The hazard of surgical smoke is often overlooked when considering the safety of medical laser procedures but can present a high level of occupational risk. Administrative procedures for operating external extraction devices and the reliance on personal protective equipment are not sufficient for reducing the risk. This paper aims to quantify the hazard of laser-generated surgical smoke and demonstrate how effective engineering control solutions can reduce the risk. A new design solution is presented with engineering controls for surgical smoke extraction and optical radiation integrated into the laser handpiece. A fibre delivered diode laser is used to simulate laser vaporisation procedures on porcine skin tissue. Conventional external extraction conditions are compared to the new design solution. Fine particulate mass concentrations (PM2.5) from the simulated procedures, under different extraction conditions, are measured using optical particle size measurements. Peak concentrations of 55.86 ± 2.79 µg/m 3 were measured without extraction;showing the hazard of laser-generated surgical smoke is five times greater than the World Health Organisation guideline of 10 µg/m 3 . A typical medical extraction setup only achieved a 16% reduction in peak concentration values, 47.07 ± 2.35 µg/m 3 ; demonstrating that conventional, external, methods of extraction are ineffective. The new solution was able to capture all particulate material, reducing particulate concentrations to background levels, 2.19 ± 0.68 µg/m 3 , safely below the current recommended guidelines. The design and results present evidence that it is not only more effective to use engineering control methods but that it is practicable to do so.

Background: The Papanicolau smear (Pap smear, Pap test) is one of the most routine of all screening tests performed in medicine. Its advent and widespread use has brought a considerable decrease in the incidence of cervical cancer. Unfortunately, this malignancy continues to convey significant morbidity and mortality. Much of this is the result of inadequate compliance with routine Pap smear screening, in which limited education is thought to play a role, particularly among ethnic minorities. Methods: A Google search using the phrase “pap smears” was performed and the first fourteen Uniform Resource Locators were analyzed using four standardized readability indices: the Flesh-Kinkaid Grade Level, the SMOG index, the Gunning Fog Index and the Automated Readability Index. An average grade level readability was then obtained and compared to the AMA recommendation that health care information be written at a 5th or 6th grade reading level. Results: The average grade level readability of the fourteen analyzed sites using four aforementioned indices were 8.86, 8.82, 11.92 and 8.35, respectfully. The total average readability after considering all four indices was 9.49, three grade levels above what the AMA has recommended. Conclusion: The readability of commonly accessed internet information regarding Pap smears is above what is recommended by the AMA. Physicians should be cognizant of this, particularly given this is a routine healthcare test that should be undergone by nearly fifty percent of the world’s population at various points throughout their lifetime.

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As more patients turn to the internet as a source for health information, guidelines by the National Institutes of Health and American Medical Association recommend online, patient-directed content be written at a 6th grade reading level. This study aims to assess the compliance to these guidelines of material found on the internet associated with basal cell carcinoma (BCC), as no data currently exists on the readability of internet infor¬mation regarding this specific condition.