Laser treatment is mainly used to make scarring or burns less visible. In the case of cosmetic surgery, laser treatment can be used to remove tattoos. The laser pulses can also be used to treat spider veins, port wine stains and acne scars. This kind of laser treatment is known as Intense Pulsed Light therapy. Laser skin treatment produces similar results to chemical peels. The technology utilizes different techniques however the changes that occur to the skin are similar (Silvfast, 2004). In this case, the layers of skin are removed to allow the dermis to be visible. This ensures that a new skin layer forms that is smoother and softer.
Classification of lasers
Class 1 Lasers
Class1
This class of lasers are unable to produce harmful radiation in any normal conditions of use (Raulin & Karsai, 2010).
- Class1M
This class of lasers cannot cause damaging radiations under normal use, unless the beams are viewed using an optical instrument such as binoculars, telescopes and microscopes. It is also important to note that class 1M lasers should always be labelled (Ion, 2005).
Class 2 Lasers
This class includes lasers that are low in power and have a wavelength of between 400-700 nm, and can be viewed properly under well controlled conditions. This class of lasers cannot present any damages unless exposed directly for extended lengths of time (Arndt & Dover, 2002).
- Class 2M
This group of lasers have a wavelength of 400-700nm, and can be viewed clearly under well controlled conditions. The class 2 lasers are not as harmful (Ion, 2005).
Class3
These are lasers that are medium in power and actually require proper control measures in order to prevent damage (Raulin & Karsai 2010).
- Class 3R
This class of lasers are potentially dangerous especially under direct viewing conditions. It is also important to emphasize the need to refrain from exposing the eye to the reflected beam. Lasers that are above 1Mw and below 5nW fall under this class (Raulin & Karsai 2010).
- Class 3B
These are lasers capable of producing a hazard if presented directly. Apart from the very high power class 3B types of lasers, the lasers in this class do not emit direct diffuse reflections. HeNe lasers that are above 5Mn, and below 500nW radiation power, fall under this class (Raulin & Karsai 2010).
Class 4
These lasers are high power and are capable of producing hazards both from direct and diffuse reflection (Sliney, 2005). This class of lasers can produce fire as well as skin hazards. The lasers that are above the class 3 excesses all fall under this class (Ion, 2005). In addition to the classification of lasers, there are several types of lasers in use today; this paper will highlight just a sample of those that are specifically used within clinical settings.
Types of lasers
The Argon laser is a type of laser used in clinics for retinal phototherapy in diabetes, confocal microscopy as well as pumping other lasers. It has a wavelength of 454.6 nm (Papel, 2009). This laser type can lead to respiratory illnesses if exposed for long hours. A general hazard of the argon laser is that it can create some level of chemical pollution in the environment, as well as cause retinal and skin burns (Claymon & Kuo, 1997).
Another type of laser is the Carbon dioxide laser, which is basically used in clinical settings for surgery, and commercially for cutting and welding, and treatment of papilloma (Iol, 2005). It has a wavelength of 10.6nm (Papel, 2009). The use of carbon dioxide laser in treatment comes with certain hazards, its use in the trachea, leads to some incidents such as the ignition of the tracheal tube, which causes burns on the laryngotracheal tissue (Lanigan, 2011).
An Excimer laser is a type of laser that is used to perform laser surgeries. It has a wave length of 308nm, and has been discovered to be very effective in the treatment of a disease known as psoriasis (Papel, 2009). However, this laser treatment has been seen to cause blisters, especially if the dose administered is too high, additionally, the long term exposure to these radiations may cause aging of the skin as well as increase the chances of developing skin cancer (Claymon & Kuo, 1997).
The dye lasers are also an important type of lasers used in treatment, under this type of lasers we have stilbene and coumarine, which have wavelengths that range between 390-514nm (Ion, 2005). The dye lasers may be used in clinical settings for birth mark and general blemish removal. Due to the high voltage involved, the dye lasers pose an electrical hazard to the user (Lanigan, 2011).
Hazard control procedures
When setting up a clinic to deal with light based treatments, it is important to be well aware of the best possible ways to minimize or even avoid hazards altogether. Through the use of correct hazard control tools, the well being of the clinicians as well as the patients is promoted to a large degree.
One of the best ways to control hazards in the use of light based treatments is the use of protective housing. It is important to ensure that the laser radiations are inaccessible to human beings. The laser equipment should be stored under very strict housing rules so as to ensure that the health hazards associated with exposure to the lasers are greatly avoided (Gerder & Siehert, 2001).
The use of warning equipment should be adopted in any clinic that has to do with light based treatment, and therefore lasers. The use of either audible or written warnings should be well utilised especially during times when the lasers are on (Mahesh, 2002). The warning system may also be very effective when harmful lasers in the classes 3B and 4 are in use, owing to the fact that the exposure to such high power laser beams can have serious effects on anyone exposed without adequate protection.
Personal protection is also highly emphasized in controlling hazards in the clinic. The use of appropriate damage control equipment should be adopted. An example of personal protection equipment is the laser eye protection glasses that are meant to protect against specific wavelengths (Sliney, 2005).
At an administrative level, the employees ought to organise regular checkups for workers who are more frequently exposed to the lasers in the various treatments being rendered. The frequent checkups will not only ensure that the workers are in stable health conditions, but also ensure that they are in good conditions to continue handling the equipment.
The provision of operator’s manuals is very important in the hazard control (Henderson, 1997). All the staff who are to directly handle the light based treatment equipment should be very familiar with the manual, and regular reference to the manual ought to be encouraged to ensure that no mistakes are made in the handling of equipment and thereby putting people’s lives in danger.
To further avoid danger, door interlocks should be used, and most especially for class 4 lasers. The use of the interlocks ensure that only the authorised staff have access to the laser equipment, and therefore minimizing risk to others (Sliney, 2005).
The laser equipment in the clinic should be stored, as mentioned earlier, under very strict rules. The equipment should be stored in such a deliberate way that is inaccessible to the average person, and this is mainly done to protect people who may not understand the dynamics behind the light based treatments from potential danger (Gerder & Siehert, 2001).
Staff training is also a very important procedure when setting up a clinic (Dawes, 1992). The main aim of training is to ensure that the staff members are competent enough when handling the equipment, so as to avoid poor maintenance and damage. The training is also to ensure that the workers are able to comprehend the meanings of the warning signs on the equipment.
The staff should also be trained on the possible health damages that may be caused by laser equipment usage to both the patient and the clinician. It would also be important to equip the staff with a general understanding of the laser radiations, in terms of their classes, so as to give an overview of the level of danger in the event of exposure to a certain laser beam with a certain wavelength.
As part of staff training, it would be important to lay down clearly the organisations policies during emergency laser accidents (Mahesh, 2002). This ensures that during a crisis everyone knows exactly what to do instead of being stranded. The training should also include proper information on the effective maintenance and handling of the equipment. In the event of a workplace incident involving laser, professionals ought to be called in, so as to asses the level of damage, minimize the hazard and they will also be able to contain the excess emissions down to the recommended levels (Hernderson, 1997).
Maintenance and auditing protocols
Before setting up a clinic, an audit would be necessary to help the medical facilities comply with the safe use of lasers in health care facilities, and also prepares the organisation for proper inspections (Proceedings, 1984). The Laser Institute of America (LIA) would be responsible for the auditing process. The auditing protocol may be interested in the current policies in the organisation, staff member competencies and credentials, the documentation of lasers, the maintenance procedures of the laser equipments, and among the most important would a look at Laser officer’s responsibilities (ibid, 1984).
As part of the process, the clinical organisation will be equipped with a sample of maintenance guidelines, a training course for the laser safety officer, a guideline for measuring competencies, as well as samples for preventative policies and maintenance procedures and guidelines (Proceedings, 1984).
Conclusion
Light based treatments are indeed extremely useful and effective in so many ways, as they are less damaging to the skin, in terms of appearance in comparison to other form of body treatment that may lead to bloodshed. However the laser beams may prove to be harmful if mishandled. Laser safety is therefore very important in any organisation that deals with human life. It is important for the staff to get adequate training on the handling of laser equipment and even possible precautions to take to ensure safety in case of an incident caused by laser.
References
Arndt, K & Dover Jeffrey. (2002). Controversies and conversations in cutaneous laser surgery. Michigan: American Medical Association.
Clayman Lewis & Kuo Paul. (1997). Lasers in maxillofacial surgery and dentistry. New York: Thieme.
Dawes, W. (1992). Laser welding: A practical guide. Cambridge: Woodhead Publishing.
Gerder E., & Siebert W. (2001). Lasers in the musolosketal system. New York: Springer.
Hecht, J. (1999). The laser guidebook. New York: Mc Graw Hill Professional.
Hernderson, R. A. (1997). A guide to laser safety. London: Chapman & Hall.
Ion, C. (2005). Laser processing of engineering materials. Oxford: Butterworth- Heinamann.
Lanigan, W. (2011). Lasers in dermatology. New York: Springer.
Mahesh, K. (2002). Medical applications of lasers. Kluner Academic Publisher.
Nouri, K. (2011). Lasers in dermatology and Medicine. New York: Springer.
Papel, D. (2009). Facial plastic and reconstructive surgery. New York: Thieme.
Proceedings. (1984). Laser institute of America. USA: Laser Institute of America.
Raulin, C., & Karsai, S. (2010). Laser and IPL technology. New York: Springer.
Silfvast, T. (2004). Laser fundamentals. London: Cambridge University Press.
Sliney, H. (2005). Selected papers on laser safety. Washington: SPIE Optical Engineering Press.
