Does High Humidity in the Operating Room OR Impact Surgical Site SSI Infection Rates

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Does High Humidity in the Operating Room (OR)
Impact Surgical Site (SSI) Infection Rates?

• The Infection Prevention and Control Program
• The Ottawa Hospital

Natalie Bruce, BScN, CIC Colette Ouellet, BScN
CIC Kathy Suh, MD, FRCPC CIC Virginia Roth, MD,
FRCPC
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Background

• Well established guidelines
• American Institute of Architects requires
  relative humidity 30-60
• Challenging to meet these standards
• Aging HVAC
• Increase personnel and equipment
• Long procedures
• Few data on the risk of SSI related to high
  humidity

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Objective

• To investigate the association of high humidity
  and SSI rates

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Setting

• University of Ottawa Heart Institute 140 bed
  academic Institution
• 900 Cardiac Bypass Procedures annually
• Operating Rooms are located in the basement of
  the facility

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Scope of the Problem

• Unusually high humidity levels between June
  11-17, 2005
• Precipitation 20-40 mm
• Temperatures 29-32 oC
• Humidity levels greater than 60 and often 85
• In 2006 similar conditions were noted throughout
  the year

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Method

• Three Comparative Studies of SSI Rates
• High humidity week June 2005 compared to
  remaining weeks
• High humidity vs no humidity days during two
  consecutive seasonal periods
• High humidity vs no humidity days over 2 years
• Observational Studies

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Observational Studies

• HVAC System
• Building expansion without increased capacity
• Limited ability to mix air
• Physical Environment
• Visible moisture
• Dampness on OR records
• Uncomfortable working conditions
• Condensation on OR walls

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Interventions

• Patients were informed of the potential risk of
  surgery
• All sterile supplies and equipment packaged in
  porous material were discarded or reprocessed
• Surgical equipment was double bagged

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Recommendations

• HVAC system upgraded
• Continuous electronic monitoring of relative
  humidity in the OR
• Maintain records of high humidity
• Immediate reporting of high humidity to Infection
  Prevention and Control

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CABG SSI Quarterly Rate January 2005-September
2007
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Conclusion

• Routine SSI surveillance may not detect rises in
  SSI rates related to humidity
• Continuous surveillance and humidity monitoring
  is needed
• Association between high humidity and SSI is
  unclear
• Further studies needed to validate our findings