surgery centers to adopt and implement a policy that prevents human
exposure to surgical smoke via the use of a smoke evacuation system
for all planned procedures likely to generate surgical smoke, and a
similar bill pending in Oregon, perioperative nurse advocates across
the country are starting conversations with their legislators with an
eye toward advancing similar legislation in their own states.
"After we came back from AORN Global Surgical Conference &
Expo, everybody was really excited and wanted smoke-free laws
passed in their state yesterday," says Ms. Pennock, only half-joking.
AORN spearheaded the Rhode Island and Colorado efforts, and is
also leading the initiative in Oregon. The Rhode Island law went into
effect on Jan. 1, 2019, and implementation for facilities reportedly has
been smooth. Colorado's law is effective in May 2021, leaving hospi-
tals and ambulatory surgery centers ample time to become compliant.
Oregon's surgical smoke evacuation bill had its first hearing in May
2019, with a vote on the bill anticipated for Oregon's 2020 legislative
session.
On the regulatory side, California's Division of Occupational Safety
and Health (Cal/OSHA) convened a meeting on surgical plume in
November 2018 and accepted comments on a proposed draft of regu-
lations in January 2019. A second round of proposed regulations and
public comment is expected from Cal/OSHA later this year.
A key lesson Ms. Pennock has learned thus far: legislation mustn't
be overly prescriptive. Some rural facilities, for example, might object
to the added cost of buying smoke evacuation equipment. Some sur-
geons might not like certain instruments they consider to be bulky or
noisy.
"The language we use is, mandating that they have a policy in
place for the evacuation of surgical smoke in hospitals and ASCs.
We give hospitals and surgery centers the flexibility to choose the
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