Occupational HPV Exposure in Otolaryngology: A Scoping Review of Detection, Risk, and Prevention

To characterize the current evidence regarding occupational human papillomavirus (HPV) exposure in otolaryngology, including mechanistic evidence of plume contamination, clinical evidence of infection among healthcare workers, and preventive practices related to personal protective equipment (PPE) and vaccination.

This OSF-registered PRISMA-ScR review evaluated English-language studies on occupational HPV exposure among otolaryngologists. The MEDLINE, EMBASE, SCOPUS, Web of Science, and CINAHL databases were searched from inception to March 3, 2026. Data regarding procedural exposures, HPV detection, clinician infection, PPE utilization, vaccination practices, and occupational risk perception were extracted. Risk of bias was assessed using Joanna Briggs Institute appraisal tools.

Ten studies published between 1990 and 2025 were included. Most studies focused on recurrent respiratory papillomatosis (RRP)-related procedures. HPV DNA was detected in plume generated during some CO₂ laser procedures, while electrocautery and potassium titanyl phosphate laser-associated contamination often did not detect HPV DNA. One study demonstrated contamination of surgical gloves following RRP treatment, although oral mucosal samples remained negative. Clinical evidence of infection was limited to one observational study, which found oral HPV positivity in 2.2% of clinicians involved in RRP treatment, a prevalence not greater than that of the general population. PPE utilization, smoke evacuation practices, and HPV vaccination uptake varied substantially across studies.

Current evidence supports the plausibility of HPV exposure during ENT procedures; however, evidence demonstrating viable virus or clinically meaningful transmission remains limited. Inconsistent PPE utilization and vaccination practices highlight the need for further prospective studies and development of specialty-specific occupational safety recommendations.