Table 4.

Characteristics of included studies on CO2 laser ablation

Author, year	Study Design	Level of Evidence	Subjects (n)	Study Groups	Study outcomes	Conclusion	Directness of evidence
Genangeli, 2019 [18]	Experimental study	N/A	N/A	Different tissues, non-human	Mass spectrometry of air sample obtained using CO2 laser on different tissues	CO2 lasers can generate aerosols with detectable molecular profiles for all tissues tested	Direct
Kashima, 1991 [20]	Descriptive, cross sectional study	N/A	22	Patients with recurrent respiratory laryngeal papillomatosis	PCR of air samples for HPV DNA	1. 17/30 vapor samples were positive for HPV. 14 paired tissue and vapor samples revealed the same HPV type. 2. HPV-DNA in the vapor can be of concern to the operating team.	Direct
Garden, 1988 [21]	Descriptive, cross sectional study	N/A	7	Patients with plantar or mosaic verrucae	Electrophoresis and visualization of HPV DNA in air samples	1. Intact human papillomavirus DNA was present in the vapor for two of the seven patients. 2. Viral DNA can be released during the laser treatment for verrucae, even with clinically relevant laser parameter settings.	Direct
Sawchuk, 1989 [22]	Experimental study	N/A	8	Human plantar warts	Dot-blot analysis of HPV DNA in air samples	Five of eight laser-derived vapors were positive for HPV DNA.	Direct
Gloster, 1995 [23]	Case control study	4	31/6124	CO2 laser surgeons and patients with warts	Incidence of HPV lesions in CO2 laser surgeons	The overall incidence of acquired HPV warts, was not significantly different from the incidence of control patients. However, the incidence of nasopharyngeal warts was higher in CO2 laser surgeons (13%) compared to the control population (0.6%).	Indirect

PCR polymerase chain reaction

HPV Human papilloma virus

DNA deoxyribonucleic acid