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Surgeons' Health is at a Great Risk

During surgical procedures using Laser / Electrosurgical equipment, the thermal destruction of tissues creates a smoke by product. This smoke plume contains various toxic gases such as benzene, hydrogen cyanide, formaldehyde, bio - aerosols, dead & live cellular material (including blood fragments) & viruses. At high concentrations the smoke causes ocular & upper respiratory tract irritation in health care personnel, and creates visual problem for the surgeon. The smoke has unpleasant odours and has been shown to have mutagenic potential.

OSHA (Occupational Safety and Health Administration, USA) has made a determination that employees face a health risk as a result of occupational exposure to blood and other potentially infectious materials present in Laser & Electrosurgical smoke plume. This smoke plume contains bloodborne pathogens. These bloodborne pathogens are pathogenic micro-organisms that are present in human blood and can cause serious diseases in humans. These pathogens include but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV). OSHA further concludes that Smoke Evacuation Equipment can be used in conjunction with Laser and Electrosurgical units to eliminate or significantly reduce the risk of contamination by bloodborne pathogens carried in the smoke plume.

Below are some comments taken from new OSHA standard :

• The Centre for Disease Control (CDC) reported 8700 cases of Hepatitis B infection (HBV) occurred among the universe of health
  care workers in the U. S. in 1988.

• As of May 1990, there are at least 65 case reports of healthcare  workers whose HIV infections are associated with occupational exposure.

• This standard also requires employers to provide personal protective equipment (PPE) to all potentially exposed workers.

• Used properly, Smoke Evacuation System will reduce the risk of occupational exposure to bloodborne pathogens.

The smoke generated can be controlled by two methods. These include general room suction system and specific high efficiency smoke
evacuation system. General room suction system is not by itself sufficient because this will not be able to produce sufficient airflow
to capture contaminants generated at source. However, the specific high efficiency smoke evacuator hose nozzle inlet is kept within 5 cm of surgical site to effectively capture airborne contaminants (viruses) before I can be inhaled by surgeons and the persons in the Operating
Room. The second method is more reliable.

Smoke Evacuation Equipment : Principles of Operation

Smoke evacuation systems have two main functions :

1) Capturing the surgical smoke (or plume) before it can be inhaled by surgeon and operating room personnel and

2) filtering harmful elements from the captured air before it is returned to the surrounding environment.

Filtration is commonlyaccomplished in stages, with captured smoke passing through a series of filters. It is important to choose a filter that is effective in collecting the contaminants. A High Efficiency Particulate Air (HEPA) filter is recommended for trapping particulates.

The filters used in the Smoke Evacuation Systems of Buffalo Filter are impregnated with chemical agents to kill and inhibit micro-organisms that are generated during the surgical procedures. This chemical agent has been tested against HIV & found to be active in decreasing HIV transmission. Since impregnation is done as an addition to the filter media during the manufacturing process, the chemical agent does not wash or blow off the filter media, nor does it leach from the media.

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