Doctors and nurses for years just put up with the smell and the haze they produced in operating rooms when cutting bones or cauterizing blood vessels or tissue, but new research about the hazards of surgical smoke have them changing their practices.

HealthEast’s three East Metro hospitals adopted a zero-tolerance policy last year requiring them to use “evacuation” systems in operating room procedures to suction away and filter out the smoke, which has been found in studies to contain harmful toxins.

“We just smelled it and we just accepted it” in the past, said Andrea Qureshi, a clinical and surgical educator for HealthEast’s St. Joseph’s, St. John’s and Woodwinds hospitals.

Then researchers in Rhode Island showed the potential health hazards of allowing surgical smoke to persist in their operating rooms.

“We realized, ‘Whoa, wait a minute, we’re doing the same thing,’ ” she said.

Rhode Island and Colorado now have laws requiring evacuation systems in surgeries to reduce smoke exposure.

Swiss researchers this spring tested the contents of smoke when cauterizing pig tissue, and found carcinogenic compounds above the exposure levels set by the U.S. National Institute of Occupational Safety and Health, though they also found that surgical masks provided substantial protection.

Before the requirement, Health-East surgeons had been inconsistent in using evacuation systems or other steps to filter out smoke, Qureshi said.

Some didn’t like the way the systems made their surgery tools different or bulkier, or how they added noise in the operating room. And few workers wear the N95 level masks that actually filter out the toxins, unless there are disease outbreaks or quarantine procedures in their hospitals.

“Its very difficult to breathe in those,” she said.

Standard suctions devices have helped surgeons by removing blood and other visual obstructions to their procedures, but those systems aren’t designed to trap toxic air particles, said Elizabeth Wood, the manager of the St. John Hospital’s operating room who originated the smoke evacuation project. Evacuation systems divert the particles to hazardous waste bags.

In addition to requiring the use of evacuation systems, HealthEast required training of operating staff and awareness programs about the dangers of surgical smoke. Their efforts received commendation from the Association of Perioperative Registered Nurses.

HealthEast recently merged with Fairview Health Services, which is one of the state’s largest health care providers and the clinical partner with the University of Minnesota. Fairview hospitals added the smoke evacuation requirement this summer as well.