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Study Identifies Operating Room Toxins as Possible COPD Risk Factor

A recent study found that nurses who worked in operating rooms for 15 or more years are up to 69% more likely to develop chronic obstructive pulmonary disease (COPD) than nurses who had never worked in an operating room. 

According to a study published on JAMA Network Open, long-time exposure to operating room chemicals may increase one’s risk of developing COPD. Disinfectants and surgical smoke are gaseous by-products produced by heat-generating surgical instruments, exposing physicians, nurses, and other hospital staff during electrosurgery and laser procedures in the operating room (OR).

The study is the first to assess the role of occupational exposure to surgical smoke and COPD risk.

Researchers analyzed data on OR employment history and COPD incidence among a cohort of 75,011 nurses working in US hospitals in 1984. The participants are part of the NIH-funded Nurses’ Health Study (NHS), an ongoing, prospective study of more than 121,000 US female nurses ages 30 to 55 who have completed biennial questionnaires since 1976. 

OR employment duration served as a proxy for nurses’ exposure to inhaled agents. The study adjusted for primary COPD risk factors, such as cigarette smoking and chronic disease.

Compared with nurses who had no OR employment and worked in administrative or nursing education roles or a non-nurse job, the study found that inpatient and outpatient nurses had higher risks (31% and 24%, respectively) of developing COPD. Nurses with less than 15 years of OR experience had a 22% higher risk.

Although the study data reflect working conditions in the 1980s, researchers said the findings apply to today’s OR environment. Disinfectant use has increased over the past decades, and there is little evidence that the hazard of surgical smoke has reduced.

“Smoke-generating laparoscopic surgery is performed in a broader range of procedures, and protective surgical masks, such as the N95 mask, cannot block the small particulates in surgical smoke,” said study lead author Wubin Xie, postdoctoral association in the Department of Global Health at the Boston University School of Public Health, in a statement. 

Additional insight from Dr. Nair: Interesting – it says results were found even after adjusting for smoking status. I can’t say I see a surprising number of OR nurses in my clinical practice. 

To read the full report, visit AJMC.