Surgical smoke: still an underestimated health hazard in the operating theatre.

Kocher, Gregor; Sesia, Sergio Bruno; Lopez-Hilfiker, Felipe; Schmid, Ralph (2019). Surgical smoke: still an underestimated health hazard in the operating theatre. European journal of cardio-thoracic surgery, 55(4), pp. 626-631. Oxford University Press 10.1093/ejcts/ezy356

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OBJECTIVES Smoke generated from electrocautery dissection contains irritating and/or carcinogenic components. The aim of this study was to investigate the effectiveness of a mobile smoke evacuation system (SES) in protecting surgical personnel from these hazardous fumes. METHODS Standardized cuts with an electrocautery device were performed on fresh porcine tissue, and the generated surgical fume was analysed with and without the additional use of a mobile SES using a real-time proton-transfer-reaction time-of-flight mass spectrometer. Furthermore, 2 different surgical masks were tested to investigate their filter capacity. RESULTS Several toxic and/or carcinogenic volatile organic compounds including 1,3-butadiene, benzene and furfural were found in concentrations clearly above the limits that were set by the National Institute of Occupational Safety and Health: 1,3-butadiene at 19.06 ± 1.54 ppb (limit: 5 ppb), benzene at 6.21 ± 1.33 ppb (limit: 0.5 ppb) and furfural at 14.34 ± 2.97 ppb (limit: 2 ppb). Although the mobile SES was able to reduce these substances to a certain degree, butadiene and benzene still remained above the permissible exposure limits with concentrations of 14.21 ± 0.07 and 1.16 ± 0.05, respectively. Both surgical masks were unable to reduce the 'inhaled' concentrations of volatile organic compounds. CONCLUSIONS Although the SES reduced the concentrations of most of the detected volatile organic compounds to a certain amount, especially the carcinogenic substances, butadiene and benzene remained high above exposure limits. According to the abovementioned significant data, further investigation on this topic is imperative, especially when considering that surgical masks were absolutely ineffective in protecting individuals from the toxic smoke and that the cautery was only used for 10 s in this experiment.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Thoraxchirurgie
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Thoracic Surgery

UniBE Contributor:

Kocher, Gregor; Sesia, Sergio Bruno and Schmid, Ralph


600 Technology > 610 Medicine & health




Oxford University Press




Thomas Michael Marti

Date Deposited:

12 Feb 2019 14:48

Last Modified:

12 Nov 2019 12:44

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