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Human Papillomavirus DNA in CO2 Laser- Generated Plume of Smoke and its Consequences to the Surgeon

From the Departments of Pathology and Gynecology, The Sir Mortimer B. Davis Jewish General Hospital and The Reddy Memorial Hospital, Montreal, Quebec, Canada; and Columbia University College of Physicians and Surgeons, New York, New York

Abstract

Carbon dioxide laser energy is absorbed by intracellular water but not by proteins or nucleic acids. The possibility of dispersing viral DNA during laser therapy of human papillomavirus (HPV)-containing genital infections was explored using a filter hybridization technique. Samples were taken using dacron swabs from 110 patients in nine separate treatment sessions as well as from five pre-filter canisters, four fume vacuum tubes, and from the nasopharynx, eyelids, and ears of the laser surgeon before and after laser surgery. The viral RNA probes were specific for groups of HPV types 6/1/6cand 31/33/35. Human papillomavirus DNA was identified in swabs from 65 of 110 (60%) of histologically unequivocal condylomata and cervical intraepithelial neoplasias. One of the five pre-filter canisters (20%) tested was HPV DNA-positive after laser treatment of 65 patients; it contained HPV DNA type 6. The four fume vacuum tubes tested in the remaining 45 patients were HPV DNA-negative, as were the nasopharynx, eyelids, and ears of the operator. Although HPV DNA may be released during laser vaporization of genital HPV infections, contamination of the operator is unlikely provided appropriate equipment for evacuating HPV DNA-positive smoke is used.

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