Is it time for a more systematic approach to the hazards of surgical smoke?: reconsidering the evidence.

Despite recognition of the potential hazards of surgical smoke in the operating room and the adoption of costly extraction devices, little attention has been given to a systematic review of available evidence to inform risk management strategies. Therefore, a comprehensive search of the surgical smoke literature over a 20-year period (1981 to 2011) was undertaken. This search identified 42 appropriate publications. Although a reasonable body of research on the hazardous nature of surgical smoke was found, little substantive data on exposures among operating room personnel or the most appropriate methods to reduce risks were identified. Further empirical data are needed to conclusively establish actual risks, exposure standards, and protective strategies.