{"id":77345,"date":"2025-03-18T07:53:03","date_gmt":"2025-03-18T07:53:03","guid":{"rendered":"https:\/\/stopcarcinogensatwork.eu\/fact\/kirurski-dim\/"},"modified":"2025-10-23T09:38:54","modified_gmt":"2025-10-23T09:38:54","slug":"kirurski-dim","status":"publish","type":"fact","link":"https:\/\/stopcarcinogensatwork.eu\/sl\/fact\/kirurski-dim\/","title":{"rendered":"kirur\u0161ki dim"},"content":{"rendered":"

Po podatkih iz leta 2018 je med 1,7 milijona zdravnikov in 3,1 milijona medicinskih sester, ki delajo v EU, na tiso\u010de vsak dan zaposlenih v operacijskih dvoranah. Med njimi je tudi 400.000 kirurgov, ki delajo v operacijskih dvoranah po vsej EU. Kirur\u0161ki dim, ki se pojavlja v operacijskih sobah (OR) ob uporabi elektrokirur\u0161ke opreme, laserjev in druge energetske opreme, lahko vsebuje odvisno od tkiva razli\u010dne in razli\u010dne koli\u010dine \u0161kodljivih snovi, vklju\u010dno s rakotvorne snovi kategorije 1A, kot so benzen in formaldehid. \u010ce smo izpostavljeni kirur\u0161kemu dimu, je lahko dan v operacijski sobi tako nevaren, kot \u010de bi pokadili 27 cigaret na dan, kar predstavlja veliko nevarnost za zdravje osebja v operacijskih sobah po vsej Evropi. <\/p><\/blockquote>\n

Zdravniki, medicinske sestre in tehniki v operacijskih dvoranah pre\u017eivijo veliko \u010dasa v operacijskih dvoranah, zato so zelo izpostavljeni tveganjem kirur\u0161kega dima in dihajo zrak, ki vsebuje do 150 \u0161kodljivih toksinov, vklju\u010dno z dobro znanimi rakotvornimi snovmi.<\/p>\n

Kje se pojavljajo tveganja<\/h2>\n

Kirur\u0161ki dim, znan tudi kot diatermi\u010dni dim, se pojavi med operacijo in nastaja pri uporabi kirur\u0161kih naprav, kot so laserji, elektrokirur\u0161ke enote, ultrazvo\u010dne enote, kauterske enote ter hitri svedri in vrtalniki, ki se uporabljajo za rezanje in razrez tkiva. Kirur\u0161ki dim vsebuje razli\u010dne strupene snovi, vklju\u010dno z benzenom in formaldehidom.<\/p>\n

Medicinske sestre, kirurgi, anesteziologi, tehniki, veterinarji in vsi, ki delajo v operacijskih dvoranah, so zaradi prekomerne izpostavljenosti kirur\u0161kemu dimu najbolj izpostavljeni zdravstvenim zapletom. Pomembno je tudi opozoriti, da zdravstveni zaposleni niso edini, ki jih ogro\u017ea kirur\u0161ki dim. <\/p>\n

Ve\u010d o nevarnosti<\/h2>\n

Kirur\u0161ki dim je sestavljen iz pribli\u017eno 95 % vode in 5 % organskih hlapov ter celi\u010dnih ostankov v obliki trdnih delcev. Delci so sestavljeni iz kemikalij, krvnih in tkivnih delcev, virusov in bakterij. Te razli\u010dne strupene in \u0161kodljive snovi so nevarne za ljudi, ki so jim izpostavljeni. <\/p>\n

Sestavine kirur\u0161kega dima so acetonitril, akrolein, benzen, toluen<\/a>, formaldehid in policikli\u010dni<\/a> aromatski ogljikovodiki.<\/a> \u0160tudije so pokazale, da so v kirur\u0161kem dimu kemi\u010dne in biolo\u0161ke spojine, ki so dra\u017eilne, mutagene, rakotvorne snovi in nevrotoksi\u010dne. <\/p>\n

Nevarnosti, ki se lahko pojavijo<\/h2>\n

Kirur\u0161ki dim lahko povzro\u010di neposredno in posredno \u0161kodo zaradi delcev, ki jih vsebuje. Pri neposrednih u\u010dinkih lahko povzro\u010di dra\u017eenje o\u010di in ko\u017ee (t. i. dermatitis), akutne glavobole ali alergijski rinitis pri bolni\u0161ni\u010dnem osebju v operacijski sobi. Pove\u010da lahko tudi tveganje za kroni\u010dne plju\u010dne bolezni, kot sta poklicna astma in kroni\u010dna obstruktivna plju\u010dna bolezen (KOPB). Raziskave so pokazale, da je pri medicinskih sestrah v operacijskih sobah tveganje za hudo trajno astmo ve\u010dje kot pri drugih medicinskih sestrah. <\/p>\n

Pri posrednih u\u010dinkih so poro\u010dali o nevarnosti zapletov nose\u010dnosti in neplodnosti pri kirurginjah. Obstajajo tudi pomisleki, da lahko kirur\u0161ki dim prena\u0161a oku\u017ebe, kot so \u017eivi virusi ali bakterije. <\/p>\n

Kaj lahko storite<\/h2>\n

Obstaja vrsta tehnologij za odpravljanje kirur\u0161kega dima, od katerih so nekatere u\u010dinkovitej\u0161e od drugih. Med njimi so sistemi za dobro prezra\u010devanje, naprave za lokalno odsesavanje dima in filtrirne kirur\u0161ke maske. Za celovit pristop je potrebna hkratna uporaba razli\u010dnih tehnologij. Z zajemanjem dima neposredno pri viru in filtriranjem majhnih delcev naprave za lokalno odsesavanje zagotavljajo minimalno izpostavljenost \u0161kodljivim u\u010dinkom kirur\u0161kega dima ali pa je sploh ni. \u010ceprav lahko za varovanje zdravja zaposlenih v operacijskih dvoranah uporabimo ve\u010d mehanizmov, ni ni\u010d tako u\u010dinkovito kot zajemanje kirur\u0161kega dima neposredno pri viru in filtriranje majhnih delcev. Naprave za lokalno evakuacijo predstavljajo najve\u010djo za\u0161\u010dito za zdravstvene delavce in bolnike. Zato je priporo\u010dljivo odstraniti kirur\u0161ki dim v bli\u017eini najve\u010d 2 cm od vira, da bi zmanj\u0161ali tveganje izpostavljenosti. <\/p>\n

Vendar lahko tkiva glede na njihovo kirur\u0161ko proizvodnjo dima razdelimo v tri razli\u010dne razrede. Tkiva z visoko vsebnostjo PM, kot so jetra, tkiva s srednjo vsebnostjo PM, vklju\u010dno z ledvi\u010dno skorjo, ledvi\u010dno medenico in skeletnimi mi\u0161icami, ter tkiva z nizko vsebnostjo PM, kot so ko\u017ea, siva snov, bela snov, bronhusi in podko\u017ena ma\u0161\u010doba. <\/p>\n

\u010ceprav je zajemanje vira na splo\u0161no zelo u\u010dinkovito, morda ne bo zadostovalo za tkiva z visoko vsebnostjo PM, kot so jetra. Tudi s sistemi za odvajanje dima lahko koncentracije delcev pri delovanju na tkiva z visoko vsebnostjo PM \u0161e vedno dose\u017eejo nezdrave ravni. To ka\u017ee, da so za zagotovitev ustrezne za\u0161\u010dite osebja v operacijski sobi potrebni dodatni za\u0161\u010ditni ukrepi, kot so filtri ULPA, organizacijski ukrepi (npr. zmanj\u0161anje \u0161tevila osebja in trajanja njegove prisotnosti v operacijski sobi) in respiratorji (FFP3) v povezavi z napravami za odvajanje dima. <\/p>\n

Obrazne maske in prezra\u010devalni sistemi se pogosto uporabljajo v operacijskih dvoranah, vendar se izka\u017eejo za neu\u010dinkovite proti kirur\u0161kemu dimu. Standardne kirur\u0161ke maske na primer ne filtrirajo 77 % delcev v kirur\u0161kem dimu, maske z visoko filtracijo pa so u\u010dinkovite le do 0,1 mikrona, kar ne filtrira vseh virusov s posledi\u010dnimi mo\u017enimi u\u010dinki na zdravje. Vendar je filter ULPA (Ultra-Low Particular Air) u\u010dinkovit pri odstranjevanju submikronskih delcev iz zraka. <\/p>\n

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

 <\/p>\n

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