David Gazzard is a senior clinical negligence lawyer who heads the Clinical Negligence Team at BLB Solicitors. Here, he highlights the significant health risks faced by medical professionals from the inhalation of surgical smoke.
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Although we lawyers tend to be the butt of many a barbed comment about “health and safety gone crazy”, few would argue that our workplaces are now the safest they have ever been. Specifically, in terms of the air we breathe at work, gone are the days when many people faced uncontrolled exposure to fumes, dust, and other noxious substances which put our health at risk.
It’s fifteen years since legislation banned smoking in the workplace. Yet still, a group of professionals are regularly exposed to a type of smoke that can be even more harmful than inhaling tobacco smoke.
Surgical smoke evacuation
During surgical procedures using lasers and diathermy devices to stop bleeding or incise tissue, the intracellular temperature is raised to a point where tissue vaporizes, producing surgical smoke. This smoke is often not visible, although it has an unpleasant odour.
Medical professionals have told me that such procedures are regularly carried out in poorly ventilated rooms with no, or inadequate, systems for surgical smoke evacuation. Typically, the only available protection is a standard surgical mask, which is not designed to prevent smoke inhalation. Even in an operating theatre, which will normally have better ventilation, there will be emissions of smoke into the room, resulting in staff exposure.
Research published over forty years ago suggests that inhaling one gram of surgical smoke is the equivalent of smoking between three and six cigarettes, depending on the procedure. But the problem is not limited to the respiratory risks of smoke inhalation – there’s also a risk of infection. Studies have demonstrated the presence of a whole variety of toxins, viruses, bacteria, carcinogens, and bloodborne pathogens in surgical smoke.
Even during the procedure, evidence shows that surgical smoke can cause eye and upper respiratory tract irritation at higher concentrations and can even create visual problems for the surgeon. And just like smoking tobacco, repeated exposure to the contents of surgical smoke may be cumulative, increasing the possibility of developing adverse and possibly severe health effects.
Surgical smoke evacuation guidelines
Employers have a non-delegable duty of care for the health and safety of their employees, a duty extending to the exposure of staff to any substance hazardous to health, such as surgical smoke. In short, employers in the healthcare sector who fail to protect their staff adequately could open themselves to a claim for compensation.
The risks associated with the inhalation of surgical smoke have been known for decades. In the UK, they even are highlighted by the Health and Safety Executive (HSE) as a specific risk for those working in the healthcare sector. Despite that, frontline medical staff continue to be exposed to this entirely preventable risk.