Clinical Studies

 Australian Standards

Standard 2015 “Systems for evacuation of plume generated by medical devices”
Author: Standards Australia
Published: 2015, Australian/New Zealand Standard AS/NZS ISO 16571

Standard 1994 “Guide to the safe use of lasers in Health Care”
Author: Standards Australia
Published: 1994, Australian/New Zealand Standard AS/NZS 4173

Standard 2002 “Surgical Plume in the Operating Theatre”
Author: Australian Council of Operating Room Nurses ACORN
Published: ACORN Standards 2002, Ref: A21, Current Issue: May 2002

Standard 1998 “Laser Safety in Practice Settings”
Author: Australian Council of Operating Room Nurses ACORN
Published: ACORN Standards 1998, Ref: A11, Current Issue: May 1998.

 Other Standards And Guidelines

Guideline 2009: “IFPN Guideline on Smoke Plume”
Author: IFPN, 2009
CB Ref #: N/A

Hazard Control: Hazard control 11 (HC11)
Author: NIOSH
Publication: Number: 96-128 – September 1996
CB Ref #: N/A

 Studies & Articles (In Chronological Order)

Article 2015: “Experimental study of the potential hazards of surgical smoke from powered instruments”
Author: S. M. In, D. -Y. Park, I.K. Sohn, C.-H. Kim, H. L. Lim, S.-A. Hong, D. Y. Jung, S.-Y. Jeong, J. H. Han, H. J. Kim
Publication: British Journal of Surgery, Volume 102, Issue 12, pages 1581-1586
CB Ref #: N/A

Article 2015: “Evolution of fine particles in surgical smoke from an urologist’s operating room by time and by distance”
Author: Hong-Kai Wong, Fei Mo, Chun-Guang Ma, Bo Dai, Guo-Hai Shi, Yao Zhu, Hai-Liangn Zhang, Ding-Wei Ye
Publication: International Urology and Nephrology, Volume 47, Issue 10, pp 1671-1678
CB Ref #: N/A

Article 2014: “How should we safely handle surgical smoke?”
Author: Hayley Born BS and Chandra Ivey MD
Publication:The Laryngoscope, Volume 124, Issue 10, pages 2213-2215
CB Ref #: N/A

Article 2014: “Surgical smoke may be a bio-hazard to surgeons performing laparoscopic surgery”
Author: Seock Hwan Choi, Tae Gyun Kwon, Sung Kwang Chung, Tae-Hwan Kim
Publication: Surgical Endoscopy, Volume 28, Issue 8, pp 2374-2380
CB Ref #: N/A

Article 2013: “Is surgical smoke harmful to theater staff? a systematic review”
Author:  Nicholas Mowbray, James Ansell, Neil Warren, Pete Wall, Jared Torkington
Publication: Surgical Endoscopy, Volume 27, Issue 9, pp 3100-3107
CB Ref #: N/A

Article 2013: “Does exposure to laser plume place the surgeon at high risk for acquiring clinical human papillomavirus infection?”
Author: Lon Thomas Manson BS and Edward J. Damrose MD, FACS
Publication: The Laryngoscope, Volume 123, Issue 6, pages 1319-1320, June 2013
CB Ref #: N/A

Article 2009: “Peritonectomy with high voltage electrocautery generates higher levels of ultrafine smoke particles”
Author: S.N Andreasson, H. Anundi, B. Sahlberg, C.-G. Ericsson, R. Walinder, G. Enlund, L. Pahlman, H. Mahteme
Publication: European Journal of Surgical Oncology (EJSO) 2009 Jul; 35(7):780-4
CB Ref #: N/A

Article 2009: “Surgical smoke evacuation guidelines – compliance among Perioperative Nurses”
Author: Kay A. Ball
Publication: PhD dissertation, Kay A. Ball, March 2009, Richmond Virginia (177 p.)
CB Ref #: N/A

Article 2008: “Taking a stand on surgical smoke”
Author: Carina Stanton, MA, Senior News Editor/Writer
Publication: AORN Connections,

CB Ref #: N/A

Article 2008: “The Hazards of Surgical Smoke”
Publication: AORN JOURNAL • APRIL 2008, VOL 87, NO 4 – Pages 721-738
CB Ref #: N/A

Article 2008: “AORN Position Statement – Statement on Surgical Smoke and Bio-Aerosols”
Author: approved by House of Delegates, Anaheim, CA. April 2008
CB Ref #: N/A

Article 2007: “Analysis of Surgical Smoke Produced by Various Energy-Based Instruments and Effect on Laparoscopic Visibility”
Author: Kyle J. Weld, MD, Stephen Dryer, Caroline D. Ames, Kuk Cho, Chris Hogan, Myonghwa Lee, Pratim Biswas, and Jaime Landman, MD
Publication: Journal of Endourology, Volume 21, Number 3, March 2007, pages 347-351
CB Ref #: N/A

Article 2007: “The visualisation of surgical smoke produced by energy delivery devices: significance and effectiveness of evacuation systems.”
Author: Tjeerd de Boorder, RudolfVerdaasdonk, John Klaessens Dept. Clinical Physics, University Medical Centre Utrecht, The Netherlands Medical Centre Utrecht
Publication: Proc. of SPIE Vol. 6440, 6440R, (2007)
CB Ref #: N/A

Article 2007: “Chemical Composition of Smoke Produced by High-frequency Electrosurgery”
Author: O. S. Al Sahaf, I. Vega-Carrascal, F. O. Cunningham, J. P. McGrath & F. J. Bloomfield
Publication: Irish Journal of Medical Science, 2007
CB Ref #: N/A

Article 2006: “Surgical smoke and infection control”
Author: Alp E, Biji D, Bleichrodt RP, Hansson A, Voss A.
Publication: J Hosp Infect. 2006; 62:1-5
CB Ref #: N/A

Article 2004: “Surgical smoke-a review of the literature”
Author: Barrett WL, Garber SM
Publication: Business Briefing: Global Surgery. 2004; 1-7
CB Ref #: N/A

Study 2003: “Randomized clinical trial of suction versus standard clearance of the diathermy plume”
Author: S. H. Pillinger, L. Delbridge and D. R. Lewis,
Publication: British Journal of Surgery 2003; 90: 1068–1071
CB Ref #: N/A

Article 1999: “Surgical Smoke: A Cause for Concern?”
Author: Coles GM & Williams CR
Published: ACORN Journal, Autumn 1999, 23-26
CB Ref #: 11

Article 1998: “Clinical Issues: …smoke plume….”
Author: Fog DM
Published: AORN Journal, 11/1998, Vol 68, No.5, 874-878
CB Ref #: 1

Article 1998: “Occupational Safety and Health Administration Acts on Guidelines for Electrosurgical Smoke”
Author: Ulmer B
Published: AORN Journal, 1998, 1244-1245
CB Ref #: 4

Article 1998: “The Epidemic Hazards of Nursing”
Author: Slattery M
Published: American Journal of Nursing, 11/1998, Vol 98, No.1150-53
CB Ref #: 3

Article 1998: “Surgical Smoke, a concern for infection control practitioners”
Author: Girolamo A. Ortolano, PhD, Joseph S. Cervia, MD, MBA, and Francis P. Canonica, PhD
Publication: Managing Infection Control, August 2009, pages 48-54
CB Ref #: N/A

Article 1998: “The potential alveolar hazard of carbon dioxide laser-induced smoke”
Author: Kunachak S, Sobhon P.
Publication: J Med Assoc Thai. 1998, Apr; 81 (4):278-82.
CB Ref #: N/A

Article 1997: “Air Quality in the Operating Room”
Author: Ulmer BC
Published: Surgical Services Management, 3/1997, Vol 3, No.3, 18-21
CB Ref #: 7

Article 1997: “Characterization and Removal of Electrosurgical Smoke”
Author: Brandon & Young
Published: Surgical Services Management, 3/1997, Vol 3, No.3, 14-16
CB Ref #: 22

Article 1997: “Surgical Smoke Plume – Principles & Function of Smoke….”
Author: Yeh
Published: Surgical Services Management, 3/1997, Vol 3, No.3, 27-29
CB Ref #: 8

Article 1997: “Smoke vs The People, Setting up a Smoke Safe Environment”
Author: Paschall
Published: Surgical Services Management, 3/1997, Vol 3, No.3, 27-29
CB Ref #: 24

Article 1997: “Surgical Smoke Evacuators a Primer”
Author: Ross KB
Published: Surgical Services Management, 3/1997, Vol 3, No.3, 33-34
CB Ref #: 10

Article 1996: “Surgical Smoke – Is It Safe to Breathe”
Author: Kay Ball
Published: Today’s Surgical Nurse; Sept/Oct 1996
CB Ref #: 23

Article 1996: “Electrosurgery Smoke: Hazards and Protection”
Author: O’Grady KF, Easty AC.
Published: Journal of Clinical Engineering 1996; Vol 21:3.
CB Ref #: N/A

Article 1996: “Control of Smoke from Laser/Electric Surgical Procedures”
Author: National Institute for Occupational Safety and Health (NIOSH) U.S.A.
Published: Hazard Controls Newsletter, September 1996
CB Ref #: 6

Article 1996: “Don’t Be A Victim of Surgical Smoke.”
Author: Giordano B
Published: AORN Journal 1996; Vol 63, No 3: 520-522
CB Ref #: 9

Study 1994: “Microbial Content of Electrosurgical Smoke”
Author: Lavoie K PhD & Greff R PhD (University of Michigan)
Published: University of Michigan; 10/1998
CB Ref #: 18

Article 1994: “Surgical & other Aerosols: Protection in the Operating Room.”
Author: Frances Conrad
Published: American Society of Safety Engineers, Pg 28-30
CB Ref #: 26

Article 1994: “The Effects of Smoke Plume Generated During Laser and Electrosurgical Procedures”
Author: Winstin C.
Published: Minimally Invasive Surgery Nursing 1994; Vol 8:3
CB Ref #: 20

Article 1993: “Clean Air: An Issue during Electrosurgery”
Published: Modern Healthcare 8/1993
CB Ref #: 21

Article 1993: “OR Exposure to Electrosurgery Smoke a Concern”
Author: Patterson P
Published: OR Manger 6/1993 pg 6.
CB Ref #: 19

Study 1993: “Exposure to Blood Containing Aerosols in the Operating Room: A Preliminary Study.”
Author: Heinsohn P, Jewett DL
Published: American Ind Hyg Association Journal 1993; Vol 54, No 1: 446-453
CB Ref #: N/A

Study 1993: “Effects of Plume Produced by the Nd: YAG Laser and Electrocautery on the Respiratory System
Author: Wenig B, Stenson K &Tracey D
Published: Laser in Surgery and Medicine 1993; Vol 13: 242-245
CB Ref #: 15

Study 1992: “The Mutagenicity of Electrocautery Smoke”
Author: Gatti JE, Bryant CJ, Noone RB & Murphy JB
Published: Plastic and Reconstructive Surgery 5/1992: 781-784
CB Ref #: 17

Article 1992: “Probing plume protection problems in the health care environment”
Author: Benedetto KJ
Published: Journal of Laser Applications 1992:39-43
CB Ref #: N/A

Article 1992: “Smoke Plume Capture; CFM/ Velocity/ Suction Pressure”
Author: Ian Williamson
Published: Stackhouse 1992
CB Ref #: 13

Study 1991: “Laryngeal Papillomatosis with Human Papillomavirus DNA Contracted By a Laser Surgeon.”
Author: Hallmo P & Naess O
Published: European Archives of Oto-Rhinolaryngology Vol 248, 425-427
CB Ref #: 5

Study 1991: “Presence of human immunodeficiency virus DNA in laser smoke.”
Author: Baggish MS, Polesz BJ, Joret D, Williamson P & Refal A.
Published: Laser in Surgery and Medicine 11/1991: 197-200
CB Ref #: 25

Study 1989: “Chemical composition of laser-tissue interaction smoke plume.”
Author: Kokosa JM & Eugene J
Published: Journal Laser Appl 7/1989; Vol 21, No 3: 59-63
CB Ref #: N/A

Study 1989: “Infectious papillomavirus in the vapor of warts treated with carbon dioxide laser or electrocoagulation: detection and protection”
Author: Sawchuck WS, Weber PJ, Lowy DR & Dzubow LM
Published: Journal American Academy of Dermatology 7/1989;Vol 21, No 1: 44-49
CB Ref #: N/A

Article 1989: “Potentially Hazardous Chemicals Present in Laser”
Published: Clinical Laser Monthly, 11/1989, Vol7, No11, 126
CB Ref #: N/A

Article 1989: “Perioperative Nursing Research Part III; – Potential Interoperative Biological Hazards to Personnel”
Author: Kneeder J & Purcell S
Published: AORN Journal 1989, 1066-1073
CB Ref #: N/A

Study 1988: “Protection of the rat lung from the harmful effects of laser smoke,”
Author: Baggish MS, Baltoyannis P, Sze E
Published: Lasers in Surgery and Medicine; 8/1988: 248-253.
CB Ref #: N/A

Study 1988: “Papillomavirus in the vapor of carbon dioxide laser – treated verrucae,”
Author: Garden JM, M.D. & O’Bannion MK, M.D.
Published: JAMA Journal American Med Assoc, 26/2/1988; Vol 259(8), 1199-1202
CB Ref #: N/A

Study 1988: “Chemical by-products produced by CO2 and Nd:YAG laser interaction with tissue”
Author: Kokosa JM & Doyle DJ
Published: SPIE 1988; Vol 8: 248-253
CB Ref #: N/A

Article 1988: “Clinical Issues. Hazards of Laser Plume Questioned”
Published: AORN Journal 1988, 462-466
CB Ref #: N/A

Study 1987: “The effects of laser smoke on the lungs of rats”
Author: Baggish MS & Elbarky M
Published: American Journal Ob/Gyn 5/1987; Vol 156, No 5: 1260-1265
CB Ref #: 16

Article 1987: “Smoke From Laser Surgery: Is There a Health Hazard?”
Author: Nezhat C, Winer WK, Nezhat F, Forrest D & Reeves W
Published: Lasers in Surgery and Medicine 1987; Vol 7: 376-382
CB Ref #: 14

Article 1987: “Intact viruses in CO2 laser plumes spur safety concern.”
Published: Clinical Laser Monthly 9/1987; Vol 5, No 9: 101-103
CB Ref #: N/A

 Studies And Article for Related Issues:

 Surgical Smoke Produced During Laparoscopic Procedures:

Article 1998: “Chemical Composition of Smoke Produced By High-Frequency Electro-surgery in a Closed Gaseous Environment”
Author: Hensman C, Batty D, Willis RG & Cuschieri A
Published: Surgical Endoscopy, 11/1998
CB Ref #: 2

Article 1996: “Smoke and Particulate Hazards during Laparoscopic Procedures”
Author: Ott D E
Published: Surgical Services Management Vol 3, No. 3, 11-12
CB Ref #: N/A

Study 1996: “The Risk of Carbon Monoxide Poisoning After Prolonged Laparoscopic Surgery”
Author: Nezhat
Published: Obstetrics & Gynaecology 1996; 88: 771-774
CB Ref #: N/A

Study 1994: “Transperitoneal Absorption of Thermocautery-Induced Carbon Monoxide Formation during Laparoscopic Cholecstectomy”
Author: Esper E
Published: Surgical Laparoscopic and Endoscopy, 1994; Vol 4: 333-335.
CB Ref #: N/A

Study 1993: “Smoke Production and Smoke Reduction in Endoscopic Surgery: Preliminary Report.”
Author: Ott DE, M.D.
Published: Endoscopic Surgery Allied Technology, 8/1993; Vol 1, No 4: 230-232.
CB Ref #: N/A

Study 1993: “Reduction of HIV Transmission during Laparoscopic Procedures”
Author: Eubanks
Published: Surgical Laparoscopic and Endoscopy, 1993; Vol 3, No 1: 2-5.
CB Ref #: N/A

Study 1993: “High levels of carbon monoxide are produced by electrocautery of tissue during Laparoscopic Cholysystectomy.”
Author: Beebe DS
Published: Aesthesia Analgesia 1993; Vol 77: 338-341
CB Ref #: N/A

 Cannula Leakage:

Study 1993: “Comparison of Smoke and Sprayback Leakage from Two Different Trocar Sleeves during Operative Laparoscopy”
Author: Baggish MS, M.D.
Published: Journal of Gynaecological Surgery 2/11/1993; Vol 9: 65-76
CB Ref #: N/A
Surgical Masks:

Study 1992: “Aerosol Penetration through Surgical Masks”
Author: Chen CC & Willeke K
Published: American Journal of Infection Control 8/1992; Vol 20, No 4: 177-184
CB Ref #: 12