Worker protection from surgical smoke

October 7, 2016

Henry M. Botuck, DDS

[Recipient address omitted]

Dear Dr. Botuck,

Thank you for your June 19, 2016 letter to the Occupational Safety and Health Administration (OSHA). Your letter was referred to OSHA's Directorate of Enforcement Programs for a response. You had specific questions regarding OSHA's requirements for the protection of hospital and dental personnel from the smoke plume generated by laser and electrosurgical instruments. This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any questions not delineated within your original correspondence. Your specific question and our response are below.

Question: What are the OSHA requirements to protect workers from the smoke plume generated by laser and electrosurgical instruments used either in a dental office or in a hospital operating room?

Response: OSHA does not have a specific standard that addresses smoke from surgical procedures in either operating rooms or dental offices. However, there are other OSHA requirements that may be enforced to ensure workers are protected from serious hazards that may occur in the use of lasers and electrosurgical instruments in a health care setting:

• Section 5(a)(1) of the OSH Act of 1970, General Duty Clause: Employers may be cited for violations of the General Duty Clause if a recognized serious hazard exists in their workplace and the employer does not take reasonable steps to prevent or abate the hazard. The General Duty Clause is used only where there is no standard that applies to the particular hazard.

• OSHA Standard 29 CFR 1910.132, Personal Protective Equipment, requires employers to provide appropriate personal protective equipment to minimize exposures to chemical, radiological and physical hazards.

• OSHA Standard 29 CFR 1910.134, Respiratory Protection, requires employers to provide appropriate respiratory protection to control respiratory hazards caused by inhaling air contaminated with harmful substances.

• OSHA Standard 29 CFR 1910.1000, Air Contaminants, requires employers to control exposures to air contaminants at or below permissible exposure limits.

You may find additional information on OSHA's website, such as OSHA's Laser/Electrosurgery Plume webpage at www.osha.gov/SLTC/laserelectrosurgeryplume/index.html. On this page you may find guidance for employers, a letter of interpretation on the hazards of smoke generated from surgical procedures, and several national consensus standards related to laser hazards and non-beam hazards.

As you may know, Virginia operates its own occupational safety and health program under a plan approved and monitored by OSHA. The state plans adopt and enforce standards and investigate safety and health concerns in their workplaces, and have jurisdiction over workers in their state. State Plans are required to have standards and enforcement programs that are at least as effective as OSHA's, but may have different or additional requirements. You may contact them directly at the following address:

Virginia Department of Labor and Industry

Main Street Centre

600 East Main Street, Suite 207

Richmond, VA 23219

Phone: (804)-317-2327

Web site: http://www.doli.virginia.gov/index.html

Thank you for your interest in occupational safety and health. We hope you find this information helpful. OSHA's requirements are set by statute, standards, and regulations. Our letters of interpretation do not create new or additional requirements but rather explain these requirements and how they apply to particular circumstances. This letter constitutes OSHA's interpretation of the requirements discussed. From time to time, letters are affected when the Agency updates a standard, a legal decision impacts a standard, or changes in technology affect the interpretation. To assure that you are using the correct information and guidance, please consult OSHA's website at http://www.osha.gov. If you have further questions, please feel free to contact the Directorate of Enforcement Programs at (202) 693-2100.

Sincerely,

Thomas Galassi, Director

Directorate of Enforcement Programs