Kim York: The Big, Bad Black Cloud You May Not Know About

This article originally appeared in the Fayetteville Observer.

North Carolina is the nation’s largest grower of tobacco — but almost 10 years ago, it passed the strict Smoke-Free Restaurants and Bars law, banning smoke from thousands of establishments across the state. It may come as a surprise, then, that there is still a place where you, your doctors, nurses and an entire team of medical professionals are exposed to significant amounts of toxic smoke on a day-to-day basis.

It’s a place that most of us visit at least once during our lives, sometimes more. If you haven’t been there yet, chances are someone close to you already has. This place is the surgical suite, better known as the operating room. Whether at a hospital or ambulatory surgery center, if you have had an invasive procedure, it’s very likely you have been exposed to toxic surgical smoke.

Surgical smoke, sometimes called surgical plume, is produced when devices that seal blood vessels and cut through human tissue are heated to high temperatures, a process necessary for nearly all invasive surgeries. When the cells explode, they release water and other byproducts that are almost identical to the chemicals found in second-hand tobacco smoke, the same fumes linked to causing cancer. Some of the familiar compounds include benzene, toluene and carbon monoxide; overall, these noxious substances number over 150 and are known to cause many reactions from sneezing, itchy eyes and coughing to more severe respiratory symptoms such as bronchitis, asthma and cancer.

Over 500,000 healthcare workers and almost all surgical patients are exposed to surgical smoke every year in the United States. Many surgical teams inhale quantities of surgical plume that equate to smoking approximately 30 unfiltered cigarettes in a day. The particles in the smoke are so tiny that they are absorbed in the deepest part of the lungs, where they can then travel around the body to all the organs and tissues.

The immediate effects are measurable in the urine and blood and can last for days and sometimes weeks. But with continuous exposure, operating room teams are known to have an almost 50 percent higher likelihood of contracting symptoms of diseases in the respiratory system. While this much is sure, it remains to be seen just how dangerous regular exposure to surgical smoke can be: the exact modes of transmission of disease, the full range of damage and long term impact on the body.

When I first entered an operating room 11 years ago, I knew that I couldn’t spend long days breathing in toxic smoke. I shouldn’t sacrifice my own health to be in the operating room. Nor should my colleagues. Nor should my patients.

Because of this problem, several nations around the world have mandated the use of surgical smoke evacuation devices, yet the United States has been slow to respond. Just last week, Rhode Island became the first state to sign legislation that requires the evacuation of surgical smoke in all hospitals and freestanding ambulatory facilities. States such as California and Colorado have introduced legislation to protect surgical teams and patients from inhaling toxic surgical smoke, though they have not yet been successful.

Though North Carolina hasn’t introduced legislation for surgical smoke, it’s still the responsibility of healthcare facilities to ensure healthcare workers are working in a smoke-free, safe and healthy environment. If smoking is too dangerous for bars and restaurants, then toxic smoke is too dangerous for hospitals.

Kim York is a registered nurse and Director of Surgical Services at Dosher Memorial Hospital in Southport, NC.

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