Risk factors for particulate and microbial contamination of air in operating theatres

Summary This study was designed to standardize dust collection in recently built operating theatres equipped with a continuous monitoring system. The objectives were to establish the relationship between microbiological and dust contamination, and then to compare those parameters with the main indicators of surgical activity in order to better define risk factors affecting air quality. The air quality during 23 surgical operations was studied in three conventionally ventilated operating theatres. Microbiological air counts were taken using both passive and active sampling methods. Air dust particles, ≥0.5 and ≥5 μm in size, were measured using a light-scattering particle analyser. The overall dust load was mainly (98%) composed of fine particulate matter, most probably due to its longer suspension time before settlement. These particles positively correlated with operation length, but not with surgical technique, suggesting that fine particles may be a good tracer of operation complexity. In contrast, the surgical technique was the main predictor for the concentration of particles ≥5 μm, with a higher risk from general conventional surgery compared with scope surgery. The frequency of door-opening, taken as an index of staff and visitor movement, was the main negative predictor of over-threshold values of both fine and larger dust particles but, conversely, was a positive predictor of raised bacterial counts.