의료ㆍ복지 건축 : 한국의료복지건축학회 논문집 (Journal of The Korea Institute of Healthcare Architecture)

  • 제30권3호
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  • Pages.67-74
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  • 2024
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  • 2733-8649(pISSN)
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  • 2733-8657(eISSN)
한국의료복지건축학회 (Korea Institute of Healthcare Architecture)
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병원 수술실에서의 복강경 수술 중 실내공기질 평가

Evaluation of Indoor Air Quality in a Hospital Operating Room During Laparoscopic Surgery

  • 최동희 (서울대학교 건설환경종합연구소) ;
  • 강동화 (건축학부 건축공학전공, 서울시립대학교)
  • 투고 : 2024.08.13
  • 심사 : 2024.08.26
  • 발행 : 2024.09.13
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초록

Purpose: The identification and quantification of indoor airborne contaminants, including bio-aerosols, particulates, and gaseous contaminants, are crucial for maintaining acceptable indoor air quality for hospital operating rooms (ORs). Laparoscopic surgery has become widely accepted for various surgical procedures due to its rapid recovery rate and the low risk associated with small incisions compared to conventional open surgery. The objective of this study is to investigate the indoor air quality in hospital ORs and to identify indoor airborne contaminants generated during laparoscopic surgery. Methods: Measurements of an indoor environment, including temperature, humidity and air quality, were performed in an OR before and during a laparoscopic surgery. Indoor airborne contaminants, including volatile organic compounds (VOCs), formaldehyde, carbon monoxide (CO), carbon dioxide (CO2), sulfur dioxide (SO2), nitrogen dioxide (NO2), suspended indoor particles, and airborne bacteria, were measured simultaneously. Results: The study determined that the concentrations of indoor air particles and airborne bacteria increased during the surgery but were within acceptable levels. However, the concentration of CO2, reached a high level of 1,791 ppm due to the CO2 gas required for maintaining the pneumoperitoneum during the surgery. Implications: The results emphasized the use of ventilation and filtration in a laparoscopic surgery room to lower the concentration of filterable and non-filterable contaminants.

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참고문헌

  1. American Institute of Architects. 2006, "Guidelines for design and construction of hospitals and health-care facilities", American Institute of Architects.
  2. ASHRAE, 2017, "Ventilation of health care facilities", ANSI/ASHRAE/ASHE Standard 170-2017. Atlanta. GA, USA.
  3. ASHRAE, 2013, "HVAC Design manual for hospitals and clinics", second edition, ASHRAE Atlanta, GA, USA.
  4. Balaras, C.A.; Dascalaki, E.; Gaglia, A., 2007, "HVAC and indoor thermal conditions in hospital operating rooms", Building and Environment 39:454-470. https://doi.org/10.1016/j.enbuild.2006.09.004
  5. Choi S.H.; Kwon T.G.; Chung S.K.; Kim T-H., 2014, "Surgical smoke may be a biohazard to surgeons performing laparoscopic surgery", Surgical Endoscopy 28:2374-2380. https://doi.org/10.1007/s00464-014-3472-3
  6. Dascalaki E.G.; Lagoudi A.; Balaras C.A.; Gaglia A.G., 2008, "Air quality in hospital operating rooms", Building and Environment 43:1945-1952. https://doi.org/10.1016/j.buildenv.2007.11.015
  7. Essex-Lopresti, M., 1999, "Operating theatre design", Lancet, 353(9157):1007-10. https://doi.org/10.1016/S0140-6736(98)11356-9
  8. Facility Guidelines Institute, 2022, "Guidelines for design and construction of hospitals", Dallas, Texas. USA.
  9. Fan J.K.; Chan F.S.; Chu K.M.; 2009, "Surgical smoke", Asian J Surg 32:253-257. https://doi.org/10.1016/S1015-9584(09)60403-6
  10. Holcatova, I.; Benesova, V.; Hartlova, D., 2003, "Comparison of the environment in operating theatres in two hospitals", Indoor and Built Environment, 12:121-124. https://doi.org/10.1177/1420326X03012001019
  11. King B.; McCullough J., 2006, "Health hazard evaluation report", NIOSH 2001-0030-3020.
  12. Kiran R.P.; El-Gazzaz G.H.; Vogel J.D.; Remzi F.H., 2010, "Laparoscopic Approach Significantly Reduces Surgical Site Infections after Colorectal Surgery: Data from National Surgical Quality Improvement Program", Journal of the American College of Surgeons 211(2):232-238. https://doi.org/10.1016/j.jamcollsurg.2010.03.028
  13. Lidwell O.M., 1988, "Air, antibiotics and spsis in replacements joint", J Hosp Infect 11(Suppl.C):18-40. https://doi.org/10.1016/0195-6701(88)90020-5
  14. ME, 2005, "Indoor Air Quality Management Act", revised version, Ministry of Environment, Korea.
  15. National Fire Protection Association, 2024, "NFPA 99: Health Care Facilities Code", Quincy, MA. USA.
  16. NHS Estates, 1994, "Health Technical Memorandum 2025: Ventilation in Healthcare Premises", HMSO London, UK.
  17. Pankhurst, L.J.; Taylor, J.; Cloutman-Green, E.A.; Hartley, J.C.; Lai, K.M., 2011, "Can clean-room particle counters be used as an infection control tool in hospital operating theatres?", Indoor and Built Environment 21:381-391. https://doi.org/10.1177/1420326X11409467
  18. Pasquarella C; Vitali P.; Saccani E.; Manotti P.; Boccuni C.; Ugolotti M.; Signorelli C.; Mariotti F.; Sansebastiano G.E.; Albertini R., 2012, "Microbial air monitoring in operating theatres: experience at the University Hospital of Parma", Journal of Hospital Infection 81:50-57. https://doi.org/10.1016/j.jhin.2012.01.007
  19. Richards C.; Edwards J.; Culver D.; Emori T.G.; Tolson J.; Gaynes R., 2003, "Does Using a Laparoscopic Approach to Cholecystectomy Decrease the Risk of Surgical Site Infection", Annals of Surgery 237(3):358-362. https://doi.org/10.1097/01.SLA.0000055221.50062.7A
  20. Satish U.; Mendell M.J.; Shekhar K.; Hotchi T.; Sullivan D.; Streufert S.; Fisk W.J., 2012, "Is CO2 an indoor pollutant? Direct effects of low-to-moderate CO2 concentrations on human decision-making performance", Environ Health Perspect 120(12):1671-1677. https://doi.org/10.1289/ehp.1104789
  21. Wan, G-H.; Chung, F-F; Tang C-S., 2011, "Long-term surveillance of air quality in medical center operating rooms", American Journal of Infection Control 39:302-308. https://doi.org/10.1016/j.ajic.2010.07.006
  22. Watson, D.S., 2010, "Surgical smoke evacuation during laparoscopic surgery", AORN Journal 92:347-350. https://doi.org/10.1016/j.aorn.2010.06.010
  23. Weston R.; Stephenson R.N.; Kutarski P.W.; Parr N.J., 2009, "Chemical composition of gases surgeons are exposed to during endoscopic urological resections", Urology 74(5):1152-1154. https://doi.org/10.1016/j.urology.2009.04.100
  24. Woloszyn, M.; Virgone, J.; Melen, S. 2004, "Diagonal air-distribution system for operating rooms: experiment and modeling", Building and Environment 39:1171-1178. https://doi.org/10.1016/j.buildenv.2004.03.013