Surgical smoke and occupational health

Abstract

Surgical smoke is generated when using electrocautery, lasers and ultrasonic devices that cuts and coagulates various tissues and are used during surgical procedures. This smoke is formed by incomplete cauterization of tissues and contains toxic gases that can accumulate in the form of living or dead organic material (1), causing harmful effects to the health of those who inhale it. Statistical data suggest that each year in the United States around 500,000 professionals, including surgeons, nurses, and anesthesiologists, are exposed to surgical smoke hazards in operating rooms and such exposures cumulate over their lifetimes (2). In Taiwan, for example, more than 10,000 nurses are exposed to these hazards each year (3). Also, if a large amount of surgical smoke is present in the environment, it can obstruct the surgeon's view and make surgery last longer (4,5). Since the 1960s, the dangers of exposure to surgical smoke constituents and their presence of bioaerosols have been investigated (4).The surgical smoke can be seen and its malodorous odor felt by operating room professionals, being composed of 95% of water vapor and 5% of combustion byproducts and cellular residues (6,7), such as chemical compounds like benzene, and biological materials such as blood particles, tissue particles, viruses and bacteria that have mutagenic and cytotoxic agents in aerosols (6,7). It is important to point out that different tissues can change the composition of surgical smoke and the compounds like acrolein, carbon monoxide, formaldehyde, hydrogen cyanide and methane are considered respiratory irritants, which make them dangerous for individuals working in the operating room