Cambios en la mucosa nasal de los médicos por exposición al humo por electrocoagulación

Abstract

Objective: to prove that exposure to smoke resulting from electrocoagulation causes changes in the nasal mucosa of physicians in training at a public hospital in Mexico. Methodology: a prospective fixed cohort study was conducted with a working universe consisting of 43 physicians distributed as follows: a group of 20 professionals with non-surgical specialties (thus unexposed to electrocautery smoke inhalation), and another group of 23 with surgical specialties (thus they were exposed to electrocautery smoke inhalation). They underwent two nasal biopsies: one at the beginning of the study and another after training as specialists for four years. The biopsies were reviewed by the hospital’s chief of Pathology and the incidence of changes in the nasal mucosa in both groups was calculated together with exposure index and the relative risk. Results: the biopsies performed at baseline showed that none of the specialists in training included in this study had damages in the nasal mucosa. The final biopsies, performed after the four-year medical training, had the following results: 70% of the medical residents, who were exposed, showed some histopathological changes in the nasal mucosa (hyperplasia or squamous metaplasia), whereas only 5% (1/20) of the unexposed individuals had them; the risk factor for nasal mucosa damage by exposure was estimated at 13.8. The most common lesions resulting from exposure to smoke from electrocoagulation were hyperplasia and squamous metaplasia. Conclusions: our results demonstrate that residents exposed to smoke produced by electrocoagulation have changes in the nasal mucosa.