Is Surgical Smoke in the Operating Room really a Problem?

Decades of evidence point to surgical smoke caused by electrocautery equipment as an increased health risk for healthcare workers in the operating room. More states are pushing to improve health standards for ASC staff in eliminating toxins that are released during many surgeries. 

In a 2020 article published by The Joint Commission, Helen Larios describes inhaling surgical smoke during her career as an operating room nurse. Despite wearing a mask, she experienced a choking cough, watery eyes, and other symptoms of respiratory illness from smoke that emanates during the cauterization process of surgery. 

(Photo by Jason Blackeye on Unsplash)

Surgical smoke is the byproduct caused by heating devices used to fuse human tissue in surgeries. They include lasers, electrosurgical systems, hyfrecators, ultrasonic scalpels, radiofrequency devices, and power tools. 

Excerpt from the CDC:

“During surgical procedures, smoke is produced when energy generating devices such as lasers or electrosurgical units also known as cautery are used to stop bleeding or incise tissue. The energy generating devices raise the intracellular temperature to boiling (i.e., 100° C /212° F). At these high temperatures, the tissue vaporizes producing surgical smoke. The smoke is often not visible and has an unpleasant odor. The smoke may contain ultra-fine particles, toxic compounds (e.g., benzene, toluene, hydrogen cyanide), viruses (e.g., human papilloma virus [HPV]), and cancer cells (Guideline for Surgical Smoke Safety).”

According to some studies, one day in the operating room is comparable to smoking 30 unfiltered cigarettes. The plume from electrosurgical procedures contains more than 150 dangerous toxins, including benzene, hydrogen cyanide, formaldehyde, viruses, metal fumes, and dead or living cellular tissue. 

According to the National Institute for Occupational Safety and Health (NIOSH), approximately a half-million health care workers are exposed to laser or electrosurgical smoke each year.

 Perioperative nurses are twice as likely to suffer severe respiratory illnesses as the general public. Even patients are at a reduced risk for lung and upper respiratory irritation, compared to nurses and surgeons in the operating room.

Organizations such as AORN (Association of periOperative Registered Nurses) have been urging OSHA to mandate smoke evacuation standards for ASC’s. 

As of 2020, nine states- Connecticut, Georgia, Kentucky, Illinois, Iowa, New Jersey, Oregon, Tennessee, and Utah have introduced legislation of surgical smoke evacuation in operating rooms.

NIOSH urges surgery centers to use a smoke evacuator during surgeries whenever airborne particles are circulated.

In Alleviating the dangers of surgical smoke, the Joint Commission recommends using a smoke evacuator to direct surgical smoke away from the operating room. Some are small and simple to use, such as a pencil-sized device that attaches to your electrocautery tool. For laparoscopic surgeries, a lapro-shield system of tubing eliminates toxins that accumulate in the intra-abdominal cavity. 

Madison Medical Construction Corp specializes in the construction and remodeling of health care facilities in Southern California including surgical centers, imaging centers, medical offices, orthopedic offices, dental practices, rehabilitation facilities, and hospitals.

From groundbreaking to tenant improvements, we can manage all of your development needs. Call today for a pre-planning project evaluation and consultation.