[Objectivized evaluation of surgeons exposure to radiofrequency electromagnetic fields -- in the context of exposure duration and Polish and new international requirements regarding workers protection].

Abstract

BACKGROUND: Use of electro surgery units (ESU) in surgeries is linked with electromagnetic field emission, which is assessed according to the requirements of occupational health and safety legislation. MATERIAL AND METHODS: Surgeons' exposure characteristics was monitored during 11 surgeries (proctectomy, patency of artery, hepatectomy, cystectomy, tonsilectomy, laparoscopy) by real time of monopolar ESU activity recorder. Investigations of root-mean-square value of electric and magnetic field strength was also performed at various modes of ESU operations during cutting (output power, 55-150 W; frequency, 330-445 kHz) and coagulating (40-240 W, 335-770 kHz). Statistical parameters of distribution of ESU operation over any 6-min periods (according to international requirements regarding protection against adverse thermal effects of electromagnetic field) were assessed. RESULTS: Electric field strength, measured 10 cm from the cable supplying an active electrode was 147-675 V/m during cutting and 297-558 V/m during coagulating; magnetic field strength was less than 0.2 A/m in both modes. Monitoring of ESUs showed the following ranges of their operation during surgeries 5-66% of time over starting 3 min of surgery, 3-40% over starting 6 min, and the distribution of their use over any 6-min periods 0-12% (median) / 7-43% (maximum value). CONCLUSIONS: The real operation time of ESUs ing surgeries was significantly shorter than that declared by workers. The distance of at least 15 cm between cables, connecting electrodes with generator and workers meets the requirements of the Polish legislation on permissible exposure limits. The assessment of localized exposure of the hand needs a detailed analysis of the SAR ratio distribution and further studies are required.

AI evidence extraction

Main findings

Electric field strength measured 10 cm from the cable supplying an active electrode was 147–675 V/m during cutting and 297–558 V/m during coagulating; magnetic field strength was <0.2 A/m in both modes. ESU operation during surgeries ranged 5–66% over the starting 3 min and 3–40% over the starting 6 min; over any 6-min periods the median distribution was 0–12% and maximum 7–43%. Authors conclude ESU real operation time was shorter than workers declared, and that keeping at least 15 cm distance between cables and workers meets Polish permissible exposure limits; localized hand exposure requires further SAR analysis.

Outcomes measured

• Electric field strength (V/m) near ESU cable
• Magnetic field strength (A/m) near ESU cable
• ESU duty cycle/operation time during surgeries (percent of time over 3-min/6-min periods)
• Compliance with occupational exposure limits (Polish legislation; international 6-min averaging requirements)
• Need for localized hand exposure/SAR distribution assessment

Limitations

• Only 11 surgeries monitored
• Exposure measurements reported at a specific location (10 cm from cable); other distances/positions not described
• Localized hand exposure/SAR not assessed; authors state further detailed analysis is needed
• No health outcomes reported (exposure characterization/compliance focus)

Suggested hubs

• occupational-exposure (0.9)
  Assesses surgeons' workplace exposure to EMF from electrosurgery units and compliance with worker protection requirements.

{
    "study_type": "exposure_assessment",
    "exposure": {
        "band": "ELF",
        "source": "occupational",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": "ESU operation time monitored during 11 surgeries; distribution assessed over 3-min and 6-min periods"
    },
    "population": "Surgeons (during 11 surgeries)",
    "sample_size": 11,
    "outcomes": [
        "Electric field strength (V/m) near ESU cable",
        "Magnetic field strength (A/m) near ESU cable",
        "ESU duty cycle/operation time during surgeries (percent of time over 3-min/6-min periods)",
        "Compliance with occupational exposure limits (Polish legislation; international 6-min averaging requirements)",
        "Need for localized hand exposure/SAR distribution assessment"
    ],
    "main_findings": "Electric field strength measured 10 cm from the cable supplying an active electrode was 147–675 V/m during cutting and 297–558 V/m during coagulating; magnetic field strength was <0.2 A/m in both modes. ESU operation during surgeries ranged 5–66% over the starting 3 min and 3–40% over the starting 6 min; over any 6-min periods the median distribution was 0–12% and maximum 7–43%. Authors conclude ESU real operation time was shorter than workers declared, and that keeping at least 15 cm distance between cables and workers meets Polish permissible exposure limits; localized hand exposure requires further SAR analysis.",
    "effect_direction": "unclear",
    "limitations": [
        "Only 11 surgeries monitored",
        "Exposure measurements reported at a specific location (10 cm from cable); other distances/positions not described",
        "Localized hand exposure/SAR not assessed; authors state further detailed analysis is needed",
        "No health outcomes reported (exposure characterization/compliance focus)"
    ],
    "evidence_strength": "low",
    "confidence": 0.7800000000000000266453525910037569701671600341796875,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "electrosurgery unit",
        "occupational exposure",
        "surgeons",
        "radiofrequency electromagnetic fields",
        "electric field strength",
        "magnetic field strength",
        "duty cycle",
        "6-min averaging",
        "Polish legislation",
        "SAR"
    ],
    "suggested_hubs": [
        {
            "slug": "occupational-exposure",
            "weight": 0.90000000000000002220446049250313080847263336181640625,
            "reason": "Assesses surgeons' workplace exposure to EMF from electrosurgery units and compliance with worker protection requirements."
        }
    ]
}

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