A Surgical Smoke: The Hidden Health Hazard to Healthcare Workers in the Operating Room: A Literature Review

Abstract

This study Surgical smoke, produced during procedures involving electrosurgical units, lasers, and other heat-generating tools, is a hazardous by-product that threatens the health of operating room (OR) personnel. It contains a mixture of toxic chemicals, bioaerosols, viable cellular materials, and infectious agents. Surgeons, anesthesiologists, nurses, and surgical technologists are repeatedly exposed to this smoke during operations. Despite its well-documented risks, evacuation and filtration practices remain inconsistent across healthcare facilities, and legislative mandates for smoke evacuation exist in only a few regions. This article attempts to sort through the available data and draw some reasonable conclusions regarding surgical smoke. In general, surgical smoke is a biohazard and cannot be ignored. Findings highlight the need for increased awareness, education, and implementation of safety measures. This review aims to assess the health risks associated with surgical smoke exposure, evaluate current awareness among OR staff, and examine the effectiveness of existing mitigation strategies. The goal is to inform healthcare professionals and administrators of the urgent need for standardized smoke evacuation protocols. A comprehensive literature review was conducted using peer-reviewed journal articles, clinical studies, and public health reports. The review focused on the chemical composition of surgical smoke, its short- and long-term health effects on healthcare workers, and the level of institutional and individual awareness and adherence to safety guidelines. Surgical smoke contains over 150 hazardous chemicals, including benzene, hydrogen cyanide, and formaldehyde, as well as viruses such as HPV. Exposure has been linked to respiratory irritation, nausea, headaches, and increased risk of chronic illnesses, including cancer. Awareness among healthcare workers remains low, and the use of smoke evacuation systems is not standardized. Facilities with mandated evacuation policies show better compliance and reduced health complaints among staff. Surgical smoke is a significant occupational hazard that demands greater attention. Comprehensive education, stronger policy enforcement, and universal implementation of smoke evacuation systems are essential to safeguarding healthcare workers.