2. The Safe Use of Lasers John Saunderson Laser Protection Adviser Hull & East Yorkshire Hospitals in Clinical Practice

3. Content Welcome Nature of laser radiation Laser classes & hazards Local safety systems Operational safety Q & As.

4. L ight A mplification by the S timulated E mission of R adiation

5. 40 W bulb - 5% efficient 2,000 x light energy from 1 mW laser pointer At 1 metre 40 W bulb = 3.2  W/mm 2 1mW laser pointer = =1 mW/mm 2 (300 x bulb), or =0  W/mm 2 40 W surgical laser 40,000 x laser pointer

7. 1 mm beam focussed to 20 microns   (1000/20) 2 =  2500 power density

8. Visible Green 532 nm Red 633 nm Invisible Nd:YAG 1064 nm CO 2 10600 nm

9. __________________________ Continuous beam __ Single pulse __ __ __ __ __ __ __ Interrupted pulses

11. Laser Device Classes & Hazards Class 1 Class 1M Class 2 Class 2M Class 3R Class 3B Class 4 Applies to device as a whole.

12. Video

13. Class 1 –no risk to eyes (including using optical viewing instruments) –no risk to skin –(either low power device or totally encased)

14. Class 1M –no risk to the naked eye –no risk to skin

15. Class 2 –no risk to eyes for short term exposure (including using optical viewing instruments) –no risk to skin –(visible, so blink response protects) –(may cause dazzle or flash blindness)

16. Class 2M –no risk to naked eye for short time exposure –no risk to skin

17. Class 3R –low risk to eyes –no risk to skin –(risk for intentional intrabeam viewing only) –(may be a dazzle hazard)

18. Class 3B –medium to high risk to eyes –low risk to skin –(aversion response protects skin, or must be focussed to such a small spot that pin-prick effect only)

19. Class 4 –high risk to eyes and skin –low risk to skin –(diffuse reflection may be hazardous) –(possible fire hazard)

20. HEYH Trust CP137 Health & Safety at Work Policy - Lasers - Includes safety of class 3B and class 4 lasers

21. Laser Safety Structure Risk assessment Controlled Area Local Rules Laser Protection Supervisor Laser Protection Adviser Authorised Operators and Assistants

22. Risk Assessments

24. Local Rules (How to work safely) Specific to each laser What are hazards? Controlled area - limit area of hazard - signs Users & Laser Protection Supervisor Safety precautions (e.g. eyewear, blinds) Methods of safe working, etc. Adverse incident procedure, LPA, etc.

25. Laser Protection Supervisor

26. Laser Protection Adviser

27. Authorised Users

30. Incidents

32. Example

33. MDA “One Liners” - Eye risk? August 2002 (Issue 17) MDA has become aware of the use of inappropriate filters for lasers used in ophthalmic surgery. This can lead to permanent eye damage for the operator.  When connecting a laser to a protective system with filters, ensure that the wavelengths of laser radiation for which the filter offer protection match the output wavelength of the laser. If a fault is suspected with the filters, the procedure should be discontinued and the filters examined by a trained engineer.

34. Example Laser 520-575 nm Green, 2 W 568-575 nm Yellow,  1 W 670 nm Red (aim), < 5 mW Goggles labelled 560-570 nm OD>4 570-580 nm OD>5 580-650 nm OD>6

35. Example Laser 520-575 nm Green, 2 W 568-575 nm Yellow,  1 W 670 nm Red (aim), < 5 mW Goggles labelled 560-570 nm OD>4 570-580 nm OD>5 580-650 nm OD>6

36. MDA “One Liners” - Hind Sight? March 2000 (Issue 8) Two separate incidents reported to MDA involving faulty laser equipment resulted in permanent retinal damage (one to a patient and one to the operator). In both cases, the operator had noticed that the equipment was behaving unusually but carried on with the procedure. Abnormal performance of any equipment should be questioned immediately.

37. Laser Eyewear Labelling DI 1060 L7 X Z 620 TO 700 nm OD 2 CARBON DIOXIDE, O.D. 10 @ 10600 NM DIR 690 - 1290 L4 D 1064 L7, IR 1064 L8, DIR 1350 - 1400 L7, DIR > 1400 - 1580 L5, DI 2090 - 2100 L5, DI 2900 - 2940 L5 D = continuous wave laser, I = pulsed laser (0.1 ms - 100 ms) R = giant pulsed laser (1 ns - 10  s), M = mode-coupled pulse laser (< 1 ns)

38. Wavelength Number before the L in nanometres “Colour” of beam May be single number (e.g. 10600) or a range (e.g. 2090 – 2100) Wavelength on laser should fall within range on eyewear

40. Optical Density Number after the L Strength of filter OD 1 – only 1 / 10 th of laser light transmitted OD2 - 1 / 100 th, OD3 - 1 / 1000 th, etc. Local rules should say strength required. Note – higher ODs may be very dark

43. Other Hazards Fire Anaesthetic gas ignition Plumes

45. f i n