Prevalence of HPV infections in surgical smoke exposed gynecologists

Xiaoli Hu,Jing Wang,Qingfeng Zhou,Jian Yu,Xueqiong Zhu,Quanmei Tu

doi:10.1007/s00420-020-01568-9

Abstract

ObjectivesHuman 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.MethodsA 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.ResultsThe 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.ConclusionsGynecologists 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.

Highlights

Cervical cancer is the third most common gynecological cancer worldwide and one of the main reasons for cancerrelated death in females in developing countries (Siegel et al 2018)
A total of 700 gynecologists in 67 local hospitals throughout Zhejiang Province from January 2016 to December 2016 were recruited to the study for detection of Human papillomavirus (HPV) DNA by HybriMax; their mean age was 35.1 ± 8.8 years
We found that (1) gynecologists who performed electrosurgery operations, including loop electrosurgical excision procedure (LEEP) for cervical lesions, especially those who were exposed to surgical smoke for a long time, were at risk for HPV-DNA infection and that (2) surgical masks, especially the N95 mask, effectively decreased the hazard of acquiring HPV DNA from surgical smoke exposure during cervical electrosurgery, including LEEP

Summary

Introduction

Cervical cancer is the third most common gynecological cancer worldwide and one of the main reasons for cancerrelated death in females in developing countries (Siegel et al 2018). The presence of high-risk types of human. International Archives of Occupational and Environmental Health (2021) 94:107–115 liberate intact cells and including viral DNA, which may be a potential risk to surgeons (Sood et al 1994). Surgical smoke can be produced during electrocautery or ultrasonic scalpel procedures. Surgical smoke is the gaseous by-product arising from tissue being burned, dissected or cauterized by heat generating devices such as laser surgery or diathermy (Georgesen and Lipner 2018; Sanderson 2012), which may be a biohazard to surgeons (Choi et al 2014). The possibility that surgeons might inhale viral particles such as HPV DNA from surgical smoke during the removal of certain lesions has been pointed out by several authors (Gloster and Roenigk 1995)

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