title: Surgical smoke and ultrafine particles.
abstract: BACKGROUND
  Electrocautery, laser tissue ablation, and ultrasonic scalpel tissue dissection all generate a 'surgical smoke' containing ultrafine (<100 nm) and accumulation mode particles (< 1 mum). Epidemiological and toxicological studies have shown that exposure to particulate air pollution is associated with adverse cardiovascular and respiratory health effects.
  
  
  METHODS
  To measure the amount of generated particulates in 'surgical smoke' during different surgical procedures and to quantify the particle number concentration for operation room personnel a condensation particle counter (CPC, model 3007, TSI Inc.) was applied.
  
  
  RESULTS
  Electro-cauterization and argon plasma tissue coagulation induced the production of very high number concentration (> 100000 cm-3) of particles in the diameter range of 10 nm to 1 mum. The peak concentration was confined to the immediate local surrounding of the production side. In the presence of a very efficient air conditioning system the increment and decrement of ultrafine particle occurrence was a matter of seconds, with accumulation of lower particle number concentrations in the operation room for only a few minutes.
  
  
  CONCLUSIONS
  Our investigation showed a short term very high exposure to ultrafine particles for surgeons and close assisting operating personnel - alternating with longer periods of low exposure.
authors.affiliation: Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany.
authors.forename: Irene
authors.initials: I
authors.lastname: Brüske-Hohlfeld
authors.affiliation: Ludwig-Maximilians-University, Klinikum Grosshadern, Department of Surgery, München, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Preissler
authors.affiliation: Ludwig-Maximilians-University, Klinikum Grosshadern, Department of Surgery, München, Germany.
authors.forename: Karl-Walter
authors.initials: KW
authors.lastname: Jauch
authors.affiliation: Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany.|University of Augsburg, Center for Science and Environment, Augsburg, Germany.
authors.forename: Mike
authors.initials: M
authors.lastname: Pitz
authors.affiliation: Ludwig-Maximilians-University, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, München, Germany.
authors.forename: Dennis
authors.initials: D
authors.lastname: Nowak
authors.affiliation: Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Peters
authors.affiliation: Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany.|IBE (Chair of Epidemiology, Ludwig-Maximilians-University) München, Germany.
authors.forename: H-Erich
authors.initials: HE
authors.lastname: Wichmann