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Influence of Surgical Smoke on Indoor Air Quality in Hospital Operating Rooms

Category: Air Pollution and Health Effects

Volume: 17 | Issue: 3 | Pages: 821-830
DOI: 10.4209/aaqr.2016.05.0191
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Dong Hee Choi1, Seock Hwan Choi2, Dong Hwa Kang 3

  • 1 Department of Architectural Engineering, College of Engineering, Kyungil University, Gyeongbuk 38428, Korea
  • 2 Department of Urology, School of Medicine, Kyungpook National University, Kyungpook National University Medical Center, Daegu 41404, Korea
  • 3 Department of Architectural Engineering, College of Urban Sciences, University of Seoul, Seoul 02504, Korea


The VOCs in surgical smoke and its influence on indoor air were investigated.
Field measurements were carried out during eight surgeries in two ORs.
The results confirm that surgical smoke contains abundant amounts of VOCs.
The indoor benzene concentration pose a potential risk, even in a ventilated OR.


The objective of this study is to analyze the volatile organic compounds (VOCs) in the surgical smoke generated during laparoscopic surgery, and determine their influence on the indoor air quality in hospital operating rooms (ORs). Field measurements were carried out during eight surgeries in conventional and robotic ORs in which an electrosurgery system was being used, thus continuously generating surgical smoke. The VOCs were measured at three different locations, in the patients’ abdominal cavities, beside the surgical table, and at the exhaust vent. Other indoor pollutants including carbon monoxide (CO), carbon dioxide (CO2), and total airborne bacteria (TAB) in the indoor air were measured at the exhaust to assess the general indoor air quality in the ORs. The results from the patients’ abdominal cavities confirmed that the surgical smoke contained abundant VOCs, with the levels of benzene and toluene exceeding the health guidelines. Compared to the results obtained in the abdominal cavity, the measurements obtained at the surgical table and exhaust vent exhibited low levels of VOCs, indicating that the actual exposure to these compounds was minimized in a highly-ventilated operating room. However, the benzene concentration in the operating room approached a level that threatens the health of the occupants. Therefore, the results of this study suggest that there is a potential health risk to the surgeon who is closest to the point of origin of the surgical gas, as well as a need for further attention to identify the local pollutant dispersion near the surgical table while the ventilation system is operating.


Surgical smoke Hospital operating room IAQ Volatile organic compounds (VOCs)

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