A new smoking gun: Smoke in the OR

Study finds smoke from tools in OR harmful to doctors, patients

LOUISVILLE, Ky. (WAVE) - Smoking is a pretty hot topic in the state of Kentucky.

It usually falls in the realm of smoking linked to tobacco use, but a new topic around smoke has captured the attention of medical teams in the bluegrass and around the country.

According to the Journal of Hospital Infection and the Center for Disease Control, surgical smoke plumes are affecting hundreds of thousands of surgeons, operating room (OR) staff and the patients for which they care.

Dr. Anthony Hedley, of the Hedley Orthopedic Institute in Arizona, is on a crusade to warn everyone about the danger of exposure to bovie smoke, or surgical smoke as it is often called.

“I want a warning for my colleagues,” Hedley proclaimed. “First of all, goes the warning and the warning needs to be heeded!”

After years of inhaling surgical smoke, Hedley received the devastating news he would need a life-saving double lung transplant after a diagnosis of idiopathic pulmonary disease. Doctors said it was caused by years in the OR breathing in the dangerous surgical smoke. Smoke he believes was generated by electrosurgical tools used in surgical procedures.

Nick Meginnis, who is now traveling the country for Styker Surgical and Medical Equipment displaying their E-SEP Smoke Evacuation Pencil, stresses, “85 percent of all surgeries across the country every year have some form of electrosurgery. And if there’s electrosurgery, then there’s hazardous smoke.”

Hedley believes the smoke was hazardous and harmful enough to almost end his life.

“I was diagnosed in 2013 with pulmonary fibrosis,” he said.

The disease caused his lung tissue to become thick and stiff, making it hard for his body to circulate oxygen.

“I was then put on a transplant list and the disease progressed fairly rapidly,” he explained.

Hedley received a double lung transplant in 2014. With more than 11,000 joint replacements under his belt, he calculated that would be 30,000 to 40,000 hours of exposure to smoke from electrosurgery.

“There are some nasty things that come out of that bovie smoke,” Hedley explained. “I looked a little deeper and found some pretty ugly things. Many of them, I do believe, could cause pulmonary fibrosis.”

The particles in the smoke, according to the Center for Diseases Control, contain toxic gases, vapors and particulates, viable and non-viable cellular material, viruses and bacteria.

Roughly 150 chemicals, including EPA priority pollutants, can be found in bovie smoke.

(Source: CDC)
(Source: CDC)

“There’s been some (studies) recently showing that surgical smoke or exposure to surgical smoke in the OR for one day could be equivalent to up to 27 to 30 unfiltered cigarettes,” Meginnis said.

Rhode Island became the first state to address the issue of surgical smoke with legislation mandating smoke evacuation in the OR. Colorado was quick to follow.

“We’re at the very beginning stages of how we used to feel about cigarette smoke,” Meginnis claimed. “People are starting to feel that way about surgical smoke.”

The National Institute for Occupational Safety and Health notes exposure to surgical smoke can cause both acute and chronic health problems. Burning one gram of tissue has the same effect as breathing in three to six cigarettes. They also believe that general room ventilation by itself is not adequate to clear contaminants at the source.

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