1 LASER SAFETY NSC Clinical and Operational Conference Calls August 24, 2005

2 AGENDA Definition Laser Hazard Classification Laser Safety Laser Signage Personnel Education and Training Resources

3 DEFINITION Light Amplification by Stimulated Emission of Radiation Since the Radiation in the definition is non- ionizing, unlike X-ray and radiation therapy, it is non-mutagenic and does not require monitoring devices.

4 LASER HAZARD CLASSIFICATION Class 1 – considered to be incapable of producing damaging radiation levels and require no specific safety precautions Class 2 – Emits visible light and eye protection is normally afforded by diversion response, i.e. blinking

5 LASER HAZARD CLASSIFICATION Class 3 – May be hazardous under direct and specular (mirror like) reflections viewing conditions, but diffuse reflection not usually a hazard Class 4 – May also be considered potential fire hazard and may produce airborne contaminants when used surgically to vaporize tissue

6 LASER HAZARD CLASSIFICATION Nearly all laser products used in surgery are Class 4 as they are designed to deliver radiation to alter biological tissues. Lower powered lasers not designed to alter tissue include visible lasers used to aim the beams of other higher powered invisible infrared and ultraviolet lasers such as the YAG

7 LASER SAFETY Before installation in a clinical setting, a laser safety program should be established according to the ANSI Z136.3 standard The program must be outlined in written policies and procedures for training, laser use, maintenance and service Some hospitals and large facilities have created a laser safety committee that oversees the laser safety program

8 LASER SAFETY A designated laser safety officer (LSO) is appointed who may be a nurse, physician or other member of a small clinic or private office The LSO is responsible for:  Familiarity with the manufacturer’s hazard evaluation for all laser systems in use in the facility  Evaluation of areas

9 LASER SAFETY  Recommendation and approval of Personal Protective Equipment  Hazard control measures  Must be in the position to implement policies and procedures, to require staff education and to maintain documentation and records  Complete list of recommended LSO duties and responsibilities can be found in ANSI Z136.6 (1996)

10 LASER SAFETY Fire Hazards  One of the most common causes of accident, most common is the ignition of flammable materials from accidental exposure to laser radiation,  Alcohol solutions are another cause Electrical Hazards  Keep IV solutions and fluid containers away  Do not use extension cords to power lasers

11 LASER SAFETY Laser Generated Airborne Contaminants (LGAC)  Produced when lasers vaporize tissues, can cause airway and eye irritation as well as bronchial and pulmonary congestion  Smoke evacuators are recommended In the case of a laser related incident, medical attention should be sought immediately to evaluate visual function and exposed areas of the skin

12 LASER SIGNAGE Access doors to be closed whenever laser is in use A sign indicating a laser is in use and appropriate goggles must be placed at the entryway of the laser treatment area

13 LASER SIGNAGE

14 PERSONNEL EDUCATION AND TRAINING All health care facilities regardless of their size are required to establish and maintain adequate safety programs for the control of laser hazards Proper policies concerning training, education, credentialing, and laser safety management must be developed according to the ANSI Z136.3 series of safety standards and supported through proper organizational controls

15 PERSONNEL EDUCATION AND TRAINING Appendix D in the ANSI Z136.3 (1996) provides sample laser training programs The importance of quality laser safety training cannot be overstated

16 RESOURCES LIA Guide to Medical Laser Safety, Laser Institute of America LIA Guide for the Selection of Laser Eye Protection, Laser Institute of America “American National Standard for Safe Use of Lasers in Health Care Facilities”, ANSI Z136.3 (1996)

17 RESOURCES Laser Institute of America Integrity Drive, Suite 128 Orlando, FL