Clearing the air: Nurses push for smoke evacuation policies for Florida surgical rooms

by | Mar 2, 2023


  • A pair of bills filed with bipartisan backing would require hospitals to impliment policies requiring the use of smoke evacuation systems during certain surgical procedures.
  • Ten states having already passed similar legislation, but some hospital associations in other states oppose the mandate, arguing that the issue is already addressed by other regulations.
  • Nurses in Florida say they are solidly behind the measure as one of their top priorities for the 2023 legislative session. They say the measure will protect healthcare workers and patients.
  • The Florida Hospital Association says it supports the bill, but is talking with members to ensure they can meet proposed deadlines.

In a move aimed at protecting healthcare workers and patients, State Representative Marie Woodson, a Democrat, and State Senator Ileana Garcia, a Republican, have introduced a pair of identical bills in their respective chambers (House Bill 587 / Senate Bill 380). The bills would require hospitals to adopt policies requiring the use of smoke evacuation systems in hospital operating rooms during certain surgical procedures.

Healthcare workers claim that smoke generated in operating rooms exposes them to the equivalent of smoking more than a pack a day of cigarettes, and patient advocates say it can cause cancer in people being operated on. The legislation has already passed in several states and is the subject of a national public affairs campaign by the  Association of periOperative Registered Nurses (AORN).

AORN has been pushing for similar laws across the country, but a spokesperson for the organization did not respond to a message seeking comment for this story.

Nurses in the Sunshine State, though, are also pushing for lawmakers to back the measure, which could require some hospital and surgery centers to purchase and install expensive smoke evacuation systems that are designed to remove smoke, particles, and other harmful substances that are generated from the use of lasers and other specific tools during some surgical procedures.

“This bill will protect both operating room nurses and physicians from harmful surgical smoke and has already been passed in other states,” said FNA lobbyist Erin Ballas of Public Affairs Consultants.

Ten states – Arizona, Colorado, Connecticut, Georgia, Illinois, Kentucky, New York, Oregon, Rhode Island, and Washington – have already passed similar laws, according to the AORN website.

The Florida Hospital Association says they are committed to providing a safe work environment for all employees and supports legislation, including the current bill, that prioritizes those efforts.

“Many hospitals across the state have already invested in the proper equipment and evacuation systems to resolve the concerns of surgical smoke in surgical settings,” said FHA President and CEO Mary Mayhew. “FHA recognizes the importance of all hospitals implementing evacuation equipment for the safety of patients and hospital employees.”

But Mayhew also noted that it’s important to  FHA’s members that the proposed bill allows hospitals and surgical centers enough time to get ready for the new mandate. As written, the law requires each licenced facility to be in compliance by the beginning of next year, which could require costly equipment and expensive installation of the smoke evacuation systems. Installation could also mean that facilities that are in high demand might be out-of-service while the new equipment gets installed.

“The proposed bill would require all hospitals to implement surgical smoke evacuation equipment in surgical environments that create surgical smoke,” she said. “FHA will continue to advocate that this proposed legislation gives hospitals ample time to meet the system requirements. FHA supports the legislation, and we commend bill sponsors Senator Garcia and Representative Woodson in their efforts to ensure hospital staff safety.”

It’s not yet clear if FHA’s members can meet the proposed timeline.

Notably, hospital associations in some states have been staunchly against the mandate. The Missouri Hospital Association, for example, opposes similar legislation because, they argue, the issue is already dealt with by other regulations – at least in that state. Further, they say, the issue is being underwritten by smoke evacuation system manufacturers who hope to sell the systems to hospitals and surgical centers so that they can meet the requirements of the new law.

If passed by the legislature and signed by Governor Ron DeSantis, the new law would go into effect July 1st, giving hospitals until January 1, 2024 – six months – until the new equipment must be in place.

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