RR922 - Evidence for exposure and harmful effects of diathermy plumes (surgical smoke) - Evidence based literature review

The methods used to dissect tissue and stem blood flow during surgery have changed as technology has developed. Lasers and electro-surgery have become commonplace, so that medical staff in the operating theatre are (potentially) increasingly exposed to the thermal decomposition products of tissues. Variations in ventilation systems and the presence or absence of local exhaust ventilation are likely to influence the extent to which this occurs. A systematic review was carried out to identify existing evidence about surgical smoke (known as diathermy plume) and the potential harm to health care workers exposed in operating theatres. Limited published data were identified, but indicated that dedicated smoke evacuation/extraction devices are effective at reducing the levels of surgical smoke during various surgical procedures, and that correct (close) positioning of smoke evacuation devices to source emissions is likely to be important to the efficiency of surgical smoke removal. The data were insufficient to allow conclusions to be drawn on reported respiratory ill health symptoms linked with surgical smoke exposure.

This report and the work it describes were funded by the Health and Safety Executive (HSE). Its contents, including any opinions and/or conclusions expressed, are those of the authors alone and do not necessarily reflect HSE policy.

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Updated 2021-04-23