Hazard summary

There is an increased risk of fire in hospital operating rooms when electrocautery devices, electrosurgery devices and lasers are used. They can be an ignition source when used:

  • in an oxygen enriched environment, for example when oxygen is being delivered to a patient during head or face surgery
  • near an ignitable material such as a recently applied alcohol-based disinfectant that is still wet when the device is triggered

The presence of easily ignitable materials (such as surgical drapes, tubing or gauze) could feed a fire if one occurs.

To protect workers, hospital employers should consider:

  • developing measures and procedures in consultation with the joint health and safety committee (JHSC) or health and safety representative (HSR) related to the prevention of fire hazards during surgeries (or other medical procedures) where these devices and lasers are used
  • providing fire prevention training that is specific to an operating-room setting

Key legal requirements

There are general legal requirements under the Occupational Health and Safety Act (OHSA) and its regulations that apply to  the prevention of surgical fires.

General duties under the OHSA

An employer who is covered by the OHSA, has a range of legal duties. For example, under clause 25(2)(h) employers must take every precaution reasonable in the circumstances for the protection of a worker. This may include protecting workers from hazards associated with electrocautery devices, electrosurgery devices and lasers.

Establish measures and procedures

Workplaces, such as hospitals, covered by O. Reg. 67/93 - Health Care and Residential Facilities must:

The measures and procedures may include:

  • safe work practices regarding the use of electrocautery devices, electrosurgery devices and laser devices in operating rooms
  • use of appropriate antiseptics, disinfectants and decontaminants when using electrocautery devices, electrosurgery devices and laser devices in operating rooms
  • proper use, maintenance and operation of equipment
  • the use, wearing and care of personal protective equipment and its limitations
  • ways to address the hazards of chemical and physical agents present in the workplace

Employers must review and revise the measures and procedures at least once a year in light of current knowledge and practice, or more frequently if :

  • the employer, on the advice of the JHSC or health and safety representative, if any, determines a revision is necessary
  • there is a change in circumstances that may affect the health and safety of workers

Provide training and education

Employers must provide information, instruction and supervision to a worker to protect the health or safety of the worker.

Employers to which O. Reg. 67/93 applies must also develop, establish and provide health and safety training and educational programs for workers on the measures and procedures that are relevant to the workers’ work, including those developed to minimize the risk of surgical fires, where applicable. This includes training and education for trainees participating in a work placement who will work with lasers and handheld electrocautery and electrosurgery devices.  Employers must consult with and consider the recommendations of the JHSC or health and safety representative regarding training and education programs for workers.

Training for workers who may be at risk should include information about:

  • the fire risks associated with electrocautery devices, electrosurgery devices and lasers
  • procedures to prevent surgical fires

Measures, procedures and training related to surgical fire prevention should include the requirements of O. Reg. 67/93 regarding machinery or equipment (section 44).

Equipment

The use and maintenance of lasers and handheld electrocautery and electrosurgery devices must be done safely. All workplace parties must:

  • ensure equipment is operated by a worker trained in its use and function
  • follow manufacturer’s recommendations and instructions for use, servicing and maintenance

Learn about the requirements in O. Reg. 67/93 – Regulation for Health Care and Residential Facilities that may apply in your workplace for:

  • equipment in general (section 44)
  • electrical equipment (section 62)
  • flammable liquids (subsection 99(1))

Related requirements

Other regulations that may apply:

Precautions to consider

Employers should assess the potential risk of fire prior to work and ensure that staff in operating rooms:

  • use alcohol-based antiseptics safely by using correct dilutions and letting the agent dry thoroughly
  • are cautious when oxygen is used near electrocautery and electrosurgery devices or lasers
  • properly position an electrocautery device or laser to avoid contact with ignitable materials

Employers should ensure that lasers, electrocautery and electrosurgery equipment and devices meet applicable standards for fire and electrical safety, including:

  • the Canadian Electrical Code
  • Safe use of lasers in health care facilities (CAN/CSA Z386.08)
  • Plume scavenging in surgical, diagnostic, therapeutic and aesthetic settings (CSA Z305.13)

Other standards that may be relevant can be found on the Canadian Standards Association web site. 

Contact us

If you need more information, please contact the Health & Safety Contact Centre at 1-877-202-0008 on Monday to Friday, from 8:30 a.m. to 5:00 p.m., or webohs@ontario.ca.

This resource does not replace the Occupational Health and Safety Act (OHSA) and its regulations and should not be used as or considered legal advice. Health and safety inspectors apply the law based on the facts in the workplace.

Mention of any organization or tool does not mean the Ministry of Labour, Training and Skills Development endorses them. Citations to websites external to the MLTSD do not constitute MLTSD endorsement of the organizations or their programs or products as OHSA compliant. The MLTSD is not responsible for the content of these websites.