Virology-Immunology Department, LabPlus, Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand
Occupational Health and Safety Department, Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand.
Occup Environ Med. 2020 Dec;77(12):809-817. doi: 10.1136/oemed-2019-106333. Epub 2020 May 8.
To evaluate what is currently known about the risk to surgeons and other operating theatre (OT) staff of human papillomavirus (HPV) transmission and HPV-related disease following surgical smoke exposure.
A systematic literature search of Embase and Ovid-MEDLINE was undertaken for primary studies relevant to the presence of HPV in surgical smoke, contamination of OT staff with HPV after performing or attending smoke-generating surgical procedures, and the presence of HPV or HPV-related disease in OT staff following occupational surgical smoke exposure. Additional articles were identified by searching the reference lists of relevant published papers.
Twenty-one relevant articles were identified. These demonstrate that surgical smoke from the treatment of HPV-related lesions can contain HPV DNA, and that this can contaminate the upper airways of OT staff. Whether this corresponds to infectious virus is not known. Increased prevalence of HPV infection or HPV-related disease in OT staff following occupational exposure to surgical smoke has not been convincingly shown.
While HPV transmission to OT staff from surgical smoke remains unproven, it would be safest to treat surgical smoke as potentially infectious. Necessary precautions should be taken when performing smoke-generating procedures, consisting of: (1) local exhaust ventilation, (2) general room ventilation and (3) full personal protective equipment including a fit tested particulate respirator of at least N95 grade. There is currently insufficient evidence to recommend HPV vaccination for OT staff or to state that the above precautions, when used properly, would not be effective at preventing HPV transmission from surgical smoke.
评估外科医生和其他手术室（OT）工作人员在接触手术烟雾后感染人乳头瘤病毒（HPV）及其相关疾病的风险。
对 Embase 和 Ovid-MEDLINE 进行了系统的文献检索，以寻找与手术烟雾中 HPV 存在、在进行或参与产生烟雾的手术程序后 OT 工作人员 HPV 污染以及在职业性手术烟雾暴露后 OT 工作人员 HPV 或 HPV 相关疾病存在相关的原始研究。通过检索相关已发表论文的参考文献，还确定了其他文章。
确定了 21 篇相关文章。这些文章表明，治疗 HPV 相关病变的手术烟雾可能含有 HPV DNA，并且可能污染 OT 工作人员的上呼吸道。但这是否对应于感染性病毒尚不清楚。OT 工作人员在职业性接触手术烟雾后 HPV 感染或 HPV 相关疾病的患病率增加尚未得到令人信服的证明。
虽然手术烟雾向 OT 工作人员传播 HPV 尚未得到证实，但将手术烟雾视为潜在传染性物质是最安全的。在进行产生烟雾的手术时，应采取必要的预防措施，包括：（1）局部排气通风，（2）全面通风和（3）全面的个人防护设备，包括经过适合性测试的至少 N95 级别的颗粒呼吸器。目前尚无足够的证据推荐对 OT 工作人员进行 HPV 疫苗接种，也无法说明上述预防措施在防止 HPV 通过手术烟雾传播时不会有效。
