A Survey on the Thermal Conditions Experienced by a Surgical Team

Abstract

The complex environment of the operating theatre is shared by a group of people having highly different needs: on one side, there is a surgical team whose work may last many hours and, on the other, an anaesthetized patient often subject to liquid infusion. Up to now, little consideration has been given to the different needs of the surgical team who may be affected according to their positions with respect to the scialytic lamp and their particular task. Clothing influences the comfort of the surgical team to a considerable degree: in fact, in some surgery (orthopaedics, neurosurgery and so on), surgeons and assistants must wear paper overalls beneath non-breathable plastic overalls and protective masks and caps; then, if X-rays are needed during surgery, the second surgeon and the assistants must also wear lead overalls and lead thyroid collars and gloves while the anaesthetists and nurses will keep on wearing non-breathable paper overalls. In consequence, the thermal resistance of the clothing of the surgical staff involved in the same surgical operation could be very different.

The purpose of the present work is to report investigations carried out at the SS. Annunziata Hospital in Cento (Ferrara, Italy) and present some of the data obtained. The article describes experimental and theoretical research activities, both ongoing and proposed, inherent to the thermo-hygrometric comfort problems of medical personnel. This study falls within a larger research programme, concerning the microbiological, chemical and physical pollution phenomena and the patient's hypothermia problems in an operating theatre.

Keywords

Thermal stress Thermal comfort Tskin Operating theatre Surgery Clothing

Get full access to this article

View all access options for this article.

References

Gagge AP , Nishi Y. : Heat exchange between human skin surface and thermal environment; in Handbook of Physiology 1977, pp. 69—92.

Smolander J. , Ilmarinen R. , Korhonen O. : An evaluation of heat stress indices (ISO 7243, ISO/DIS 7933) in the prediction of heat strain in unacclimated men: Intl Arch Occup Environ Hlth 1991;63:39—41.

Dukes-Dobos FN : Heat stress; in Gochfeld M , Hertzein J , Jackson RJ , Schenker MB (eds) Environmental Medicine, Mosby, St Louis, 1995,pp.563-575.

Parsons KC : International heat stress standards: a review; in Parsons KC , Fox JG , Metz B (eds) Special Issue — Heat Stress Indices, Taylor and Francis, London , 1995, pp. 6—22.

Bethea D. , Parsons K. : The development of a practical heat stress assessment methodology for use in UK Industry. HSE Books,1999.

Eissing G. : Climatic indices; in Parsons KC , Fox JG , Metz B (eds) Special Issue — Heat Stress Indices, Taylor and Francis, London, 1995 , pp. 47—57.

Enander AE : Effects of thermal stress on human performance: Scand J Work Environ Hlth 1989;15:27—33.

Mairiaux P. , Malchaire J. : Comparison and validation of heat stress indices in experimental studies; in Parsons KC , Fox JG , Metz B (eds) Ergonomics: Special Issue — Heat Stress Indices, Taylor and Francis , London, 1995, pp. 58—72.

Parsons KC : Human Thermal Environments: The Effects of Hot, Moderate and Cold Environments on Human Health and Performance. Taylor & Francis, London, 1993, Ch. 4, 8, 10 and 12.

10.

Kampmann B. , Piekarski C. : The evaluation of workplaces subject to heat stress: can ISO 7933 (1989) adequately describe heat strain in industrial workplaces? Appl Ergonom 2000;31:59—72.

11.

Kurz A. : Prevention and treatment of perioperative hypothermia: Curr Anaesthesia Crit Care 2001;12:96—102.

12.

Perl T. , Bräuer A. , Weyland W. , Braun U. : Application of heat flux transducer to determine perioperative heat exchang: thermochim Acta 2004;422:35—40.

13.

D'Alessandro D. , Pasquarella C. , Mura I. , Vescia N. , Pitzurra M. et al. Studio multicentrico sull'inquinamento ambientale delle sale operatorie: view Rev Hosp 1996;2:13—23.

14.

Martini E. , Bruschi R. , Fontana L. , Savini S. , D'Errico MM : La valutazione ambientale delle sale operatorie: esperienza in Una Azienda Ospedaliera Marchigiana: View Rev Hosp 1999 ;13:21—28.

15.

Mazzacane S. , Agostani E. , Alberani L. : Impianti a portata variabile per la climatizzazione di sale operatorie. Proc Nat Congr AICARR, 2000.

16.

Azara A. , Masia MD , Maida I. , Sotgiu G. , Giaconi GL , Gusinu R. : Inquinamento ambientale nelle sale operatorie. Nota II: condizioni microclimatiche e microbiologiche: View Rev Hosp 2000;1:4—10.

17.

Mazzacane S. , Alberani L. , Giaconia C. , Costanzo S. , Cusumano A. , Margelli F. : Un apparato sperimentale per lo studio dei fenomeni di inquinamento fisico, chimico e microbiologico in sale operatorie. Proc 60th Natl Congr ATI Roma 2005;175—187.

18.

Huang JJ , Kurz A. : Body warmer and upper extremities position affect the accuracy of cutaneous thermometers during anaesthesia: J Clin Anesthesia 2001;13:241—243.

19.

Huizenga C. , Zhang H. , Arens E. , Wang D. : Skin and core temperature response to partial and whole-body heating and cooling: J Therm Biol 2004;29:549—558.

20.

Jansky L. , Vivra V. , Jansky P. , Cunc P. : Skin temperature changes in human induced by local peripheral Cooling: J Therm Biol 2003; 28:429—437.

21.

Choi JK , Miki K. , Sagawa S. , Shiraki K. : Evaluation of mean skin temperature formulas by infrared thermography: Intl J Biometeorol 1997;41:68—75.

22.

Sramek P. , Simeckova M. , Jansky L. , Zeman V. : Human physiological responses due to immersion into water of different temperatures : Eur J Appl Physiol 2000;81:436—442.

23.

Cork RC , Vaughan RW , Humphrey LS : Precision and accuracy of intra-operative temperature monitoring: anesth analg 1983; 62:211—214.

24.

Humphrey MA , McCartney KJ , Nicol KF , Raja IA : An analysis of Some observations of the finger temperatures and thermal comfort of office workers: Indoor Air `99 1999;1: 602—607.

25.

Hardy JD , DuBois EF : The technique of measuring radiation and convection: J Nutr 1938;15:461—475.

26.

Houdas Y. , Ring Ejj : Human body temperature. plenum press, New York,1982, pp. 95—103.

27.

Olesen BW : How many sites are necessary to estimate a mean skin temperature? Thermal Physiology. Raven Press, New York , 1982, pp.34-38.

28.

Mitchell D. , Wyndham CH : Comparison of weighting formula for calculating mean skin temperature: J Appl Physiol 1969;26: 616—622.

29.

Melhado MA , Beyer PO , Hensen JM , Siqueira Lfg : The thermal comfort, the indoor environment control, and the energy consumption in three types of operating rooms. Proc 9th Int IBPSA Conf Montreal 2005; 747—754.

30.

ISPESL Guidelines : (1999) (Istituto Superiore Prevenzione e Sicurezza sul Lavoro), Dipartimento di Igiene del Lavoro. Linee guida per la definizione degli standard di sicurezza e di igiene ambientale dei reparti operatori. [Department of Occupational Hygiene. Guidelines defining safety standards and environmental hygiene for surgical departments.] (accessed 10 January 2007. http://www.ispesl.it/linee_guida/soggetto/saleop.htm).