OBJECTIVE The objective was to find the factors that pose a possible health risk to OR personnel. Work-related health problems of operating room (OR) personnel were signalled by an occupational physician and preparations for the development of new Worker's Health Surveillance (WHS) were started with a systematic review of the literature. METHODS A systematic review was performed of articles in Pubmed, published from January 1991 to December 2007, concerning risks or health effects in the working conditions of OR personnel. RESULTS Twenty-three articles reported that workers in the OR are exposed to infectious agents, noise, anaesthetic gases and radiation. Eleven studies reported elevated risk for (allergic) skin diseases, musculoskeletal complaints and infectious diseases. CONCLUSIONS Factors that form a health risk for workers in the operating room are infectious agents, noise, anaesthetic gases and radiation. Health effects on workers in the OR are (allergic) skin disorders, musculoskeletal complaints and infectious diseases.