* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * INFORMATION ALERT * * * * Produced by: Ontario Ministry of Labour * * Provided by: Canadian Centre for Occupational Health and Safety * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * INFO ALERT: 24 DATE: August 19, 1992 *** SUMMARY: *** Laser Plume in Surgical Procedures Medical staff and patients in hospitals and health clinics may be at risk of infectious diseases transmitted through exposure to a "plume" generated during laser surgical procedures. This plume of mostly water vapours, organic vapours and carbonized cell fragments is generated by the irradiation of tissue. Suspected concerns associated with this plume are the transmission of viable human viruses such HPV, hepatitis or human immunodeficiency (HIV), their infectious components, a rancid odour and irritation to the eyes and respiratory tracts. Chemicals such as formaldehyde, acrolein, benzene and polyaromatic hydrocarbons can also be found in the plumes. These contaminants can cause flu-like symptoms in people who are exposed to them. *** LOCATION(S) AND SECTOR(S) WHERE HAZARD MAY BE ENCOUNTERED: *** Hospitals and health clinics. *** SUGGESTED PRECAUTIONS: *** A mechanical smoke evacuator system with a high-efficiency particulate air (HEPA) or an ultra-low penetration air (ULPA) filter should be used to capture the plume. Each smoke evacuator should be equipped with a charcoal filter for odour and gas adsorption and, where possible and practicable, vented outdoors. Smoke evacuators should have the ability to detect filter overloading (ie. pressure drop) and the nozzle of the evacuator should be placed to optimize the capture of the plume (2-5 cm of the lasing site). Fluid aspiration should be carried out independently to smoke evacuation. In addition to using a properly functioning and maintained smoke evacuator, medical personnel should wear surgical masks, eye protection and gloves during laser surgeries. When it is not possible to remove a significant portion of the plume, a properly fitted half-mask respirator for protection against respirable dust and organic vapour should be used. NOTE: "Information Alert" is produced by the Occupational Health and Safey Branch, Ministry of Labour for use by Ministry inspectors, health and safety associations and other interested groups or individuals in Ontario. The goal of this publication is to communicate hazard information as soon as it becomes available to prevent injury to workers. Reproduction and use of these alerts is encouraged.