The Hazards of Surgical Smoke

Abstract

Surgical smoke is a part of the environment during operative and invasive procedures. As lasers and electrosurgery have become commonplace, perioperative practitioners are at increased risk for health concerns associated with exposure to surgical smoke. Since the mid 1970s, the body of evidence documenting the hazardous components of surgical smoke has continued to grow. Despite the evidence and recommendations of a variety of organizations, there are no uniform requirements mandating surgical smoke evacuation. This article reviews current research to identify the potential health hazards as well as the current recommendations related to the filtration and evacuation of surgical smoke.

Safety considerations for Health care Workers involved in Cytoreductive Surgery and Perioperative chemotherapy

“…The various chemicals found in electrosurgical smoke are listed in Table 2 [18]. Surgical smoke can produce nausea, headache, eye irritation, respiratory tract irritation, cardiovascular changes, obstruct visualization of the surgical field and has a bad smell [19,20].…”

Is It Time for a More Systematic Approach to the Hazards of Surgical Smoke?: Reconsidering the Evidence

“…Two studies on animals revealed decreased ciliary action and increased inflammatory responses in the lungs (Freitag, Chapman, Sielczak, Ahmed, & Russin, 1987) as well as histological lung changes (Wenig, Stenson, Wenig, & Tracey, 1993). Other studies have reported similarities between surgical smoke and the adverse effects of air pollution and passive cigarette smoke (Barrett & Garber, 2003;Brüske-Hohlfeld et al, 2008;Ulmer, 2008;Weston et al, 2009). Furthermore, Ball (2009) reported that OR nurses experience higher rates of respiratory disorders, such as bronchitis, asthma, sinus infections, and allergies, than the general population.…”

“…Surgical smoke is a by-product of the heat produced by electrosurgical tools causing vaporization of protein and fat (Ulmer, 2008). For example, at 45°C, cellular proteins are denatured; at 90°C, liquid evaporates; and at 200°C, tissue is carbonized (Massarweh, Cosgriff, & Slakey, 2006).…”

Influence of Surgical Smoke on Indoor Air Quality in Hospital Operating Rooms

“…Surgical smoke resulting from the application of laser and electrosurgery technology is considered a potential health risk to both patients and surgical staff (Ball, 2001;Ulmer, 2008). The Occupational Safety and Health Administration (OSHA) reported that about 500,000 OR related personnel including surgeons and nurses are exposed to surgical smoke (OSHA, 2016).…”

“…Air quality control is also significant for achieving safety and comfort, which are directly associated with the well-being and productivity of personnel. Surgical gas generated by the use of anesthetic gas, lasers, and other surgical energy-based devices is regarded as constituting a threat to the surgical staff (Ball, 2001;Ulmer, 2008). To provide a high level of IAQ in ORs, many studies on OR ventilation system have been conducted (Chow and Yang, 2003;Balaras et al, 2007;Liu et al, 2009;Chow and Yang, 2012), and standards and guidelines for the air quality in ORs have been proposed, focusing on general OR ventilation requirements, e.g., the minimum total air exchange rate and outdoor air exchange rate, as well as air flow design to reduce pollutant entrainment (NFPA, 2005;AIA, 2006;ASHRAE, 2008;FGI, 2010).…”