NIOSH Study Finds Healthcare Workers’ Exposure to Surgical Smoke Still Common

November 3, 2015
NIOSH Update:

Contact: Stephanie Stevens (202) 245-0641

Healthcare workers continue to be exposed to hazardous surgical smoke despite the existence of evidence-based practices and recommended controls available to protect them, according to a new study by the National Institute for Occupational Safety and Health (NIOSH) that will be presented November 3, 2015 at the American Public Health Association’s annual meeting in Chicago.

“OSHA estimates that one-half million healthcare workers are exposed to surgical smoke each year,” said Andrea Steege, PhD, NIOSH epidemiologist and study author. “We found that while guidelines have been available to protect these workers for over 20 years, they are not widely followed. It is important for employers and workers to understand the risks and take steps to put recommended controls into practice.”

Results of the study were derived from the 2011 Health and Safety Practices Survey of Healthcare Workers. More than 4,500 survey respondents who indicated exposure to surgical smoke, either during electrosurgery or laser surgery, were directed to a hazard module that asked about their practices related to control of surgical smoke. Findings indicated that only half of respondents reported that local exhaust ventilation (LEV), a widely recommended control, was always used during laser surgery and only 15% reported LEV was always used during electrosurgery.

The study also indicated that control of surgical smoke in workplaces may not be a priority. Nearly half of respondents reported that they had never received training on the hazards of surgical smoke and one-third said that LEV use was not part of their workplace’s protocol.

Exposure to surgical smoke can cause both acute and chronic health effects ranging from eye, nose and throat irritation to emphysema, asthma or chronic bronchitis. The smoke, which is a by-product of thermal destruction of tissue, may contain toxic gases and particulates in addition to viruses and bacteria.

NIOSH recommends general room ventilation in addition to LEV to control healthcare workers’ exposure to surgical smoke.

The Health and Safety Practices Survey of Healthcare Workers is the largest federally-sponsored survey of healthcare workers in the U.S. and addresses safety and health practices relative to use of hazardous chemicals. The anonymous, web-based survey included more than 12,000 healthcare workers. Using data obtained from this survey, NIOSH previously reported on healthcare workers who administer and compound antineoplastic drugs and found that recommended safe handling practices were lacking.

The findings from the survey are expected to help NIOSH, partners, employers, and healthcare workers better understand current health and safety practices relative to working with hazardous chemicals, identify gaps in current knowledge about those practices, and, in collaboration with partners, design further research for addressing those gaps.

NIOSH is the federal agency that conducts research and makes recommendations for preventing work-related injuries, illnesses, and deaths. To learn more about healthcare safety and health, visit: For more information about NIOSH visit