High levels of microplastics have been found in operating theatres by researchers who highlighted the “astoundingly high” amounts of single-use plastic used in modern surgical procedures.
A team from the University of Hull found the amount of microplastics in a cardiothoracic operating theatre was almost three times that found in homes, and said this identifies another route through which the tiny particles can enter the human body, with unknown consequences.
The study, published in the journal Environment International, is the first to examine the prevalence of microplastics in surgical environments.
The team analysed levels in the operating theatre and the anaesthetic room in cardiothoracic surgeries and discovered an average of 5,000 microplastics per metre squared when the theatre was in use.
In knowing the numbers and characteristics of the microplastics found in this study, we can now conduct more realistic cell-type experiments to establish possible health impacts— Professor Jeanette Rotchell
The anaesthetic room showed average levels of 500 per metre squared, when in use.
Neither setting had microplastics settling out from the air when not in use.
The study is the latest in a series of microplastics research projects from the University of Hull, Hull York Medical School and Hull University Teaching Hospitals NHS Trust.
Jeanette Rotchell, professor of environmental toxicology at the university, said the types of microplastic particles identified relate to common plastic wrapping materials and could also come from blister packs, surgical gowns, hairnets and drapes for patients.
She said: “You can imagine that during a cardiothoracic operation, which may last as long as eight hours, there will be a lot of people, utensils and consumable items.
“These items are all wrapped in plastic and this is contributing to all those particles in the operating room.
“It is a very dense environment for plastic particles to be introduced into the surrounding air.”
Prof Rotchell said: “Although we know microplastics are in the air in a variety of settings, we can’t yet say what the consequences are or whether microplastics are harmful to health. Researchers have yet to establish this.
We have to consider ways of packaging the instruments as well as ways to open them that reduces the release of microplastics in the theatre environment— Professor Mahmoud Loubani
“We do know that microplastics cause immune response-type reactions such as inflammation in cell or tissue-based experiments.
“This study also highlights another route of exposure that differs from either inhalation or ingestion via our diet.
“In knowing the numbers and characteristics of the microplastics found in this study, we can now conduct more realistic cell-type experiments to establish possible health impacts.”
Lead investigator Daniel Field said the invention of plastics was revolutionary for the surgical environment and vacuum packing equipment reduces risks to patients.
But Dr Field added: “The amount of plastic used in operating theatres across Europe is astoundingly high – you can’t ignore it. We are producing a lot of plastic – much of it sterile, single-use plastic, and you can use 10-20 of these in a single operation just to take out a section of the lung, for example.”
Professor Mahmoud Loubani, co-author and a consultant cardiothoracic surgeon, said: “The environments in which we undertook our research are typical of most NHS operating theatres and anaesthetic rooms across the country, so we are confident in saying our findings will also be applicable to most if not all other clinical settings, locally and nationally, where major surgery is carried out.
“The NHS has moved to use a lot of single-use instruments and equipment in surgery in the last 20 years which have improved our technical capabilities, however this happened at the cost of increasing microplastics in the theatre environment.
“We have to consider ways of packaging the instruments as well as ways to open them that reduces the release of microplastics in the theatre environment.”
