Nurses concerned about surgical smoke health risks

Theatre nurses and their colleagues are universally concerned about the risk surgical smoke plume poses to their health, a survey has found.

The poll heard from 955 perioperative practitioners in UK, 37% of whom were registered nurses, and almost all (90%) said they were worried about exposure to smoke plume at work.

Surgical smoke plume is produced when energy generating devices such as lasers are used in surgery to cut, coagulate, or vaporise tissue.

The plume contains smoke, toxins, bacteria and viruses, and if it not effectively removed, it leaves people like theatre nurses at risk of short-term and long-term illnesses.

Over three quarters (79%) of perioperative practitioners surveyed said their workplace has smoke plume evacuation equipment in place, but respondents added that it was only used in the minority of surgical procedures.

The findings are laid out in a report published by the Surgical Plume Alliance (SPA), a joint advocacy initiative between the Association for Perioperative Practice (AfPP) and the International Council on Surgical Plume (ICSP).

It was co-authored by Lindsay Keeley, a nurse and the patient safety and quality lead at AfPP, and Penny Smalley, director of education and regulatory affairs at ICSP.

Ms Keeley said: “This report provides evidence of what we’ve spoken out about for years. Exposure to surgical smoke plume is one of the most overlooked hazards in the operating theatre."

The report also called for consistent and accurate reporting mechanisms to allow staff to report any negative health symptoms associated with surgical smoke, which almost three quarters of respondents (72%) said they have experienced.

Only 12% of people who had experienced symptoms, such as headaches, coughing, eye irritation and shortness of breath, reported them and for the majority of those no action was taken.

The report has demanded a recognised, national training programme, as over half of respondents said they had not received any education on the hazards of exposure to surgical smoke plume.


Ms Keeley said: “We knew anecdotally that theatre staff continue to be concerned about this issue, that there was a lack of formalised training and policy, and that plume evacuation equipment was often available but in insufficient quantities and used infrequently. These findings provide the first-hand data to support that.”

She added that alongside the report, SPA published a position statement on the perioperative management of surgical smoke plume, “to minimise the risks, ensure a safe treatment environment for patients, and provide a safe and healthy workplace for the perioperative team”.

The statement included recommendations for organisations, including ensuring perioperative practitioners are protected from the hazards of smoke plume during every procedure where energy generating devices are used, and providing education to those entering theatres.

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