Advanced Laser Education Content - Part 4 Laser Safety

This page contains treatments advanced education content about laser and treatments. 


National agencies regulating lasers

ANSI -  American national standards institute – provides guidance for the safe use of lasers for diagnostic, cosmetic, preventative ad therapeutic application in health care facilities

OSHA – occupational safety and health administration – regulatory body for industry and for medical use of lasers

Department of FDA – responsible for implementing and enforcing the federal laser product performance standard

ANSI regulations

Stipulates that a healthcare facility shall delegate authority to a laser safety officer

LSO is responsible for

  • supervision and control of laser hazards
  • education training and policies and procedures
  • ensuring that all safety equipment is available and in good working order

Protective equipment needs to be audited every 6 months to ensure proper working order

ANSI 136.3

  • All laser incidents (accidents or adverse events), no matter how minimal shall require an incident report
  • An ocular evaluation shall be made at the time of the incident if any injury to personnel is suspected

Records

  • The LSO shall assure that the necessary records required by applicable government regulations are maintained the includes maintenance records of the lasers
  • Records documenting the maintenance of the safely program such as training records, audits, etc shall be maintained.

 Arizona Agency

  •  ARRA – Arizona Radiation Regulatory Agency
  • This is the agency in Arizona that is responsible for enforcing all state and federal laws.
  • You must submit documentation of completion of 40 hour didactic course and all laser logs in order to receive certification to operate lasers in Arizona

ANSI laser classifications

Class 1 Laser - A laser system that may produce visible or invisible laser radiation, under all normal conditions of operation, a class 2 laser is considered incapable of causing injury from directly viewing the radiation beam.

Class 2 laser - A laser or laser system that produces low-power visible laser radiation not exceeding 1mW. Eye protection is normally afforded by the natural blink reflex time (0.25 seconds) direct viewing of the radiation beam from a class 2 laser is prohibited

Class 2A - A laser products mean any laser product that permits human access levels of visible radiation in excess of the Class 2 accessible emission limits, during its operation, but does not permit human access to levels of laser radiation in excess of the accessible class 2a emission limits.

Class 3 Laser - A laser or system that produces moderate levels of visible or invisible laser radiation on 1–5 mW and requires more stringent control than a class2 laser

Class 3B - laser produces visible laser radiation of 5-500 mW. It is considered a medium power laser and is capable of producing eye injury. It does not produce a hazardous diffuse reflection or fire hazard.

Class 4 Laser - A laser or laser system that produces visible or invisible laser radiation capable or causing injury to the eye and skin, and dangerous specular reflection (mirror) and diffuse reflections. In proper use may result in a fire hazard.

Terminology

Maximum permissible exposure (MPS): the level of laser radiation a person may be exposed to without hazardous effecs or adverse biological changes in the eye or skin

Nominal hazard zone (NHZ): the space in which the level of radiation uring normal operation exceeds the MPE

Operating Rules

  • All windows at ground level should be covered within the NHZ
  • The doorways, screens or curtains must be used to attenuated laser radiation in the entryway to the NHZ.
  • The entrance to the NHZ must be labeled with the appropriate warning signed indicating the type of laser device being used
  • Protective eyewear MUST be work by the operator, patient and all personnel when the laser is in operation
  • Keys must be removed and stored in a secure area when the laser is not in use
  • Laser must be in standby when not firing

Warning Signs

  • Contains a white international safety alert symbol surrounding red exclamation mark places to the left of the white signal word danger on a red background
  • Contains the wavelength, maximum power, maximum pulse energy
  • Also contains the laser class
  • Warns that protective eyewear is required
  • Hazards associated with laser usage

Beam Hazards:

  • Eye damage
  • Skin damage
  • Enotrachael fire

Non Beam Hazards:

  • Electrical
  • Hazardous Gases
  • Fire
  • Airborne contaminates

Eye Hazards

Never look directly into the laser beam

  • Lense damage
  • Retinal burns
  • Corneal burns
  • The most likely effect of intercepting a laser beam with the eye is thermal burn which descroys the retinal tissue
  • Damage is permanent

Possible symptoms of laser injuries to the eye

  • Burning pain
  • Bright color class of the emitted wavelength and an after image of the complimentary color
  • IR lasers are more dangerous than those in the visible light range becauseit does not cause the natural eye blink reflex

Protective Eyewear

All safety glasses are labeled with the laser wavelength that the glasses are intended to be worn for

They also have the Optical Density of the glasses:

  • OD 1: Only one tenth of the light gets through
  • OD 2: One hundredth of the light gets through
  • OD 3: 1/1000 (0.001%)
  • OD 4: 1/10,000 (0.0001%)
  • OD 5: 1/100,000 (0.00001%)

 $7,000.00 fine for eyewear protection violation

Fire safety

  • Do not use lasers when flammable gas or liquids are present
  • Flammable materials include paper drapes, gauze gowns, alcohol or solutions containing alcohol and petroleum based products
  • Avoid shiny instruments near lasers
  • Check aiming bean with wet tongue depressor before firing the laser (CO2 laser)
  • Fire extinguisher should be available for use

Electrical safety

  • OSHA requirement to have a safe environment free of recognized hazards
  • Check that all power cords are intact and not frayed
  • Check for loose wired or any unsafe condition
  • Do not use electrical equipment if you are standing on a wet surface or if body parts are wet, especially hands
  • Must report all cases of electrical shock or burn