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Improving the Health of Perioperative Nurses by Eliminating Surgical Smoke
Surgical smoke is a serious occupational hazard for perioperative nurses and other health care workers who are exposed to it during surgical procedures. Surgical smoke is the aerosolized by-product of tissue vaporization by various energy-generating devices, such as electrosurgical units, lasers, and ultrasonic scalpels. It contains toxic chemicals, carcinogens, viruses, bacteria, and nanoparticles that can cause acute and chronic health effects, such as eye irritation, respiratory problems, headaches, nausea, and cancer (Munro et al., 2019).
The Occupational Safety and Health Administration (OSHA) estimates that about 500,000 workers are exposed to surgical smoke each year in the United States. However, there are no specific regulations or standards for controlling surgical smoke exposure in health care settings. The current recommendations from professional organizations, such as the Association of periOperative Registered Nurses (AORN), the American National Standards Institute (ANSI), and the National Institute for Occupational Safety and Health (NIOSH), are based on voluntary guidelines and best practices that are not widely implemented or enforced (Alp et al., 2018).
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Therefore, there is an urgent need for legislative and regulatory actions to protect perioperative nurses and other health care workers from surgical smoke exposure. Several states have introduced or passed bills that require the use of smoke evacuation systems in operating rooms, such as California, Colorado, Rhode Island, and Kentucky. These systems consist of a suction device that captures the surgical smoke at its source and a filter that removes the harmful contaminants before releasing the air. Smoke evacuation systems have been shown to be effective in reducing surgical smoke exposure and improving air quality in operating rooms (Bigony et al., 2007).
However, there are still barriers to the widespread adoption of smoke evacuation systems, such as cost, availability, training, maintenance, and compliance. Perioperative nurses play a key role in advocating for the elimination of surgical smoke by raising awareness of its hazards, educating their colleagues and patients, participating in research and policy making, and using smoke evacuation systems consistently and correctly. Perioperative nurses can also join the Go Clear initiative, a program launched by AORN in 2017 that provides resources and support for health care facilities to become smoke-free (AORN, 2021).
By eliminating surgical smoke, perioperative nurses can improve their own health and safety, as well as the health and safety of their co-workers and patients. Surgical smoke is a preventable risk that should not be tolerated in the modern health care environment. Perioperative nurses have the power and the responsibility to make a difference by eliminating surgical smoke.
References
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AORN (2021). Go Clear: Eliminate Surgical Smoke. Retrieved from https://www.aorn.org/education/staff-development/go-clear-award-program
Alp E., Cakir O., Cevahir F., Goktas U., & Kose R. (2018). Surgical smoke: Risks assessment and mitigation strategies. Journal of Perioperative Practice, 28(5), 127-134.
Bigony L., Brull S., & Wainwright M. (2007). Surgical plume: A review of the literature and standards relevant to occupational exposure. AANA Journal, 75(5), 377-383.
Munro M.G., Storz K., Abbott J.A., Brölmann H., Carmona F., Fraser I.S., … & Wagenfeld A. (2019). The impact of surgical plume on the health of operating room personnel: A systematic review. Surgical Endoscopy, 33(10), 3323-3331.