Surgical Smoke as an Occupational Hazard: Exposure of Healthcare Workers, Preventive Strategies, and Institutional Responsibility
DOI:
https://doi.org/10.64784/329Palabras clave:
surgical smoke, surgical plume, occupational exposure, healthcare workers, electrosurgery, ultrafine particles, volatile organic compounds, smoke evacuation, occupational health, operating room, preventive measures, institutional responsibility, occupational safety, legal medicineResumen
Surgical smoke is an occupational hazard generated during the use of electrosurgical units, lasers, ultrasonic devices, and other energy-based technologies capable of producing thermal disruption of biological tissue. This study analyzed occupational exposure to surgical smoke among healthcare professionals, its physical, chemical, and biological components, associated health manifestations, preventive measures, and institutional responsibilities related to risk control. A structured integrative documentary review was conducted using the Scientific Method, incorporating evidence from clinical studies, occupational exposure assessments, systematic reviews, preventive intervention studies, and occupational-safety regulations. The analyzed evidence demonstrated that surgical smoke contains ultrafine particles, volatile organic compounds, cellular debris, and, under certain conditions, detectable biological material. Exposure was identified among surgeons, nurses, anesthesiology personnel, residents, technicians, and other operating-room professionals, with substantial variability according to the type of surgical procedure, energy device, proximity to the operative field, duration of exposure, ventilation, and use of smoke-evacuation systems. Reported manifestations included headache, cough, ocular irritation, throat discomfort, and other nonspecific symptoms, although current evidence does not establish a direct causal relationship between surgical-smoke exposure and specific long-term diseases such as cancer. Preventive interventions, particularly local smoke evacuation, demonstrated significant reductions in airborne contaminants, including decreases in acetaldehyde, formaldehyde, and particulate concentrations. The findings support the implementation of engineering controls, adequate ventilation, appropriate personal protective equipment, staff training, occupational surveillance, and standardized institutional protocols. Surgical smoke should therefore be considered a multidisciplinary occupational-safety problem requiring coordinated action from General Surgery, Occupational Medicine, Legal Medicine, and healthcare institutions to reduce preventable exposure and strengthen operating-room safety.
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