Diathermy smoke: hazardous to health?

The heat used in electrocautery causes cells to boil and explode, or simply dry up, producing a gaseous by-product known as diathermy smoke. This smoke may have mutagenic and carcinogenic potential, similar to that of cigarette smoke (Spearman et al, 2007). A search of electronic databases was performed and selected articles were reviewed using the Critical Appraisal Skills Programme (CASP) tool to enable a review of relevant material to be undertaken. The findings of the review identified 45 compounds, 9 of these were found to be hazardous when cross referenced against the Control of Substances Hazardous to Health (COSHH) list of approved workplace exposure limits (Health and Safety Executive (HSE),
2011) and 4 were carcinogens. This research indicates that the use of an extraction device to remove smoke when using diathermy is best practice. However, until more conclusive evidence is available on the actual health risks of diathermy smoke, as opposed to the potential health risks, it will be difficult for organisations that govern health and safety at work to create legislation on the need to extract it from the operating theatre air.