| Title: | Electrocautery smoke exposure and efficacy of smoke evacuation systems in minimally invasive and open surgery: a prospective randomized study |
| Author(s): | Kocher GJ; Koss AR; Groessl M; Schefold JC; Luedi MM; Quapp C; Dorn P; Lutz J; Cappellin L; Hutterli M; Lopez-Hilfiker FD; Al-Hurani M; Sesia SB; |
| Address: | "Division of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland. gregor.kocher@hin.ch. Tofwerk AG, Thun, Switzerland. Department of Nephrology and Hypertension and Department of BioMedical Research, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Department of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Division of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland. Department of General and Special Surgery, Faculty of Medicine, The Hashemite University, Zarqa, Jordan" |
| DOI: | 10.1038/s41598-022-08970-y |
| ISSN/ISBN: | 2045-2322 (Electronic) 2045-2322 (Linking) |
| Abstract: | "Worldwide, health care professionals working in operating rooms (ORs) are exposed to electrocautery smoke on a daily basis. Aims of this study were to determine composition and concentrations of electrocautery smoke in the OR using mass spectrometry. Prospective observational study at a tertiary care academic center, involving 122 surgical procedures of which 84 were 1:1 computer randomized to smoke evacuation system (SES) versus no SES use. Irritating, toxic, carcinogenic and mutagenic VOCs were observed in OR air, with some exceeding permissible exposure limits (OSHA/NIOSH). Mean total concentration of harmful compounds was 272.69 ppb (+/- 189 ppb) with a maximum total concentration of harmful substances of 8991 ppb (at surgeon level, no SES). Maximum total VOC concentrations were 1.6 +/- 1.2 ppm (minimally-invasive surgery) and 2.1 +/- 1.5 ppm (open surgery), and total maximum VOC concentrations were 1.8 +/- 1.3 ppm at the OR table 'at surgeon level' and 1.4 +/- 1.0 ppm 'in OR room air' away from the operating table. Neither difference was statistically significant. In open surgery, SES significantly reduced maximum concentrations of specific VOCs at surgeon level, including aromatics and aldehydes. Our data indicate relevant exposure of health care professionals to volatile organic compounds in the OR. Surgical technique and distance to cautery devices did not significantly reduce exposure. SES reduced exposure to specific harmful VOC's during open surgery.Trial Registration Number: NCT03924206 (clinicaltrials.gov)" |
| Keywords: | Carcinogens/analysis Electrocoagulation/methods *Occupational Exposure/analysis Operating Rooms Prospective Studies *Volatile Organic Compounds/analysis; |
| Notes: | "MedlineKocher, Gregor J Koss, Abigail R Groessl, Michael Schefold, Joerg C Luedi, Markus M Quapp, Christopher Dorn, Patrick Lutz, Jon Cappellin, Luca Hutterli, Manuel Lopez-Hilfiker, Felipe D Al-Hurani, Mohammad Sesia, Sergio B eng Observational Study Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2022/03/25 Sci Rep. 2022 Mar 23; 12(1):4941. doi: 10.1038/s41598-022-08970-y" |
