Surgical Smoke Evacuation Laws: What Healthcare Facilities Need to Know in 2025

1. What are Plumes?
2. What are the updates on the smoke evacuation laws?
3. What are Smoke Evacuators?
4. Why Act Now?

As we navigate the extensive topic of healthcare regulations, one significant development should be at the top of any healthcare facility with an operating room (OR): the hazards of surgical smoke. At some point, every OR has encountered the plume generated during procedures. This seemingly innocuous byproduct poses serious health risks to staff. We’ll dive into the dangers of surgical smoke, the latest updates on state laws mandating its evacuation, and the essential equipment that can help your facility stay compliant and safe.

What are Plumes

That haze in the OR isn’t just harmless steam. It’s surgical smoke, a dangerous byproduct from tools like cautery pens and lasers. This dangerous surgical smoke is what we call plumes. Inside that plume are three major threats:

• Toxic Chemicals: It’s loaded with known carcinogens like benzene and formaldehyde.
• Particulate Matter: fine particles that get deep into your lungs, much like the smoke from a cigarette.
• Bioaerosols: live bacteria and viruses, such as HPV and HIV.

Studies have equated that the typical plumes that one could inhale per day on an OR is similar to smoking 27-30 unfiltered cigarettes per day. Healthcare workers exposed over time report symptoms like headaches, eye irritation, nausea, and respiratory issues. In the long term, they can experience chronic lung diseases, asthma exacerbations, and increased cancer rates. The National Institute for Occupational Safety and Health (NIOSH) and the Association of periOperative Registered Nurses (AORN) have long warned about these dangers, emphasizing that standard room ventilation or N95 masks alone aren’t sufficient and that the smoke must be captured at the source. Raising awareness is important; without proper evacuation, OR teams are essentially working in a hazardous environment daily.

What are the updates on the smoke evacuation laws?

As of August 2025, there’s no federal mandate for surgical smoke evacuation, but momentum at the state level is building rapidly. Rhode Island in 2019 started smoke evacuation regulations. These laws require hospitals and ASCs to implement policies and use smoke evacuation systems during procedures that generate plumes. For them to be able to comply, they need to use evacuators, train their staff, conduct routine maintenance, and keep everything documented. Failure to comply can result in fines, penalties, and can interfere with accreditations. You can follow the areas affected on the official AORN Surgical Smoke Evacuation Legislation Status map.

Here’s a breakdown of the 19 states with enacted legislation following Rhode Island’s implementation and their respective dates:

1. Arizona – January 1, 2024
2. California – January 1, 2025
3. Colorado – May 1, 2021
4. Connecticut – January 1, 2024
5. Georgia – July 2022
6. Illinois – January 1, 2022
7. Kentucky – January 1, 2022
8. Louisiana – August 1, 2023
9. Minnesota – January 1, 2025
10. Missouri – January 1, 2025
11. New Jersey – June 11, 2023
12. New York – June 24, 2023
13. North Carolina – July 1, 2025
14. Ohio – January 1, 2025
15. Oregon – January 1, 2023
16. Rhode Ilsnad – January 1, 2019
17. Virginia – July 1, 2025
18. Washington – January 1, 2024
19. West Virginia – January 1, 2025

*For more details and up to date information, please visit the AORN Website.

What are Smoke Evacuators?

Smoke evacuators are machines that suck up surgical smoke during procedures. The evacuator removes this hazard right at the source. This protects the staff from breathing it in and keeps the air in the OR clean. It also clears the surgeon’s view, which is critical for precision and patient safety. 

Effective smoke evacuation systems reduce airborne contaminants by over 99% when used correctly. They typically feature a vacuum pump, high-efficiency filters (like ULPA for 99.999% particle removal at 0.12 microns), and other source-capture tools. They outperform N95 masks alone, which only filter around 70-80% of particles. AORN suggests you look for a few key things in a smoke evacuator: it should turn on automatically, run quietly (under 50 dB), and have filters that are easy to change.

You’ll generally find a few common types:

• Portable Units: Great for moving between rooms and are a flexible choice for surgery centers.
• Integrated Systems: Built directly into the operating room’s ceiling or wall for a permanent, streamlined setup.
• Laparoscopic: Designed specifically for keyhole surgery to keep the visual field clear during procedures.

Here are examples of different smoke evacuators that Soma offers.

Medtronic Covidien Valleylab RapidVac

Conmed Buffalo Filter PlumeSafe Turbo

Buffalo Filter Plumesafe Whisper

Why Act Now?

The laws are changing fast, and awareness is growing. As these regulations spread to the rest of the country or the world, the demand for this equipment will rise. Acting proactively will put you in a better position to adapt. You’ll create a safer environment, which boosts morale and reduces staff sick days. And if you’re in a state with these laws, it’s not just a good idea, it’s a requirement.