Institute of Experimental Medicine CAS

Toxic effects of surgical smoke. How can they affect the health of surgeons? The article by Dr Rössner from the Department of Nanotoxicology and Molecular Epidemiology

Published 25. 03. 2021

Are the surgeons at risk?

COMMENTS: Pavel Rössner, PhD / Department of Nanotoxicology and Molecular Epidemiology

During some surgical procedures, medical staff breathe so-called surgical smoke over the patient's body  - fumes from human tissue produced during cutting or cauterization or wound healing by burning. This aerosol consists of water vapour and gaseous substances that may contain toxic compounds such as benzene, toluene and hydrogen cyanide; bacteria and viruses are able to spread in it. According to studies, staff working in perioperative teams, have twice as many respiratory problems as the average person.

Surgical smoke is generated during operations, in which electro catheterizations tools, lasers, are used along with ultrasonic scalpels. It consists of 95 per cent water vapor with the rest falling onto dust particles that arise from the cells of the remains. Although the possible negative effects of surgical smoke on human health have been debated for some time, the actual level of harm caused has not yet been determined. The negative effects of surgical smoke are evidenced by the fact that the components contained in it are also present, for example, in polluted ambient air which ranks among human carcinogens. One of them is fine dust particles, ie smaller than 2.5 µm, which can penetrate the lungs and are known to contribute to the development of asthma and other respiratory or cardiovascular diseases. The prolonged inhalation of these particles in heavily polluted areas is associated with a decrease in the average life span. The chemical composition of surgical smoke is not accurately defined, as it depends on the type of surgical instruments used and operated tissue. Researchers have shown elevated concentrations of carcinogens such as benzene or formaldehyde, or other irritating and otherwise harmful compounds including acetonitrile, carbon monoxide, ethylbenzene, styrene, toluene or xylene.

The presence of infectious agents should also be noted;  these include bacteriophages, viruses or cells that pose a particular problémin case where lasers that generate less heat are used in surgery. Surgical smoke is unlikely to pose an acute risk to human health. However, due to its composition, similar effects can be expected as those with passive cigarette smoking. It is estimated that all-day exposure to surgical smoke is equivalent to smoking 27-30 cigarettes. Although several studies suggest an increased risk of cancer as a result of the inhalation of surgical smoke, there are no specific data to confirm this. It can, however, be reliably concluded that surgical smoke contains a number of harmful substances that have the potential to adversely affect human health.

Link to the original article

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