As a long-time operating room clinical nurse specialist, I work tirelessly for my patients and in support of frontline caregivers. Patients entrust their lives into our hands as members of the team providing them with safe surgical care. Unfortunately, however, my life is also on the line as I inhale the harmful surgical smoke prevalent in operating rooms across Oregon.
Surgical smoke is generated in the operating room when electrosurgical pencils and lasers are used to cut or cauterize tissue. In other words, it is the smoke produced from burning human flesh.
Like cigarette smoke, surgical smoke can be seen and smelled. The average impact of this smoke to the surgical team is equivalent to inhaling the smoke of 27-30 unfiltered cigarettes during each day spent in the operating room. Secondhand smoke exposure at this level is not acceptable in our restaurants or bars. Surely, we shouldn’t accept it in any of Oregon’s healthcare settings.
In addition to causing respiratory illness, asthma and allergy-like symptoms, surgical smoke can contain live viruses such as human papilloma virus. In fact, there are documented cases of HPV transmission from patients to providers via surgical smoke inhalation.
Surgical smoke can also cause cancer cells to metastasize in the incision site of patients undergoing the surgical removal of a cancer. For babies born by cesarean-section, their first breath outside the womb may be one filled with surgical smoke.
Toxic surgical smoke, which contains over 150 hazardous chemicals as well as, carcinogenic and mutagenic cells, can be safely evacuated from the operating room with the use of a simple hand-held device. No expensive construction or HVAC changes are needed. In fact, all operating rooms already are equipped with suction equipment that can be used to evacuate surgical smoke, and costs for the filters are minimal.
For electrosurgical pencils, cost differences between traditional pencils and those with attached evacuators can be as little as a few dollars per pencil.
For decades, several health and safety agencies have recognized the hazards of surgical smoke and recommended surgical smoke evacuation, but there are no state or national enforceable requirements for such evacuation. Even though some Oregon surgical facilities evacuate smoke voluntarily during some procedures, few facilities evacuate consistently during every procedure.
Nurses have little control over whether we are assigned to a smoking or nonsmoking operating room. We are forced to argue for the use of life-saving smoke evacuation equipment at a time when we should all be focused on the surgery at hand.
While hospital associations in Kentucky and Colorado have supported similar legislation in their states, the Oregon hospital association has opposed the legislation here for three years. They argue that voluntary compliance is sufficient.
However, we on the front lines know that voluntary compliance is insufficient because operating room staff in Oregon continue to work in hazardous, smoke-filled operating rooms — even in the middle of a deadly, viral pandemic.
This is why the Oregon Legislature must pass HB 2622 this year and make Oregon a surgical smoke-free state. HB 2622 would require hospitals and outpatient surgery facilities to create and implement policies to evacuate surgical smoke. The bill allows maximum flexibility for surgical teams and facilities to select and use the equipment of their choice.
Oregon must become surgical smoke-free. My health depends on it.