By Marilynn Larkin
NEW YORK (Reuters Health) - Close to three-quarters of dermatology residents feel they are not adequately protected from carcinogens and infectious diseases in surgical smoke, researchers say.
Dr. Lance Chapman of the University of California-Irvine Medical Center told Reuters Health in email, “Our study highlights that most clinicians do feel that surgical smoke contains toxic compounds that pose significant health concerns, yet only a minority actually use protective measures such as a mask and/or a smoke evacuator.”
Dr. Chapman and colleagues sent a link to an anonymous online survey to dermatology residency programs in the U.S. A total of 153 (44% male) residents responded to the survey, which asked whether they: wear a mask during electrosurgery, and if so, what type; were educated about the hazards of surgical smoke; had a smoke evacuation system and/or high-efficiency particulate air filter in rooms where electrosurgery is performed; were concerned about transmission of infectious diseases and/or presence of carcinogens in surgical smoke; and thought that adequate precautions were being taken to protect them from surgical smoke.
As reported in JAMA Dermatology, online March 1, 71.9% of residents said they did not receive formal education on the hazards of electrosurgery smoke; 69.2% said they “sometimes or never” wore a mask during electrosurgery and 88.2% said they never wore a high-filtration (N95) mask.
Forty-five percent did not know if a smoke evacuation system was available in rooms where electrosurgery was performed. Despite low reported use of protective equipment, 76.5% were concerned about infectious disease transmission via surgical smoke and 71.9% were concerned about carcinogens. Close to three quarters (73%) said adequate precautions were not being taken to protect them.
Dr. Chapman noted that while the study “does not examine motivations for not taking proper precautions . . . it is known that N95 masks do pose an additional cost to a clinic, as does the investment in a smoke evacuator.”
Dr. John Meyer, director of the Occupational Medicine Residency Program at Icahn School of Medicine in New York City, told Reuters Health that risks to clinicians “include transmission of human papillomavirus . . . human immunodeficiency virus, and some bacteria, such as Staph and E. coli, all of which have been found in viable particles in electrocautery or medical laser smoke.”
“Although the authors indicate the potential generation and inhalation of carcinogenic chemicals such as benzene, it is less clear whether these exposures are significant in amount or duration, whereas viral particles in small numbers may still be infectious,” he said by email.
“Smoke evacuators have been recommended,” he continued. “The use of N95 respirator masks . . . should be strongly encouraged as well, (rather than) surgical masks, which are variable in their filtering capacity, and are not tightly sealed against the face and breathing zones to form a barrier as is the N95 mask.”
Dr. Meyer took issue with the notion that cost could be a barrier to protective measures.
“A busy outpatient service can likely well afford the estimated cost of the smoke evacuator,” he said. “More to the point, N95 masks are reusable - as opposed to surgical masks, which are thrown away after almost every procedure - and can remain functional for long periods of time, obviating the cost differential. Use of these should be encouraged somewhat more than the authors indicate.”
Dr. Gary Chuang of the David Geffen School of Medicine at the University of California, Los Angeles, who has done related work (https://bit.ly/29DQ74N), told Reuters Health by email, “Clinicians may not be taking precaution because they are either unaware of the health risks posed by surgical plume or poorly educated on plume protection. Bringing this awareness and knowledge to training programs will have a long-lasting impact.”
Patients, he added, “should be wary of going to offices with poor air ventilation or undergoing procedures without proper suction filter devices."
Dr. Kally Papantoniou, assistant clinical professor of dermatology at The Mount Sinai Hospital in New York City with a private practice in Great Neck, New York, told Reuters Health, “In my practice, I do not wear protective respiratory masks, but I will use a medical-grade vacuum to reduce exposure to both the patient and staff.”
“It is a concern that these seemingly harmless procedures can be increasing the risk for health problems for practitioners,” she said by email. “For patients, the short and infrequent exposure to the fumes will make it less likely to pose a health hazard, but for those who are having daily exposure it would be prudent to take better safety precautions.”
“Further research should be done to see what the risk is to patients,” Dr. Papantoniou concluded.
SOURCE: https://bit.ly/2nnlJSx
JAMA Dermatol 2017.
(c) Copyright Thomson Reuters 2017. Click For Restrictions - https://about.reuters.com/fulllegal.asp
By Marilynn Larkin
NEW YORK (Reuters Health) - Close to three-quarters of dermatology residents feel they are not adequately protected from carcinogens and infectious diseases in surgical smoke, researchers say.
Dr. Lance Chapman of the University of California-Irvine Medical Center told Reuters Health in email, “Our study highlights that most clinicians do feel that surgical smoke contains toxic compounds that pose significant health concerns, yet only a minority actually use protective measures such as a mask and/or a smoke evacuator.”
Dr. Chapman and colleagues sent a link to an anonymous online survey to dermatology residency programs in the U.S. A total of 153 (44% male) residents responded to the survey, which asked whether they: wear a mask during electrosurgery, and if so, what type; were educated about the hazards of surgical smoke; had a smoke evacuation system and/or high-efficiency particulate air filter in rooms where electrosurgery is performed; were concerned about transmission of infectious diseases and/or presence of carcinogens in surgical smoke; and thought that adequate precautions were being taken to protect them from surgical smoke.
As reported in JAMA Dermatology, online March 1, 71.9% of residents said they did not receive formal education on the hazards of electrosurgery smoke; 69.2% said they “sometimes or never” wore a mask during electrosurgery and 88.2% said they never wore a high-filtration (N95) mask.
Forty-five percent did not know if a smoke evacuation system was available in rooms where electrosurgery was performed. Despite low reported use of protective equipment, 76.5% were concerned about infectious disease transmission via surgical smoke and 71.9% were concerned about carcinogens. Close to three quarters (73%) said adequate precautions were not being taken to protect them.
Dr. Chapman noted that while the study “does not examine motivations for not taking proper precautions . . . it is known that N95 masks do pose an additional cost to a clinic, as does the investment in a smoke evacuator.”
Dr. John Meyer, director of the Occupational Medicine Residency Program at Icahn School of Medicine in New York City, told Reuters Health that risks to clinicians “include transmission of human papillomavirus . . . human immunodeficiency virus, and some bacteria, such as Staph and E. coli, all of which have been found in viable particles in electrocautery or medical laser smoke.”
“Although the authors indicate the potential generation and inhalation of carcinogenic chemicals such as benzene, it is less clear whether these exposures are significant in amount or duration, whereas viral particles in small numbers may still be infectious,” he said by email.
“Smoke evacuators have been recommended,” he continued. “The use of N95 respirator masks . . . should be strongly encouraged as well, (rather than) surgical masks, which are variable in their filtering capacity, and are not tightly sealed against the face and breathing zones to form a barrier as is the N95 mask.”
Dr. Meyer took issue with the notion that cost could be a barrier to protective measures.
“A busy outpatient service can likely well afford the estimated cost of the smoke evacuator,” he said. “More to the point, N95 masks are reusable - as opposed to surgical masks, which are thrown away after almost every procedure - and can remain functional for long periods of time, obviating the cost differential. Use of these should be encouraged somewhat more than the authors indicate.”
Dr. Gary Chuang of the David Geffen School of Medicine at the University of California, Los Angeles, who has done related work (https://bit.ly/29DQ74N), told Reuters Health by email, “Clinicians may not be taking precaution because they are either unaware of the health risks posed by surgical plume or poorly educated on plume protection. Bringing this awareness and knowledge to training programs will have a long-lasting impact.”
Patients, he added, “should be wary of going to offices with poor air ventilation or undergoing procedures without proper suction filter devices."
Dr. Kally Papantoniou, assistant clinical professor of dermatology at The Mount Sinai Hospital in New York City with a private practice in Great Neck, New York, told Reuters Health, “In my practice, I do not wear protective respiratory masks, but I will use a medical-grade vacuum to reduce exposure to both the patient and staff.”
“It is a concern that these seemingly harmless procedures can be increasing the risk for health problems for practitioners,” she said by email. “For patients, the short and infrequent exposure to the fumes will make it less likely to pose a health hazard, but for those who are having daily exposure it would be prudent to take better safety precautions.”
“Further research should be done to see what the risk is to patients,” Dr. Papantoniou concluded.
SOURCE: https://bit.ly/2nnlJSx
JAMA Dermatol 2017.
(c) Copyright Thomson Reuters 2017. Click For Restrictions - https://about.reuters.com/fulllegal.asp
By Marilynn Larkin
NEW YORK (Reuters Health) - Close to three-quarters of dermatology residents feel they are not adequately protected from carcinogens and infectious diseases in surgical smoke, researchers say.
Dr. Lance Chapman of the University of California-Irvine Medical Center told Reuters Health in email, “Our study highlights that most clinicians do feel that surgical smoke contains toxic compounds that pose significant health concerns, yet only a minority actually use protective measures such as a mask and/or a smoke evacuator.”
Dr. Chapman and colleagues sent a link to an anonymous online survey to dermatology residency programs in the U.S. A total of 153 (44% male) residents responded to the survey, which asked whether they: wear a mask during electrosurgery, and if so, what type; were educated about the hazards of surgical smoke; had a smoke evacuation system and/or high-efficiency particulate air filter in rooms where electrosurgery is performed; were concerned about transmission of infectious diseases and/or presence of carcinogens in surgical smoke; and thought that adequate precautions were being taken to protect them from surgical smoke.
As reported in JAMA Dermatology, online March 1, 71.9% of residents said they did not receive formal education on the hazards of electrosurgery smoke; 69.2% said they “sometimes or never” wore a mask during electrosurgery and 88.2% said they never wore a high-filtration (N95) mask.
Forty-five percent did not know if a smoke evacuation system was available in rooms where electrosurgery was performed. Despite low reported use of protective equipment, 76.5% were concerned about infectious disease transmission via surgical smoke and 71.9% were concerned about carcinogens. Close to three quarters (73%) said adequate precautions were not being taken to protect them.
Dr. Chapman noted that while the study “does not examine motivations for not taking proper precautions . . . it is known that N95 masks do pose an additional cost to a clinic, as does the investment in a smoke evacuator.”
Dr. John Meyer, director of the Occupational Medicine Residency Program at Icahn School of Medicine in New York City, told Reuters Health that risks to clinicians “include transmission of human papillomavirus . . . human immunodeficiency virus, and some bacteria, such as Staph and E. coli, all of which have been found in viable particles in electrocautery or medical laser smoke.”
“Although the authors indicate the potential generation and inhalation of carcinogenic chemicals such as benzene, it is less clear whether these exposures are significant in amount or duration, whereas viral particles in small numbers may still be infectious,” he said by email.
“Smoke evacuators have been recommended,” he continued. “The use of N95 respirator masks . . . should be strongly encouraged as well, (rather than) surgical masks, which are variable in their filtering capacity, and are not tightly sealed against the face and breathing zones to form a barrier as is the N95 mask.”
Dr. Meyer took issue with the notion that cost could be a barrier to protective measures.
“A busy outpatient service can likely well afford the estimated cost of the smoke evacuator,” he said. “More to the point, N95 masks are reusable - as opposed to surgical masks, which are thrown away after almost every procedure - and can remain functional for long periods of time, obviating the cost differential. Use of these should be encouraged somewhat more than the authors indicate.”
Dr. Gary Chuang of the David Geffen School of Medicine at the University of California, Los Angeles, who has done related work (https://bit.ly/29DQ74N), told Reuters Health by email, “Clinicians may not be taking precaution because they are either unaware of the health risks posed by surgical plume or poorly educated on plume protection. Bringing this awareness and knowledge to training programs will have a long-lasting impact.”
Patients, he added, “should be wary of going to offices with poor air ventilation or undergoing procedures without proper suction filter devices."
Dr. Kally Papantoniou, assistant clinical professor of dermatology at The Mount Sinai Hospital in New York City with a private practice in Great Neck, New York, told Reuters Health, “In my practice, I do not wear protective respiratory masks, but I will use a medical-grade vacuum to reduce exposure to both the patient and staff.”
“It is a concern that these seemingly harmless procedures can be increasing the risk for health problems for practitioners,” she said by email. “For patients, the short and infrequent exposure to the fumes will make it less likely to pose a health hazard, but for those who are having daily exposure it would be prudent to take better safety precautions.”
“Further research should be done to see what the risk is to patients,” Dr. Papantoniou concluded.
SOURCE: https://bit.ly/2nnlJSx
JAMA Dermatol 2017.
(c) Copyright Thomson Reuters 2017. Click For Restrictions - https://about.reuters.com/fulllegal.asp
