The nature and hazards of diathermy plumes: a review

Perioperative nurses in the OR may experience more extensive and sustained exposure to surgical plumes than other surgical personnel. Compared with laser plumes, less policy attention has been given to mitigating the risks associated with exposure to diathermy plumes. Diathermy can produce ultrafine particles and volatile chemical and biological substances, of which a number are teratogenic or carcinogenic. Evidence suggests diathermy plumes contain more biohazards than laser plumes, although protective smoke evacuation equipment is less likely to be used with diathermy. Although there is no direct evidence of harm to OR personnel, further research is required to conclusively establish actual risks and appropriate standards for safe exposure. Interventional strategies should address staff attitudes toward diathermy plume exposure and protective measures. This structured review of the literature describes the nature and risks associated with exposure to diathermy plumes and clarifies the implications for protective techniques and nursing practices.