HB 218: DOH; Hospitals; Surgical Smoke; Exposure Prevention; Operating Rooms; Policies

A BILL FOR AN ACT

RELATING TO HOSPITALS.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that the vapor inside an operating room that is created during a surgical procedure is often referred to as surgical smoke.  According to the National Institute for Occupational Safety and Health, tools used during a surgical procedure, including lasers or electrosurgical devices, produce aerosolized chemicals that can be harmful to inhale.  Surgical smoke may contain chemicals such as benzene and formaldehyde.  Studies report that exposure to these chemicals can produce a range of debilitating effects, including migraines, nausea, and irritation of the eyes or nose.

     The legislature further finds that data suggests that each year roughly five hundred thousand health care professionals are exposed to hazardous chemicals produced during surgical operations.  Surgical smoke affects health care workers such as surgeons, nurses, and anesthesiologists, exposing them to respiratory issues and long-term health risks.  Patients and support staff in health care facilities may also be affected by inhalation.  As a result, eighteen states have enacted surgical smoke evacuation mandate laws.

     Accordingly, the purpose of this Act is to require any hospital licensed by the department of health that has an operating room to adopt and implement policies to prevent exposure to surgical smoke.

     SECTION 2.  Chapter 321, Hawaii Revised Statutes, is amended by adding a new section to part I to be appropriately designated and to read as follows:

     "§321-     Surgical smoke; exposure prevention; operating rooms; policies.  (a)  No later than July 1, 2027, any hospital licensed pursuant to section 321-14.5 that has an operating room shall adopt and implement policies to prevent exposure to surgical smoke by using a smoke evacuation system or any other appropriate measure for each procedure that generates surgical smoke.  The department shall ensure compliance with this section during any onsite inspection and in response to any complaint received relating to a violation of this section.

     (b)  For the purposes of this section:

     "Smoke evacuation system" means smoke evacuation equipment and technologies designed to capture, filter, and remove surgical smoke at the site of origin and to prevent surgical smoke from making ocular contact or contact with a person's respiratory tract.

     "Surgical smoke" means the surgical plume that is generated from the use of an energy-generating surgical device, including a smoke plume, bio-aerosol, laser-generated airborne contaminant, and lung-damaging dust."

     SECTION 3.  New statutory material is underscored.

     SECTION 4.  This Act shall take effect on July 1, 3000.

Report Title:

DOH; Hospitals; Surgical Smoke; Exposure Prevention; Operating Rooms; Policies

Description:

Requires any hospital licensed by the Department of Health that has an operating room to adopt and implement policies to prevent exposure to surgical smoke.  Effective 7/1/3000.  (HD1)

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

A BILL FOR AN ACT

relating to Hospitals.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that surgical smoke refers to the vapor inside an operating room that is created during a surgical procedure.  Tools used during a surgical procedure, including lasers or electrosurgical devices, produce aerosolized chemicals that can be harmful to inhale, according to the National Institute for Occupational Safety and Health.  Surgical smoke may contain chemicals such as benzene and formaldehyde.  Studies report that exposure to these chemicals can produce a range of debilitating effects, including migraines, nausea, and irritation of the eyes or nose.

     The legislature further finds that data suggests that each year roughly five hundred thousand health care professionals are exposed to hazardous chemicals produced during surgical operations.  Surgical smoke affects health care workers such as surgeons, nurses, and anesthesiologists, exposing them to respiratory issues and long-term health risks.  Patients and support staff in health care facilities may also be affected by inhalation.  As a result, eighteen states have enacted surgical smoke evacuation mandate laws, including Minnesota, Virginia, and West Virginia.

     Accordingly, the purpose of this Act is to require any hospital with an operating room licensed by the department of health to adopt and implement policies to prevent exposure to surgical smoke.

     SECTION 2.  Chapter 321, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§321-    Surgical smoke evacuation system; definitions.  (a)  No later than July 1, 2026, any hospital with an operating room licensed pursuant to section 321-14.5 shall adopt and implement policies to prevent exposure to surgical smoke by using a smoke evacuation system for each procedure that generates surgical smoke.  The department shall ensure compliance with this section during any onsite inspection and in response to any complaint received relating to a violation of this section.

     (b)  For the purposes of this section:

     "Smoke evacuation system" means smoke evacuation equipment and technologies designed to capture, filter, and remove surgical smoke at the site of origin and to prevent surgical smoke from making ocular contact or contact with a person's respiratory tract.

     "Surgical smoke" means the surgical plume that is generated from the use of an energy-generating surgical device, including a smoke plume, bio-aerosol, laser-generated airborne contaminant, and lung-damaging dust."

     SECTION 3.  New statutory material is underscored.

     SECTION 4.  This Act shall take effect upon its approval.

Report Title:

DOH; Hospitals; Surgical Smoke; Smoke Evacuation System

Description:

Requires any hospital with an operating room licensed by the Department of Health to adopt and implement policies to prevent exposure to surgical smoke.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

STAND. COM. REP. NO.  31-26

Honolulu, Hawaii

                , 2026

RE:   H.B. No. 218

      H.D. 1

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2026

State of Hawaii

Madame:

     Your Committee on Health, to which was referred H.B. No. 218 entitled:

"A BILL FOR AN ACT RELATING TO HOSPITALS,"

begs leave to report as follows:

     The purpose of this measure is to require any hospital licensed by the Department of Health that has an operating room to adopt and implement policies to prevent exposure to surgical smoke.

     Your Committee received testimony in support of this measure from the Association of periOperative Registered Nurses and three individuals.  Your Committee received comments on this measure from the Department of Health and Healthcare Association of Hawaii.

     Your Committee finds that surgical smoke, a byproduct of surgical procedures that use lasers or other electrosurgical devices, contains hazardous chemicals such as benzene and formaldehyde.  Your Committee further finds that exposure to surgical smoke presents a significant health risk for health care professionals conducting a surgical operation and to the patients receiving the operation.  This measure is intended to reduce the potential health risks posed by surgical smoke by requiring all licensed hospitals in the State that have an operating room to adopt and implement polices to control and evacuate surgical smoke.

     Your Committee has amended this measure by:

     (1)  Authorizing a licensed hospital to use a smoke evacuation system or other appropriate measure to address surgical smoke;

     (2)  Changing the effective date to July 1, 3000, to encourage further discussion; and

     (3)  Making technical, nonsubstantive amendments for the purposes of clarity, consistency, and style.

     As affirmed by the record of votes of the members of your Committee on Health that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 218, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 218, H.D. 1, and be referred to your Committee on Consumer Protection & Commerce.

Respectfully submitted on behalf of the members of the Committee on Health,