title: Studies on the transmission of viral disease via the CO2 laser plume and ejecta.
abstract: While recent reports have noted the presence of viral DNA sequences in the laser plume, no significant effort has been made to study transmission of the virus in vivo via airborne laser debris. Studies were undertaken to identify potential hazards to operating room occupants in gynecologic laser surgery. ACO2 laser in the continuous wave mode using a power density of 666 W/cm2 was fired through a 5-cm metal cylinder at virus-infected tissues. Airborne particulate debris, 100-200 microns, was removed from the cylinder's inner surfaces. In one instance, deposition of the debris was found on the surgeon's eyeglasses 1 m from the site of impact despite the use of a smoke evacuator. The first set of studies involved confirmed human papillomavirus (HPV) lesions of the human female lower genital tract. Specimens were collected for electron microscopy and Southern Blot viral hybridization. Additional cervical electron microscopy specimens were recovered from the speculum during pulsed CO2 laser treatment at 13 W average power during conization. Electron microscopy of the vulvar debris revealed only anucleate keratinized squamous epithelial cells. Cervical specimens demonstrated similar cells with nearly instantaneous vaporization of intracellular water and apparent condensation of cellular carbon. HPV Southern Blot testing revealed insufficient quantities of DNA for that technique. The second set of studies involved bovine papillomavirus lesions from dairy cattle. The debris was transmitted to susceptible animals. The bovine studies failed to demonstrate the transmission of disease in vivo.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Obstetrics and Gynecology, Pennsylvania Hospital, Philadelphia.
authors.forename: P M
authors.initials: PM
authors.lastname: Wisniewski
authors.forename: M J
authors.initials: MJ
authors.lastname: Warhol
authors.forename: R F
authors.initials: RF
authors.lastname: Rando
authors.forename: T V
authors.initials: TV
authors.lastname: Sedlacek
authors.forename: J E
authors.initials: JE
authors.lastname: Kemp
authors.forename: J C
authors.initials: JC
authors.lastname: Fisher
mesh_terms: D000818:Animals; D001706:Biopsy; D002417:Cattle; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects*; D008397:Masks / Q000592:standards; D016273:Occupational Exposure; D009873:Operating Rooms; D027383:Papillomaviridae; D014412:Tumor Virus Infections / Q000473:pathology / Q000601:surgery / Q000635:transmission*; D002577:Uterine Cervical Diseases / Q000473:pathology / Q000601:surgery*