Changes in the Nasal Mucosa of Physicians due to Exposure to Smoke from Electrocoagulation
DOI:
https://doi.org/10.17533/udea.rfnsp.v34n2a02Keywords:
electrocoagulation, electrocautery smoke, in training specialty physicians, occupational healthAbstract
Objective: to prove that exposure to smoke resulting from electrocoagulation causes changes in the nasal mucosa of physicians in training at a public hospital in Mexico. Methodology: a prospective fixed cohort study was conducted with a working universe consisting of 43 physicians distributed as follows: a group of 20 professionals with non-surgical specialties (thus unexposed to electrocautery smoke inhalation), and another group of 23 with surgical specialties (thus they were exposed to electrocautery smoke inhalation). They underwent two nasal biopsies: one at the beginning of the study and another after training as specialists for four years. The biopsies were reviewed by the hospital’s chief of Pathology and the incidence of changes in the nasal mucosa in both groups was calculated together with exposure index and the relative risk. Results: the biopsies performed at baseline showed that none of the specialists in training included in this study had damages in the nasal mucosa. The final biopsies, performed after the four-year medical training, had the following results: 70% of the medical residents, who were exposed, showed some histopathological changes in the nasal mucosa (hyperplasia or squamous metaplasia), whereas only 5% (1/20) of the unexposed individuals had them; the risk factor for nasal mucosa damage by exposure was estimated at 13.8. The most common lesions resulting from exposure to smoke from electrocoagulation were hyperplasia and squamous metaplasia. Conclusions: our results demonstrate that residents exposed to smoke produced by electrocoagulation have changes in the nasal mucosa.
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(1). Al Sahaf OS, Vega-Carrascal I. Chemical composition of smoke produced by high-frequency electrosurgery. Ir J Med Sci. [Revista en Internet] 2007 [Acceso 13 de mayo de 2014]; 176(3):229-32. Disponible en: www.ncbi.nlm.nih.gov/pubmed/17653513
(2). Hollmann R, Hort CE, Kammer E, Naegele M, Sigrist MW, Meuli Simmen C. Smoke in the operating theater: an unregarded source of danger. Plastic & Reconstructive Surgery [Revista en Internet] 2004 [Acceso 13 de mayo de 2014]; 114(2):458-463. www.ncbi. nlm.nih.gov/pubmed/15277814
(3). Ott DB. Smoke production and smoke reduction in endoscopic surgery: Preliminary report. Endosc Surg Allied Technol. 1993; 1(4):230-232.
(4). Barrett WL, Garber SM.. Surgical smoke: a review of the literature. Is This just a lot of hot air? Surg Endosc. 2003;17(6):979-987.
(5). Scott E, Beswick A, Wakefield K. The hazards of diathermy plume. Part The literature search. British Journal of Perioperative Nursing. 2004; 14(9):409-414.
(6). Ribes A. Development and validation of a method for air quality and nuisance odours monitoring of volatile organic compounds using multisorbent adsorption and GC/MS thermal desortion system. Journal of Chromatography A. [Revista en Internet] 2007 [Acceso 15 de julio de 2014]; 1140 (1-2): 44-55. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/17187810.
(7). Pope CA. Epidemiology of Fine Particulate Air Pollution and Human Health: Biologic Mechanisms and whos at Risk? Environ. Health. Prospect. 2000; 108, 713-723.
(8). Nezhat C, Winer WK, Nezhat F, Forrest D. Reeves WG. Smoke from laser surgery: is there a health hazard?. Surg Med. [Revista en Internet] 1987 [Acceso 20 de abril de 2014]; 7:376-382. . Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/3683071
(9). Ott DB. Laparoscopic surgical smoke absorbed into bloodstream. OR Manager. 1994; 10:19.
(10). Sagar PM, Meagher A, Sobczak S. Chemical Composition and Potential Hazards Of Electrocautery Smoke. Journul British of Surgery. [Revista en Internet] 1996 [Acceso 15 de marzo de 2014]; 83(12): 1792. Disponible en: http://onlinelibrary.wiley.com/doi/10.1002/bjs.1800831241/abstract.
(11). Lai K, Dutta KK, Vachhrajani KD, Gupta GS, Srivastava AK. Histomorphological changes in lung of rats following exposure to wood smoke. Indian J Exp Biol. [Revista en Internet] 1993 [Acceso 15 de marzo de 2014]; 31: 761- 4. Disponible en: www. ncbi.nlm.nih.gov/pmc/articles/PMC3129947.
(12). Bross D, Astorga R, Arrieta J, Parra S, González Á, Guzmán R, et al. Cambios histológicos de la mucosa nasal en habitantes de la Ciudad de México en comparación con quienes no habitan en áreas metropolitanas. An Med Asoc Med Hosp ABC. [Revista en Internet] 2001 [Acceso 13 de marzo de 2016]; 46 (1): 26- 30. Disponible en: http://www.imbiomed.com.mx/1/1/articulos.php?id_revista=35&id_ejemplar=194
(13). Weld KJ, Dryer S, Ames CD. Analysis of surgical smoke produced by various energy-based instruments and effect on laparoscopic visibility. Journal of end Urology. 2007; 21(3):347-351.
(14). Bigony L. Risks associated with exposure to surgical smoke plume: a review of the literature. AORN J. 2007; 86(6):1013-20. Doi: 10.1016/j. aorn.2007.07.005.
(15). Junemann A, Legarreta G. Inhalación de humo de leña: una causa relevante pero poco conocida de Enfermedad Pulmonar Obstructiva Crónica. Revista Argentina de Medicina Respiratoria. 2007;2:51-57.
(16). Calderón, C, Guallar Castillón P, Moreno, V. Estudio de las incapacidades temporales en una población laboral de alto riesgo. Arch Prev Riesgos Labor. [Revista en Internet] 2000 [Acceso 06 de abril de 2007];; 3(4):106-65. Disponible en: www.scielo.org. pe/…?pid=S1726-46342013000100008&.
(17). González PJ, Díaz Padrón Heliodora, González Ricardo Fredy J, Duarte Bringas Osvaldo. Evaluación química de un sistema de extracción de gases anestésicos residuales para el control de la contaminación en salones de operaciones. Rev. Cubana Hig. Epidemiol. [Revista en Internet] 2007. [Acceso 06 de abril de 2007]; 37(3): 136-140. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-30031999000300006
(18). Zarhi J, Toso J, Cifuentes J, Vacca F, Stuardo P. Cirugía Endoscópica Ginecológica: Experiencia de 8 años. Rev Chil Obstet Ginecol. [Revista en Internet] 2004 [Acceso 06 de abril de 2007]; 69(4). Disponible en: http://www.scielo.cl/pdf/rchog/v69n4/art03.pdf.
(19). Soto E, Aguilar L, Mendez M. Bronquitis industrial en trabajadores expuestos a hidroalcoholes. Rev Med Inst Mex Seguro Soc. 2007; 45(6): 565-572
(20). Prieto SE, López-Benítez W, Jiménez-Bernardino CA. Medición de la calidad de vida en médicos residentes. Educ. méd. [Revista en la Internet]. 2009 [citado 2013 Abr 03]; 12(3): 169-177. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1575-18132009000400006.
(21). Beroggi GE, Wallace WA. Operational risk management: a new paradigm for decision making. IEEE Transactions on Systems, Man, & Cybernetics. 1994; 24(10): 1450-1457.
(22). Heinsohn P, Jewett DL. Exposure to blood containing aerosols in the operating room: a preliminary study. Am Ind Hyg Assoc J. 1993; 54(8):446-453.
(23). González-Martínez F, García-García JA, Arnaud-Viñas MR, Arámbula-Morales EG, Uriega-González S, Mendoza-Guerrero JA. Evaluación de la satisfacción educativa de médicos residentes. Cir Cir. [Revista en internet] 2011 [Acceso 7 de abril de 2010]; 79:156-167. Disponible en: www.redalyc.org/articulo. oa?id=66221099009.
(24). Moot AR, Ledingham KM, Wilson PF. Composition of volatile organic compounds in diathermy plume as detected by selected ion flow tube mass spectrometry. ANZ J Surg. 2007; 77(1-2):20- 23. Doi: 10.1111/. 14452197.2006.03827.
(25). Massarweh NN, Cosgriff N, Slakey DP. Electrosurgery: History, principles, and current and future uses. J Am Coll Surg. 2006; 202(3):520-530.
(26). Kunachak S, Sobhon P. The potential alveolar hazard of carbon dioxide laser-induced smoke. J Med Assoc. 1998; 81(4):278-282.
(27). Karoo RO, Whitaker IS, Offer G, Sharpe DT. Surgical smoke without fire: the risks to the plastic surgeon. Plastic & Reconstructive Surgery. 2004; 114(6):1658-1660.
(28). Aurrekoetxea JJ, Ispizua A, Grijalba M, Pérez C, Asua J. Estudio citológico de los trabajadores expuestos a polvo de madera. Salud y Trabajo. [Revista en internet]1988 [Acceso 7 de abril de 2018]; 67. Disponible en: https://www.fundacionmapfre.org/documentacion/publico/i18n/catalogo_imagenes/grupo.cmd?path=1009880
(29). Gatti JE, Bryant CJ, Noone RB. Murphy JB. The mutagenicity of electrocautery smoke. Plast Reconstr Surg. 1992; 89(5):781-784.
(30). Pérez Padilla R, Regalado J, Vedal S. Exposure to biomasa smoke and chronic airway diseases in Mexican women. Am J Respir Crit Care Med. 1996; 154: 701-6.
(31). Jewett DL, Heinsohn P, Bennett C, Rosen A, Neuilly C. Blood containing aerosols generated by surgical techniques: a possible infectious hazard. An Ind Hyg Assoc J. 1992; 53(4): 228-231.
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