Heinsohn P, Jewett D L
Department of Environmental Health Sciences, School of Public Health, University of California, CA 94720.
Am Ind Hyg Assoc J. 1993 Aug;54(8):446-53. doi: 10.1080/15298669391354946.
A personal sampling study was conducted to assess exposure to blood aerosols in the operating room. The breathing zones of primary and assistant surgeons were monitored using a personal cascade impactor configured with three stages corresponding to effective cut-off aerodynamic diameters of 14.8 microns, 3.5 microns, and 0.52 microns, respectively. Hemastix was used to assess the hemoglobin content of each particle size fraction. The arithmetic mean exposure concentration for primary surgeons (n = 14) was 1.4 micrograms Hb/m3 (range, none detected to 7.4 micrograms Hb/m3), while that for assistant surgeons (n = 12) was 1.8 micrograms Hb/m3 (range, 0.3 to 4.8 micrograms Hb/m3). Hemoglobin was detected in Stage 2 in 26 (90%) of the samples, in Stage 5 in 19 (66%) of the samples, and in Stage 8 in 11 (38%) of the samples. These data show that the mucous membrane lining of the upper respiratory tract and alveolar macrophages in the gas-exchange region are likely to be exposed to aerosolized blood in the operating room. Until further research determines the potential of infected blood aerosols to transmit disease, the authors recommend the proper use of respiratory protection equipment instead of surgical masks because the latter do not offer adequate protection.
开展了一项个人采样研究，以评估手术室中血液气溶胶的暴露情况。使用个人级联撞击器对主刀医生和助手医生的呼吸区域进行监测，该撞击器配置有三个阶段，分别对应有效截止空气动力学直径为14.8微米、3.5微米和0.52微米。使用Hemastix评估每个粒径级分的血红蛋白含量。主刀医生（n = 14）的算术平均暴露浓度为1.4微克血红蛋白/立方米（范围为未检测到至7.4微克血红蛋白/立方米），而助手医生（n = 12）的算术平均暴露浓度为1.8微克血红蛋白/立方米（范围为0.3至4.8微克血红蛋白/立方米）。在26份（90%）样本的第2阶段检测到血红蛋白，在19份（66%）样本的第5阶段检测到血红蛋白，在11份（38%）样本的第8阶段检测到血红蛋白。这些数据表明，上呼吸道的黏膜衬里和气体交换区域的肺泡巨噬细胞很可能在手术室中接触到雾化血液。在进一步研究确定受感染的血液气溶胶传播疾病的可能性之前，作者建议正确使用呼吸防护设备而非外科口罩，因为后者无法提供足够的防护。
