The hazard of surgical smoke is often overlooked when considering the safety of medical laser procedures but can present a high level of occupational risk. Administrative procedures for operating external extraction devices and the reliance on personal protective equipment are not sufficient for reducing the risk. This paper aims to quantify the hazard of laser-generated surgical smoke and demonstrate how effective engineering control solutions can reduce the risk. A new design solution is presented with engineering controls for surgical smoke extraction and optical radiation integrated into the laser handpiece. A fiber delivered diode laser is used to simulate laser vaporization procedures on porcine skin tissue. Conventional external extraction conditions are compared to the new design solution. Fine particulate mass concentrations (PM2.5) from the simulated procedures, under different extraction conditions, are measured using optical particle size measurements. Peak concentrations of 55.86 ± 2.79 μg/m³ were measured without extraction; showing that the hazard of laser-generated surgical smoke is five times greater than the World Health Organization guideline of 10 μg/m³. A typical medical extraction setup only achieved a 16% reduction in peak concentration values, 47.07 ± 2.35 μg/m³; demonstrating that conventional, external, methods of extraction are ineffective. The new solution was able to capture all particulate materials, reducing particulate concentrations to background levels, 2.19 ± 0.68 μg/m³, safely below the current recommended guidelines. The design and results present evidence that it is not only more effective to use engineering control methods but that it is practicable to do so.

中文翻译：

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激光医疗手机中手术烟雾的工程控制

在考虑医疗激光手术的安全性时，手术烟雾的危害往往被忽视，但可能会带来高水平的职业风险。操作外部提取设备的管理程序和对个人防护设备的依赖不足以降低风险。本文旨在量化激光产生的手术烟雾的危害，并展示有效的工程控制解决方案如何降低风险。提出了一种新的设计解决方案，其中包含集成到激光手机中的手术烟雾提取和光辐射的工程控制。光纤传输的二极管激光器用于模拟猪皮肤组织上的激光汽化程序。将传统的外部萃取条件与新的设计解决方案进行比较。细颗粒物质量浓度 (PM2. 5) 从模拟程序中，在不同的提取条件下，使用光学粒度测量方法进行测量。峰浓度 55.86 ± 2.79 μ g/m ³未经萃取测量；表明激光产生的手术烟雾的危害是世界卫生组织指导方针 10 μg /m ^{3 的}五倍 。典型的医学提取设置仅使峰值浓度值降低了 16%，即 47.07 ± 2.35  μ g/m ³；证明传统的外部提取方法无效。新解决方案能够捕获所有颗粒材料，将颗粒浓度降低到背景水平，2.19 ± 0.68  μ g/m ³，安全地低于当前推荐的指南。设计和结果证明，使用工程控制方法不仅更有效，而且这样做是可行的。