Is surgical smoke dangerous? Let’s look at the facts

Daniel Patrick Moynihan, noted American statesman and scholar, once famously said: “Everyone is entitled to his own opinion, but not his own facts.”  

In our industry, there are those who contend that existing research doesn’t support claims about the dangers of inhaling surgical plume. Some go further to say that because some advocacy and interest groups receive funding from surgical smoke equipment manufacturers, concerns about the health risks associated with surgical fumes are ipso facto spurious. 

Despite the fact that surgical smoke is known to contain toxic chemicals, viable bacteria, viruses, carcinogens and mutagenic substances, these naysayers dismiss the concerns of surgeons, nurses and surgical team members, scoffing that warnings of health risks are based on limited evidence and driven by self-serving motives.

Most people who have worked in ORs have experienced firsthand the effects of the noxious fumes and nauseating odors that hamper efficient surgical practice. And while it is certainly true that more and better evidence about the dangers of inhaling plume is needed, and larger, more up-to-date clinical research studies are warranted, those who reject the possibility that surgical smoke is harmful and disparage the research and development that has gone into minimizing its risk promote a cynical and disingenuous approach to the very real health danger of surgical smoke inhalation.

Should we deny the issue simply because there is more to learn about it? Or is a more balanced approach to continue to push to obtain more and better data so that we can advance the field of smoke evacuation and make evidence-based recommendations for safety improvements in the OR?

Practitioners who trust science and rely on evidence-based medicine should invite inquiry and seek to evaluate workplace safety issues in a balanced manner rather than merely bowing to naysayers who pervert what is known and impugn the motives of researchers and workplace safety advocates.

Clearly, there is a need to continue to make people undeniably aware of the hazards and best practices associated with surgical smoke. Surgical smoke evacuation is recognized as an increasingly critical issue in clinical settings. Advances in surgical smoke evacuation today are on par with significant past medical breakthroughs in areas of infection prevention, treatment methods, surgical education and standards, improved ways of collecting and processing blood, transplant technology, laparoscopic surgery, and other major developments in terms of improving OR safety, quality and clinical outcomes.

We have much yet to learn about the dangers of surgical smoke and the science of surgical smoke removal. The research and development work continues. In the meantime, we should remain laser-focused on promoting safety in the OR and helping to enlighten the medical community about the risks appurtenant to surgical smoke exposure.

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