Surgical smoke – A health hazard in the operating theatre: A study to quantify exposure and a survey of the use of smoke extractor systems in UK plastic surgery units

Hill, Dave; O'Neill, Joy; Powell, Roy; Oliver, Douglas L.

doi:10.1016/j.bjps.2012.02.012

Cited by 105 publications

(127 citation statements)

References 16 publications

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“…Many previous studies have investigated particle characterization in surgical smoke and its infection risks (DesCoteaux et al, 1996;Kunachak et al, 1996;Capizzi et al, 1998;Hughes and Hughes, 1998;BruskeHohfeld et al, 2008;Andreasson et al, 2009;Mowbray et al, 2013). However, chemical pollutants such as VOCs in surgical smoke have been addressed by only a few studies (Al Sahaf et al, 2007;Weston et al, 2009;Hill et al, 2012;Mellor and Hutchinson, 2013;Choi et al, 2014) and their impact on the indoor air is rarely discussed. The results of this study indicated that surgical smoke contain large amounts of VOCs, and also showed that the concentrations of several VOCs such as benzene and toluene exceed concentration guidelines such as those published by the WHO, RfC, and REL.…”

Section: Surgical Smoke As Voc Sourcementioning

confidence: 99%

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

Choi

Kang

2017

Aerosol Air Qual. Res.

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The objective of this study is to analyze the volatile organic compounds (VOCs) in the surgical smoke generated during laparoscopic surgery, and determine their influence on the indoor air quality in hospital operating rooms (ORs). Field measurements were carried out during eight surgeries in conventional and robotic ORs in which an electrosurgery system was being used, thus continuously generating surgical smoke. The VOCs were measured at three different locations, in the patients' abdominal cavities, beside the surgical table, and at the exhaust vent. Other indoor pollutants including carbon monoxide (CO), carbon dioxide (CO 2 ), and total airborne bacteria (TAB) in the indoor air were measured at the exhaust to assess the general indoor air quality in the ORs. The results from the patients' abdominal cavities confirmed that the surgical smoke contained abundant VOCs, with the levels of benzene and toluene exceeding the health guidelines. Compared to the results obtained in the abdominal cavity, the measurements obtained at the surgical table and exhaust vent exhibited low levels of VOCs, indicating that the actual exposure to these compounds was minimized in a highlyventilated operating room. However, the benzene concentration in the operating room approached a level that threatens the health of the occupants. Therefore, the results of this study suggest that there is a potential health risk to the surgeon who is closest to the point of origin of the surgical gas, as well as a need for further attention to identify the local pollutant dispersion near the surgical table while the ventilation system is operating.

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Section: Surgical Smoke As Voc Sourcementioning

confidence: 99%

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

Choi

Kang

2017

Aerosol Air Qual. Res.

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“…Increased concern has been raised regarding the health effects of surgical smoke on OR personnel [2,[5][6][7][8][9][10][11][12][13][14][15][16]. Small particles carry chemical risks and larger particles have infectivity potential [3,4,10].…”

Section: Introductionmentioning

confidence: 99%

“…Small particles carry chemical risks and larger particles have infectivity potential [3,4,10]. Surgical smoke inhalation is a known respiratory irritant and experience in an OR confirms its noxious odor [7,11].…”

Section: Introductionmentioning

confidence: 99%

“…Electrocautery dissection of tissue releases airborne hydrocarbons, nitriles, fatty acids, and phenols [3]. Lasers similarly release benzene, formaldehyde, acrolein, carbon monoxide, and hydrogen cyanide amongst other constituents [3,4,10,23,[25][26][27][28]. The contents of ultrasonic scalpel vapor is not well studied or characterized [2,3,29].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, the Canadian Centre for Occupational Health and Safety has published guidelines for laser plume safety [27]. Manufacturers of electrosurgical dissection devices have responded by creating devices with built-in smoke evacuators, however, studies indicate that these devices are often cumbersome for surgeons, and are therefore often not used [2,[8][9][10].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Brace

Stevens

Taylor

et al. 2014

J Otolaryngol - Head Neck Surg

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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.

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Association of Occupational Exposure to Inhaled Agents in Operating Rooms With Incidence of Chronic Obstructive Pulmonary Disease Among US Female Nurses

et al. 2021

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IMPORTANCE Employment in operating rooms (ORs) may involve exposure to several inhaled agents, including surgical smoke and disinfectants, which are associated with adverse respiratory health effects. However, the association of long-term employment in ORs and chronic obstructive pulmonary disease (COPD) remains unknown. OBJECTIVE To examine the association of working in an OR with incidence of COPD among female nurses in the US. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the Nurses' Health Study for US female registered nurses who provided information on questionnaires regarding OR

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Surgical smoke – A health hazard in the operating theatre: A study to quantify exposure and a survey of the use of smoke extractor systems in UK plastic surgery units

Cited by 105 publications

References 16 publications

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

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

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

Association of Occupational Exposure to Inhaled Agents in Operating Rooms With Incidence of Chronic Obstructive Pulmonary Disease Among US Female Nurses

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