Surgical Smoke Legislation

See the status of legislation passed at the country
and state levels:


Guideline on Work Health and Safety-Controlling Exposure to Surgical Plume published by government in 2015

  • Conduct surgical risk assessments
  • Implement controls to address identified risks
  • Monitor controls to ensure effective smoke evacuation


Canadian Standards Group (CSG)

Developed smoke evacuation standard in Canada in 2009, revised 2013

  • Z305.13-13 Plume Scavenging in Surgical, Diagnostic, Therapeutic, and Aesthetic Settings
  • Outlines purchase, install, test, use, service, and maintenance of systems

The Canadian Standards Group (CSG), formerly known as the Canadian Standards Association (CSA), is a standards development organization responsible for testing, inspecting and certifying products in healthcare and other market standards. CSG Health & Safety standards are recognized by regulatory bodies including the Standards Council of Canada (SCC) and the U.S. Occupational Safety and Health Administration (OSHA). CSG developed a standard for smoke evacuation in Canada in 2009 and revised the standard in 2013; titled Z305.13-13 Plume Scavenging in Surgical, Diagnostic, Therapeutic, and Aesthetic Settings, this standard outlines information on purchasing, installing, testing, using, servicing, and maintaining plume scavenging systems (eg, surgical smoke evacuation). This standard states that any healthcare facility applying techniques that create plume must have policies that address potential associated hazards. It also discusses the application of required engineering controls to mitigate surgical smoke exposure risk, such as ensuring 20 total air exchanges per hour.


  • 2010 Working Environment Act - mandates the removal of surgical smoke
  • Many Nordic countries have followed suit without regulation

United Kingdom

Guideline established by British Occupational Hygiene Society (BOHS)

Discusses engineering controls to mitigate risk

  • LEV
  • Min of 22 liters/minute

Medicines and Healthcare products Regulatory Agency (MHRA)

Recommends evacuation during laser surgery

  • Extractor nozzle inlet placed close to plume generation point
  • Masks considered 2nd level of defense


Colorado has legislation pending.


Connecticut has legislation pending.


Georgia has legislation pending.


Iowa has legislation pending.


Illinois has legislation pending.


Kentucky has legislation pending.

New Jersey

New Jersey has legislation pending.


Oregon has legislation pending.

Rhode Island

Rhose Island legislation (law to make OR’s smoke free) became effective January 2019


Tennessee has legislation pending.


Utah has legislation pending.

New Zealand

New Zealand has enacted regulations that carry the force of law to protect surgical workers from surgical smoke.