The Surgical Smoke Problem

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 had been collecting signatures for its petition to OSHA, asking for uniform national standards regarding workplace exposure to surgical smoke. The petition was delivered during Perioperative Nurses Week (Nov. 14–20, 2021).

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.

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.

In this Article: Legislation and Public Policy, Workplace Safety