In a change from previous editions of the National Fire Protection Association's NFPA 99, Health Care Facilities Code, the 2012 edition doesn't require supply and exhaust systems for windowless anesthetizing locations to be arranged to automatically vent smoke and products of combustion. "With the complexity of operating room (OR) ventilation systems and the constant air change rate and volume of air being moved in ORs, the committee removed this section from the code," says Chad Beebe, AIA, SASHE, CHFM, director of codes and standards for the American Society for Healthcare Engineering. Growing concerns over OR surgical fires still were noted, but they tend to be quick-burning with limited smoke. ORs are pressurized so as to not affect adjacent rooms, and incorporating such smoke control provisions could upset that balance, placing patients in other areas of the hospital at risk. "This has repeatedly come up as a question from facilities," Beebe adds.

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