Nursing & Healthcare News

The Surgical Smoke Problem

AORN to petition OSHA for national standards

COVID-19 isn’t the only airborne threat facing hospital staffs: The smoke generated by modern surgical equipment remains a serious health hazard for both OR teams and patients.

Many Hazards, Few Rules

As a growing number of states adopt laws to protect healthcare workers and surgical patients from surgical smoke, the Association of periOperative Registered Nurses (AORN) is calling on the Occupational Safety and Health Administration (OSHA) to finally set federal standards for surgical smoke exposure.

OSHA first issued an alert on the dangers of surgical smoke more than 30 years ago, but the agency has never issued any formal rules, leaving states and individual hospitals to set their own standards.

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Five states now have laws requiring “smoke-free” operating rooms, and six other states are considering similar legislation. (The California Legislature passed such a bill in 2017, but it was vetoed by then-Governor Brown.)

AORN has been collecting signatures for its petition to OSHA, asking for uniform national standards regarding workplace exposure to surgical smoke. The petition will be delivered during Perioperative Nurses Week (Nov. 14–20).

Like a Pack and a Half of Cigarettes

Surgical smoke is generated when tissue is vaporized by a surgical laser or electrocautery knife. Ninety-five percent of the surgical plume is steam, but the vaporization process also creates hazardous chemicals, which can include carbon monoxide, formaldehyde, hydrogen cyanide and more.

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Being exposed to that smoke during a full shift in the OR carries health risks comparable to smoking 27 to 30 cigarettes — a pack and a half! The plume may also carry pathogens like bacteria and viruses, which in some cases could actually be transmitted to others in the operating room.

Because the hazardous particulate matter in surgical smoke is often extremely small, surgical masks are largely ineffective against it, and N95 respirators provide only limited protection.

AORN offers a free tool kit on managing the risks of surgical smoke, which you can find on the AORN website, www.aorn.org. AORN and Medtronic have also created the Go Clear Award program, which recognize facilities that make their ORs smoke-free.


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