Regulations Are Changing: Is Your OR Prepared for Smoke Safety?

  • Published: 4/20/2026
  • 2 min

The landscape of surgical smoke safety is evolving rapidly—and hospitals across the country are being called to act. As of December 2025, 20 states have enacted legislation requiring smoke evacuation in operating rooms. These laws apply to procedures that generate surgical smoke plume, which occur in approximately 90% of all surgeries.

This isn’t just a regulatory shift—it’s a reflection of growing national momentum to protect perioperative staff and patients from the harmful effects of surgical smoke.

A Movement Gaining Speed

Earlier in 2025, Delaware became the 20th state to pass a mandate, with its law taking effect April 1, 2026. These additions reflect a powerful trend: more states are recognizing that surgical smoke is a serious occupational hazard—and they’re taking action to eliminate it.

North Carolina shaped image

Advocacy That Drives Change

One of the most inspiring examples comes from North Carolina, where legislation was passed requiring hospitals to implement smoke evacuation systems beginning January 1, 2026. The law was championed by the North Carolina Council of Operating Room Nurses, whose members have long advocated for safer surgical environments.

“We’ve been fighting this for several years now and we’re very, very happy that this has finally been approved. This is going to provide a safe environment free from those types of dangers”.

— Amanda Heitman, President of the Council

Her words echo the sentiment of nurses nationwide, those who’ve led the charge for change, often long before legislation caught up.

What This Means for Hospitals

With 20 states now mandating smoke evacuation, hospitals must assess their readiness. These laws vary in implementation timelines and scope, but the message is clear: compliance is coming, and preparation is essential.

Facilities that act early not only meet regulatory requirements, but they also demonstrate leadership, protect their teams, and foster a culture of safety.

Education Before Enforcement

The path to legislation isn’t always fast. It takes time to educate stakeholders, build consensus, and ensure that policies reflect the realities of surgical practice. This movement proves that lasting change comes from informed action—not rushed mandates.

Hospitals that invest in education and proactive implementation now will be better positioned to meet future standards—and to support the nurses and surgical teams who make safe care possible.

Clear the Air with CONMED