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Surgical Smoke FAQs

Does OSHA mandate the evacuation of surgical smoke?

The Occupational Safety and Health Administration (OSHA) does not have a specific standard that requires the evacuation of surgical smoke. Under the General Duty Clause, Section 5(a)(1) of the Occupational Safety and Health Act of 1970, employers are required to provide their employees with a place of employment that is “free from recognizable hazards that are causing or likely to cause death or serious harm to employees.”

Does the CDC/NIOSH recommend smoke evacuation?

A study by the National Institute for Occupational Safety and Health (NIOSH), which was presented November 3, 2015 at the American Public Health Association’s annual meeting, found healthcare workers continue to be exposed to hazardous surgical smoke despite the existence of evidence-based practices and recommended controls available to protect them.

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.

Which states have laws and regulations?

Rhode Island: Effective January 2019

R.I. Gen. Laws, 23-17-49.1(b),(c): In order to protect patient and health workers from the hazards of surgical smoke, each hospital and freestanding ambulatory surgical facility licensed in the state of Rhode Island pursuant to this chapter shall adopt policies to ensure the elimination of surgical smoke by use of a smoke evacuation system for each procedure that generates surgical smoke from the use of energy-based devices such as but not limited to electrosurgery and lasers.

Each hospital and freestanding ambulatory surgical center shall report to the department of health within ninety days (90) of the effective date of this act that policies pursuant to this section have been adopted.