Diathermy smoke and human health

Abstract

Our hospitals are usually designated as ‘smoke-free workplaces’. Yet a form of chronic smoking persists and is either ignored or tolerated. We refer to ‘surgical smoke’ produced when diathermy or laser is used within the operating theatre. This smoke (or plume) contains hazardous chemicals, some of which are known to be carcinogenic [1]. Viral DNA and cells have also been recovered from surgical smoke [2, 3]. The use of surgical facemasks does not provide protection from inhalation of the aerosol fraction of such smoke [4]. Surgeons who routinely use carbon dioxide lasers for wart treatment have more intranasal lesions [5]. It is certainly plausible that surgical smoke is harmful, and an approach based on a precautionary principle would aim to avoid, or at least reduce, exposure. Devices are available that scavenge smoke from the diathermy source, and the use of these is advised [6]. There has been much recent publicity about the banning of tobacco smoking in public spaces in the Republic of Ireland, and there are proposals to do the same in Scotland. One of the key arguments for this is that passive smoking of tobacco may cause harm to others. So may surgical smoke. This is a form of occupational pollution, and should be more widely understood, acknowledged and addressed.