This presentation will be available to view as a discussion poster at the 7th International Conference on the Science of Exposure Assessment - X2012.
It will be presented on 04 July 2012 from 09.30 – 11.45 am followed by a chaired discussion of all posters in this session on Chemicals in the Workplace.
Appointments with the authors are available to book at https://x2012discussionposters.acuityscheduling.com
Udo Eickmann - Surgical Smoke - Hazards and Protective Measures
1. X2012: 7th International Conference
on the Science on Exposure Assessment, 2-5 July 2012, Edinburgh
Surgical Smoke –
Hazards and Protective Measures
Udo Eickmann, ISSA, Hamburg, Germany
Inga Fokuhl, BGW, Hamburg, Germany
Martine Bloch, Michel Falcy, INRS, Paris, France
Brigitte Merz, Martin Rüegger, Suva, Lucerne, Switzerland
Contact: Udo.Eickmann@bgw-online.de
2. www.bgw-online.de
Problem:
Some surgical procedures emit Critical multi-substance mixtures
smoke: constitute smoke:
o electro-surgical instruments
-> gaseous, vaporous, particulate,
(e.g. electrocautery)
-> with cmr properties,
o surgical lasers
-> possibly biologically active,
o special activities such as the
removal of bone cement in -> nauseating odour
revision endoprosthetics Recommended measures are the
subject of controversy
3. www.bgw-online.de
Aim of the work
• To create an international consensus
(CH, F, D) within the “Hazardous
Substances” working group of the
Healthcare ISSA Section.
• To describe the composition and
effect of surgical smoke.
• To describe and analyse the
exposure occurring.
• To determine the current knowledge
status on the risks.
www.issa.int/About-ISSA/Prevention-
• To describe the recommended safety Sections/Section-on-Prevention-of-Occupational-
Risks-in-Health-Services
measures.
4. www.bgw-online.de
Surgical smoke: effects on health
• Irritation of the respiratory passages (animal tests)
• Mutagenic effect in the Ames test
• Effects on humans:
o individual infections (papillomatosis), recognised as “occupational”,
o increased frequency of warts in surgical dermatologists (USA, 1995)
o non-specific symptoms (irritation of the respiratory tract and eyes,
headaches)
o highly unpleasant odours
o no epidemiological evidence of (bronchial) carcinoma
5. www.bgw-online.de
Safety measures
• Based on analysis of published recommendations (e.g. Ball (2001,
2005); Barrett (2003); Frenette (2003); NIOSH (1999); TRGS 525 (1998))
• Local extraction of surgical smoke (Priority 1)
o surgical extraction systems with disposable filter (small quantities)
o mobile smoke evacuators: (HEPA filter system, active carbon filter
only in special cases)
o modified holder with integrated suction nozzle
• Technical room ventilation: air-con system in compliance with national
requirements (in Germany: DIN 1946 Part 4)
• PPE: FFP2 masks during special surgical interventions
• No specific medical surveillance