The Exposure of Surgeons to Volatile Organic Compounds in Electrosurgical Smoke Resulted from Surgeries
Date Issued
2016
Date
2016
Author(s)
Cheng, Nai-Yun
Abstract
Using electrosurgical units (EU) effectively improve the efficiency and safety of surgery. However, the resulted electrosurgical smoke could make surgeons and relevant health workers uncomfortable and even adverse health effects to them. Surgical mask is the usual personal protective equipment for surgeons and relevant health workers in the regular surgical procedures, which could not provide effective protection for volatile organic compounds (VOCs) in electrosurgical smoke. This study aimed to assess the exposure level of VOCs in electrosurgical smoke for surgeons and relevant health worker by surgical division, EU type and use time of EU. Area samples were collected from surgeries and breath samples were collected from surgeons and relevant health workers before and after surgical procedure in an area hospital located in northern Taiwan. This study also investigated the self-reported symptoms of surgeon and relevant health workers after each surgery in order to assess the relationship of electrosurgical smoke exposure and health effect. Results showed that 15 VOCs were detected in breath samples. Among them, 13 VOCs were also found in area samples, such as sevoflurane, hexane, benzene, toluene, m/p-xylene and hexamethyldisiloxane etc. High compliance in VOC species between two types of samples implies that breath samples might reflect the exposure scenario of electrosurgical smoke during electrosurgical procedures. Benzene level in breath samples significantly increased for surgeons who experienced longer time for EU use (p = 0.031). Comparing the results of breath samples after surgery between traditional and endoscopy surgeries, samples of surgeons of traditional surgeries presented higher VOCs (benzene and toluene etc.) exposure level, while surgeons who used Pulsed Electron Avalanche Knife (PEAK) in surgical procedures showed lower exposure levels of VOCs (hexane and toluene etc.) in electrosurgical smoke than those surgeons who used electrocautery. In addition, the levels of benzene in breath samples after surgery were significantly higher among surgeons who reported cough and shortness of breath after surgical procedure. On the other hand, this study also found that the maximum level of sevoflurane, one kind of anesthetic gas, in the operating room already exceeded the action level and warranted immediate measures to lower this kind of exposure. Besides, sevoflurane in breath samples of surgeons also significantly increased as the surgical time lasted longer (p = 0.011). This study illustrated that use time of EU, type of EU and endoscopic surgery were the factors which effected the exposure level of VOCs in electrosurgical smoke and exposure to attention-requiring anesthetic gas level were common for surgeons and relevant health workers. It’s expected that our findings would urge the hospitals to adopt the necessary exposure prevention measure and adequate ventilation system in operating room in order to protect the health of surgeons and relevant health workers.
Subjects
electrosurgical smoke exposure
volatile organic compound
anesthetic
breath sampling
self-reported symptom
Type
thesis
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