Research progress on harm and protection of surgical smoke on exposed population

Abstract

Abstract: The surgical smoke contains gaseous compounds （such as carbon monoxide,benzene,toluene,hydrogen cyanide,sevoflurane）,pathogens（such as human papillomavirus,human immunodeficiency virus,hepatitis B virus）,surviving cancer cells,blood debris,bacteria and other harmful substances,which are extremely harmful to the respiratory system,circulatory system,nervous system and other systems of the exposed population. However,due to the hidden nature of the harm,most surgical related medical personnel lack relevant knowledge and ignore the harm of surgical smoke to their health. The paper summarizes the harm of surgical smoke exposed people,smoke exhaust system in operating room,personal protection,smoke reduction,education of operating room staff and other protective measures and protection status,so as to provide reference for surgical related medical personnel and decision-makers.

Key words: Surgical smoke, Occupational exposure, Occupational hazards, Occupational protection, Research progress

CLC Number:

R181.3⁺1

LIU Aobo, ZHI Hui, SHAN Dandan, FAN Xiaowen, XU Li, SHANG Kun. Research progress on harm and protection of surgical smoke on exposed population. [J]OCCUPATION AND HEALTH, 2023, 39(16): 2291-2294.

References

[1] VORTMAN R,MCPHERSON S,CECILIA W M.State of the Science:A Concept Analysis of Surgical Smoke[J].Aorn J,2021,113(1):41-51.
[2] 周青. 美国对手术室烟雾的管理和防范[J].中华护理杂志,2013,48(12):1080-1082.
[3] 中华人民共和国国家统计局.中国统计年鉴[M].北京:中国统计出版社,2021:707-740.
[4] AORN.Guideline for surgical smoke safety[J].Aorn J,2016,104(4):10-12.
[5] 何妍明. 电刀烟雾的防范意识调查及相关危险因素分析[J].齐齐哈尔医学院学报,2016,37(8):1110-1111.
[6] TOMITA Y,MIHASHI S,NAGATA K,et al.Mutagenicity of smoke condensates induced by CO2-laser irradiation and electrocauterization[J].Mutat Res,1981,89(2):145-149.
[7] BARRETT W L,GARBER S M.Surgical smoke:a review of the literature.Is this just a lot of hot air?[J].Surg Endosc,2003,17(6):979-987.
[8] HILL D S,O'NEILL J K,POWELL R J,et al.Surgical smoke-a health hazard in the operating theatre:a study to quantify exposure and a survey of the use of smoke extractor systems in UK plastic surgery units[J].J Plast Reconstr Aesthet Surg,2012,65(7):911-916.
[9] 金哲君,王雪,瞿春华.手术烟雾对大鼠生理功能损害的实验研究[J].西部医学,2019,31(12):1837-1840.
[10] ALP E,BIJL D,BLEICHRODT R P,et al.Surgical smoke and infection control[J].J Hosp Infect,2006,62(1):1-5.
[11] BRÜSKE-HOHLFELD I,PREISSLER G,JAUCH K W,et al.Surgical smoke and ultrafine particles[J].J Occup Med Toxicol,2008(3):31.
[12] CANICOBA A,POVEDA V B.Surgical smoke and biological symptoms in healthcare professionals and patients:a systematic review[J].J Perianesth Nurs,2022,37(1):130-136.
[13] PRACTICE B O P H,DIVISION H A M.National academies of sciences E A M.health risks of indoor exposure to particulate matter:workshop summary[M].Washington(DC):National Academies Press (US),2016:59-67.
[14] BALL K.Compliance with surgical smoke evacuation guidelines:implications for practice[J].ORNAC J,2012,30(1):14-16,18-19,35-37.
[15] XIE W,DUMAS O,VARRASO R,et al.Association of occupational exposure to inhaled agents in operating rooms with incidence of chronic obstructive pulmonary disease among us female nurses[J].JAMA Netw Open,2021,4(9):e2125749.
[16] LING S H,VAN EEDEN S F.Particulate matter air pollution exposure:role in the development and exacerbation of chronic obstructive pulmonary disease[J].Int J Chron Obstruct Pulmon Dis,2009(4):233-243.
[17] BROOK R D,RAJAGOPALAN S,POPE C R,et al.Particulate matter air pollution and cardiovascular disease:An update to the scientific statement from the American Heart Association[J].Circulation,2010,121(21):2331-2378.
[18] HUI Y,YAN J.Effect of electrosurgery in the operating room on surgeons' blood indices:a simulation model and experiment on rabbits[J].J Int Med Res,2018,46(12):5245-5256.
[19] OBERDÖRSTER G,SHARP Z,ATUDOREI V,et al.Translocation of inhaled ultrafine particles to the brain[J].Inhal Toxicol,2004,16(6-7):437-445.
[20] ALLEN J L,OBERDORSTER G,MORRIS-SCHAFFER K,et al.Developmental neurotoxicity of inhaled ambient ultrafine particle air pollution: Parallels with neuropathological and behavioral features of autism and other neurodevelopmental disorders[J].Neurotoxicology,2017,59:140-154.
[21] STEFFEN M,GAIL D,SHUJUN L.An Assessment on ethanol-blended gasoline/diesel fuels on cancer risk and mortality[J].Int J Environ Res Public Health,2021,18(13):6930.
[22] YAN L,LIU Y,ZHANG J,et al.In vivo and in vitro study of the potential hazards of surgical smoke during cervical cancer treatment with an ultrasonic scalpel[J].Gynecol Oncol,2022,164(3):587-595.
[23] ZHOU Q,HU X,ZHOU J,et al.Human papillomavirus DNA in surgical smoke during cervical loop electrosurgical excision procedures and its impact on the surgeon[J].Cancer Manag Res,2019(11):3643-3654.
[24] HU X,ZHOU Q,YU J,et al.Prevalence of HPV infections in surgical smoke exposed gynecologists[J].Int Arch Occup Environ Health,2021,94(1):107-115.
[25] TSENG H S,LIU S P,UANG S N,et al.Cancer risk of incremental exposure to polycyclic aromatic hydrocarbons in electrocautery smoke for mastectomy personnel[J].World J Surg Oncol,2014(12):31.
[26] FAIZ A S,RHOADS G G,DEMISSIE K,et al.Does ambient air pollution trigger stillbirth?[J].Epidemiology,2013,24(4):538-544.
[27] VORTMAN R,MCPHERSON S,CECILIA W M.State of the science:a concept analysis of surgical smoke[J].AORN J,2021,113(1):41-51.
[28] MATTA I,LAGANÀ A S,GHABI E,et al.COVID-19 transmission in surgical smoke during laparoscopy and open surgery:a systematic review[J].Minim Invasive Ther Allied Technol,2022,31(5):690-697.
[29] 宋文娟,戴红霞,张石红.手术烟雾防护的研究进展[J].护士进修杂志,2004,19(9):839-842.
[30] 中华护理学会手术室护理专业委员会.手术室护理实践指南(2020年版)[M].北京:人民卫生出版社,2020:218-219.
[31] NIOSH.Control of smoke from laser/electric surgical procedures[EB/OL].(2014-06-06)[2021-01-21].https://www.cdc.gov/niosh/docs/hazardcontrol/hc11.html.
[32] FENCL J L.Guideline implementation:surgical smoke safety[J].AORN J,2017,105(5):488-497.
[33] LISA S.Back to basics:protection from surgical smoke:1.2 www.aornjournal.org/content/cme[J].AORN J,2018,108(1):24-32.
[34] V H,M K.Exposure of operating room surgical staff to surgical smoke under different ventilation schemes[J].Indoor Air,2022,32(1):e12947.
[35] A M,B I,S K,et al.Impact of surgical smoke on the surgical team and operating room nurses and its reduction strategies:a systematic review[J].Iran J Public Health,2022,51(1):27-36.
[36] CARBAJO-RODRÍGUEZ H,AGUAYO-ALBASINI J L,SORIA-ALEDO V,et al.Surgical smoke:risks and preventive measures[J].Cir Esp,2009,85(5):274-279.
[37] DALAL A J,MCLENNAN A S.Surgical smoke evacuation:a modification to improve efficiency and minimise potential health risk[J].Br J Oral Maxillofac Surg,2017,55(1):90-91.
[38] AORN.Guideline Summary:Surgical Smoke Safety[J].AORN J,2017,105(5):498-500.
[39] KISCH T,LIODAKI E,KRAEMER R,et al.Electrocautery devices with feedback mode and teflon-coated blades create less surgical smoke for a quality improvement in the operating theater[J].Medicine(Baltimore),2015,94(27):e1104.
[40] KOCHER G J,KOSS A R,GROESSL M,et al.Electrocautery smoke exposure and efficacy of smoke evacuation systems in minimally invasive and open surgery:a prospective randomized study[J].Sci Rep,2022,12(1):4941.
[41] 孙育红,张颖,支慧,等.手术室护理人员手术烟雾知识与防护行为的调查[J].中国护理管理,2022,22(4):529-533.
[42] 陶花,邱雪梅,熊真峰.手术室护士规避烟雾体验相关影响因素[J].国际护理学杂志,2022,41(4):604-607.
[43] 闻永,覃勤,毛艳,等.手术烟雾与感染风险及其控制的研究进展[J].职业与健康,2022,38(2):284-288.
[44] STEEGE A L,BOIANO J M,SWEENEY M H.Secondhand smoke in the operating room Precautionary practices lacking for surgical smoke[J]. Am J Ind Med,2016,59(11):1020-1031.
[45] CHAVIS S,WAGNER V,BECKER M,et al.Clearing the air about surgical smoke:an education program[J].AORN J,2016,103(3):289-296.
[46] 潘静. 手术烟雾对职业暴露人群健康影响的初步研究[D].广州:南方医科大学,2012.