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Objectives  To measure changes in air quality during surgery.    Methods  Operating room (OR) and hallway air quality was continuously monitored over a 3-month period. Rooftop monitoring was used to control for environmental changes and to account for the infiltration of outdoor air pollutants. Air quality measurements were correlated with operative times and electro-dissection equipment used.    Results  OR air is cooler and drier compared to the adjacent hallway. Volatile organic compounds and other gases are below indoor air exposure limit guidelines. Lasers create greater 2.5 μm particulate matter (PM 2.5 ) mass concentration, and greater fine and coarse particle number than cautery or cold tissue dissection. Cautery produces more ultrafine particles (UFP) than other dissection techniques. OR air has lower particle counts than outdoor environmental air by virtue of air conditioning HEPA filtration.    Conclusion  Compared to the outside air, operating room air has lower particle counts. Lasers produce higher concentrations of PM 2.5  mass and, fine and coarse particle number counts. Cautery produces higher concentrations of UFP number counts than other modalities and warrants consideration of the use of masks with ultrafine particle filtration capacity. Operating room air is consistently cooler with decreased humidity, which may cause airway irritation.

‘The air that we breathe’: assessment of laser and electrosurgical dissection devices on operating theater air quality