Archive February 2018 XIX, No. 2

Surgical Smoke Nearly Killed Me

An orthopedic surgeon who needed a double lung transplant is on a crusade to warn others about the dangers of plume.

Anthony Hedley

Anthony Hedley, MD, FACS

BIO

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BOVIE TO BLAME?
BOVIE TO BLAME? After years of inhaling surgical plume, orthopedic surgeon Anthony Hedley, MD, FACS, of the Hedley Orthpaedic Institute in Phoenix, Ariz., was diagnosed with idiopathic pulmonary fibrosis and underwent a life-saving double lung transplant.

Y You wouldn't want your surgeons to sit in the OR and smoke a pack-and-a-half of cigarettes while operating on their patients, but many are doing nearly the equivalent by creating surgical smoke and refusing to evacuate it.

I would know. Just over 3 years ago, at age 70, I underwent a life-saving double lung transplant, something I believe was a result of a danger that is lurking in ORs across the country: surgical smoke, one of the largest unaddressed health hazards facing operating room staff today.

After taking a walk alongside a river bank and noticing I was short of breath, I went to my doctor to find out what was going on. They took a look and in 2013, I was diagnosed with idiopathic pulmonary fibrosis. The disease causes lung tissue to become thick and stiff, making it hard for the body to circulate oxygen properly. The disease has no cure and many patients live only 3 to 5 years after diagnosis if they don't undergo a lung transplant.

Fortunately, I was placed on the transplant list. While I waited for a donor, the disease progressed fairly rapidly. I was on oxygen 24/7, could hardly move and felt like I was dying. Eventually in 2014, I underwent the double lung transplant and slowly got my life back.

Still, I was stumped. Environmental pollutants are often attributed to idiopathic pulmonary fibrosis, and being a smoker can increase your risk of getting the disease. But I hadn't smoked cigarettes in more than 40 years, and though I spent time in the military when I was younger, I was never exposed to agent orange or other similar materials. It was an open-ended question. But the more I thought about it, the more I fixated on Bovie smoke.

Surgical smoke dangers

Surgical smoke includes roughly 150 chemicals, including 16 EPA priority pollutants, toxic and carcinogenic substances, viruses and bacteria. I carry a list that contains the dozens of toxic chemicals that are contained in the smoke. They include formaldehyde, benzene, hydrogen cyanide and more. When you ablate tissue, the organisms found within that tissue are also ablated and carried by the smoke. That's why there have been reported cases where gynecologists develop warts in their throat and nose after years of breathing in the smoke created during laser ablation of warts. Many groups, including AORN, note that the average plume created in a single day in the OR is equivalent to smoking as many as 30 unfiltered cigarettes.

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