LASER SAFETY

Dr. ESTER WANGSASAPUTRA

Laser Skin Rejuvenation Clinic,
Pluit Hospital, Jakarta, Indonesia.

INTENSE

LASER

COHERENT

SYSTEM

LIGHT

POTENTIAL HAZARDS

SKIN

EYE

OTHERS

MEDICAL LASER HAZARDS

Burns : Skin, eye, drapes, etc.
Blindness : - Total
- Partial
- Temporary
- Permanent
Explosion : - Airway
- Digestive tract
- intra-cavity
- Endoscopic, flammable anesthetics.

A.N.S.I.
(American National Standards Institute)

N.C.D.R.H.
(National Center for Devices and Radiological Health)
NCDRH Standard : Laser Classification : 4 Major
Hazard Categories / Class

Class I Laser

Low energy laser

Cannot emit radiation of known hazard (eye)
Less than MPE (= Maximum Permissible Exposure)
No need for control, no safety requirement.
Example : - Completely enclosed diagnostic
laboratory equipment.
- Video laser disc player
- etc.

Class II Laser
Low power laser, visible, up to 1-2 mW.
Incapable to cause injury within aversion
reflex/response of the eye (0,25sec.)
Hazard can exist only if stares directly into
the laser beam or point directly to the eye.
Need to have a CAUTION label and
indicator light.
Example : laser pointer/alignment

Class III Laser

Medium Power laser
Capable to cause injury to the eye within 0,25
sec.
Divided into 2 subgroups:
- Class IIIA laser
- Class IIIB laser

Class IIIA Laser

Output in the range 1-5 mW
Not hazardous if exposed in short period.
Low laser beam density (irradiance) less than
2.5 mW/cm2
Usually large beam diameter/expanded
diameter (with diffusing/diverging lens)
Need a CAUTION label

Class IIIB Laser

Power range 1-500 mW.
Can be hazardous if eye expose to direct
laser beam.
Need a DANGER & Laser Aperture
label
Examples : - Laser pain attenuator
- Laser acupuncture apparatus
- Ophthalmic laser photo-coagulator

Class IV Laser
High Power laser
Are Hazardous to view either directly or
indirectly
Most surgical lasers are Class IV laser
Can cause serious damage to skin and eye
within less than 0.25 sec.
Need a DANGER & Laser Aperture"
label

MEDICAL LASER PROTECTION

Organ prone to laser injury : - Skin
- Eye
Protection toward :
Skin = wet gauge, inflammable drape, etc.
avoid direct or indirect exposure to laser
Eye : CO2 laser = Ordinary Goggles
Argon, KTP, Nd.YAG, Ruby lasers =
Goggles for specific wavelength.
Avoid using flammable material.
Use black coated /non reflecting instrument

LASER DANGERS
No comprehensive list
Each procedure have : - different situations
- different conditions
- different hazards
To achieve successful laser applications :
Mastering Laser Physics, Laser Tissue
Interactions, Laser Safety, Laser Operating
Principles/Technique is a MUST

Qualification and Training

Staff / Personnel involve in Laser Treatment
should have laser safety training.
Only Qualified and Authorized Operators are
permitted to operate the laser.
Every Safety precaution provided by the
manufacturer of each individual laser
equipment should be followed routinely,
particularly Class III & IV Lasers.

Conclusion
Laser Applications/treatment are beneficial
and superior to conventional treatment when
done in Good Hands and Correct indications.
In the Contrary Laser Treatment have the
potential to harm the Patient, the Operator as
well as the Personnel assisting the Laser
Treatment.