Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Department of Radiology, Yale Medical Center, New Haven, Connecticut.
JAMA Otolaryngol Head Neck Surg. 2018 Sep 1;144(9):797-801. doi: 10.1001/jamaoto.2018.1516.
Three-dimensional (3-D) printing of temporal bones is becoming more prevalent. However, there has been no measure of the safety of drilling these models to date. It is unknown whether the heat and sheer from the drill may create harmful volatile organic compounds (VOCs).
To determine the level of exposure to airborne contaminants when conducting high-speed drilling on 3-D-printed models and to explore whether there is a need for exposure control measures.
DESIGN, SETTING, AND PARTICIPANTS: In this occupational safety assessment carried out in a temporal bone laboratory, 3 individual 3-D-printed temporal bones were made using 3 different materials commonly cited in the literature: polylactic acid (PLA), photoreactive acrylic resin (PAR), and acrylonitrile butadiene styrene (ABS). Each model was drilled for 40 minutes while the surgeon wore a sampling badge. Sampling was conducted for airborne concentrations of VOCs and total particulate (TP). Monitoring for VOCs was conducted using Assay Technology 521-25 organic vapor badge worn at the surgeon's neckline. Monitoring for TP was conducted using a polyvinyl chloride filter housed inside a cassette and coupled with an SKC AirChek 52 personal air-sampling pump. Samples were collected and analyzed in accordance with NIOSH Method 500.
Presence of VOCs and TP count exposures at Occupational Safety and Health Administration (OSHA) actionable levels.
Results of the VOC sample were less than detection limits except for isopropyl alcohol at 0.24 ppm for PAR. The TP samples were less than the detection limit of 1.4 mg/m3. The results are below all applicable OSHA Action Levels and Permissible Exposure Limits for all contaminants sampled for.
Drilling 3-D-printed models made from PLA, ABS, and PAR was safe by OSHA standards. Continued monitoring and safety testing are needed as 3-D-printed technologies are introduced to our specialty.
三维（3-D）打印颞骨的应用越来越普遍。然而，迄今为止，尚无关于在这些模型上进行钻孔操作的安全性的评估。目前尚不清楚钻头产生的热量和摩擦力是否会产生有害的挥发性有机化合物（VOCs）。
确定在 3-D 打印模型上进行高速钻孔时空气污染物的暴露水平，并探讨是否需要采取暴露控制措施。
设计、设置和参与者：在颞骨实验室进行的这项职业安全评估中，使用文献中常提到的 3 种不同材料（聚乳酸（PLA）、光反应性丙烯酸树脂（PAR）和丙烯腈丁二烯苯乙烯（ABS））分别制作了 3 个独立的 3-D 打印颞骨模型。在手术医生佩戴采样徽章的情况下，每个模型均被钻 40 分钟。对空气中 VOC 和总颗粒物（TP）的浓度进行采样。使用 Assay Technology 521-25 有机蒸气badge 对手术医生颈下的 VOC 进行监测，使用装在盒内的聚氯乙烯过滤器与 SKC AirChek 52 个人空气采样泵结合对 TP 进行监测。根据 NIOSH 方法 500 进行样品采集和分析。
在职业安全与健康管理局（OSHA）可采取行动的水平下，VOC 和 TP 计数暴露的存在情况。
除 PAR 中的异丙醇为 0.24ppm 外，VOC 样本的结果均低于检测极限。TP 样本低于 1.4mg/m3 的检测极限。所有采样的污染物的结果均低于 OSHA 所有可采取行动的水平和允许暴露限值。
按照 OSHA 标准，对 PLA、ABS 和 PAR 制成的 3-D 打印模型进行钻孔是安全的。随着 3-D 打印技术在我们的专业领域中引入，需要继续进行监测和安全测试。
