Surgical Team Exposure to Cautery Smoke and Its Mitigation During Tonsillectomy

Daniel C. O’Brien; Eun Gyung Lee; Jhy-Charm Soo; Sherri Friend; Michele M. Carr

Surgical Team Exposure to Cautery Smoke and Its Mitigation During Tonsillectomy

Daniel C. O’Brien, Eun Gyung Lee, Jhy-Charm Soo, Sherri Friend, Michele M. Carr

Biostatistics, Epidemiology & Environmental Health Sciences

Research output: Contribution to conference › Presentation

Abstract

   Objectives:   (1) To assess the exposure of surgical personnel to known carcinogens during pediatric tonsillectomy and adenoidectomy (T&A) and (2) to compare the efficacy of surgical smoke evacuation systems during T&A.
 
   Methods:   In this study at a tertiary children’s hospital in 2017 to 2018, we measured the type and concentration of volatile organic compounds (VOCs) and particulates created during T&A. These cases were performed using either a suction pencil cautery (SC), cautery with suction by assistant (SA), or cautery without suction (NS).
 
   Results:   A total of 30 cases were included: 12 in the SC group, 9 in SA, and 9 in NS. Multiple VOCs were identified in the air, including acetaldehyde, formaldehyde, benzene, and toluene. None of the measured VOC exposure levels approached the Occupational Safety and Health Administration–set occupational exposure limits. The mean particulate concentration in the breathing zone during tonsillectomy was 508 particles per cm   3   for SC compared with 1661 particles per cm   3   for SA and 8208 particles per cm   3   for NS cases (   P   = .001). Pairwise comparisons showed that NS was the outlying group. There were also significant differences between the maximum particulate concentrations (   P   < .001) for the groups (SC = 3952, SA = 56,149, NS = 363,770 particles per cm   3  ). There were no significant differences between mean or maximum particulate concentrations in the breathing zone during adenoidectomy. Most particles included chemical elements of C and O only, and for some particles, other chemical elements (eg, Cr, Cu, S, Mn) were observed.
 
   Conclusions:   It is strongly suggested that surgical personnel use a suction cautery to minimize exposure levels to aerosolized particles during routine T&A.
 
   Abstracts

Original language	American English
State	Published - Sep 2019
Event	American Academy of Otolaryngology-Head and Neck Surgery Annual Meeting - New Orleans, LA Duration: Sep 1 2019 → …

Conference

Conference	American Academy of Otolaryngology-Head and Neck Surgery Annual Meeting
Period	09/1/19 → …

Disciplines

Biostatistics

Cite this

@conference{2652b6aaa0f84655a37df713b17d912e,

title = "Surgical Team Exposure to Cautery Smoke and Its Mitigation During Tonsillectomy",

abstract = " Objectives: (1) To assess the exposure of surgical personnel to known carcinogens during pediatric tonsillectomy and adenoidectomy (T&A) and (2) to compare the efficacy of surgical smoke evacuation systems during T&A. Methods: In this study at a tertiary children{\textquoteright}s hospital in 2017 to 2018, we measured the type and concentration of volatile organic compounds (VOCs) and particulates created during T&A. These cases were performed using either a suction pencil cautery (SC), cautery with suction by assistant (SA), or cautery without suction (NS). Results: A total of 30 cases were included: 12 in the SC group, 9 in SA, and 9 in NS. Multiple VOCs were identified in the air, including acetaldehyde, formaldehyde, benzene, and toluene. None of the measured VOC exposure levels approached the Occupational Safety and Health Administration–set occupational exposure limits. The mean particulate concentration in the breathing zone during tonsillectomy was 508 particles per cm 3 for SC compared with 1661 particles per cm 3 for SA and 8208 particles per cm 3 for NS cases ( P = .001). Pairwise comparisons showed that NS was the outlying group. There were also significant differences between the maximum particulate concentrations ( P < .001) for the groups (SC = 3952, SA = 56,149, NS = 363,770 particles per cm 3 ). There were no significant differences between mean or maximum particulate concentrations in the breathing zone during adenoidectomy. Most particles included chemical elements of C and O only, and for some particles, other chemical elements (eg, Cr, Cu, S, Mn) were observed. Conclusions: It is strongly suggested that surgical personnel use a suction cautery to minimize exposure levels to aerosolized particles during routine T&A. Abstracts ",

author = "O{\textquoteright}Brien, {Daniel C.} and Lee, {Eun Gyung} and Jhy-Charm Soo and Sherri Friend and Carr, {Michele M.}",

year = "2019",

month = sep,

language = "American English",

note = "American Academy of Otolaryngology-Head and Neck Surgery Annual Meeting ; Conference date: 01-09-2019",

}

TY - CONF

T1 - Surgical Team Exposure to Cautery Smoke and Its Mitigation During Tonsillectomy

AU - O’Brien, Daniel C.

AU - Lee, Eun Gyung

AU - Soo, Jhy-Charm

AU - Friend, Sherri

AU - Carr, Michele M.

PY - 2019/9

Y1 - 2019/9

N2 - Objectives: (1) To assess the exposure of surgical personnel to known carcinogens during pediatric tonsillectomy and adenoidectomy (T&A) and (2) to compare the efficacy of surgical smoke evacuation systems during T&A. Methods: In this study at a tertiary children’s hospital in 2017 to 2018, we measured the type and concentration of volatile organic compounds (VOCs) and particulates created during T&A. These cases were performed using either a suction pencil cautery (SC), cautery with suction by assistant (SA), or cautery without suction (NS). Results: A total of 30 cases were included: 12 in the SC group, 9 in SA, and 9 in NS. Multiple VOCs were identified in the air, including acetaldehyde, formaldehyde, benzene, and toluene. None of the measured VOC exposure levels approached the Occupational Safety and Health Administration–set occupational exposure limits. The mean particulate concentration in the breathing zone during tonsillectomy was 508 particles per cm 3 for SC compared with 1661 particles per cm 3 for SA and 8208 particles per cm 3 for NS cases ( P = .001). Pairwise comparisons showed that NS was the outlying group. There were also significant differences between the maximum particulate concentrations ( P < .001) for the groups (SC = 3952, SA = 56,149, NS = 363,770 particles per cm 3 ). There were no significant differences between mean or maximum particulate concentrations in the breathing zone during adenoidectomy. Most particles included chemical elements of C and O only, and for some particles, other chemical elements (eg, Cr, Cu, S, Mn) were observed. Conclusions: It is strongly suggested that surgical personnel use a suction cautery to minimize exposure levels to aerosolized particles during routine T&A. Abstracts

AB - Objectives: (1) To assess the exposure of surgical personnel to known carcinogens during pediatric tonsillectomy and adenoidectomy (T&A) and (2) to compare the efficacy of surgical smoke evacuation systems during T&A. Methods: In this study at a tertiary children’s hospital in 2017 to 2018, we measured the type and concentration of volatile organic compounds (VOCs) and particulates created during T&A. These cases were performed using either a suction pencil cautery (SC), cautery with suction by assistant (SA), or cautery without suction (NS). Results: A total of 30 cases were included: 12 in the SC group, 9 in SA, and 9 in NS. Multiple VOCs were identified in the air, including acetaldehyde, formaldehyde, benzene, and toluene. None of the measured VOC exposure levels approached the Occupational Safety and Health Administration–set occupational exposure limits. The mean particulate concentration in the breathing zone during tonsillectomy was 508 particles per cm 3 for SC compared with 1661 particles per cm 3 for SA and 8208 particles per cm 3 for NS cases ( P = .001). Pairwise comparisons showed that NS was the outlying group. There were also significant differences between the maximum particulate concentrations ( P < .001) for the groups (SC = 3952, SA = 56,149, NS = 363,770 particles per cm 3 ). There were no significant differences between mean or maximum particulate concentrations in the breathing zone during adenoidectomy. Most particles included chemical elements of C and O only, and for some particles, other chemical elements (eg, Cr, Cu, S, Mn) were observed. Conclusions: It is strongly suggested that surgical personnel use a suction cautery to minimize exposure levels to aerosolized particles during routine T&A. Abstracts

M3 - Presentation

T2 - American Academy of Otolaryngology-Head and Neck Surgery Annual Meeting

Y2 - 1 September 2019

ER -

Surgical Team Exposure to Cautery Smoke and Its Mitigation During Tonsillectomy

Abstract

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