Evaluation of a smoke extraction system for veterinarian exposures to surgical smoke-A pilot study

Electrosurgery generates surgical smoke, which contains hazardous compounds. The concentration, composition, and size distribution of surgical smoke vary significantly with surgery type, duration, and number of times electrocautery is used. Exposure assessments have focused on characterizing occupational exposure to surgical smoke during human surgeries, but occupational exposure to surgical smoke during veterinary surgeries is largely unknown. Given the hazardous exposure concentrations identified in human surgical procedures, similar occupational exposures are expected in small animal surgeries. Thus, there is a critical need to evaluate occupational exposures among veterinarians conducting small animal surgeries and to evaluate potential exposure reduction systems. The objectives of the study are to quantify the particle number concentration and size distribution during canine limb amputation (CLA) surgery and to quantify the exposure reductions associated with a smoke evacuation system (SES). Exposure to ultrafine particles (UFP) during CLA was measured using a TSI NanoScan Scanning Mobility Particle Sizer (SMPS) Nanoparticle Sizer 3910 during surgeries with and without the SES. Particle number concentrations were 11 times higher compared to background concentrations during CLA surgeries. The particle number concentration was significantly reduced when using SES during surgery compared to surgeries without SES. The average total particle number concentration near the veterinarian's breathing zone was 25,141 particles/cm³ for surgeries without SES and 7,643 particles/cm³ when the SES was used during surgeries, which represents about a 70% reduction in exposure. CLA was associated with particle exposures similar to those seen in human surgeries. The use of SES effectively reduced the concentration of particles near the surgeon's breathing zone.