Small Steps that Can Lead to Big Change


The dangers surrounding surgical smoke have been leading conversations at perioperative conferences. It’s even making its way into state legislation across the country. 

Why? Because growing data supports the fact that surgical smoke is hazardous to health. 

Throughout the last decade, the perception of surgical smoke has transitioned from a mere annoyance to a considerable health risk for everyone in the operating room. 

With 90% of procedures generating surgical smoke1, over half-a-million healthcare workers are exposed annually.2 Surgical smoke particles contain over 150 chemicals known to be carcinogenic, or to cause lung, heart, or brain damage.3 And unfortunately, data suggests standard surgical masks offer staff little protection, with 77% of surgical smoke particles not being filtered out.4

Because of these facts, there is mounting motivation to pursue stronger protection measures. And Nurses are leading the charge, including promoting the implementation of smoke evacuation policies. 

Smoke evacuators are designed to reduce the concentration of smoke generated from electrocautery devices, and minimize risks associated with exposure to smoke plume. Some nurses who’ve led implementation efforts have learned that they can be met with resistance. Among their leading obstacles are lack of education, cost or resource constraints, and plain old opposition to change. 

"From the first time I set foot in an OR, I knew that surgical smoke was a problem," said Rob Scroggins, RN, BSN, CMLSO. "The smell was bad. My eyes were watering. It was just really bad." The surgical nurse with decades of experience recalled the worst part – "It was just accepted. If you worked in the OR, you knew you were going to get the smoke."5

But if the current state of surgical smoke legislation shows us anything, it’s this: The commitment, dedication, and persistence of nurses and perioperative leaders is making a difference nationwide.
“I first became involved with surgical smoke when I noticed I was having respiratory issues myself. I had coworkers who developed pulmonary embolists, I had coworkers who had chronic bronchitis, I even had a coworker who developed lung cancer. None of these people had predispositions to these diseases.” So Scroggins began searching for the cause. “In doing research I discovered that surgical smoke was the most likely culprit.” Scroggins became passionate about finding a solution and began working towards implementing a surgical smoke evacuation policy at his hospital. “My goal was to create a healthier workplace for everyone.”

You can initiate change at your hospital or surgery center too. Here are three tips to achieving a successful implementation program for smoke evacuation.  

Education. There are some who still believe the risks associated with surgical smoke are insignificant, but sharing studies, data, and expert opinions that explain the hazards of exposure can help. Request a CE course for your facility or local AORN chapter to start the conversation from a place of learning. 

Address concerns. Each facility faces its own unique set of barriers to implementing smoke evacuation. Gain a keen understanding of these obstacles so you can help problem solve and brainstorm ways to overcome them. Partnering with smoke evacuation providers who have experience overcoming lots of different types of challenges may also prove beneficial. 

Engage key stakeholders. No one can fight this fight alone. Change must come from a collection of leaders coming together to plan for the better. Request transparency and foster open communication about surgical smoke. Agree on the common end goal – a safer OR for everyone – and work backwards from there. Get involved in the decision-making process by presenting data, success stories, and firsthand experiences from others who have walked a similar path. 

CONMED is committed to the movement towards smoke-free ORs because we believe every breath matters. To discuss options for education or smoke evacuation, reach out to your local CONMED Representative. 

1 Steege AL, Boiano JM, Sweeney MH. Secondhand smoke in the operating room? Precautionary practices lacking for surgical smoke. Am J Ind Med. 2016;59(11):1020-1031.
2 Choi SH, Kwon TG, Chung SK, Kim TH. Surgical smoke may be a biohazard to surgeons performing laparoscopic surgery. Surgical endoscopy. 2014;28:2374–80.
Pierce JS, Lacey SE, Lippert JF, Lopez R, Franke JE. Laser-generated air contaminants from medical laser applications: a state-of-the-science review of exposure characterization, health effects, and control. J Occup Environ Hyg. 2011;8(7):447-466
Liu Y, Song Y, Hu X, Yan L, Zhu X. Awareness of surgical smoke hazards and enhancement of surgical smoke prevention among the gynecologists. Journal of Cancer, 2019; 10(12):2788-2799
5 Bernard, D. (2013, January 14). Clearing the air, for safety's sake. Outpatient Surgery Magazine, Smoke Evacuation Success Stories.