The smoke plume from laser or electrosurgical equipment used in the operating room can contain toxic gases and vapors including benzene (71432), hydrogen-cyanide (74908), formaldehyde (50000), bioaerosols, dead and living cellular material, and viruses. Eye and lung irritation has been reported among health care workers exposed to these plumes during surgical procedures. Visual problems are also created for the surgeon. The smoke has unpleasant odors and has been shown to have mutagenic potential. General room ventilation is not sufficient to control these exposures. A combination of newly recommended ventilation techniques and work practices was recommended. Smoke evacuators and room suction systems were described. The smoke evacuators contained a suction unit, filter, hose, and an inlet nozzle. The smoke evacuator should have high efficiency in airborne particle reduction. 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 particulates or gases. Users must install appropriate filters in the line, insure that the line is cleared, and that filters are disposed of properly. In general the use of smoke evacuators is more effective than room suction systems. In order to effectively capture the airborne contaminants generated by these surgical devices, the smoke evacuator or room suction hose nozzle inlet must be within 2 inches of the surgical site. The smoke evacuator should be activated at all times when airborne particles are produced during all surgical or other procedures. Many commercially available smoke evacuator systems exist. Each of them must be regularly inspected and maintained to prevent possible leaks.
NIOSH-Author; Airborne-particles; Ventilation; Ventilation-equipment; Ventilation-systems; Exhaust-systems; Exhaust-ventilation; Work-practices; Worker-health; Smoke-control; Smoke-inhalation; Operating-rooms; Biohazards; Air-quality-monitoring; Indoor-air-pollution; Nurses; Health-care-personnel; Surgeons; Control-technology; Combustion-products; Indoor-environmental-quality