New legislation mandates California’s Occupational Safety and Health Standards Board to adopt regulations to mandate removal of toxic surgical plumes in health facilities

California Nurses Association (CNA) celebrates Gov. Gavin Newsom’s signing of A.B. 1007, a bill that requires the development and adoption of enforceable workplace health and safety protections from surgical smoke in California hospitals, authored by Assemblymember Liz Ortega and sponsored by CNA, which has more than 120,000 members in the state. This important legislation is designed to protect health care workers from toxic airborne contaminants that pose a hazard to patients, nurses, and other health care professionals in operating rooms and other surgical settings.

“As an operating room nurse for more than three decades, I am so proud of the nurse advocacy that’s propelled California to take this critical action to protect health care professionals and patients from noxious, carcinogenic surgical plumes,” said CNA President Sandy Reding, RN and operating room nurse. “Mandating and improving workplace health and safety standards through legislation like A.B. 1007 ensures that California can retain skilled nursing staff at the bedside at a time when the industry-created staffing crisis is worsening. California regulators must rein in employer practices that expose us to unsafe working conditions and push nurses out of the profession.”

"I am thrilled Governor Newsom has signed our AB 1007 into law," said Assemblymember Ortega. "With these regulations, California will continue to prioritize the wellbeing of health care workers and patients, creating a safer health care environment for all."

Surgical plume, or smoke, is the toxic byproduct of laser and electrosurgery procedures that destroy human tissue. When tissue is cut, cauterized, or destroyed, the smoke or plume emits toxic gases and vapors which contain human tissue, carcinogens, blood, drug-resistant bacteria, fungi, viruses, pathogens, and even malignant cancerous cells. These surgical plumes may contain dozens of toxic chemicals and particulates, including infectious diseases and known carcinogens.

Health care professionals who are exposed to these plumes can suffer multiple health impacts such as eye, skin, and respiratory irritation, asthma, pneumonia, infectious disease transmission, and possibly even cancer.

Fortunately, workplace protection from surgical smoke is relatively simple — a smoke evacuation device (also known as plume scavenging systems) can be used whenever electro- or laser surgery is performed and surgical smoke is generated.

A.B. 1007 specifically directs the California Occupational Safety and Health Administration (Cal/OSHA) to develop standards and the California’s Occupational Safety and Health Standards Board to consider for adoption an enforceable workplace standard to mandate removal of surgical plumes in health facilities. It would require the use of smoke evacuators that capture and neutralize surgical smoke at the site of origin before it makes contact with patients or health personnel.

CNA nurses have been advocating for legally mandated workplace protections from surgical smoke for nearly a decade. Gov. Newsom’s signing of A.B. 1007 comes after former Gov. Brown vetoed two similar bills in 2016 and 2017, and after the Cal/OSHA Standards Board unanimously granted CNA’s regulatory petition in 2017 to pass a similar standard, but has not progressed through the regulatory process.

“We have seen too many nurses needlessly become ill, some so seriously that it took years for them to recover, because they did not have the protections they needed as they cared for their patients,” said Reding. “It is my sincerest hope that with these new regulations, nurses and others will no longer lose their ability to work or face serious illness as they provide much needed care. This is an important victory for nurses and patients.”

California Nurses Association/National Nurses United is the largest and fastest-growing union and professional association of registered nurses in the nation with 100,000 members in more than 200 facilities throughout California and nearly 225,000 RNs nationwide.