Practical laser safety and exploration of safety issues Flashcards
What are the main regulations and guidance relevant to laser use in the medical sector? Who enforces the regulations?
- Regulations: Control of Artificial Optical Radiation at Work Regulations 2010 (AOR10). Enforced by HSE.
- Guidance: MHRA Lasers, intense light source systems and LEDs - guidance for safe use in medical, surgical, dental and aesthetic procedures.
What are two of the main requirements of AOR10 that ensure protection of staff from artificial optical radiation?
- Risk assessment performed by a qualified person.
- Limit values for exposure to worker’s eyes and skin.
Why is a risk assessment performed for laser use?
- Legal requirement as part of the Health and Safety at Work Regulations and AOR10 Regulations.
- To identify and categorise hazards.
- To protect people as far as reasonably practicable from risks.
- Assess the effectiveness of existing controls and identify shortfalls that need further control.
What are the HSE’s five steps to a risk assessment?
- Identify hazards.
- Decide who might be harmed and how.
- Evaluate the risks and decide on precautions.
- Record findings and implement.
- Review risk assessment and update.
How is risk often evaluated in a risk assessment?
Risk is a combination of the likelihood of harm occurring and the severity of harm caused. This is often evaluated using a risk matrix.
What aspects of a risk assessment will ensure it is ‘suitable and sufficient’?
- A proper check was made.
- All obvious significant risks and all those who could be involved have been considered.
- Precautions are reasonable and the remaining risk is low.
- Workers and their representatives involved in the process.
What equipment specifics may be considered as part of a laser risk assessment?
Equipment:
- Laser class.
- Laser medium (e.g. toxic gas?).
- Electric shock.
- Trip hazards.
- Fire.
- Beam delivery.
What process specifics may be considered as part of a laser risk assessment?
Process:
- Part of the body being treated.
- Laser plume.
- External and internal patient fire.
What environment specifics may be considered as part of a laser risk assessment?
Environment:
- Controlled area designation (NOHD).
- Warning signage.
- Reflective surfaces.
- Windows.
- Door locks.
- Ambient lighting levels.
- Space.
- Socket locations.
How can exposure to plume be reduced?
- Specific grade face masks.
- Smoke evacuation systems (must be close to source of plume).
- Staff training (e.g. in controls and use of PPE/vacuum systems).
What is the NOHD? What is the equation? What can affect the NOHD?
- Nominal ocular hazard distance.
- Distance at which beam irradiance or radiant exposure equals the maximum permissible exposure.
- NOHD = (sqrt(4.radiant power/pi.MPE) - initial beam diameter)/beam divergence.
- Components such as headpieces with different focal lengths and spot sizes can affect the NOHD.
What will a typical laser room warning sign contain?
- Warning: Laser controlled area.
- No access to unauthorised users.
- Laser protective eyewear must be worn.
What is a specular reflection? What is a diffuse reflection?
- Specular: Reflection from a mirror-like surface.
- Diffuse: Reflection from rough/irregular surfaces.
- Could cause harm depending on the class of laser used.
What personnel specifics may be considered as part of a laser risk assessment?
Staff:
- Authorised users.
- Other staff working in/near controlled area (cleaners, maintenance, contractors etc.).
- Appropriately and adequately trained.
- Provided with appropriate PPE.
Patient:
- Appropriately protected.
- Anaesthetised?
What are some examples of laser engineering controls?
- Device interlocks (e.g. key, password etc.).
- Enclosed light sources (i.e. laser in box - not usually possible in medical sector).
- Room interlocks (needs to be justified that risks to patient will not outweigh the risk to the individual entering the room if laser stops).
- Warning lights and signs.
- Barriers and laser proof blinds.
- Drapes.
