Particle and Carbon Dioxide Concentration Levels in a Surgical Room Conditioned with a Window/Wall Air-conditioning System

Int J Environ Res Public Health. 2020 Feb 13;17(4):1180. doi: 10.3390/ijerph17041180.


One of the most important functions of air conditioning systems in operating rooms is to protect occupants against pathogenic agents transported by air. This protection is done by simultaneously controlling the air distribution, temperature, humidity, filtration and infiltration from other areas etc. Due to their low price, simple installation, operation and maintenance, window/wall air conditioning system have largely been used in operating rooms in Brazil, even if these types of equipment only recirculate the air inside the room without appropriate filtration and renovation with outdoor air. In this context, this work aims to analyse the performance of the window/wall air conditioning systems on indoor air ventilation in operating rooms by measuring particle number concentrations and carbon dioxide concentrations during different surgical procedures, in a single surgical room and in the nearby areas (corridor) for two cases: single surgery and two subsequent surgeries. In addition, the efficiency of the analysed air conditioning system was evaluated by comparing the ventilation level calculated in the surgical room with the ventilation required in order to maintain the carbon dioxide concentration within acceptable levels. The results showed that this type of air conditioning system is not appropriate for use in operating rooms since it cannot provide an adequate level of ventilation. The CO2 concentrations during surgeries, in fact, significantly exceeded acceptable values and a simultaneous increase in particle number concentration was observed. The results also showed that there is a high risk of contamination between subsequent surgeries in the same surgical room, due to residues of contaminants transported by the particles emitted during the surgeries that were not removed from the operating room by the air conditioning system. The particle number concentration measured in the second surgery, in fact, was approximately six times higher than in the first surgery.

Keywords: CO2 concentration; air conditioning systems; air contamination; particle number concentration; surgical room.

MeSH terms

  • Air Conditioning*
  • Air Pollution, Indoor* / analysis
  • Brazil
  • Carbon Dioxide* / analysis
  • Operating Rooms*
  • Particulate Matter* / analysis
  • Ventilation


  • Particulate Matter
  • Carbon Dioxide