tor of regulatory compliance at the ASC at Barnet Dulaney Perkins Eye
Center in Phoenix, Ariz.
While many respondents are concerned about surgical smoke, sev-
eral say they don't have a good grip on what exactly makes it such a
problem. As one facility leader puts it, "What is aerosolized in the
smoke that is harmful?"
Surgical smoke is made up of 95% water and 5% other matter, stud-
ies say, but it's that 5% that is worrying. Several studies have shown
that there are toxic chemicals like benzene — which has been identi-
fied as a trigger for leukemia — as well as hydrogen cyanide, toluene,
perchloroethylene, formaldehyde, acrylonitrile and ethylbenzene.
Many of these components are carcinogenic and linked to respiratory
problems, says Dr. Ball.
Surgical smoke is also made up of the vaporized blood, fluids and
tissue of the patient. According to Dr. Ball, studies have shown that
HPV, HIV and hepatitis pathogens capable of transmitting the diseases
can be found in the smoke.
One director of perioperative services says that before her hospital
began evacuating smoke, she had a staff member who believed she
had contracted oral warts from laser plume. The manager also says
that staff would frequently say they felt nauseous after working on
procedures that produce a lot of smoke, like abdominoplasties and
breast cases. Many of the nurses who worked extensively on these
types of cases now complain of a chronic cough, she says. Although
she is careful to stress that she can't prove that the smoke was the
cause, she says it's easy to see how breathing in the contaminated
material and toxic chemicals could contribute to the lasting health
effects.
Many managers say they wish that workers would take the risks
more seriously. "Staff and surgeons are not as concerned about it as
they should be," says Susan Knerr, RN, MSN, CNOR, educator and
manager of perioperative services at St. Rita's Medical Center in Lima,
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | February 2015
