Ergonomics in health care : working conditions in the operating theatre

Hospital management is often confronted with discussions concerning (re)building of the operating theatre. Criteria regarding working conditions and well-being of the staff cannot easily be set. In order to get more insight, relevant aspects were studied interdependently. These were climate, illumination, acoustics, ventilation of anaesthetic gases and concentration of bacteria and dust particles in the operating-room air. The influence of working postures and movements of the operating-room personnel on air quality is briefly characterized. Most measurements were performed during open-heart surgeries, although for some a simulation needed to be set up. Some remarkable results were found. Ventilation systems do not operate as was intended because of the heat production of the surgical team. Microcirculations originating thereof may cause high local concentrations of anaesthetic gases and heavily contaminated spots in the incision area . The hierarchical air pressure distribution in the ward is disturbed by the intense 'traffic'. The static and dynamic load on the surgical team can give rise to complaints. Unless precautions are taken, the indoor climate cannot be comfortable and safe for everybody at the same time. Monjtoring systems have to be developed to check the quality of ventilation systems, to visualize microcirculations with respect to bacteria and anaesthetic gases, and to synchronize all different registrations. Optimization of the working conditions concerned implies an indispensable co-operation between a variety of medical and technical disciplines that does not develop automatically.