From the Guidelines
Providers performing cryotherapy for HPV are at risk of exposure to infectious material, including HPV transmission through contact with infected tissue or aerosolized viral particles, and cryogen-related hazards, such as thermal injury from liquid nitrogen and asphyxiation risks in poorly ventilated rooms. The risk of HPV transmission is a significant concern, as studies have documented the presence of intact HPV DNA in laser smoke plumes after treatment of genital and common warts with electrosurgical modalities 1. However, the use of personal protective equipment (PPE), such as goggles, masks, and smoke evacuators, can minimize this risk. A study examining healthcare workers for HPV DNA contamination found no evidence of facial/oral contamination after electrosurgical treatment of genital warts when PPE was used, including goggles and masks, and smoke evacuators were used or procedures were performed in the operating room with exhaust ventilation 1.
To minimize the risks associated with cryotherapy for HPV, providers should:
- Use proper PPE, including gloves, masks, and eye protection
- Ensure adequate room ventilation to prevent asphyxiation risks
- Receive proper training in cryotherapy techniques and equipment handling
- Maintain regular equipment inspection and maintenance schedules
- Follow strict infection control protocols to prevent exposure to infectious material. Additionally, providers should be aware of the potential for musculoskeletal strain from maintaining awkward positions during treatment and take steps to minimize this risk, such as using ergonomic equipment and taking regular breaks. Equipment malfunctions, such as cryogen container leaks or pressure buildup, also pose hazards and should be addressed through regular maintenance and inspection. Overall, the risks associated with cryotherapy for HPV can be minimized with proper training, equipment, and infection control protocols.
From the Research
Risks for the Provider
- The studies provided do not directly address the risks for the provider when doing cryotherapy for HPV on patients 2, 3, 4, 5, 6.
Potential Risks
- However, based on the information provided, potential risks for the provider may include:
- Exposure to infectious diseases, such as HPV, during the treatment process
- Potential for accidental injury or exposure to cryotherapy equipment
- Emotional and psychological stress related to treating patients with HPV infections
Infection Control
- The study by 5 highlights the importance of aggressive preventive measures, including documentation of recent negative cultures for Neisseria gonorrhoeae and Chlamydia, to minimize the risk of infectious complications.
- The use of prophylactic antibiotics may also be investigated for adolescents undergoing cervical cryotherapy 5.
Equipment Safety
- The study by 4 compares the efficacy and adverse effects of trichloroacetic acid and cryotherapy (using liquid nitrogen) in the treatment of external genital warts, but does not specifically address the risks for the provider.
- The study by 6 uses a novel ex vivo approach to compare the efficacy of a new product with conventional liquid-nitrogen cryotherapy, but also does not address the risks for the provider.