Committee advances bill to require hospital policies on surgical smoke

Chair Greg Takayama told the committee he recommended passing HB 218 with house amendments that would require hospitals to adopt and implement policies to prevent exposure to surgical smoke by using a smoke-evacuation system or other appropriate measures for each procedure.

The Department of Health’s Paula Sperio, chief for the Office of Healthcare Assurance, said the department supports the measure and the amendments. "We stand on our testimony in support of HB 218," she said, adding the department supports the association-proposed language the committee considered.

Paige Choi, vice president of government affairs for the Health Care Association of Hawaii, told members hospitals already follow standards from organizations such as the Joint Commission and NIOSH and asked for language that retains flexibility for a wide range of procedures. "There are standards set out by entities such as the Joint Commission and NIOSH, around surgical smoke that our hospitals are compliant with," Choi said. She and the association offered to rework the bill language so it sets hospital-level policy but avoids clinically unnecessary mandates for brief cautery uses.

Members pressed for clarity on when smoke-evacuation systems must be used and whether the law should specify duration or procedural thresholds. Choi said hospitals want standard policies rather than leaving each call to a single clinician for every procedure; the committee agreed to a compromise amendment that keeps mandated policy use but allows other appropriate measures per procedure.

The committee adopted the chair's recommendation to pass HB 218 with those amendments and added a defective date to indicate further work on the language. The committee's recommendation was adopted by voice vote.