Laser Plume From Human Papillomavirus-Infected Tissue: A Systematic Review

Dermatol Surg. 2020 Dec;46(12):1676-1682. doi: 10.1097/DSS.0000000000002757.

Abstract

Background: Laser procedures are becoming more prevalent across multiple medical specialties for a variety of indications. The plumes created by these lasers have raised concern for the dissemination of an infectious material.

Objective: To review and summarize the information on viral dissemination in laser plumes available in the literature.

Materials and methods: Data Sources A systematic review was performed on English and non-English articles using the PubMed and the Cochrane databases. A manual search of bibliographies from relevant articles was also performed to collect additional studies.

Study selection: Only articles in the English language with full texts available that pertained to viral particles in laser plumes were included. Data Extraction Two authors performed independent article selections using predefined inclusion and exclusion criteria.

Results: There have been case reports of possible transmission of human papillomavirus (HPV) by inhalation of laser-produced aerosols. Multiple investigators have attempted to recreate this scenario in the laboratory to qualify this risk. Others have conducted clinical experiments to determine the presence of HPV in laser plumes.

Conclusion: The current body of the literature suggests that laser surgeons are at a risk for HPV exposure by inhalation of laser-derived aerosols. We offer best practice recommendations for laser operators.

Publication types

  • Systematic Review

MeSH terms

  • Aerosols / adverse effects*
  • Alphapapillomavirus / pathogenicity
  • Dermatologists / standards
  • Dermatologists / statistics & numerical data
  • Head and Neck Neoplasms / epidemiology
  • Head and Neck Neoplasms / prevention & control
  • Head and Neck Neoplasms / virology
  • Humans
  • Incidence
  • Inhalation Exposure / adverse effects
  • Inhalation Exposure / standards
  • Inhalation Exposure / statistics & numerical data
  • Laryngeal Diseases / epidemiology
  • Laryngeal Diseases / prevention & control
  • Laryngeal Diseases / virology
  • Laser Therapy / adverse effects*
  • Laser Therapy / standards
  • Laser Therapy / statistics & numerical data
  • Masks / standards
  • Occupational Diseases / epidemiology
  • Occupational Diseases / prevention & control*
  • Occupational Diseases / virology
  • Occupational Exposure / adverse effects*
  • Occupational Exposure / statistics & numerical data
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / surgery
  • Papillomavirus Infections / transmission*
  • Papillomavirus Infections / virology
  • Practice Guidelines as Topic
  • Protective Clothing / standards
  • Skin / radiation effects
  • Skin / virology
  • Skin Neoplasms / surgery
  • Skin Neoplasms / virology
  • Squamous Cell Carcinoma of Head and Neck / epidemiology
  • Squamous Cell Carcinoma of Head and Neck / prevention & control
  • Squamous Cell Carcinoma of Head and Neck / virology
  • Surgeons / standards
  • Surgeons / statistics & numerical data

Substances

  • Aerosols