Evaluation of surgeon’s exposure to formaldehyde, PM 2.5, and volatile organic compounds

Background and Objectives: Electrocautery is an essential tool in surgery used for dissecting tissue layers and to control bleeding. Health risks from the exposure to surgical smoke are not completely understood. The purpose of this study was to measure the extent of exposure to chemicals present in surgical smoke during surgery.

Methods: Personal air monitoring of known carcinogens such as formaldehyde and volatile organic compounds (VOCs) and real-time area monitoring of PM 2.5 particles originating from electrocautery use was conducted during a live surgery. A quantitative survey was administered to surgeons in a medical center to assess the exposure and health effects related to surgical smoke. Personal air monitoring was achieved by measuring the concentration of formaldehyde and VOCs from passive samplers placed on surgeons’ caps. A particle counter was used to monitor the concentration of PM 2.5 particles in the surgical field. A health symptoms questionnaire was collected from 43 surgeons in a medical center located in a Midwestern state.

Results: A low but detectable level of formaldehyde was reported from sampled data during personal exposure monitoring. The mean concentration of PM 2.5 particles during the active use of electrocautery period was 795 μg/m3 and was far greater than background and post-exposure concentrations. The irritation of upper respiratory mucosa after the use of electrocautery were commonly reported in the survey.

Conclusions: The study was highlighted by the detectable presence of formaldehyde in personal environment. Future research should explore cause-and-effect relationship of occupational exposure to surgical smoke at low levels.