Aerosol hazards in operating rooms: A review of numerical and experimental studies

In Operating Rooms (OR), the transport of Colony-Forming Units (CFU) can generate surgical site infections in patients and, as a consequence, CFU must be properly evacuated from the surgical site. Moreover, Fine Particles (FP) and UltraFine Particles (UFP) can be generated during surgeries by cutting and cauterizing surgical tools, with consequent effects on the health of patients and medical staff. Therefore, indoor air quality, comfort and safety conditions in OR must take into account CFU, FP and UFP concentrations. Due to the importance of the topic, the authors have carried out a review of the experimental, numerical and experimental-numerical combined works available in the literature, that analyse generation, diffusion and deposition of CFU, FP and UFP in ORs. Numerical studies have been majorly focused on the simulation of CFU using computational fluid dynamics, in order to model the motion inside ORs and the evaluation of factors that influence it. Experimental studies mainly deal with the analysis of particles and CFU motion and deposition. Based on the present analysis, it appears that more research effort is needed to analyse FP and UFP in ORs. Technical standards and national laws have been reviewed in order to analyse the constraints commonly used in the design and operation of ORs and ventilation systems, such as to find the technical aspects that are not yet properly considered.