Surgical Smoke Rulemaking
This rulemaking effort seeks to establish workplace safety & health requirements pertaining to procedures for the use of surgical smoke evacuation systems in hospitals and ambulatory surgical centers as required by RCW 49.17.500.
Status
Because most provisions of RCW 49.17.505 must be implemented and enforced by January 1, 2024, and L&I did not create additional requirements for employers, L&I has filed Expedited Rulemaking. The Permanent Rule Adoption (CR-103P) was filed November 21, 2023 and the rule is effective January 1, 2024
See L&I’s Rulemaking Activity webpage for additional details.
Learn more about our rulemaking process and terminology
Background
The use of lasers and other types of specialized surgical equipment on human tissue during surgery can create a smoke byproduct that contains potentially hazardous chemical and biological compounds that pose a significant risk to exposed healthcare workers. There are currently no Occupational Safety and Health Administration (OSHA) or Washington Industrial safety and Health Act (WISHA) standards specifically governing surgical smoke.
To address this hazard, Substitute House Bill (SHB) 1779 was passed by the Washington State Legislature and signed into law by Governor Inslee on March 7, 2022. The new law became RCW 49.17.500 and RCW 49.17.505, which will take effect on January 1, 2024.
RCW 49.17.500 requires hospitals and ambulatory surgical centers to adopt policies requiring the use of smoke evacuation systems during planned procedures that are likely to generate surgical smoke. Because these new requirements fall under the jurisdiction of L&I and must be enforced by DOSH compliance staff, L&I will conduct rulemaking to ensure our rules (WACs) permit us to adequately enforce the new workplace safety & health requirements.
Reimbursement
Between January 1, 2025 and June 30, 2025, RCW 49.17.500 will allow eligible hospitals (smaller hospitals with 25 or fewer beds or those certified as “sole community hospitals” by Medicare/Medicaid) to apply for reimbursement of up to $1,000 per operating room for surgical smoke equipment purchased and installed before January 1, 2025. Reimbursements will only be issued if funding is available.
Stakeholder meetings
Although rulemaking followed the Expedited Rulemaking process, DOSH scheduled a public meeting to gather stakeholder feedback and answer questions about this rulemaking before filing the permanent rule.
Rule drafts & documents
Other resources
- Surgical Smoke (NIOSH/CDC)
- Surgical Smoke-Free OR (AORN) Contains links to AORN member resources, the section "Clinical and Educational Resources" includes publically available materials.
Staff Contacts:
For rulemaking questions, please contact:
Arthur.Wagner@Lni.wa.gov or 360-902-4233
For Technical questions, please contact:
Larissa.Lewis@Lni.wa.gov or 360-489-2196
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