HC11
During surgical procedures using a laser or electrosurgical unit, the thermal destruction of tissue creates a smoke byproduct. Research studies have confirmed that this smoke plume can contain toxic gases and vapors such as benzene, hydrogen cyanide, and formaldehyde, bioaerosols, dead and live cellular material (including blood fragments), and viruses. At high concentrations the smoke causes ocular and upper respiratory tract irritation in health care personnel, and creates visual problems for the surgeon. The smoke has unpleasant odors and has been shown to have mutagenic potential.
NIOSH research has shown airborne contaminants generated by these surgical devices can be effectively controlled. Two methods of control are recommended:
Smoke evacuators contain a suction unit (vacuum pump), filter, hose, and an inlet nozzle. The smoke evacuator should have high efficiency in airborne particle reduction and should be used in accordance with the manufacturer's recommendations to achieve maximum efficiency. A capture velocity of about 100 to 150 feet per minute at the inlet nozzle is generally recommended. It is also important to choose a filter that is effective in collecting the contaminants. A High Efficiency Particulate Air (HEPA) filter or equivalent is recommended for trapping particulates. Various filtering and cleaning processes also exist which remove or inactivate airborne gases and vapors. The various filters and absorbers used in smoke evacuators require monitoring and replacement on a regular basis and are considered a possible biohazard requiring proper disposal.
Room suction systems can pull at a much lower rate and were designed primarily to capture liquids rather than particulate or gases. If these systems are used to capture generated smoke, users must install appropriate filters in the line, insure that the line is cleared, and that filters are disposed properly. Generally speaking, the use of smoke evacuators are more effective than room suction systems to control the generated smoke from nonendoscopic laser/electric surgical procedures.
To obtain more information about controlling this hazard, or for
information on other occupational health and safety issues, call
the National Institute for Occupational Safety and Health (NIOSH)*
at:
The following reports on this topic are available free upon request from NIOSH:
The principal contributor to this HAZARD CONTROLS is C. Eugene Moss, Division of Surveillance, Hazard Evaluations and Field Studies. Assistance was provided by the Education and Information Division, NIOSH.
This document is in the public domain and may be freely copied or reprinted. NIOSH encourages all readers of this HAZARD CONTROLS to make it available to all interested employers and workers. |
DHHS (NIOSH) Publication No. 96-128