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Senate of Pennsylvania
Session of 2021 - 2022 Regular Session


Posted: December 7, 2020 03:29 PM
From: Senator Katie J. Muth and Sen. Maria Collett, Sen. Amanda M. Cappelletti
To: All Senate members
Subject: Surgical Smoke Evacuation
In the near future, we will be introducing legislation that would ensure that operating rooms utilize surgical smoke evacuation systems to combat the negative health effects of surgical smoke and work towards creating a smoke-free environment for Pennsylvania’s healthcare workers and patients. 

Surgical smoke, or bovie smoke, is produced from the use of high-heat electrical tools such as lasers or electrosurgical devices used to dissect and cauterize tissue during surgery. Not only does this smoke have a repulsive odor and can obscure one’s view of the surgical site, it behaves as a carcinogen, a mutagen and an infectious vector.

The need for this legislation now has new urgency due to the COVID-19 pandemic.  According to the Association of periOperative Registered Nurses (AORN), research has shown the presence of viruses (e.g. human papilloma virus) in surgical smoke with documented transmission to healthcare providers.  Although there has not yet been time to test for the transmission of COVID-19 through surgical smoke, the American College of Surgeons is recommending the use of a smoke evacuator where surgical smoke will be present in recognition of the hazard posed by aerosolization and droplet transmission of the COVID-19 virus.  

Even without the risk to our healthcare workers of the spread of COVID-19, surgical smoke is a serious health hazard on its own.  The National Institute for Occupational Safety and Health (NIOSH) has found that surgical smoke may contain toxic gases, viruses and bacteria, and more than 150 hazardous chemicals, including EPA priority pollutants.  NIOSH has found that burning 1 gram of tissue has the same effect as breathing in 3-6 cigarettes.  Another study revealed that one day’s exposure to surgical smoke was the equivalent of inhaling the smoke of 27-30 cigarettes. 

NIOSH has also determined that evacuation of the smoke near the source has the greatest likelihood of preventing exposure and any health consequences associated with it and that general room ventilation by itself is not adequate to clear contaminants at the source. 

By requiring operating rooms within hospitals and ambulatory surgical centers to utilize smoke evacuation systems, this legislation conforms to important guidance on reducing the transmission of COVID-19 and protects healthcare workers from the harmful components of surgical smoke.

Rhode Island and Colorado have already enacted such a law and Connecticut, New Jersey, Kentucky, Tennessee, Georgia, Illinois, Iowa, Utah and Oregon are considering similar legislation. 

Please join us in co-sponsoring this legislation creating smoke free operating rooms for Pennsylvania’s patients and healthcare workers.

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Introduced as SB903