There are two primary objectives in achieving acceptable air quality in the operating room: (1) control of anesthetic gases for the benefit of operating room staff, and (2) infection control for the benefit of the patient.
Control of Anesthetic Gases
Supply and scavenging systems, as well as general ventilation in the OR, must be functioning optimally for the surgical staff to be protected from exposure to anesthetic gases.
OSHA has established guidelines for the protection of operating room personnel but does not have Permissible Exposure Limits (PELs) for the most common anesthetic gases, nitrous oxide (N2O) and the halogenated gases (Enflurane, Halothane, Isoflurane, Desflurane and Sevoflurane). Monitoring for these anesthetic gases is not complicated. Diffusion badges or small battery powered air samplers can be attached to OR occupants and worn while performing their duties. Direct reading measurements can also be made using an infrared spectrophotometer as a leak detector for the gas supply system or effective operation of the waste gas scavenging system. Air quality testing during surgical procedures does not allow for an industrial hygienist/air quality specialist to be in the OR during surgeries but this can often be overcome by using battery powered samplers and air/gas collection bags that can be retrieved and read by the IR Spec Instrument.
There are recommended exposure levels for each of the anesthetic gases, either recommended by other agencies/groups or standards set in other countries: