Surgical Smoke – An Occupational Hazard for the Surgeons
Keywords:
Surgical smoke, surgical plume, electrocautery, suction evacuation
Abstract
It is not well known that “surgical smoke” generated from using electrocautery, lasers and harmonic scalpels during surgery
is as harmful as cigarette smoking. The combustion by-products of the surgical plume, have substances like hydrocarbons,
nitriles and hydrogen cyanide that have proven carcinogenic potential. Prolonged exposure to it has shown to cause headaches,
rhinitis, weakness, dermatitis and even pneumonia. Smaller particles are a chemical hazard and larger particles are
more of a biological hazard. Therefore, effective measures must be taken by the operation theatre personnel and by the management of hospitals to decrease the exposure to surgical smoke and thereby reduce it’s dangerous after effects.
References
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Jul;65(7):911-6. doi: 10.1016/j.bjps.2012.02.012. Epub 2012 Mar 23.
2. NIOSH, Health Hazard Evaluation Report. HETA 85-126- 1932, 1988. p. 2.
3. Mintz Y, Arezzo A, Boni L, Baldari L, Cassinotti E, Brodie R, Uranues S, Zheng M, Fingerhut A. The risk of COVID-19 transmission by laparoscopic smoke may be lower than for laparotomy: a narrative review. Surg Endosc. 2020 Aug;34(8):3298-3305. doi: 10.1007/s00464-020-07652-y. Epub 2020 May 26.
4. Baggish MS, Baltoyannis P, Sze E. Protection of the rat lung from the harmful effects of laser smoke. Lasers in surgery and
medicine. 1988;8(3):248-53.
5. Okoshi K, Kobayashi K, Kinoshita K, Tomizawa Y, Hasegawa S, Sakai Y. Health risks associated with exposure to surgical smoke for surgeons and operation room personnel. Surg Today. 2015 Aug;45(8):957-65. doi: 10.1007/s00595- 014-1085-z. Epub 2014 Nov 25.
6. Ball K. Update for nurse anesthetists. Part 1. The hazards of surgical smoke. AANA J. 2001;69:125–32.
7. Hallmo P, Naess O. Laryngeal papillomatosis with human papillomavirus DNA contracted by a laser surgeon. Eur Arch
Otorhinolaryngol. 1991;248(7):425-7. doi: 10.1007/BF01463570.
8. Robertson-More C, Wu T. A knowledge gap unmasked: viral transmission in surgical smoke: a systematic review. Surg Endosc. 2021 Jun;35(6):2428-2439. doi: 10.1007/s00464-020- 08261-5. Epub 2021 Jan 25.
9. Karjalainen M, Kontunen A, Saari S, Rönkkö T, Lekkala J, Roine A, Oksala N. The characterization of surgical smoke from various tissues and its implications for occupational safety. PLoS One. 2018 Apr 12;13(4):e0195274. doi: 10.1371/
journal.pone.0195274.
10. Liu Y, Song Y, Hu X, Yan L, Zhu X. Awareness of surgical smoke hazards and enhancement of surgical smoke prevention among the gynaecologists. J Cancer. 2019 Jun 2;10(12):2788-2799. doi: 10.7150/jca.31464.
11. Bree K, Barnhill S, Rundell W. The Dangers of Electrosurgical Smoke to Operating Room Personnel: A Review. Workplace Health Saf. 2017 Nov;65(11):517-526. doi: 10.1177/2165079917691063. Epub 2017 Apr 17.
12. Abbas A, Altaf S, Javeed F, Umerani MS, Rizvi SRK. Surgical Smoke – Do we know enough about it ? Jornalul de Chirugie
2020;16:1-4.
13. Thamboo A, Lea J, Sommer DD, Sowerby L, Abdalkhani A, Diamond C, Ham J, Heffernan A, Cai Long M, Phulka J, Wu YQ, Yeung P, Lammers M. Clinical evidence based review and recommendations of aerosol generating medical procedures
in otolaryngology - head and neck surgery during the COVID-19 pandemic. J Otolaryngol Head Neck Surg. 2020 May 6;49(1):28. doi: 10.1186/s40463-020-00425-6.
14. Kirschbaum S, Hommel H, Strache P, Horn R, Falk R, Perka C. Laminar air flow reduces particle load in TKA-even outside
the LAF panel: a prospective, randomized cohort study. Knee Surg Sports Traumatol Arthrosc. 2021 Nov;29(11):3641- 3647. doi: 10.1007/s00167-020-06344-3. Epub 2020 Nov 9.
15. Mowbray NG, Ansell J, Horwood J, Cornish J, Rizkallah P, Parker A, Wall P, Spinelli A, Torkington J. Safe management of surgical smoke in the age of COVID-19. Br J Surg. 2020 Oct;107(11):1406-1413. doi: 10.1002/bjs.11679. Epub 2020 May 3
16. Steege AL, Boiano JM, Sweeney MH. Second hand smoke in the operating room? Precautionary practices lacking for surgical
smoke. Am J Ind Med. 2016 Nov;59(11):1020-1031. doi: 10.1002/ajim.22614. Epub 2016 Jun 10.
17. Mani G, Surgical smoke: A silent hazard in healthcare. Al Ameen J Med Sci 2020;13(4): 309-312.
Published
2022-03-04
How to Cite
Kaushik Bhattacharya, Neela Bhattacharya. (2022). Surgical Smoke – An Occupational Hazard for the Surgeons. The Indian Practitioner, 75(2), 23-25. Retrieved from https://articles.theindianpractitioner.com/index.php/tip/article/view/1314
Section
Special Article
