1
|
Kahramansoy N. Surgical smoke: a matter of hygiene, toxicology, and occupational health. GMS HYGIENE AND INFECTION CONTROL 2024; 19:Doc14. [PMID: 38655124 PMCID: PMC11035985 DOI: 10.3205/dgkh000469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
The use of devices for tissue dissection and hemostasis during surgery is almost unavoidable. Electrically powered devices such as electrocautery, ultrasonic and laser units produce surgical smoke containing more than a thousand different products of combustion. These include large amounts of carcinogenic, mutagenic and potentially teratogenic noxae. The smoke contains particles that range widely in size, even as small as 0.007 µm. Most of the particles (90%) in electrocautery smoke are ≤6.27 µm in size, but surgical masks cannot filter particles smaller than 5 µm. In this situation, 95% of the smoke particles which pass through the mask reach deep into the respiratory tract and frequently cause various symptoms, such as headache, dizziness, nausea, eye and respiratory tract irritation, weakness, and abdominal pain in the acute period. The smoke can transport bacteria and viruses that are mostly between 0.02 µm and 3 µm in size and there is a risk of contamination. Among these viruses, SARS-CoV-2, influenza virus, HIV, HPV, HBV must be considered. The smoke may also carry malignant cells. The long-term effects of the surgical smoke are always ignored, because causality can hardly be clarified in individual cases. The quantity of the smoke changes with the technique of the surgeon, the room ventilation system, the characteristics of the power device used, the energy level at which it is set, and the characteristics of the tissue processed. The surgical team is highly exposed to the smoke, with the surgeon experiencing the highest exposure. However, the severity of exposure differs according to certain factors, e.g., ventilation by laminar or turbulent mixed airflow or smoke evacuation system. In any case, the surgical smoke must be removed from the operation area. The most effective method is to collect the smoke from the source through an aspiration system and to evacuate it outside. Awareness and legal regulations in terms of hygiene, toxicology, as well as occupational health and safety should increase.
Collapse
Affiliation(s)
- Nurettin Kahramansoy
- Department of Surgery, İzmir Bozyaka Education and Research Hospital, İzmir, Turkiye
| |
Collapse
|
2
|
LeDuc R, Eikani C, Dickens B, Schiff A, Brown N. Surgical smoke and the orthopedic surgeon: a non-systematic review of the hazards and strategies for mitigating risk. Arch Orthop Trauma Surg 2023; 143:6975-6981. [PMID: 37439949 DOI: 10.1007/s00402-023-04967-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/22/2023] [Indexed: 07/14/2023]
Abstract
INTRODUCTION Surgical smoke generated through the use of electrical surgical devices poses a risk to the surgeon, medical personnel in the operating room, and the patient by exposing them to environmentally hazardous particulate matter. Previous investigation has shown that surgical smoke leads to an increased risk of pulmonary conditions, circulatory disorders, and irritation of the eyes, nose, and throat. Transmission of infectious disease can occur through inhalation of viral particles, and the presence of carcinogens are also of major concern. The deleterious effects of surgical smoke are well documented in several subspecialties, namely dermatology and general surgery, but there has been little discussion on the topic amongst orthopedic surgeons. METHODS A non-systematic review of the literature was completed with the aim of identifying the major categories of adverse health effects associated with surgical smoke inhalation and offering recommendations to reduce these hazards in the orthopedic surgical community. RESULTS Three primary categories of risk associated with surgical smoke inhalation were identified: inflammation, viral/bacterial transmission, and carcinogenicity. In addition, strategies for mitigating risk and best practice recommendations were explored. CONCLUSION Surgical smoke is an under-recognized occupational hazard within the orthopedic surgery literature. There are several strategies which can be employed to reduce risk. Further investigation is needed to understand the long-term impact of these risks, as well as what can be done to improve the practicality and compliance with protective measures.
Collapse
Affiliation(s)
- Ryan LeDuc
- Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, 2160 S 1St Ave, Suite 1700, Maywood, IL, 60153, USA.
| | - Carlo Eikani
- Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, 2160 S 1St Ave, Suite 1700, Maywood, IL, 60153, USA
| | - Brooke Dickens
- Department of Orthopaedic Surgery, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA
| | - Adam Schiff
- Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, 2160 S 1St Ave, Suite 1700, Maywood, IL, 60153, USA
| | - Nicholas Brown
- Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, 2160 S 1St Ave, Suite 1700, Maywood, IL, 60153, USA
| |
Collapse
|
3
|
Fereidouni A, Teymoori E, Maleki Z, Ghanavati M, Vizeshfar F. Relationships Between Job Satisfaction of Operating Room Nurses and Hospital's Compliance With Protective Guidelines During the Covid-19 Pandemic: A Cross-Sectional Study, Iran. J Perianesth Nurs 2023; 38:51-57. [PMID: 35752524 PMCID: PMC9058135 DOI: 10.1016/j.jopan.2022.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 03/24/2022] [Accepted: 03/27/2022] [Indexed: 01/28/2023]
Abstract
PURPOSE The Covid-19 pandemic is considered the biggest threat to human health in the recent century. During emergency surgeries, the possibility of infection of members of the surgical team with Covid-19 increases due to the direct contact with patients. The present study has been conducted aimed to investigate the relationships between job satisfaction of operating room nurses and the hospital's compliance with protective guidelines (guidance) during Covid-19 pandemic from the perspective of operating room nurses. DESIGN This was a descriptive and cross-sectional study conducted from September 22, 2020 to April 21, 2021. METHODS This study was conducted on 926 nurses working in operating rooms in 15 metropolises of Iran. The sampling method in this study was multistage clustering. The questionnaire was sent to the target group through social apps (WhatsApp and Telegram). The collected data were analyzed by SPSS software version 26 using descriptive and analytical statistics. FINDINGS The mean age and job satisfaction of the participants were 28.81 ± 5.64 years and 51.15 ± 11.45, respectively. Participants (n = 259; 27.97%) reported very good job satisfaction. Also, the mean hospital's compliance with protective guidelines during Covid-19 pandemic from the perspective of operating room nurses was 42.29 ± 7.11. The results of the present study showed a significant relationship between job satisfaction and hospital's compliance with protective guidelines during Covid-19 pandemic (P-value ≤ .001). CONCLUSIONS Optimization of infrastructure, improvement of management decisions and increasing human resources in a crisis can affect the quality of performance and job satisfaction of operating room nurses. The researchers suggest that health system managers can contribute to the safety and efficiency of the existing human resources by taking measures to increase job satisfaction.
Collapse
Affiliation(s)
- Armin Fereidouni
- Department of Operating Room Technology, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran,Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Esmaeil Teymoori
- Department of Operating Room Technology, Faculty of Paramedical Sciences, AJA University of Medical Sciences, Tehran, Iran
| | - Zahra Maleki
- Department of Epidemiology, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Ghanavati
- Department of Nursing, School of Nursing and Midwifery, Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Vizeshfar
- Associate Professor, Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
4
|
Canicoba ARB. Surgical smoke and occupational health. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1303. [PMID: 36660725 PMCID: PMC9843373 DOI: 10.21037/atm-22-5631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
|
5
|
The effect of plastic tape seal to reduce face seal leak in respirator N-95 type 1860. Ann Med Surg (Lond) 2022; 81:104287. [PMID: 35966406 PMCID: PMC9364724 DOI: 10.1016/j.amsu.2022.104287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 11/21/2022] Open
Abstract
The risk of face seal leak while using N-95 respirators is experienced by health workers and thus failing fit test are quite common. Finding solutions to overcome face seal leaks is crucial; one of which is by sealing the N-95 respirator. The seal used in this research was Tegaderm® a transparent film dressing or a plastic tape which is known to have the advantages of strong adhesion, high level of pore density and standardized medical grade. This study tries to determine the effectiveness of plastic tape adhesive on the N-95 type 1860 respirator in overcoming face seal leak qualitative fit test using Bitrex immediately after being worn and after 4 h of using it. The study used a quantitative approach with an incidence study design conducted pre and post experimental without comparison to see the effectiveness of plastic tape sealing. The subjects for the research were 81 health workers in the CMH environment who were at risk of being exposed to COVID-19. The study found a significant difference in the Bitrex fit test immediately after sealing the N-95 type 1860 respirator with plastic tape; 100% passed the fit test immediately after sealing, and 64.2% passed the fit test after 4 h of working. The effectiveness of sealing using plastic tape is considered to be quite good to overcome face seal leak on the N-95 type 1860 respirator. Health care workers need to be more vigilance to ensure better face seal. There is an increase need of protection against aerosol born disease (COVID-19). Disruption in face seal when using respirator increases exposure. Utilisation of plastic tape eliminate face seal leak while using N-95 respirator.
Collapse
|
6
|
Heroor AA, Asaf BB, Deo SSV, Lau EHL, Mok CW, DiPasco PJ, Jain P, Anand U. Occupational Hazards of Surgical Smoke and Achieving a Smoke Free Operating Room Environment: Asia-Pacific Consensus Statement on Practice Recommendations. Front Public Health 2022; 10:899171. [PMID: 35692344 PMCID: PMC9178078 DOI: 10.3389/fpubh.2022.899171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/13/2022] [Indexed: 11/20/2022] Open
Abstract
Background Surgical smoke generated through energy devices may present detrimental effects on individuals present in the operating room (OR). Despite the concerns possibly associated with surgical smoke, there may be no mandatory policies that suggest protective measures and limited firm standards are committed yet to address the same. Aim The aim of this paper is to present recommendations for surgeons and OR personnel by taking a consensus approach based on available literature and its interpretation by a multi-national panel of experts. Methods The Asia-Pacific (APAC) group was established with the aims of reviewing literature evidence, discussing key issues regarding surgical smoke and its hazards, and offering a summary of statements in achieving a smoke-free OR environment. Eleven expert surgeons from the international APAC region were gathered with the purpose of coming to a consensus on engineering, best work-practices, and administrative controls in minimizing surgical smoke exposure. A two-phase consensus method was used to obtain opinions from the expert panel of specialists. Statements with an agreement of more than 80% were accepted. Findings For twenty-one statements, the panel achieved consensus on 17 statements; another 5 were dropped due to lack of consensus. The consensus was obtained on statements that address the need for the implementation of administrative policies, training and awareness, standard procedure for the continued use of engineering controls, stringent work practice controls and preventive controls. Conclusion The statements presented may guide surgeons and OR personnel in the practical management of surgical smoke safety, mitigating the risks associated with it. The consensus statement also provides a series of recommendations that can be used with other stakeholders, such as policymakers, hospital administrators and professional societies, to highlight and motivate the implementation of meaningful policies.
Collapse
Affiliation(s)
| | - Belal Bin Asaf
- Institute of Chest Surgery, Chest Onco Surgery and Lung Transplantation, Medanta-The Medicity, Gurugram, India
| | | | - Eric Hui-Lun Lau
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Chi Wei Mok
- Division of Breast Surgery, Department of Surgery, Changi General Hospital, Singapore, Singapore
- Singhealth Duke-NUS Breast Centre, Singapore, Singapore
| | | | - Pradeep Jain
- Gastro-Intestinal Oncosurgery, Fortis Hospitals, New Delhi, India
| | - Utpal Anand
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, India
| |
Collapse
|
7
|
Yu CL, Hsieh SI, Lin LH, Chi SF, Huang TH, Yeh SL, Wang C. Factors Associated with Surgical Smoke Self-Protection Behavior of Operating Room Nurses. Healthcare (Basel) 2022; 10:healthcare10050965. [PMID: 35628101 PMCID: PMC9141096 DOI: 10.3390/healthcare10050965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 12/04/2022] Open
Abstract
Surgical smoke has been proven to be harmful and carcinogenic to humans as well as increasing the risk of acquiring infectious diseases. The operating room nurses' willingness to use protective equipment against surgical smoke was low. The factors associated with personal protective behavior in the operating room against surgical smoke were sparsely explored. The purpose of this study is to determine factors associated with surgical smoke self-protection behavior of the operating room nurses. This was a descriptive correlational study using a convenience sample from a medical center in northern Taiwan. The self-designed questionnaires included personal characteristics and perceived attributes. The data were analyzed by descriptive and linear regression. Attendance at in-service education with regard to surgical smoke, the attitude to surgical smoke, and surgical smoke self-protection barriers were significant factors found in multivariate linear regression after controlling the covariates. The overall model was significant and accounted for 14.2% of variances. In summary, attending in-service education, attitude and barriers in executing self-protective behaviors were significant factors. It is important to promote operating room nurses' health through providing correct surgical smoke knowledge, self-protection strategies to improve attitudes toward surgical smoke, improving the hospital's environment by adding surgical smoke evacuation equipment, and standardizing the operating procedures.
Collapse
Affiliation(s)
- Ching-Lan Yu
- Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Chang Gung University of Science and Technology, Taoyuan City 33378, Taiwan; (C.-L.Y.); (L.-H.L.); (S.-F.C.); (S.-L.Y.)
| | - Suh-Ing Hsieh
- Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Chang Gung University of Science and Technology, Taoyuan City 33378, Taiwan; (C.-L.Y.); (L.-H.L.); (S.-F.C.); (S.-L.Y.)
- Correspondence: ; Tel.: +886-3-2118999 (ext. 3423)
| | - Li-Hung Lin
- Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Chang Gung University of Science and Technology, Taoyuan City 33378, Taiwan; (C.-L.Y.); (L.-H.L.); (S.-F.C.); (S.-L.Y.)
| | - Shu-Fen Chi
- Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Chang Gung University of Science and Technology, Taoyuan City 33378, Taiwan; (C.-L.Y.); (L.-H.L.); (S.-F.C.); (S.-L.Y.)
| | - Tzu-Hsin Huang
- Taiwan Union of Nurses Association, Taipei City 103, Taiwan;
| | - Shu-Ling Yeh
- Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Chang Gung University of Science and Technology, Taoyuan City 33378, Taiwan; (C.-L.Y.); (L.-H.L.); (S.-F.C.); (S.-L.Y.)
| | - Chi Wang
- Department of Nursing, Linkou Chang Gung Memorial Hospital, School of Nursing, Chang Gung University, Taoyuan City 33305, Taiwan;
| |
Collapse
|
8
|
Tanaka Y, Sawakami K, Shoji H, Segawa H, Ishikawa S, Kameyama H, Ohashi M, Watanabe K, Kawashima H. Dynamics of surgical smoke in the operating room during spinal surgery: Comparison of particulate matter 2.5-air concentration between the electric scalpel with and without a smoke evacuation pencil: A cross-sectional study. J Orthop Sci 2022:S0949-2658(22)00114-2. [PMID: 35585006 DOI: 10.1016/j.jos.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/28/2022] [Accepted: 04/19/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Surgical smoke is a vaporous by-product generated during tissue incision and cauterization with an electric scalpel. This smoke contains tissue- and blood/vascular-derived substances, bacteria, viruses, and chemical substances. Among them, it contains many fine particles called particulate matter (PM) 2.5, which are harmful and hazardous to the human body. We aimed to investigate the occurrence of PM2.5 in surgical smoke produced during spinal surgery and to evaluate the efficacy of an electric scalpel with a smoke evacuation pencil. METHODS In this retrospective observational study, 89 patients who underwent spinal surgery between June 2019 and May 2021 were included. A dust monitor was installed in the operating room to measure the PM2.5 air concentration during the surgery. During each surgery, the total amount of PM2.5, the maximum PM2.5 air concentration, the exposure time to PM2.5, and the average value of PM2.5 air concentration from the start to the end of the surgery were calculated. RESULTS We found that in 29 of the 89 cases (32.6%), the air concentration of PM2.5 increased to a level that could cause health damage during the surgery. Twelve cases (13.4%) reached the level that could cause serious health damage, and 8 cases (9%) reached an emergency warning level. The total amount and the maximum and average levels of PM2.5 were significantly suppressed in the surgery with a smoke evacuation pencil group than in the surgery without a smoke evacuation pencil group. CONCLUSION We detected hazardous levels of PM2.5 in the air during spinal surgery, highlighting the importance of considering smoke control or reduction during spinal surgery. We recommend using an electric scalpel with a smoke evacuation pencil for regulating PM2.5 levels in the operating room.
Collapse
Affiliation(s)
- Yuki Tanaka
- Department of Orthopaedic Surgery, Niigata City General Hospital, Niigata, Japan.
| | - Kimihiko Sawakami
- Department of Orthopaedic Surgery, Niigata City General Hospital, Niigata, Japan
| | - Hirokazu Shoji
- Department of Orthopaedic Surgery, Niigata City General Hospital, Niigata, Japan
| | - Hiroyuki Segawa
- Department of Orthopaedic Surgery, Niigata City General Hospital, Niigata, Japan
| | - Seiichi Ishikawa
- Department of Orthopaedic Surgery, Niigata City General Hospital, Niigata, Japan
| | - Hitoshi Kameyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Masayuki Ohashi
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kei Watanabe
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Hiroyuki Kawashima
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| |
Collapse
|
9
|
Lotfi M, sheikhalipour Z, Zamanzadeh V, Aghazadeh A, Khordeforoush H, Rahmani P, akhuleh OZ. Attitude, preventive practice and perceived barriers among perioperative and anesthesia nurses toward surgical smoke hazards during the COVID-19 outbreak. PERIOPERATIVE CARE AND OPERATING ROOM MANAGEMENT 2022; 26:100234. [PMID: 34957337 PMCID: PMC8685536 DOI: 10.1016/j.pcorm.2021.100234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/28/2021] [Accepted: 12/11/2021] [Indexed: 11/23/2022]
Abstract
Background Surgical smoke (SS), which is produced by the use of high-temperature devices for cutting and coagulation of tissue during surgical procedures, is considered a serious threat to the health of operating room (OR) staff due to the presence of hazardous substances and possibility of transmitting various infections such as HPV, HIV, COVID-19 and so on. This study was conducted to determine the Attitude, preventive practice and perceived barriers among perioperative and anesthesia nurses toward surgical smoke hazards. Methods In this cross-sectional descriptive study, conducted at hospitals of Tabriz University of Medical Sciences (Iran) in 2021, 262 perioperative and anesthesia nurses were included by stratified random sampling. Data were collected using a demographic questionnaire and an SS questionnaire consisting of questions on attitude (17 item), practice (8 item), and barriers (13 item). Collected data were analyzed using SPSS16. Results The mean attitude and preventive practice scores (49.52 ± 12.36 and 15.8 ± 2.05, respectively) of the operating room nurses were reported at moderate and weak levels, respectively. There was a direct and significant relationship between attitude and practice scores (r = 0.129, P = 0.019). The main barriers to the prevention and dealing with the hazards of SS in ORs were reported in management (3.68 ± 1.06) and equipment (3.24 ± 0.66) dimensions, respectively. Conclusion It is recommended to adopt strategies to improve the attitude of OR staff regarding the preventive measures against surgical smoke hazards. Moreover, appropriate equipment and support of managers should be provided by explaining the policies and guidelines to prevent the complications of surgical smoke.
Collapse
|
10
|
Sinha D, Bhandary SK, Aroor R, Reddy R, Alva S. Effect of N-95 Mask on Oxygen Saturation Level in Health Care Workers and Their Experience While Using N-95 Mask. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2021. [DOI: 10.1055/s-0041-1740329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Background N-95 masks are in high demand during this COVID-19 pandemic but wearing an N-95 mask is a real challenge to the health workers during their duty hours. The present study aims to measure the effect of the N-95 mask on oxygen saturation level in the blood and the discomforts experienced while using it.
Materials and Methods Oxygen saturation was measured in 80 health care workers before and after wearing the N-95 mask continuously for more than 6 hours. The participants were asked to fill a questionnaire regarding various discomforts of N-95 mask usage, which consisted of 14 questions.
Results The most common discomfort was pain around the pinna followed by difficulty in breathing and fogging of spectacles or goggles. In addition, 71% of them had decreased oxygen saturation by 1%.
Conclusion N-95 mask can alter the oxygen saturation but it does not produce significant effects in healthy individuals. It can significantly affect patients with compromised airways.
Collapse
Affiliation(s)
- Devika Sinha
- Department of Otorhinolaryngology, KS Hegde Medical Academy, Nitte (Deemed to be) University, Mangalore, Karnataka, India
| | - Satheesh Kumar Bhandary
- Department of Otorhinolaryngology, KS Hegde Medical Academy, Nitte (Deemed to be) University, Mangalore, Karnataka, India
| | - Rajeshwary Aroor
- Department of Otorhinolaryngology, KS Hegde Medical Academy, Nitte (Deemed to be) University, Mangalore, Karnataka, India
| | - Rashmitha Reddy
- Department of Otorhinolaryngology, KS Hegde Medical Academy, Nitte (Deemed to be) University, Mangalore, Karnataka, India
| | - Shravan Alva
- Department of Otorhinolaryngology, KS Hegde Medical Academy, Nitte (Deemed to be) University, Mangalore, Karnataka, India
| |
Collapse
|
11
|
Canicoba ARB, Poveda VDB. Surgical Smoke and Biological Symptoms in Healthcare Professionals and Patients: A Systematic Review. J Perianesth Nurs 2021; 37:130-136. [PMID: 34802919 DOI: 10.1016/j.jopan.2021.06.106] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/16/2021] [Accepted: 06/18/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE This study aimed to identify the evidence in the scientific literature between exposure to surgical smoke and biological symptoms in healthcare professionals and patients. DESIGN A systematic review. METHODS Electronic databases were searched, including vivo observational and experimental studies published until August 2020 in Portuguese, English, Spanish and French. FINDINGS We identified 13 studies, with a predominance of cross-sectional (6; 46.15%), experimental laboratory (4; 30.76%) and cohort (3; 23.07%) studies. The main manifestations identified were related to respiratory tract and headache. There was identification of histopathological changes in the nasal mucosa of healthcare professionals and the presence of toxic substances from smoke identified in the urine of patients and healthcare professionals. CONCLUSION The scientific literature on the biological symptoms of surgical smoke is mainly composed of observational studies with a reduced sample size, thus constituting aspects which limit a broader and long-term understanding of the biological effects of surgical smoke exposure in healthcare professionals and patients.
Collapse
Affiliation(s)
| | - Vanessa de Brito Poveda
- School of Nursing, University of Sao Paulo, The Brazilian Centre of Evidence-based Healthcare: A JBI Centre of Excellence (JBI Brazil), São Paulo, Brazil
| |
Collapse
|
12
|
Do industrial N95 respirators meet the requirements to be used in healthcare? - A possible solution to respirator shortages during the next pandemic. Am J Infect Control 2021; 49:1194-1196. [PMID: 33774099 PMCID: PMC10068805 DOI: 10.1016/j.ajic.2021.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/19/2021] [Accepted: 03/19/2021] [Indexed: 11/22/2022]
Abstract
Shortages of surgical N95 respirators (surgical N95 FFRs) can occur during a pandemic. To understand if industrial N95 FFRs have FDA required fluid penetration resistance and flammability, five NIOSH approved N95 models were evaluated using the ASTM F1862 method and flammability using the 16 CFR 1610 method, respectively. Three models passed both fluid penetration resistance and flammability indicating that some N95 models on the market can be used as surgical N95 FFRs during a pandemic.
Collapse
|
13
|
Abdelwahab SF, Mohamed MK, Ali WY, Ali AS. Role of polymeric materials in preventing COVID-19 infection. Arch Virol 2021; 166:2487-2493. [PMID: 34231028 PMCID: PMC8260016 DOI: 10.1007/s00705-021-05151-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/06/2021] [Indexed: 02/05/2023]
Abstract
The safety of personal protective equipment (PPE) is very important, and so is the choice of materials used. The ability of electrostatic charges (ESCs) generated from the friction of engineered materials to attract or repel viruses has a significant impact on their applications. This study examined the ESCs generated on the surface of PPE used by healthcare workers to enhance their potential effectiveness in protecting the wearer from viruses. This is a crucial consideration for the newly emerged severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), which has a negative charge. The magnitudes and signs of generated ESCs on the surfaces of the PPE were determined experimentally using an Ultra Stable Surface DC Voltmeter. The high negative ESCs acquired by the polyethylene disposable cap and facemask are expected to repel negatively charged viruses and prevent them from adhering to the outer layer of the material. Also, the choice of polypropylene for facemasks and gowns is excellent because it is an aggressively negatively charged material in the triboelectric series. This property guarantees that facemasks and gowns can repel viruses from the wearer. However, the positive ESCs generated on latex glove surfaces are of great concern because they can attract negatively charged viruses and create a source of infection. In conclusion, it is necessary to ensure that PPE be made of materials whose surfaces develop a negative ESC to repel viruses, as well as to select polyethylene gloves.
Collapse
Affiliation(s)
- Sayed F Abdelwahab
- Department of Pharmaceutics and Industrial Pharmacy, Taif College of Pharmacy, Taif University, Al-Haweiah, P.O. Box 11099, Taif, 21944, Kingdom of Saudi Arabia.
| | - Mostafa K Mohamed
- Department of Production Engineering and Mechanical Design, Faculty of Engineering, Minia University, Minia, 61511, Egypt
| | - Waheed Y Ali
- Department of Production Engineering and Mechanical Design, Faculty of Engineering, Minia University, Minia, 61511, Egypt
| | - Ahmed S Ali
- Department of Mechanical Engineering, Faculty of Engineering, Suez Canal University, Suez, 41522, Egypt
| |
Collapse
|
14
|
Knowledge about the effects of electrosurgery smoke among operating room nurses during COVID-19 Pandemic: A Cross-Sectional Study. ACTA ACUST UNITED AC 2021; 24:100189. [PMID: 34179520 PMCID: PMC8214320 DOI: 10.1016/j.pcorm.2021.100189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/02/2021] [Accepted: 06/14/2021] [Indexed: 12/28/2022]
Abstract
Background Electrosurgery smoke is the smoke emitted from tissue cauterization when using the electrosurgery device. Accordingly, in this smoke, more than 80 harmful toxins have been discovered. In the current study, we aimed to investigate the level of knowledge reported by the operating room nurses on the effects of electrosurgery smoke during the current COVID-19 pandemic. Methods This descriptive, survey-based cross-sectional study was performed on 533 OR nurses in all the referring hospitals of COVID-19 infection. The required information were collected using a questionnaire regarding the knowledge on the side effects of electrosurgery smoke. The obtained data were then analyzed using t-test and ANOVA by SPSS software. Results Most of the included participants (93.6%) had a low level of awareness and only a small number of them (0.4%) had a good level of knowledge on the effects of electrosurgery smoke. As well, a significant relationship (P˂0.05) was found between the level of knowledge reported by the OR nurses and the type of hospital (educational or private). Most of the studied hospitals used no electrosurgery smoke reduction equipment during electrosurgery. Conclusion The level of knowledge reported by the OR nurses was generally poor. It is recommended that managers and health officials try to increase the level of awareness of OR nurses during the COVID-19 pandemic by providing standard and protective equipment as well as holding some well-organized and related training courses.
Collapse
|
15
|
Lee K, Oh J, Kim D, Yoo J, Yun GJ, Kim J. Effects of the filter microstructure and ambient air condition on the aerodynamic dispersion of sneezing droplets: A multiscale and multiphysics simulation study. PHYSICS OF FLUIDS (WOODBURY, N.Y. : 1994) 2021; 33:063317. [PMID: 34335005 PMCID: PMC8320464 DOI: 10.1063/5.0053449] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/01/2021] [Indexed: 05/13/2023]
Abstract
Concerns have been ramping up with regard to the propagation of infectious droplets due to the recent COVID-19 pandemic. The effects of filter microstructures and ambient air flows on droplet dispersion by sneezing are investigated by a fully coupled Eulerian-Lagrangian computational modeling with a micro-to-macroscale bridging approach. Materials that are commonly applied to face masks are modeled to generate two different virtual masks with various levels of filtration efficiency, and the leakage percentages through the unsealed nose and cheek areas were set to 11% and 25%, respectively. The droplet propagation distance was simulated with and without mask wearing in still and windy conditions involving head wind, tail wind, and side wind. The results demonstrate that wearing a face mask reduces the transmittance distance of droplets by about 90%-95% depending on the mask type; nonetheless, the droplets can be transmitted to distances of 20-25 cm in the forward direction even with mask-wearing. Thus, a social distance of at least 20 cm between people would help to prevent them from becoming exposed to ejected droplets. This study is significant in that important aspects of mask materials, in this case the porous microstructure-dependent filtration efficiency and permeability under varied ambient flow conditions, were considered for the first time in an evaluation of the barrier performance against droplet transmittance through a multiphase computational fluid dynamics simulation of air-droplet interaction and turbulence flow dynamics.
Collapse
Affiliation(s)
| | - Jungtaek Oh
- Reliability Assessment Center, FITI Testing and Research Institute, Seoul 07791, South Korea
| | - Dongwhan Kim
- Reliability Assessment Center, FITI Testing and Research Institute, Seoul 07791, South Korea
| | - Jinbok Yoo
- UniAET Co., Ltd., Seoul 08502, South Korea
| | - Gun Jin Yun
- Authors to whom correspondence should be addressed: . Phone: +82-2-880-8302 and . Phone: +82-2-880-6846
| | - Jooyoun Kim
- Authors to whom correspondence should be addressed: . Phone: +82-2-880-8302 and . Phone: +82-2-880-6846
| |
Collapse
|
16
|
Furman E, Cressman A, Shin S, Kuznetsov A, Razak F, Verma A, Diamant A. Prediction of personal protective equipment use in hospitals during COVID-19. Health Care Manag Sci 2021; 24:439-453. [PMID: 33843005 PMCID: PMC8038877 DOI: 10.1007/s10729-021-09561-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/03/2021] [Indexed: 12/26/2022]
Abstract
Demand for Personal Protective Equipment (PPE) such as surgical masks, gloves, and gowns has increased significantly since the onset of the COVID-19 pandemic. In hospital settings, both medical staff and patients are required to wear PPE. As these facilities resume regular operations, staff will be required to wear PPE at all times while additional PPE will be mandated during medical procedures. This will put increased pressure on hospitals which have had problems predicting PPE usage and sourcing its supply. To meet this challenge, we propose an approach to predict demand for PPE. Specifically, we model the admission of patients to a medical department using multiple independent [Formula: see text] queues. Each queue represents a class of patients with similar treatment plans and hospital length-of-stay. By estimating the total workload of each class, we derive closed-form estimates for the expected amount of PPE required over a specified time horizon using current PPE guidelines. We apply our approach to a data set of 22,039 patients admitted to the general internal medicine department at St. Michael's hospital in Toronto, Canada from April 2010 to November 2019. We find that gloves and surgical masks represent approximately 90% of predicted PPE usage. We also find that while demand for gloves is driven entirely by patient-practitioner interactions, 86% of the predicted demand for surgical masks can be attributed to the requirement that medical practitioners will need to wear them when not interacting with patients.
Collapse
Affiliation(s)
- Eugene Furman
- Department of Operations Management, Rotman School of Management, Toronto, ON, Canada.
| | - Alex Cressman
- Division of General Internal Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Saeha Shin
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Alexey Kuznetsov
- Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Fahad Razak
- Division of General Internal Medicine and Li Ka Shing Knowledge Institute, St. Michael's Hospital; Department of Medicine and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Amol Verma
- Division of General Internal Medicine and Li Ka Shing Knowledge Institute, St. Michael's Hospital; Department of Medicine and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Adam Diamant
- Department of Operations Management and Information Systems, Schulich School of Business, Toronto, ON, Canada
| |
Collapse
|
17
|
Mboowa G, Semugenze D, Nakabuye H, Bulafu D, Aruhomukama D. Efficacy of Face Masks Used in Uganda: A Laboratory-Based Inquiry during the COVID-19 Pandemic. Am J Trop Med Hyg 2021; 104:1703-1708. [PMID: 33724922 PMCID: PMC8103455 DOI: 10.4269/ajtmh.21-0030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 03/05/2021] [Indexed: 11/07/2022] Open
Abstract
With shortages of face masks being reported worldwide, it is critical to consider alternatives to commercially manufactured face masks. This study aimed to test and compare the efficacy of various makes of locally made or homemade cloth face masks obtained from face-mask vendors in Kampala, Uganda, during the COVID-19 pandemic. The testing was performed to assess the bacterial filtration efficiency (BFE), breathability, distance-dependent fitness, and reusability of the locally made or homemade cloth face masks, while considering the most commonly used non-published face-mask decontamination approaches in Uganda. During laboratory experimentation, modified protocols from various face-mask testing organizations were adopted. Ten different face-mask types were experimented upon; each face-mask type was tested four times for every single test, except for the decontamination protocols involving washing where KN95 and surgical face masks were not included. Among the locally made or homemade cloth face masks, the double-layered cloth face masks (described as F) had better BFE and distance-dependent fitness characteristics, they could be reused, and had good breathability, than the other locally made or homemade cloth face masks. Despite these good qualities, the certainty of these face masks protecting wearers against COVID-19 remains subject to viral filtration efficiency testing.
Collapse
Affiliation(s)
- Gerald Mboowa
- Department of Immunology and Molecular Biology, College of Health Sciences, School of Biomedical Sciences, Makerere University, Kampala, Uganda
- The African Center of Excellence in Bioinformatics and Data Intensive Sciences, the Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | - Derrick Semugenze
- Department of Medical Microbiology, College of Health Sciences, School of Biomedical Sciences, Makerere University, Kampala, Uganda
| | - Hellen Nakabuye
- Department of Immunology and Molecular Biology, College of Health Sciences, School of Biomedical Sciences, Makerere University, Kampala, Uganda
- Department of Medical Microbiology, College of Health Sciences, School of Biomedical Sciences, Makerere University, Kampala, Uganda
| | - Douglas Bulafu
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Dickson Aruhomukama
- Department of Immunology and Molecular Biology, College of Health Sciences, School of Biomedical Sciences, Makerere University, Kampala, Uganda
- Department of Medical Microbiology, College of Health Sciences, School of Biomedical Sciences, Makerere University, Kampala, Uganda
| |
Collapse
|
18
|
Pasquier J, Villalta O, Sarria Lamorú S, Balagué C, Vilallonga R, Targarona EM. Are Smoke and Aerosols Generated During Laparoscopic Surgery a Biohazard? A Systematic Evidence-Based Review. Surg Innov 2021; 28:485-495. [PMID: 33573518 DOI: 10.1177/1553350621992309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background. Laparoscopic surgery generates end products that can have potentially harmful effects for the surgical team from short- or long-time exposure. In view of the current SARS-CoV-2 circumstances, controversy has risen concerning the safety of surgical smoke (SS) and aerosols and the perception of an increased risk of exposure during laparoscopic surgery. Methods. The present qualitative systematic review was conducted according to Meta-Analyses and Systematic Reviews of Observational Studies (MOOSE). A literature search was performed from March 2020 up to May 10, 2020, using the PubMed database, Cochrane, and Google Scholar to assess the risk of airborne transmission of viruses and the potential health risk of surgical smoke- and aerosol-generating procedures produced during laparoscopic surgery. The keywords were introduced in combination to obtain better search results. Application of the inclusion and exclusion criteria identified 44 relevant articles. Results. Genetic material from certain viruses, or the virus itself, has been detected in SS and aerosols. However, in the current SARS-CoV-2, as in other coronavirus situations, studies analyzing the presence of airborne transmission of viruses in surgical smoke are lacking. Conclusion. Despite the lack of clear evidence regarding the risk of diseases as the result of smoke- and aerosol-generating procedures during laparoscopic surgery, further investigation is needed. Meanwhile, all available precautions must be taken.
Collapse
Affiliation(s)
- Jorge Pasquier
- Service of General and Digestive Surgery, 16689Hospital de La Santa Creu I Sant Pau, Hospital Universitari de la Universitat Autònoma de Barcelona, Spain
| | - Oscar Villalta
- Service of General and Digestive Surgery, 16689Hospital de La Santa Creu I Sant Pau, Hospital Universitari de la Universitat Autònoma de Barcelona, Spain
| | - Sunaymy Sarria Lamorú
- Service of General and Digestive Surgery, 16689Hospital de La Santa Creu I Sant Pau, Hospital Universitari de la Universitat Autònoma de Barcelona, Spain
| | - Carmen Balagué
- Service of General and Digestive Surgery, 16689Hospital de La Santa Creu I Sant Pau, Hospital Universitari de la Universitat Autònoma de Barcelona, Spain
| | - Ramon Vilallonga
- Endocrine, Metabolic and Bariatric Unit, Vall D'Hebron University Hospital, Universitat Autònoma de Barcelona, Spain
| | - Eduardo M Targarona
- Service of General and Digestive Surgery, 16689Hospital de La Santa Creu I Sant Pau, Hospital Universitari de la Universitat Autònoma de Barcelona, Spain
| |
Collapse
|
19
|
Surgical Masks and Respirators for Plastic Surgical and Nonsurgical Aesthetic Procedures. Plast Surg Nurs 2020; 40:185-188. [PMID: 33259413 DOI: 10.1097/psn.0000000000000338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
20
|
Hu X, Zhou Q, Yu J, Wang J, Tu Q, Zhu X. Prevalence of HPV infections in surgical smoke exposed gynecologists. Int Arch Occup Environ Health 2020; 94:107-115. [PMID: 32870342 PMCID: PMC7826298 DOI: 10.1007/s00420-020-01568-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 08/25/2020] [Indexed: 01/27/2023]
Abstract
Objectives Human papillomavirus (HPV) has been reported recently in surgical smoke generated by gynecological operations. The objective of this study was to investigate whether gynecologists who have performed electrosurgery including loop electrosurgical excision procedure (LEEP), are at risk of acquiring HPV DNA through surgical smoke. Methods A related questionnaire was designed and 700 gynecologist nasal swab samples were collected in 67 hospitals. In addition, the flow fluorescence hybridization technique was used to detect HPV DNA, and the Chi-square test was applied to analyze whether related risk factors including electrical surgery, were correlated with HPV infection in surgeons’ nasal epithelial cells. Results The HPV infection rate in the nasal epithelial cells of the participants who performed electrosurgery (8.96%, 42/469) or LEEP (10.11%, 36/356) was significantly higher than that in the remaining participants who did not perform electrosurgery (1.73%, 4/231) or LEEP (2.91%, 10/344), respectively. The most prevalent HPV genotype in the electrosurgery group was HPV16 (76.19%, 32/42). The HPV-positive rate was increased in the group that had a longer duration of electrosurgery (P = 0.016). Additionally, the HPV detection rate was significantly lower in electrosurgery operators who used surgical mask (7.64%, 33/432) than in those who did not use protective masks (24.32%, 9/37). Furthermore, the N95 mask (0%, 0/196) significantly reduced the risk for HPV infection compared to that with the general mask (13.98%, 33/236, P < 0.001). Furthermore, 46 participants infected with HPV were followed-up for 3–24 months, and approximately 43.48% (20/46) and 100% (41/41) became negative for HPV DNA, respectively. Conclusions Gynecologists who performed electrosurgery including LEEP were at risk of acquiring HPV infection. Surgical masks, especially the N95 mask, significantly decreased the hazard of HPV transmission from surgical smoke. Electronic supplementary material The online version of this article (10.1007/s00420-020-01568-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Xiaoli Hu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 Xueyuan Xi Road, Wenzhou, 325027, Zhejiang, China
| | - Qingfeng Zhou
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 Xueyuan Xi Road, Wenzhou, 325027, Zhejiang, China
| | - Jian Yu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 Xueyuan Xi Road, Wenzhou, 325027, Zhejiang, China
| | - Jing Wang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 Xueyuan Xi Road, Wenzhou, 325027, Zhejiang, China
| | - Quanmei Tu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 Xueyuan Xi Road, Wenzhou, 325027, Zhejiang, China
| | - Xueqiong Zhu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 Xueyuan Xi Road, Wenzhou, 325027, Zhejiang, China.
| |
Collapse
|
21
|
Abstract
Surgical smoke is formed when energy-generating devices (ie, electrosurgery units, lasers, powered instruments) raise the intracellular temperature of tissue to at least 100º C (212º F), causing tissue vaporization in the form of surgical smoke. Surgical smoke contains components that are known health hazards, such as benzene, toluene, hydrogen cyanide, formaldehyde, volatile organic compounds, viruses, and bacteria. There have been case reports of human disease tied to the inhalation of surgical smoke; therefore, it is important for perioperative team members to minimize their exposure and patient exposure. In spite of the health risks, many perioperative departments do not consistently and effectively evacuate surgical smoke. This Back to Basics article provides basic steps that perioperative team members can take to protect themselves and their patients from the harm caused by surgical smoke exposure.
Collapse
|
22
|
Benson SM, Maskrey JR, Nembhard MD, Unice KM, Shirley MA, Panko JM. Evaluation of Personal Exposure to Surgical Smoke Generated from Electrocautery Instruments: A Pilot Study. Ann Work Expo Health 2019; 63:990-1003. [DOI: 10.1093/annweh/wxz070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 07/14/2019] [Accepted: 08/13/2019] [Indexed: 11/12/2022] Open
Abstract
Abstract
Hospital technician surgical smoke exposures during several types of electrocautery-based procedures were evaluated. Personal and area air sampling was performed for 106 individual analytes including ultrafine particulate matter (UFP), volatile organic compounds, polycyclic aromatic hydrocarbons, phenol, aldehydes, carbon monoxide, hydrogen sulfide, and hydrogen cyanide. Acetone, d-limonene, ethanol, ethyl acetate, and fluorene were measured in surgical suites at concentrations 1.1- to 3.7-fold higher than those observed in background. Benzene, α-pinene, methylene chloride, and n-hexane were measured in the absence of a detectable background concentration. All analytes were measured at concentrations that were <1% of the corresponding US federal and state 8-h permissible exposure limits (PELs), if PELs existed. Full-shift average UFP concentrations ranged from 773 to 2257 particles/cm3, approximately one order of magnitude higher than surgical suite background concentrations. A comparison of two breast reduction procedures suggested that the use of smoke evacuators reduced UFP exposure by 6-fold. We concluded that selection and evaluation of key hazards, particularly UFP, under a variety of experimental conditions would be beneficial to elucidate potential health effects and causes osf employee complaints. Recommendations for successful sampling campaigns in future surgical smoke occupational exposure studies are provided. We also recommend the continued use of engineering controls, local exhaust ventilation, and surgical N95 respirators to reduce personal exposures to UFP in surgical smoke.
Collapse
|
23
|
Stanganelli NC, Bieniek AA, Margatho AS, Galdino MJQ, Barbosa KH, Ribeiro RP. Inalação da fumaça cirúrgica: coorte de sinais e sintomas em residentes. ACTA PAUL ENFERM 2019. [DOI: 10.1590/1982-0194201900053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Analisar os sinais e sintomas apresentados por médicos residentes das clínicas cirúrgicas e anestesiologia expostos à fumaça cirúrgica. Métodos Estudo de coorte prospectivo realizado com médicos residentes expostos a fumaça cirúrgica em um hospital universitário. Houve um acompanhamento durante 17 meses dos residentes ingressantes nos anos de 2015 e 2016, que atendiam aos critérios de estar regularmente matriculado na residência de clínica cirúrgica ou anestesiologia e não ser tabagista. O instrumento de coleta de dados foi composto de dados sociodemográficos e acadêmicos e dos sinais e sintomas relacionados com a inalação da fumaça cirúrgica, citados na literatura. A análise de dados ocorreu de forma descritiva e inferencial, por testes estatísticos e medidas de efeito. Resultados A amostra foi composta por 39 residentes, cuja maioria era do sexo masculino (56,4%) e idade abaixo dos 30 anos (74,3%). Prevaleceram residentes da ginecologia e obstetrícia (30,8%), seguidos de cirurgia geral (28,2%) e anestesiologia (20,5%). Ardência na faringe (p=0,030), náusea e vômito (p=0,018) e irritação dos olhos (p=0,050) incidiram ainda no primeiro ano de residência. O risco de desenvolver ardência de faringe foi 7,765 vezes (p=0,019) no sexo feminino em relação ao masculino. Conclusão Os sinais e sintomas analisados incidiram em até 12 meses do início da residência e o risco de apresentar ardência de faringe foi maior no sexo feminino, o que indica a exposição aos riscos da inalação da fumaça cirúrgica e, portanto, a necessidade de adoção de medidas de proteção individuais e coletivas.
Collapse
|
24
|
Liu Y, Song Y, Hu X, Yan L, Zhu X. Awareness of surgical smoke hazards and enhancement of surgical smoke prevention among the gynecologists. J Cancer 2019; 10:2788-2799. [PMID: 31258787 PMCID: PMC6584931 DOI: 10.7150/jca.31464] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 04/29/2019] [Indexed: 12/31/2022] Open
Abstract
Surgical smoke is the gaseous by-product produced by heat generating devices in various surgical operations including laser conization and loop electrosurgical procedures that often are performed by gynecologists. Surgical smoke contains chemicals, blood and tissue particles, bacteria, and viruses, which has been shown to exhibit potential risks for surgeons, nurses, anesthesiologists, and technicians in the operation room due to long term exposure of smoke. In this review, we describe the detailed information of the components of surgical smoke. Moreover, we highlight the effects of surgical smoke on carcinogenesis, mutagenesis, and infection in gynecologists. Furthermore, we discussed how to prevent the surgical smoke via using high-filtration masks and smoke evacuation systems as well as legal guidelines for protection measures among the gynecologists.
Collapse
Affiliation(s)
- Yi Liu
- Department of obstetrics and gynecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yizuo Song
- Department of obstetrics and gynecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaoli Hu
- Department of obstetrics and gynecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Linzhi Yan
- Department of obstetrics and gynecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xueqiong Zhu
- Department of obstetrics and gynecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| |
Collapse
|
25
|
Bree K, Barnhill S, Rundell W. The Dangers of Electrosurgical Smoke to Operating Room Personnel: A Review. Workplace Health Saf 2017; 65:517-526. [PMID: 28414627 DOI: 10.1177/2165079917691063] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A 2007 study in the United Kingdom showed that three of 98 surgeons surveyed admitted using dedicated smoke extractors; 72% of respondents believed inadequate precautions were in place to protect staff from the potential dangers of electrosurgical smoke. Surgical smoke contains harmful chemicals (e.g., hydrogen cyanide, acetylene, and butadiene) that can circumvent standard masks used in the operating room (OR). In addition, bacteria and viruses can be transmitted through this smoke. The topic of electrosurgical smoke is important to occupational health nurses not only because of their responsibility to protect workers, but also because they, like other health care providers, may be exposed to smoke routinely. The authors of this review recommend the regular use of smoke evacuation in ORs and avoidance of electrosurgery whenever possible to protect OR personnel from the potential long-term harmful effects of electrosurgical smoke.
Collapse
|
26
|
Gao S, Koehler RH, Yermakov M, Grinshpun SA. Performance of Facepiece Respirators and Surgical Masks Against Surgical Smoke: Simulated Workplace Protection Factor Study. ANNALS OF OCCUPATIONAL HYGIENE 2016; 60:608-18. [PMID: 26929204 PMCID: PMC7109898 DOI: 10.1093/annhyg/mew006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 01/11/2016] [Indexed: 02/04/2023]
Abstract
Objective: Surgical smoke generated during electrocautery contains toxins which may cause adverse health effects to operating room (OR) personnel. The objective of this study was to investigate the performance of surgical masks (SMs), which are routinely used in ORs, more efficient N95 surgical mask respirator (SMRs) and N100 filtering facepiece respirator (FFRs), against surgical smoke. Methods: Ten subjects were recruited to perform surgical dissections on animal tissue in a simulated OR chamber, using a standard electrocautery device, generating surgical smoke. Six respiratory protective devices (RPDs) were tested: two SMs, two SMRs, and two N100 FFRs [including a newly developed faceseal (FS) prototype]. Fit testing was conducted before the experiment. Each subject was then exposed to the surgical smoke while wearing an RPD under the tests. Concentrations inside (Cin) and outside (Cout) of the RPD were measured by a particle size spectrometer. The simulated workplace protection factor (SWPF) was determined by the ratio of Cout and Cin for each RPD-wearing subject. Results: For the SMs, the geometric means of SWPFtotal (based on the total aerosol concentration) were 1.49 and 1.76, indicating minimal protection. The SWPFtotal values of the SMRs and N100 FFRs were significantly higher than those of the SMs: for the two SMRs, the SWPFtotal were 208 and 263; for the two N100s, the SWPFtotal values were 1,089 and 2,199. No significant difference was observed between either the two SMs or the two SMRs. The SWPFtotal for the novel FS prototype N100 FFR was significantly higher than the conventional N100 FFR. The correlation between SWPFtotal and fit factor (FF) determined for two N95 SMRs was not significant. Conclusions: SMs do not provide measurable protection against surgical smoke. SMRs offer considerably improved protection versus SMs, while the N100 FFRs showed significant improvement over the SMRs. The FS prototype offered a higher level of protection than the standard N100 FFR, due to a tighter seal. While we acknowledge that conventional N100 FFRs (equipped with exhalation valves) are not practical for human OR use, the results obtained with the FS prototype demonstrate the potential of the new FS technology for implementation on various types of respirators.
Collapse
Affiliation(s)
- Shuang Gao
- 1.Department of Environmental Health, Center for Health-Related Aerosol Studies, University of Cincinnati, PO Box 670056, Cincinnati, OH, USA
| | - Richard H Koehler
- 2.Department of Surgery, Martha's Vineyard Hospital, 1 Hospital Rd, Oak Bluffs, MA 02557, USA
| | - Michael Yermakov
- 1.Department of Environmental Health, Center for Health-Related Aerosol Studies, University of Cincinnati, PO Box 670056, Cincinnati, OH, USA
| | - Sergey A Grinshpun
- 1.Department of Environmental Health, Center for Health-Related Aerosol Studies, University of Cincinnati, PO Box 670056, Cincinnati, OH, USA;
| |
Collapse
|
27
|
Tramontini CC, Galvão CM, Claudio CV, Ribeiro RP, Martins JT. Composition of the electrocautery smoke: integrative literature review. Rev Esc Enferm USP 2016; 50:148-57. [DOI: 10.1590/s0080-623420160000100019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 08/29/2015] [Indexed: 11/22/2022] Open
Abstract
Abstract OBJECTIVE To identify the composition of the smoke produced by electrocautery use during surgery. METHOD Integrative review with search for primary studies conducted in the databases of the US National Library of Medicine National Institutes of Health, Cumulative Index to Nursing and Allied Health Literature, and Latin American and Caribbean Health Sciences, covering the studies published between 2004 and 2014. RESULTS The final sample consisted of 14 studies grouped into three categories, namely; polycyclic aromatic hydrocarbons, volatile compounds and volatile organic compounds. CONCLUSION There is scientific evidence that electrocautery smoke has volatile toxic, carcinogenic and mutagenic compounds, and its inhalation constitutes a potential chemical risk to the health of workers involved in surgeries.
Collapse
|
28
|
MYONG JP, BYUN J, CHO Y, SEO HK, BAEK JE, KOO JW, KIM H. The education and practice program for medical students with quantitative and qualitative fit test for respiratory protective equipment. INDUSTRIAL HEALTH 2016; 54:177-82. [PMID: 26538001 PMCID: PMC4821901 DOI: 10.2486/indhealth.2015-0072] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Tuberculosis infection is prevalent in Korea and health care workers are vulnerable to tuberculosis infection in the hospital. The aims of this study were to develop and validate an education program that teaches senior medical students how to wear and choose the proper size and type of respiratory protective equipment (RPE), which may help reduce the risk of contracting Mycobacterium tuberculosis (MTB) from patients. Overall, 50 senior medical students participated in this education program. Methods of choosing the proper type of RPE, performing a fit check of the RPE, and choosing a suitable mask size were taught by certified instructors using the real-time quantitative fit test (QNFT). The validity of education program was evaluated with qualitative fit test (QLFT) before and after the education as pass or fail. The education program was effective, as shown by the significantly pass rate (increased 30 to 74%) in the QLFT after the education program (p<0.05). Among study participants, changing mask size from medium to small significantly increased the pass rate (p<0.001). Incorporation of this program into the medical school curriculum may help reduce risk of MTB infection in medical students working in the hospital.
Collapse
Affiliation(s)
- Jun-Pyo MYONG
- Department of Occupational and Environmental Medicine, Seoul
St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Republic of
Korea
| | - JunSu BYUN
- Department of Occupational and Environmental Medicine, Seoul
St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Republic of
Korea
| | - YounMo CHO
- Department of Occupational and Environmental Medicine, Seoul
St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Republic of
Korea
| | - Hye-Kyung SEO
- Department of Preventive Medicine, College of Medicine, The
Catholic University of Korea, Republic of Korea
| | - Jung-Eun BAEK
- Department of Preventive Medicine, College of Medicine, The
Catholic University of Korea, Republic of Korea
| | - Jung-Wan KOO
- Department of Occupational and Environmental Medicine, Seoul
St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Republic of
Korea
| | - Hyunwook KIM
- Department of Preventive Medicine, College of Medicine, The
Catholic University of Korea, Republic of Korea
- *To whom correspondence should be addressed. E-mail:
| |
Collapse
|
29
|
Okoshi K, Kobayashi K, Kinoshita K, Tomizawa Y, Hasegawa S, Sakai Y. Health risks associated with exposure to surgical smoke for surgeons and operation room personnel. Surg Today 2014; 45:957-65. [DOI: 10.1007/s00595-014-1085-z] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 10/09/2014] [Indexed: 01/02/2023]
|