{"id":82772,"date":"2025-03-18T07:53:03","date_gmt":"2025-03-18T07:53:03","guid":{"rendered":"https:\/\/stopcarcinogensatwork.eu\/fact\/kirurski-dim\/"},"modified":"2025-10-23T09:37:06","modified_gmt":"2025-10-23T09:37:06","slug":"kirurski-dim","status":"publish","type":"fact","link":"https:\/\/stopcarcinogensatwork.eu\/hr\/fact\/kirurski-dim\/","title":{"rendered":"Kirur\u0161ki dim"},"content":{"rendered":"

Prema podacima iz 2018. godine, od 1,7 milijuna lije\u010dnika i 3,1 milijuna medicinskih sestara koji rade u EU, tisu\u0107e svakodnevno rade u operacijskim salama. To uklju\u010duje 400 000 kirurga koji rade u operacijskim salama diljem EU. Kirur\u0161ki dim, koji se javlja u operacijskim salama kada se koristi elektrokirur\u0161ka oprema, laseri i druga energetska oprema, mo\u017ee, ovisno o tkivu, sadr\u017eavati razne i razli\u010dite koli\u010dine \u0161tetnih tvari, uklju\u010duju\u0107i karcinogene kategorije 1A poput benzena i formaldehida. Ako ste izlo\u017eeni kirur\u0161kom dimu, dan u operacijskoj sali mo\u017ee biti jednako opasan kao i pu\u0161enje 27 cigareta dnevno, \u0161to predstavlja zna\u010dajnu prijetnju zdravlju osoblja operacijske sale diljem Europe. <\/p><\/blockquote>\n

Lije\u010dnici, medicinske sestre i operacijski tehni\u010dari provode zna\u010dajnu koli\u010dinu vremena u operacijskim salama i stoga su vrlo izlo\u017eeni rizicima kirur\u0161kog dima, udi\u0161u\u0107i zrak koji sadr\u017ei do 150 \u0161tetnih toksina, uklju\u010duju\u0107i dobro poznate kancerogene tvari.<\/p>\n

Gdje se javljaju rizici<\/h2>\n

Kirur\u0161ki dim, tako\u0111er poznat kao dijatermijski oblak, nastaje tijekom operacije i proizvodi se kori\u0161tenjem kirur\u0161kih ure\u0111aja kao \u0161to su laseri, elektrokirur\u0161ki ure\u0111aji, ultrazvu\u010dni ure\u0111aji, ure\u0111aji za kauterizaciju te brze bu\u0161ilice i svrdla koja se koriste za rezanje i disekciju tkiva. Kirur\u0161ki dim sadr\u017ei razne otrovne tvari, uklju\u010duju\u0107i benzen i formaldehid. <\/p>\n

Medicinske sestre, kirurzi, anesteziolozi, tehni\u010dari, veterinari i svi koji rade u operacijskim salama najvi\u0161e su izlo\u017eeni riziku od zdravstvenih komplikacija uzrokovanih kirur\u0161kim dimom zbog prekomjerne izlo\u017eenosti. Tako\u0111er je va\u017eno napomenuti da zdravstveni radnici nisu jedini koji su ugro\u017eeni kirur\u0161kim dimom. <\/p>\n

Vi\u0161e o opasnosti<\/h2>\n

Kirur\u0161ki dim sastoji se od pribli\u017eno 95% vode i 5% organskih para i stani\u010dnih ostataka u obliku \u010destica. \u010cestice se sastoje od kemikalija, \u010destica krvi i tkiva, virusa i bakterija. Ove razne otrovne i \u0161tetne tvari opasne su za ljude koji su im izlo\u017eeni. <\/p>\n

Komponente kirur\u0161kog dima uklju\u010duju acetonitril, akrolein, benzen<\/a> , toluen, formaldehid<\/a> i policikli\u010dke aromatske ugljikovodike<\/a> . Studije su pokazale da se u kirur\u0161kom dimu nalaze kemijski i biolo\u0161ki spojevi koji su nadra\u017euju\u0107i, mutageni, kancerogeni i neurotoksi\u010dni.<\/p>\n

Opasnosti koje se mogu pojaviti<\/h2>\n

Kirur\u0161ki dim mo\u017ee uzrokovati izravnu i neizravnu \u0161tetu zbog \u010destica koje sadr\u017ei. U slu\u010daju izravnih u\u010dinaka, mo\u017ee dovesti do iritacije o\u010diju i ko\u017ee (poznate kao dermatitis), akutnih glavobolja ili alergijskog rinitisa kod osoblja u operacijskoj sali bolnice. Tako\u0111er mo\u017ee pove\u0107ati rizik od kroni\u010dnih plu\u0107nih bolesti, poput profesionalne astme i kroni\u010dne opstruktivne plu\u0107ne bolesti (KOPB). Istra\u017eivanja su pokazala da su medicinske sestre u operacijskoj sali izlo\u017eene ve\u0107em riziku od te\u0161ke perzistentne astme od ostalih medicinskih sestara. <\/p>\n

U slu\u010daju neizravnih u\u010dinaka, zabilje\u017eena je opasnost od komplikacija u trudno\u0107i i neplodnosti kod kirurginja. Tako\u0111er postoji zabrinutost da kirur\u0161ki dim mo\u017ee prenositi infekcije, poput \u017eivih virusa ili bakterija. <\/p>\n

\u0160to mo\u017eete u\u010diniti<\/h2>\n

Postoji niz tehnologija za rje\u0161avanje problema kirur\u0161kog dima, od kojih su neke u\u010dinkovitije od drugih. To uklju\u010duje sustave visoke ventilacije, lokalne ure\u0111aje za odvod dima i filtracijske kirur\u0161ke maske. Sveobuhvatan pristup zahtijeva istovremenu upotrebu razli\u010ditih tehnologija. Hvatanjem dima izravno na izvoru i filtriranjem malih \u010destica, lokalni ure\u0111aji za evakuaciju osiguravaju minimalnu ili nikakvu izlo\u017eenost \u0161tetnim u\u010dincima kirur\u0161kog dima. \u010cak i ako se mo\u017ee koristiti nekoliko mehanizama za za\u0161titu zdravlja onih koji rade u operacijskim salama, ni\u0161ta nije tako u\u010dinkovito kao hvatanje kirur\u0161kog dima izravno na izvoru i filtriranje malih \u010destica. Lokalni ure\u0111aji za evakuaciju pru\u017eaju najve\u0107u za\u0161titu zdravstvenim djelatnicima i pacijentima. Stoga se preporu\u010duje uklanjanje kirur\u0161kog dima u blizini ne ve\u0107oj od 2 cm od izvora kako bi se smanjio rizik od izlo\u017eenosti. <\/p>\n

Me\u0111utim, tkiva se mogu podijeliti u tri razli\u010dite klase prema njihovoj kirur\u0161koj proizvodnji dima. Tkiva s visokim udjelom PM-a, poput jetre, tkiva sa srednjim udjelom PM-a, uklju\u010duju\u0107i bubre\u017enu koru, bubre\u017enu zdjelicu i skeletne mi\u0161i\u0107e, te tkiva s niskim udjelom PM-a, poput ko\u017ee, sive tvari, bijele tvari, bronha i potko\u017enog masnog tkiva. <\/p>\n

Iako je hvatanje izvora op\u0107enito vrlo u\u010dinkovito, mo\u017eda nije dovoljno za tkiva s visokim udjelom PM-a poput jetre. \u010cak i sa sustavima za evakuaciju dima, koncentracije \u010destica i dalje mogu dose\u0107i nezdrave razine pri radu na tkivima s visokim udjelom PM-a. To sugerira da su dodatne za\u0161titne mjere, poput ULPA filtera, organizacijskih mjera (npr. smanjenje broja osoblja i trajanja njihove prisutnosti u operacijskoj sali) i respiratora (FFP3), zajedno s evakuatorima dima, potrebne kako bi se osigurala odgovaraju\u0107a za\u0161tita osoblja operacijske sale. <\/p>\n

Maske za lice i ventilacijski sustavi \u0161iroko se koriste u operacijskim salama, no pokazuju se neu\u010dinkovitima protiv kirur\u0161kog dima. Na primjer, 77% \u010destica u kirur\u0161kom dimu nije adekvatno filtrirano standardnim kirur\u0161kim maskama, a maske s visokom filtracijom u\u010dinkovite su samo do 0,1 mikrona, \u0161to ne filtrira sve viruse s posljedi\u010dnim potencijalnim zdravstvenim u\u010dincima. Me\u0111utim, ULPA (ultra-niski partikularni zrak) filter u\u010dinkovit je u uklanjanju submikronskih \u010destica iz zraka. <\/p>\n

Reference: Koalicija za kirur\u0161ki dim<\/p>\n

 <\/p>\n

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