Assessment of the absorbed dose after exposure to surgical smoke in an operating room

Abstract Background No prospective evaluation of surgical smoke evacuation systems has yet been conducted anywhere in the world. A prospective randomized study was conducted to clarify the usefulness of a surgical smoke evacuation system in terms of reducing the quantity of environmental pollutants found in operating room air and reducing the occupational exposure of doctors and nurses involved in surgical procedures to surgical smoke, volatile organic compounds, formaldehyde, etc. Methods Operating room environment conditions with and without the use of a surgical smoke evacuation system were measured, and the personal exposure levels of doctors and nurses involved in surgical procedures were also surveyed. Use of the evacuation system was determined randomly, and the procedures involved were breast-conserving surgery and mastectomy, which were treated as stratification factors. Results The average total volatile organic compound concentration in the operating room was significantly lower when the evacuation system was used compared with when it was not used. The findings were similar for formaldehyde concentration. Multiple regression analysis for healthcare professionals’ personal exposure levels showed that the evacuation system was a factor that significantly impacted their formaldehyde and acetaldehyde personal exposure levels, which were greatly reduced by the use of the system. Conclusion This study’s findings demonstrate the effectiveness of the evacuation systems, which should increase awareness that their benefits take priority over the drawbacks.

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Potential hazards of surgical smoke in the operating room

The Journal of the American Association of Gynecologic Laparoscopists ◽

10.1016/s1074-3804(04)80314-1 ◽

2004 ◽

Vol 11 (3) ◽

pp. S20

Author(s):

WK Winer

Keyword(s):

Operating Room ◽

Surgical Smoke

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The Dangers of Electrosurgical Smoke to Operating Room Personnel: A Review

Workplace Health & Safety ◽

10.1177/2165079917691063 ◽

2017 ◽

Vol 65 (11) ◽

pp. 517-526 ◽

Cited By ~ 25

Author(s):

Kevin Bree ◽

Spencer Barnhill ◽

William Rundell

Keyword(s):

Operating Room ◽

Health Care Providers ◽

Responsibility To Protect ◽

Care Providers ◽

Operating Room Personnel ◽

Surgical Smoke ◽

The United Kingdom ◽

Smoke Evacuation ◽

Harmful Effects

A 2007 study in the United Kingdom showed that three of 98 surgeons surveyed admitted using dedicated smoke extractors; 72% of respondents believed inadequate precautions were in place to protect staff from the potential dangers of electrosurgical smoke. Surgical smoke contains harmful chemicals (e.g., hydrogen cyanide, acetylene, and butadiene) that can circumvent standard masks used in the operating room (OR). In addition, bacteria and viruses can be transmitted through this smoke. The topic of electrosurgical smoke is important to occupational health nurses not only because of their responsibility to protect workers, but also because they, like other health care providers, may be exposed to smoke routinely. The authors of this review recommend the regular use of smoke evacuation in ORs and avoidance of electrosurgery whenever possible to protect OR personnel from the potential long-term harmful effects of electrosurgical smoke.

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A Systems Approach to Assess Transport and Diffusion of Hazardous Airborne Particles in a Large Surgical Suite: Potential Impacts on Viral Airborne Transmission

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17155404 ◽

2020 ◽

Vol 17 (15) ◽

pp. 5404 ◽

Cited By ~ 1

Author(s):

Marc Garbey ◽

Guillaume Joerger ◽

Shannon Furr

Keyword(s):

Operating Room ◽

Systems Approach ◽

Airborne Particles ◽

Mathematical Framework ◽

Airborne Transmission ◽

Surgical Smoke ◽

Airborne Contamination ◽

Transport And Diffusion ◽

And Diffusion

Airborne transmission of viruses, such as the coronavirus 2 (SARS-CoV-2), in hospital systems are under debate: it has been shown that transmission of SARS-CoV-2 virus goes beyond droplet dynamics that is limited to 1 to 2 m, but it is unclear if the airborne viral load is significant enough to ensure transmission of the disease. Surgical smoke can act as a carrier for tissue particles, viruses, and bacteria. To quantify airborne transmission from a physical point of view, we consider surgical smoke produced by thermal destruction of tissue during the use of electrosurgical instruments as a marker of airborne particle diffusion-transportation. Surgical smoke plumes are also known to be dangerous for human health, especially to surgical staff who receive long-term exposure over the years. There are limited quantified metrics reported on long-term effects of surgical smoke on staff’s health. The purpose of this paper is to provide a mathematical framework and experimental protocol to assess the transport and diffusion of hazardous airborne particles in every large operating room suite. Measurements from a network of air quality sensors gathered during a clinical study provide validation for the main part of the model. Overall, the model estimates staff exposure to airborne contamination from surgical smoke and biological material. To address the clinical implication over a long period of time, the systems approach is built upon previous work on multi-scale modeling of surgical flow in a large operating room suite and takes into account human behavior factors.

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Minimizing operating room personnel exposure to surgical smoke with an easy and costless method

Aesthetic Plastic Surgery ◽

10.1007/s00266-021-02451-9 ◽

2021 ◽

Author(s):

Marco Borsetti ◽

Luca Patanè ◽

Silvia Germano ◽

Filippo Rivarossa ◽

Enrico Cavalieri

Keyword(s):

Operating Room ◽

Operating Room Personnel ◽

Surgical Smoke

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Aerosols, airflow, and airspace contamination during laparoscopy

British Journal of Surgery ◽

10.1093/bjs/znab114 ◽

2021 ◽

Author(s):

N Hardy ◽

J Dalli ◽

M F Khan ◽

K Nolan ◽

R A Cahill

Keyword(s):

Laparoscopic Surgery ◽

Real Time ◽

Operating Room ◽

Best Practice ◽

Occupational Hazard ◽

Surgical Smoke ◽

Operating Team ◽

Infectious Risk ◽

Surgical Teams

Lay summary Laparoscopic surgery has been undermined throughout the COVID-19 pandemic by concerns that it may generate an infectious risk to the operating team through aerosolization of peritoneal particles. There is anyway a need for increased awareness and understanding of the occupational hazard for surgical teams regarding unfiltered escape of pollutants generated by surgical smoke and other microbials. Here, the aerosol-generating nature of this access modality was confirmed through repeatable real-time methodology both qualitatively and quantitively to inform best practice and additional engineering solutions to optimize the operating room environment.

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Prospective Randomized Study Evaluating the Usefulness of a Surgical Smoke Evacuation System in Operating Rooms for Breast Surgery

10.21203/rs.2.20119/v3 ◽

2020 ◽

Author(s):

Yutaka Tokuda ◽

Takuho Okamura ◽

Miki Maruta ◽

Mutsuko Orita ◽

Miyuki Noguchi ◽

...

Keyword(s):

Operating Room ◽

Surgical Procedures ◽

Randomized Study ◽

Personal Exposure ◽

Prospective Randomized Study ◽

Surgical Smoke ◽

Volatile Organic ◽

Smoke Evacuation ◽

Exposure Levels ◽

Evacuation System

Abstract Background: No prospective evaluation of surgical smoke evacuation systems has yet been conducted anywhere in the world. A prospective randomized study was conducted to clarify the usefulness of a surgical smoke evacuation system in terms of reducing the quantity of environmental pollutants found in operating room air and reducing the occupational exposure of doctors and nurses involved in surgical procedures to surgical smoke, volatile organic compounds, formaldehyde, etc. Methods: Operating room environment conditions with and without the use of a surgical smoke evacuation system were measured, and the personal exposure levels of doctors and nurses involved in surgical procedures were also surveyed. Use of the evacuation system was determined randomly, and the procedures involved were breast-conserving surgery and mastectomy, which were treated as stratification factors. Results: The average total volatile organic compound concentration in the operating room was significantly lower when the evacuation system was used compared with when it was not used. The findings were similar for formaldehyde concentration. Multiple regression analysis for healthcare professionals’ personal exposure levels showed that the evacuation system was a factor that significantly impacted their formaldehyde and acetaldehyde personal exposure levels, which were greatly reduced by the use of the system. Conclusion: This study’s findings demonstrate the effectiveness of the evacuation systems, which should increase awareness that their benefits take priority over the drawbacks. Trial Registration: The study was conducted after explaining to participants that it was a study of operating room environments in which their participation was voluntary and obtaining their consent. The study was also approved by the Tokai University Hospital clinical research review committee (no. 5R-022) and registered with the UMIN registry　(UMIN000029092) on 13, September, 2017-　retrospectively registered, http://www.umin.ac.jp/ctr/UMIN000029092.

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