Non-beam hazards: In addition to the beam hazards discussed above, there are non- beam hazards also such as electrical, mechanical, chemical hazards (due to materials used in the laser such as halogens in exciter lasers) and high temperature/fire hazards for which protective measures must be taken. In USA, the Federal Laser Product Performance Standard (FLPPS) for laser products (21 CFR 1040.

10 and 1040.11) requires that the operating manuals for HCLSs contain adequate instructions for assembly, calibration, operation and maintenance, including clear warnings concerning precautions to avoid possible exposure to hazardous levels of laser and/or collateral radiation. The guidelines for safe use of lasers in health care facilities are given in ANSI Z136.3. JCAHO has referenced the American National Standards (Z136.

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1 and Z136.3) as guidelines for hospital surveillance in laser audits and safety in health care facilities. In European countries eye protection requirements are specified in EN 207 and EN 208

2. Safety Measures:

i. Everyone who uses a laser should be aware of the risks of unprotected use ii. Watches and other jewelry that might enter the optical plane (and cause specula reflections) should not be allowed in the area iii. Adequate eye protection for everyone in the room while operating lasers of classes 3 b and 4 iv. It may be in the form of spectacles or goggles with appropriately filtering optics for protection from both the reflected/scattered light as well as direct exposure.

Eye protection must be specific to the wavelength of the laser in use otherwise, it may not be effective. For lasers emitting radiations of more than one wave length such as 532 nm “green laser pointers”, and frequency doubled YAG lasers, dual frequency eyewear should be used. The protective specifications are usually printed on the goggles v. All class 3b and class 4 lasers are required to have five standard safety features: a key switch, a safety interlock, a power indicator, an aperture shutter and an emission delay (normally 2-3 seconds). Safety interlocks are circuits that shut down a laser, if the laser casing or room door is open vi.

Safety measures for prevention of non-beam hazards vii. Laser pointers and laser pens in use may be up to class 3A or Class 2 depending upon the local regulations. They are a potential hazard as they can cause physical injuries to the eyes and should be used with care. They certainly should not be allowed in the hands of minors.

3. Appointment of a Laser Safety Officer:

Laser Safety officers (LSO) have the training and experience to administer a laser safety program and have an important role in health care facilities using the laser systems. A laser safety officer is responsible for: i. Hazard classification of all lasers and laser systems in use in the organization, in case not already certified by the manufacturer ii. Hazard evaluation iii.

Hazard response in case of imminent danger from a laser hazard iv. Documenting and enforcing the SOPs for safe and hazard free usage of laser systems v. Ensuring availability of protective equipment in good working order and its correct usage vi. Correct area signage and equipment labels vii.

Approval of the HCLS equipment and its installation in accordance with the manufacturers safety instructions viii.Education and training of all staff/students about laser safety program.