Surgical Team Exposure to Cautery Smoke and Its Mitigation During Tonsillectomy

Details

• Personal Author:
  Callaham S ; Carr MM ; Friend S ; Lee EG ; O'Brien DC ; Soo J-C
• Description:
  Objectives: To assess the exposure of surgical personnel to known carcinogens during pediatric tonsillectomy and adenoidectomy (T&A) and compare the efficacy of surgical smoke evacuation systems during T&A. Study Design: Prospective, case series. Setting: Tertiary children's hospital. Subjects and Methods: The present study assessed operating room workers' exposure to chemical compounds and aerosolized particulates generated during T&A. We also investigated the effect of 3 different smoke-controlling methods: smoke-evacuator pencil cautery (SE), cautery with suction held by an assistant (SA), and cautery without suction (NS). Results: Thirty cases were included: 12 in the SE group, 9 in SA, and 9 in NS. The chemical exposure levels were lower than or similar to baseline background concentrations, with the exception of methylene chloride and acetaldehyde. Within the surgical plume, none of the chemical compounds exceeded the corresponding occupational exposure limit (OEL). The mean particulate number concentration in the breathing zone during tonsillectomy was 508 particles/cm3 for SE compared to 1661 particles/cm3 for SA and 8208 particles/cm3 for NS cases. NS was significantly different compared to the other two methods (P = .0009). Conclusions: Although the exposure levels to chemicals were considerably lower than the OELs, continuous exposures to these chemicals could cause adverse health effects to surgical personnel. These findings suggest that the use of a smoke-evacuator pencil cautery or an attentive assistant with handheld suction would reduce exposure levels to the aerosolized particles during routine T&A, compared to the use of cautery without suction. [Description provided by NIOSH]
• Subjects:
  Aerosols Carcinogens Chemistry Environmental Exposure Health Personnel Occupational Health Particulate Matter Risk Assessment Risk Factors Safety
• Keywords:
  Aerosol Particles Author Keywords: Electrocautery Breathing Zone Chemical Composition Exposure Levels Health Effects Medical Personnel Occupational Exposure Limits Occupational Safety OELs Operating Room Particulates Risk Factors Smoke Detection Smoke Evacuation Surgeons Surgery Surgical Plume Surgical Smoke Tonsillectomy

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• ISSN:
  0194-5998
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Louisiana ; OSHA Region 3 ; OSHA Region 6 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  HELD - Health Effects Laboratory Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  163
• Issue:
  3
• NIOSHTIC Number:
  nn:20059901
• Citation:
  Otolaryngol Head Neck Surg 2020 Sep; 163(3):508-516
• Contact Point Address:
  Michele M.Carr, DDS, MD, PhD, Department of Otolaryngology Head and Neck Surgery, University of West Virginia, Medical Center Drive, PO Box 9200, Morgantown, WV 26506
• Email:
  mmcarr2001@gmail.com
• CAS Registry Number:
  Acetaldehyde (CAS RN 75-07-0) ; Dichloromethane (CAS RN 75-09-2)
• Federal Fiscal Year:
  2020
• NORA Priority Area:
  Healthcare and Social Assistance
• Peer Reviewed:
  True
• Source Full Name:
  Otolaryngology - Head and Neck Surgery
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7a808d01662b6b307d7ee4126ad9fa8656c3733a49cc7cfbb8651a47311a87a4b3f5c1131b5a6cdb0848c4e85fd3fe1ff48ff399200fd47abdeb2cc354f2a1bc
• Download URL:
  https://stacks.cdc.gov/view/cdc/223955/cdc_223955_DS1.pdf
• File Type:
  [PDF - 342.77 KB ]