1. Know the risks
The long-term effects of exposure to surgical smoke may not be fully
understood yet, but the list of potential hazards contained in plume
reads like a sign at a toxic waste site. There's benzene, for example,
which can cause anemia by suppressing the production of red blood
cells, and which can also damage the immune system by altering
blood levels of antibodies. There's hydrogen cyanide, which is poten-
tially deadly, because it prevents cells from properly absorbing oxy-
gen. There's also formaldehyde, which can cause a whole host of
problems, including nasal and eye irritation, sore throats, nosebleeds,
neurological effects and an increased risk of asthma.
Those are just a few of the concerns. Smoke particles travel fast —
up to 40 mph. When electrosurgical units are activated, the concentra-
tion of particles can quickly increase from 60,000 particles per cubic
foot to more than 1 million particles per cubic foot. It takes another
20 minutes for levels to return to normal.
It's believed that inhaling the smoke caused by cauterizing 1 gram
of tissue is like smoking 6 cigarettes in 15 minutes. Carbon dioxide
lasers, often used to treat skin conditions, are only about half that
toxic, but how do you think your health would be affected if several
times a day you smoked 3 cigarettes in a 15-minute period?
Physicians may only be exposed while they're performing a given
procedure, but OR staff can be exposed for 8 to 10 hours a day. When
we see surgical professionals having respiratory problems, headaches,
bronchitis, eye irritations, fatigue and other maladies, we can't be sure
their problems are caused by surgical smoke, but we can be pretty
darned sure that the exposure isn't helping.
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