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Surgical smoke exposure is an important occupational hazard posing risk to all working in Operating Room (OR) environments.A questionnaire was designed to evaluate the knowledge of OR staff about the risks of surgical smoke exposure. It was distributed to all OR medical and nursing staff within Antrim Area Hospital, United Kingdom.The response rate was >75% and was representative of the study group. 98% of OR staff were aware that both the operator and scrubbed staff were at risk from smoke inhalation; whilst only 78% and 57% respectively were concerned about risk to non-scrubbed staff and the patient. 98% of respondents recognised electro-surgery as a source of surgical smoke, however less identified laser and ultrasonic surgical devices as additional sources. 61% knew that surgical smoke could potentially contain water, chemicals, bacterial and viruses; whilst 11% were unsure. 2% believed smoke exposure caused no symptoms. 35% of staff felt a standard facemask was protective. Only 22% and 63% respectively were aware of availability of smoke wands and portable evacuation devices as risk reduction measures within their unit. 76% deemed current risk reduction inadequate. The majority of staff (63%) were exposed to surgical smoke at least twice weekly; 32% for >90 min per episode. 59% of respondents experienced symptoms which they attributed to smoke exposure, most commonly headache (28%). 74% had multiple symptoms and 4% had had associated sickness absence.Those with the greatest exposure (frequency and duration) were more likely to have relevant symptoms and were the only group to have attributable sick absence. Evaluation of policies; staff education; and risk reduction measures are recommended.