Smoking Ban Petition

A woman who has worked in UK operating theatres for over 30 years, has launched a petition to protect thousands of healthcare workers who are exposed to a toxic smoke plume produced during surgery.


Kathy Nabbie, who works as a surgical first assistant and scrub theatre practitioner, says thousands of healthcare workers are routinely exposed to harmful smoke that is produced by electrosurgery, due to the lack of evacuation devices within theatres.

Kathy, who has never smoked in her life, suffered with chronic bronchitis which she claims was a direct result of exposure to the toxic chemicals circulating in operating theatres and is now unable to scrub, or even circulate in operating theatres where smoke evacuation devices are not used.

Kathy said: “In 2007, smoking bans were introduced in the UK, yet we are still “smoking” within operating theatres because some healthcare professionals are reluctant to use evacuation technology.

“This continues to put perioperative staff, visitors and patients at risk of breathing in many harmful compounds found in surgical smoke plume, including hydrogen cyanide.”

Surgical smoke plume is visible to the naked eye and releases a distinctive odour. If not correctly evacuated using industry-approved local evacuation ventilation systems (LEVs), it can be inhaled by theatre staff and re-absorbed.

Over the past 12 years Kathy has tried to raise awareness by contacting key political figures within the Department of Health and The Royal College of Surgeons (RCS), but sadly has been unable to progress the matter.

She has now taken her campaign to the next level by launching a nationwide government petition to make the use of smoke evacuation devices compulsory in all theatres, so that healthcare workers in all specialities can work in a smoke free environment.

Ultimately, she hopes that by sharing her story, government officials, perioperative staff and the public will become more aware of the mutagenic properties of surgical smoke, which is akin to cigarette smoke.

Kathy added: “In 2007 I moved to work in the speciality of breast oncology, where I introduced smoke evacuation systems to the current professor of breast oncology surgery. Since then, I haven’t once developed AQ  chronic bronchitis following a common cold.”

“Two states in America; Colorado and Rhode Island, have already passed laws to make evacuation systems mandatory, with others following closely behind. We have the technology available, so it’s about time we utilised it and followed the US.

“Your mum, dad, sister, brother or child could be one of the people in theatre who are unaware of breathing in harmful smoke.As well as protecting patients, we must also protect our colleagues who should not have to go to work every day and breathe in toxic smoke.”

Since the launch of the petition, Kathy has been supported by the Association for Perioperative Practice (AfPP) – the UK’s leading membership organisation for perioperative practitioners who put patient safety at the heart of all they do.

Lindsay Keeley, patient safety & quality lead of the association commented: “What Kathy is doing is amazing and we are delighted to be supporting the campaign. It is important that we work together to raise awareness of the harmful effects of surgical smoke plume and attempt to make the use of evacuation devices mandatory in all theatres. It is a risk for both patients and staff, so we must ensure that appropriate guidelines and procedures are in place to address the hazards of surgical smoke plume.”

The International Council of Surgical Plume and numerous UK manufacturers of LEVs including Single Use Surgical, have also shown their support by backing Kathy.

Thanks to their support, she has already reached over 5000 signatures, but for the government to respond, she needs a further 5000 signatures before the deadline on 25 July.

Anyone inside or outside of the healthcare industry can show their support by signing the petition at

Why is surgical smoke so dangerous?

Surgical smoke has serious health implications for theatre practitioners, medical device reps and patients. Surgical plume is present with all interventional surgical procedures including diathermy, electrosurgery, laser and ultrasonic devices. Operating theatre practitioners often inhale surgical smoke due to inconsistent or non-adherence to policy and practice.

It contains up to 80 harmful toxic gases, viruses, bacteria & vapours, including hydrogen cyanide. It also releases an unpleasant odour and can obstruct the surgeon’s view of the surgical site.

It is known that exposure to tobacco smoke can cause cardiovascular and respiratory disease, as well as affecting the lungs, oral cavity, pharynx, larynx, oesophagus, pancreas, and bladder. Surgical smoke plume has been shown to be as mutagenic as tobacco smoke, however further research is needed.

Over 1.5 million healthcare workers, including surgeons, nurses, operating department practitioners and others, are exposed to surgical smoke each year. Acute health effects of exposure to surgical smokeinclude eye, nose and throat irritation, nausea, headache, cough, nasal congestion, asthma and asthma-like symptoms.

An article published in the Journal of Perioperative Nursing in Australia indicates that perioperative staff inconsistently comply with smoke evacuation recommendations, however there is strong support from management for the implementation of regular staff education to help improve practice.

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