Posted: April 30th, 2022

The Impacts of Surgical Smoke on the Surgical Staff

The Impacts of Surgical Smoke on the Surgical Staff

Surgical smoke is a visible plume of aerosolized combustion byproducts produced by heat-generating surgical instruments. It consists of water vapor and gaseous substances; can carry toxic chemicals such as benzene, toluene and hydrogen cyanide; bacteria, viruses, and tumors; can obscure the surgical field; and can be inhaled (Vortman et al., 2021). Surgical smoke poses a health risk to everyone in the operating room, especially the surgical staff who are exposed to it on a regular basis. In this blog post, we will discuss the potential impacts of surgical smoke on the health and safety of the surgical staff and the strategies to prevent or reduce them.

Health Risks of Surgical Smoke

According to the Occupational Safety and Health Association (OSHA), more than half a million health care workers are exposed to surgical smoke every year. Repeated exposure to the contents of surgical smoke may be cumulative and increases the possibility of developing adverse health effects (Alp et al., 2006). Some of the health risks associated with exposure to surgical smoke are:

– Respiratory problems: Surgical smoke can cause eye and upper respiratory tract irritation, coughing, wheezing, asthma, bronchitis, and sinusitis in health care personnel (CDC, 2020). The smoke can also contain viruses, such as human papilloma virus (HPV), that can infect the respiratory mucosa and potentially cause cancer (Guideline for Surgical Smoke Safety, 2017).
– Dermatological problems: Surgical smoke can cause skin irritation, dermatitis, and allergic reactions in health care personnel who come in contact with it. The smoke can also carry tumor cells that can implant on the skin and cause malignancies (Guideline for Surgical Smoke Safety, 2017).
– Neurological problems: Surgical smoke can cause headaches, nausea, dizziness, fatigue, and mood changes in health care personnel who inhale it. The smoke can also contain toxic chemicals, such as carbon monoxide, that can impair cognitive function and reduce oxygen delivery to the brain (Guideline for Surgical Smoke Safety, 2017).

Safety Risks of Surgical Smoke

Surgical smoke can also pose safety risks to the surgical staff by affecting their visibility, communication, and performance. Some of the safety risks associated with surgical smoke are:

– Reduced visibility: Surgical smoke can obscure the surgical field and impair the surgeon’s vision, especially during longer operations where cauterizing tools are heavily used. This can increase the risk of errors, complications, and injuries during surgery (CDC, 2020).
– Impaired communication: Surgical smoke can interfere with the verbal communication between the surgical team members by creating noise and reducing audibility. This can affect the coordination, collaboration, and efficiency of the surgical team and compromise patient safety (Guideline for Surgical Smoke Safety, 2017).
– Decreased performance: Surgical smoke can affect the performance of the surgical staff by causing discomfort, distraction, stress, and fatigue. The smoke can also reduce the quality of the surgical instruments by causing corrosion, damage, or malfunction (Guideline for Surgical Smoke Safety, 2017).

Strategies to Prevent or Reduce Surgical Smoke

The best way to prevent or reduce the impacts of surgical smoke on the surgical staff is to evacuate it from the operating room using appropriate devices and techniques. Some of the strategies to evacuate surgical smoke are:

– Use a local exhaust ventilation (LEV) system that captures the smoke at its source and filters it before releasing it into the environment. The LEV system should have a high-efficiency particulate air (HEPA) filter that can remove at least 99.97% of particles with a diameter of 0.3 micrometers or larger (Guideline for Surgical Smoke Safety, 2017).
– Use a wall suction system that connects to a disposable tubing and a nozzle that is placed near the surgical site. The wall suction system should have a flow rate of at least 25 cubic feet per minute (cfm) and a negative pressure of at least -100 mmHg to effectively remove the smoke (Guideline for Surgical Smoke Safety, 2017).
– Use a personal protective equipment (PPE) that protects the eyes, nose, mouth, and skin from exposure to surgical smoke. The PPE should include goggles or glasses, masks or respirators, gloves, gowns, and caps or hoods. The masks or respirators should have a filtration efficiency of at least 95% for particles with a diameter of 0.3 micrometers or larger (Guideline for Surgical Smoke Safety, 2017).

Conclusion

Surgical smoke is a hazardous byproduct of heat-generating surgical instruments that can affect the health and safety of the surgical staff. The potential impacts of surgical smoke include respiratory problems, dermatological problems, neurological problems, reduced visibility, impaired communication, and decreased performance. The best way to prevent or reduce these impacts is to evacuate surgical smoke from the operating room using appropriate devices and techniques. By doing so, the surgical staff can protect themselves and their patients from the harmful effects of surgical smoke.

Works Cited

Alp, E., Bijl, D., Bleichrodt, R. P., Hansson, B., & Voss, A. (2006). Surgical smoke and infection control. Journal of Hospital Infection, 62(1), 1-5.

CDC. (2020). Surgical Smoke Inhalation: Dangerous Consequences for the Surgical Team. Retrieved from https://blogs.cdc.gov/niosh-science-blog/2020/06/18/surgical-smoke/

Guideline for Surgical Smoke Safety. (2017). AORN Journal, 105(5), P11-P24.

Vortman, R., Ogg, M., & Alvarado, R. (2021). Defining Surgical Smoke: A Concept Analysis. AORN Journal, 113(1), 4-14.

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