The management of air contamination control in operating theaters: the experience of the Parma University Hospital (IT)

As part of the overall management of a Hospital, the Hygiene Unit has specific tasks including the improvement in the levels of hospital safety by air quality monitoring in hospital environments to control the sources of infection and assessing the healthiness of hospital facilities. Operating theaters (OTs) and cleanrooms air quality control can represent a focal point considering that environmental contamination depends on not only factors such as characteristics and level of maintenance of Heating, Ventilation and Air Conditioning systems (HVAC), but it also depends on the number of people present, their behavioral habits, sanitation and disinfection procedures adopted. Several studies demonstrate a high variability in microbial air contamination in different OTs with similar HVAC, suggesting the need for achieving strict control over the factors affecting air quality. The control of air contamination, as an indicator of the quality care provided, therefore sets precise objectives, accuracy from a scientific point of view including planning, analysis and interpretation of results to propose corrective actions. However, there are no generally accepted standards for sampling nor threshold values on microbial air contamination. Aerobiology skills can improve the approach to involved issues. The monitoring plan of air quality assessment at the Parma University Hospital, by the Laboratory of Aerobiology, involves approximately 80 environments equipped with turbulent or mixed air flow. This paper describes the practical approach to air contamination control of the Hospital Hygiene Department at the Parma University Hospital as an example of how Health Departments can improve safety standards for patients and operators.