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Ambient air pollution in gastrointestinal endoscopy unit

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Abstract

Background

The gastrointestinal endoscopy unit is frequently exposed to gastrointestinal gas expelled from patients and electrocoagulated tissue through carbonation. This can be potentially harmful to the health of not only the healthcare personnel but also patients who undergo endoscopy. This study aimed to measure the air quality in the endoscopy unit.

Methods

We measured indoor air quality indices (CO2, total volatile organic compounds (VOCs), PM2.5, NO2, CO, and ozone) using portable passive air quality monitoring sensors in the procedural area, recovery area, and cleansing-of-equipment area, at 1-min intervals for 1 week, and the type and number of endoscopic procedures were recorded.

Results

CO2, PM2.5, NO2, and ozone levels were the highest in the cleansing area, followed by the procedural and recovery areas, and VOC level was highest in the procedural area. The proportion of poor-quality level of CO2 and VOCs was highest in the procedural area and that of NO2 was highest in the cleansing area. The proportion of tolerable to poor-quality (exceeding acceptable level) level of CO2 and total VOCs in the procedural area was 26% and 19.2% in all measurement times, respectively. The proportion of tolerable to poor-quality level of NO2 in the cleansing area of the endoscopy unit was 32.1% in all measurement times. Multivariate analyses revealed that tolerable to poor-quality (exceeding acceptable level) level of VOCs was associated with the number of endoscopic procedures (odds ratio, 1.79; 95% confidence interval, 1.42–2.27) and PM2.5 level (1.27, 1.12–1.44). Moreover, tolerable to poor-quality level of CO2 was associated with the number of colonoscopy (5.35, 1.19–24.02), especially with electrocoagulation procedures (24.31, 1.31–452.44) in the procedural area.

Conclusions

Healthcare personnel and patients who undergo endoscopy are frequently exposed to ambient air pollution. Health-related protective strategies for ambient air pollution in the endoscopy unit are warranted.

ClinicalTrials.gov registration number

NCT03724565.

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Abbreviations

VOCs:

Volatile organic compounds

PM2.5 :

Particulate matter that have a diameter of less than 2.5 μm

DALYs:

Disability-adjusted life-years

CO2 :

Carbon dioxide

NO2 :

Nitrogen dioxide

CO:

Carbon monoxide

US EPA:

United States Environmental Protection Agency

WHO:

World Health Organization

UL:

Underwriters Laboratories Inc

NIOSH:

National Institute for Occupational Safety and Health

US OSHA:

United States Occupational Safety and Health Administration

ppm:

Parts-per-million

ppb:

Parts-per-billion

mbar:

Millibar

IRB:

Institutional review board

EGD:

Esophagogastroduodenoscopy

CFS:

Colonoscopy

ESD:

Endoscopic submucosal dissection

EMR:

Endoscopic mucosal resection

SFS:

Sigmoidoscopy

EVL:

Esophageal variceal ligation

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Acknowledgements

C.S.B. and K.L. contributed equally to this work. This study was supported by grants from Hallym University Research Fund 2018 (H20180249).

Funding

This study was supported by grants from Hallym University Research Fund 2018 (H20180249).

Author information

Author notes

  1. Chang Seok Bang and Keunwook Lee have equally contributed to this work.

Authors and Affiliations

  1. Department of Internal Medicine, Hallym University College of Medicine, Sakju-ro 77, Chuncheon, Gangwon-do, 24253, Republic of Korea

    Chang Seok Bang, Young Joo Yang & Gwang Ho Baik

  2. Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, Republic of Korea

    Chang Seok Bang, Young Joo Yang & Gwang Ho Baik

  3. Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of Korea

    Chang Seok Bang

  4. Department of Biomedical Science, Hallym University College of Natural Science, Chuncheon, Republic of Korea

    Keunwook Lee

Authors
  1. Chang Seok Bang
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Contributions

CSB: Conception and design of the study. CSB, KL, YJY, GHB: Generation, collection, assembly, analysis, and/or interpretation of data. CSB, KL: Drafting or revision of the manuscript. CSB: Approval of the final version of the manuscript.

Corresponding author

Correspondence to Chang Seok Bang.

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Disclosures

Chang Seok Bang, Keunwook Lee, Young Joo Yang, and Gwang Ho Baik have no conflicts of interest or financial ties to disclose.

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IRB approval number Institutional review board of Chuncheon Sacred Heart hospital (NON2018-002).

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Bang, C.S., Lee, K., Yang, Y.J. et al. Ambient air pollution in gastrointestinal endoscopy unit. Surg Endosc 34, 3795–3804 (2020). https://doi.org/10.1007/s00464-019-07144-8

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