Surgical Smoke Evacuation Laws by State (2026)

Updated October 2026. 22 states have now passed laws requiring hospitals and surgery centers to protect staff and patients from surgical smoke, the plume created when electrosurgical units, lasers and ultrasonic devices cut or cauterize tissue. Most of these laws require a written policy and the use of a smoke evacuation system for any procedure likely to generate surgical smoke. Here is where each state stands, what the laws require and how to comply.

Don't Get Caught Off Guard

Several deadlines are still ahead: Michigan facilities must comply by July 21, 2027, Maryland by January 1, 2028, and Cal/OSHA is drafting a statewide standard for California health facilities. Bills are also moving in Pennsylvania, Massachusetts, South Carolina and other states. If your facility doesn't have evacuation in every OR and procedure room yet, now is the time to budget for it.

Shop surgical smoke evacuators, filters and pencils →

What Is Surgical Smoke and Why Is It Regulated?

Surgical smoke can contain toxic gases and vapors, bioaerosols, and viable or nonviable cellular material. According to NIOSH, the plume should be controlled with local exhaust ventilation: a smoke evacuator or room suction with the capture point held within 2 inches of the surgical site. Surgical masks are not designed to filter it. Perioperative nurses and surgical teams breathe it every day, which is why the Association of periOperative Registered Nurses (AORN) has led the push for state laws.

What the State Laws Typically Require

• A written policy to prevent exposure to surgical smoke.
• Use of a smoke evacuation system during procedures likely to generate smoke (Georgia's law requires a policy to reduce exposure but does not name evacuation systems specifically).
• Coverage of hospitals and, in most states, ambulatory surgical centers. Some laws reach any licensed facility that uses energy-based devices.
• Enforcement through the state health department or, in Oregon and Washington, the state workplace safety agency.

Surgical Smoke Evacuation Laws by State

Sources: state legislature and statute pages linked above, and AORN's Surgical Smoke-Free OR tracker. Minnesota's link goes to AORN's summary of the law.

Bills Pending or Introduced (Not Yet Law)

• Pennsylvania: HB 27 passed the House in 2025 and went to the Senate.
• Massachusetts: S.1482 / H.2442 are in committee.
• South Carolina: S. 170 passed the Senate and is in a House committee.
• Also introduced: Florida (passed the House in 2026, died in the Senate), Wisconsin, Hawaii, Iowa, Kansas and Oklahoma.

Is There a Federal Requirement?

There is no OSHA standard specific to surgical smoke. OSHA can address it under the General Duty Clause and its respiratory protection and bloodborne pathogens standards (OSHA laser/electrosurgery plume page). NIOSH recommends local exhaust ventilation, and AORN's Guideline for Surgical Smoke Safety recommends evacuating all surgical smoke at the source. Accreditation surveyors increasingly ask about smoke evacuation policies even in states without a law.

How to Comply: A Practical Checklist

1. Write the policy. Name the procedures that generate smoke and require evacuation for them.
2. Put an evacuator in every room that needs one. ORs and procedure rooms doing electrosurgery, laser or ultrasonic work. The compact ConMed ViroVac suits procedure rooms and ASCs; the ConMed VisiClear handles laparoscopic, pencil and open-tubing modes in the OR.
3. Capture at the source. Smoke evacuation pencils and pencil adapters capture plume right at the tip so the team doesn't need a second hand on a wand. See smoke evacuation pencils and adapters.
4. Stock the consumables. Filters wear out by the hour, and tubing and pencils are single use. Keep replacement filters and tubing on the shelf.
5. Train staff and document it. Surveyors will ask to see the policy and training records.

Which Filter Does My Evacuator Use?

Smoke evacuator	Replacement filter	Filter life
ConMed Buffalo Filter ViroVac (VV120 / VV220)	VS353 (also 2- and 4-packs)	18–35 hours depending on flow
ConMed Buffalo Filter VisiClear (VC120 / VC220)	VS135	18–35 hours depending on mode
ConMed AER DEFENSE	FilterOne 60-8084-001	Up to 35 hours

Frequently Asked Questions

Does my state require surgical smoke evacuation?

As of October 2026, 22 states have enacted laws: Arizona, California (rule in development), Colorado, Connecticut, Delaware, Georgia, Illinois, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Ohio, Oregon, Rhode Island, Virginia, Washington and West Virginia. Check the table above for your compliance date.

Do the laws apply to ambulatory surgery centers?

In most states, yes. Missouri's law covers Joint Commission-accredited hospitals and ASCs only, and a few states cover any licensed facility that uses energy-based devices.

Is a surgical mask enough?

Not on its own. Surgical masks are not designed to filter surgical smoke, and masks do nothing to remove the plume from the room. The state laws and NIOSH guidance call for evacuating the smoke at the source.

Can we buy on our GPO contract?

Yes. We are Vizient and Provista contracted, so your facility's negotiated pricing applies. Contact us for a multi-room quote.

This page is a summary for planning purposes, not legal advice. Laws and compliance dates change; confirm requirements with your state health department, compliance team or counsel.