense, an environmental quality management solution that measures small and large airborne particulate count, CO2 levels, air pressure variance and volatile organic compound (VOC) levels in real time. The unit operates quietly and independently to sense and record 11 environmental parameters per second without disrupting OR work flows.

Aerobiotix CEO Dr. David Kirschman says he’s not surprised by the results of Ball’s latest study. “The data hospitals are gathering validate what we’ve always suspected,” Dr. Kirschman said. “Despite existing ventilation systems in hospital operating rooms, contaminated air is still a significant issue. Our latest technology allows hospitals to see the unseen in our environmental assessment reports to understand what is in their OR air at any given minute.”

In addition to identifying airborne contaminants, the Illuvia Sense includes a patented IntraViolet Core technology, proven internal ultraviolet system, HEPA filtration, and carbon-copper filters to inactivate over 99.9% of bacteria, viruses, and spores in the air—including SARS-Cov-2. The standalone unit is designed to run in conjunction with existing environmental systems.

Many hospitals currently use ventilation systems in their operating rooms to protect patients and staff from airborne contaminants, but those systems are largely a “one-size fits-all” approach to air flow and distribution. The commonly-used laminar flow system delivers clean air directly over the surgical site. However, this leaves a ring of contaminated air around the clean air of the surgical table called the “dirty donut” which continues to pose a danger to the patient and staff.

Anything, and anyone, passing through the “dirty donut” can potentially re-expose the surgical site to contaminated air and increase risk of infection. This includes surgical staff, drapes, instruments, implants, gloves, and other surgical equipment and devices.

Dr. Courtney Adams, Aerobiotix VP of Clinical and Medical Affairs, said hospitals can deploy the Illuvia Sense in three phases to improve environmental quality. “The first step is running the integrated particle counter to understanding what is in your OR air. The next step is decontaminating the air to eliminate those contaminants and VOCs. The last step is using the continuous data reporting to make smart decisions about managing your OR,” Dr. Adams said. Dr. Adams noted how barometric pressure readings, which correlate to door openings, align with spikes in airborne contaminants. Hospitals can use this data to limit in-and-out traffic during procedures. The real-time air quality reports can also help OR managers schedule time between procedures more efficiently.

Ball encouraged hospital administrators to advocate to have these technologies deployed in their ORs for the benefit of patients and staff. “Otherwise, we might conduct this same study again 10 years from now and find nurses still having the same respiratory issues,” Ball said.

Hospitals interested in learning more about their OR environmental quality can request a complimentary assessment by calling (888) 978-7087. Aerobiotix will deploy an Illuvia Sense to the site for 14 days and provide a free, no risk, no obligation OR environmental quality report.

 

1. Ball, K. (2010). Surgical smoke evacuation guidelines: Compliance among perioperative nurses. AORN Journal. 2010; 92(2): e1-e23.

2. Ball, K. (2022). A mixed method survey on the impact of exposure to surgical smoke on perioperative nurses. Perioperative Care and Operating Room Management 26:100232.

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