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Smoke from surgical lasers as well as other tissue-burning surgical tools contains potentially toxic substances that make their way readily past surgical masks and into the lungs of operating room personnel. Suzanne Kiraly, president of the Canadian Standards Association (CSA) reports that the "smoke created by burning one gram of tissue is equivalent to smoking three unfiltered cigarettes". She adds that over 600 different organic substances have been identified in the "plume" of smoke created when tissue is burned in the surgical environment. The vapors can include cellular debris, toxic metals, aerosolized blood and blood-borne pathogens, and chemicals such as benzene or hydrogen cyanide.


Kiraly continues to note that harmful effects resulting from exposure to these substances include irritation to the eyes, nose and throat; liver and kidney damage; carcinogenic cell changes; headaches, dizziness and drowsiness. One specific problem attributed to surgical "plume" involved a physician who developed a rare throat tumor caused by human papillomavirus (HPV).DNAtests revealed that the tumor contained HPV DNA types identical to those of patients this physician had treated using a laser, most likely transferred to him through surgical "plume" emanating from lasered tissues.


Susan Taylor, a nurse educator at St Joseph's Health Care in London, Ontario says that the use of "plume evacuating systems" has the potential o improve the quality of life for health care workers. Taylor also explains that patients are at lower risk for inhaling the "plume" during surgery since they are almost always on a ventilator.


Standards for control of surgical 'plume" in the United States have been evaluated and/or proposed. (1) Nursing students who desire to work in the surgical environment should be made aware of these risks and methods to decrease risk.


Source: Ubelecker S. Wednesday, March 19, 2009. Smoke from tissue-burning tools like lasers can be toxic to surgical team. Lethbridge Herald. Available at Accessed March 26, 2009.




1. Bigony L. Risks associated with exposure to surgical plume smoke: A review of the literature. AORN Jour. 2007;86(6):1013-20. [Context Link]