ORLANDO, FL, March 21, 2018 — Published through the Laser Institute of America (LIA), renowned author Dr. Kay Ball has revised her book, Lasers – The Perioperative Challenge, to provide updated laser technology information to healthcare professionals. This is the fourth edition; the first was published in 1990, and Dr. Ball notes that much has evolved in the laser world since then.
“Dr. Ball’s book is an excellent read for medical personnel who are new to the use of lasers in medicine and wish to get a comprehensive understanding of lasers used in surgery and other areas outside of the OR. The book is written with the reader in mind and the information is easily understood,” said Gus Anibarro, LIA’s Education Director.
While writing this edition of her book, Dr. Ball focused on evidence from research and published articles on laser procedure applications and outcomes. Since she also travels the world to present laser technology, she included personal clinical experience and addressed common questions she receives from practitioners worldwide.
“Lasers: The Perioperative Challenge takes a complex technology and simplifies it for ready access by nurses, physicians, risk managers, and other healthcare providers. It offers valuable information on how to apply current standards and guidelines for a laser-safe environment,” said Dr. Ball. “I updated the book because there’s such a lack of comprehensive books on the market that address all aspects of laser technology in healthcare.”
The book highlights laser research and applications while incorporating current laser standards and guidelines. Sample laser safety policies provide templates for writing policies and procedures for the clinical environment.
“Everyone needs a really good reference or resource—especially if you’re just beginning your laser services,” said Vangie Dennis, who helped review the book and is the Executive Director of Perioperative Services for WellStar Atlanta Medical Center and Atlanta Medical Center South located in the metropolitan area of Atlanta. “It’s a really great product. It’s the ‘Alexander’ of the operating room—except for lasers.”
Within its 410 pages, the book contains more than 300 illustrations and graphics that are intended to deepen the reader’s understanding of foundational physics, safety, and administrative aspects. There is also an extensive glossary that offers an easy reference for laser terminology.
“As new procedures are introduced and accepted, laser safety is the strong foundation upon which practices are based. When safety is the primary cog in the wheel of laser applications, successful outcomes can be evidenced to validate practice changes. Laser technology continues to advance and mature as safe practices are demonstrated while patients benefit,” said Dr. Ball in the preface of her book.
The 18 chapters are broken up into three sections: “Laser Biophysics, Systems, and Safety,” “Clinical Laser Applications,” and “Administrative Aspects of a Laser Program.”
The cost of the book is $80 for LIA members and $90 for non-members.
“This book is a ‘must’ for all professionals participating in laser surgery and therapy,” said Dr. Ball.
It can be purchased at www.lia.org/store/product/241.
About Laser Institute of America
Laser Institute of America (LIA) is the professional society for laser applications and safety serving the industrial, educational, medical, research and government communities throughout the world since 1968. http://www.lia.org, 13501 Ingenuity Drive, Ste 128, Orlando, FL 32826, +1.407.380.1553.
ORLANDO, FL (March 19, 2018) – The Laser Institute of America is excited to announce that the 2018 Lasers for Manufacturing Event® (LME®) will be held at the Schaumburg Convention Center in Schaumburg, Illinois March 28-29. This year will be the first time the event will be co-located with the Laser Additive Manufacturing (LAM®) Conference, which takes place March 27-28.
LME offers an opportunity for anyone interested in using lasers in manufacturing to learn more about commercial applications and interact with companies that offer laser manufacturing solutions.
The event will feature about 60 exhibitors, including Amplitude, Ekspla, Light Conversion, Lumentum, SPI, Alabama Lasers, GF Machining Solutions, Hass Laser technologies, Lasea, Kentek, LPW Technology, and Powder Alloy Corporation.
LME is made possible by generous sponsors Han’s Laser, IPG Photonics, Laser Mechanisms and Trumpf. All four companies will have exhibit booths attendees can visit to learn more about the laser manufacturing solutions they provide.
On day one, keynote speaker Ron D. Schaeffer, a technical consultant for PhotoMachining, will give an overview on the industrial laser market, and host a tutorial on current trends in laser micromachining.
On the second day, Dr. Geoff Shannon from Amada Miyachi America will give his keynote address on lasers used for medical device manufacturing, and David Havrilla of Trumpf will present a tutorial on Laser Welding Techniques and Applications.
Throughout both days of the event, industry experts will host an ongoing series of laser introductory courses on the exhibit floor that will cover topics such as laser sources, beam delivery systems, laser safety, laser marking, laser cleaning, laser cutting, laser welding, laser cladding and optics.
An “Ask the Experts” booth will also be open both days on the exhibit floor. Organized by Directed Light Inc. President Neil Ball, this booth will have laser industry experts ready to help supply attendees with all the information they need to increase profits and efficiency and expand their businesses.
After gaining a world-class laser education from the exhibitors and experts, attendees can enjoy live laser demonstrations, tour the TRUMPF smart factory, and relax and mingle during the complimentary ice cream social and drink reception. All LME attendees will also be entered in a giveaway.
For more information, and to register for the event, visit www.laserevent.org.
About LIA
The Laser Institute of America (LIA) is the professional society for laser applications and safety serving the industrial, educational, medical, research and government communities throughout the world since 1968. www.lia.org, 13501 Ingenuity Drive, Suite 128, Orlando, FL 32826, +1.407.380.1553.
The classification of lasers by the product’s manufacturer – from Class 1 to Class 4 – is a valuable means to provide the end user with simplified information about the potential hazards to the eye and skin.
The concept of product classification can be considered a success story. Developed in the USA by the CDRH in the 1970s, it has been accepted internationally for more than 30 years, based on the standard IEC 60825-1. While the basic system of classification has remained unchanged since its inception, some adjustments were necessary over the years and will also be necessary for the future, when reacting to new types of lasers and scientific data on injury thresholds.
For a few years, diffractive optical elements (DOE) and microscanners have driven a large group of new products; mainly gesture controls and 3D cameras for consumer electronics (see Image 1), but also scanned lidars for machine vision and autonomous cars, as well as pico-projector scanners. For these new products, the combination of factors results in challenges for product safety and standardization. They are not intended as specialized professional products, such as lidars have been for the military, but are for consumer use. Therefore, in practice, they would need to be Class 1, Class 2 or Class 3R devices (depending on the wavelength range and country) but at the same time, for a satisfying performance in terms of detection distances, emission levels need to be relatively high. Because of the diverging or scanned nature of the emission, these systems suffer particularly from the conservative combination of classification rules of a 7-mm diameter pupil, an assumed exposure distance of 10 cm from the DOE or from the scanning mirror, together with an assumed accommodation to the apparent source at such short distance. While laser safety classification was always historically on the conservative side, it might be possible in the future to consider that the combination of those three exposure conditions is not only highly unlikely, but there are also reflexes (the near triad of accommodation) that result in pupil constriction when accommodating to a close target.
Defining measurement (pupil) diameters smaller than 7 mm for very close distances and as function of accommodation target might be a possible relaxation for future amendments, but would make the analysis even more complex. Also, possibly, emission limits can be raised somewhat in the higher nanosecond and lower microsecond regime, which is a task for the International Commission on Non-Ionizing Radiation Protection, ICNIRP to which the IEC refers for bio-effects committee work. Particularly for a change in the emission limits the general “predicament” exists that the injury thresholds depend in a very complex manner on wavelength, pulse duration and retinal spot size. When emission limits for products (or exposure limits for the eye) are to be made to reflect the thresholds more accurately to reduce needlessly large safety margins, it automatically makes the limits more complex since simple limits by default would be, for many scenarios, over-restrictive. One exception in the 2014 IEC and ANSI revision applied to small retinal sources, where it was possible to greatly simplify the analysis of pulsed emission by setting the multiple pulse correction factor CP (or C5) to unity, at the same time permitting significantly higher emission levels as compared to earlier editions. On the other hand, in the same revisions, the analysis of extended retinal images became more complex by permitting significantly higher emission levels for devices in the range of the lower “safe” classes.
Besides possible adjustments in the emission limits, two concepts based on engineering safety features are currently in development in the responsible standardization committee at IEC to permit higher emission levels for divergent or scanned systems – but still achieve classification as “safe” class, such as Class 1 for IR and Class 2 for visible emission.
The first is a virtual protective housing (VPH) where the emission is automatically reduced when an object enters the VPH. In such a device, one or more sensors monitor the protected volume. Outside of the protected volume, the emission needs to be below the limits for the class that is to be achieved, such as Class 1. When the VPH is free of relevant objects, the emission level within that volume can be higher: as long as human access to this radiation is prevented by the system, it is not relevant for product classification. The sensor system thus establishes a virtual protective housing instead of a real one, and defines what is referred to as the “closest point of human access”.
The second type of engineering measure to raise permitted emission levels applies to lasers mounted on vehicles and other moving platforms. When the vehicle is stationary, only normal emission levels are permitted. When the vehicle is at a certain speed, it can be assumed that another vehicle that is driving at the same speed will do so with a minimum distance. Thus the speed of the platform is the basis to define the closest point of human access that is to be considered for classification, which can, for instance, be 1 or 2 meters from the car with the laser.
Both types of engineering features have the advantage that the emission is tested against permitted levels at farther distances than usual, resulting in significant increases of the permitted emission level for diverging or scanned emission. While the IEC standard can already be interpreted in a way as to permit classification on engineering features that prevent human access, in order to assure international standardized testing conditions, it is necessary to update the IEC standard and provide specific performance requirements. For instance, for the virtual protective housing, it will be necessary to define probes used to test if the emission is reduced when an object enters the VPH. For the “moving platform” concept, it will be necessary to define the measurement distance as function of vehicle speed, as well as additional requirements to prevent that people on or in the vehicle have access to hazardous levels of laser radiation, such as when the laser is mounted on the roof of the car and there is a sunroof, or people on a pickup truck’s bed. A virtual protective housing might be needed to prevent access for these cases and to ensure that the concept of “moving platform” is internationally accepted for formal product classification. After all, it needs to be appreciated that classification of products following IEC 60825-1, as a basic principle, can only rely on engineering performance of the device and cannot depend on proper installation or behavior of the user.
**Several of the issues discussed in this article were also topics of ILSC 2017 papers, including the history of CDRH and IEC standards in invited presentations by Jerome Dennis and David Sliney, respectively, as well as the moving platform concept. The 2014 updates of IEC and ANSI standards were discussed in earlier ILSC papers.
Karl Schulmeister was project leader for the 3rd Edition of IEC 60825-1 and is a consultant on laser product safety at Seibersdorf Laboratories in Austria. For more information, visit http://laser-led-lamp-safety.seibersdorf-laboratories.at.
High power lasers are routinely used in entertainment environments as a special lighting effect. Historically such lasers could only be used in situations where the budget, infrastructure, (namely power supply and cooling), and space permitted.
In recent years, however, these barriers have disappeared with the proliferation of low-cost solid-state laser light sources that now dominate this sector. This has created new opportunities in how the effects are being used, as well as who is able to now use them.
Business is healthy for the specialist laser effects providers that typically supply lasers for events and music performance tours, using output powers ranging from 1W through to 40W CW, with not a drop of water or three-phase in sight. Dramatic reductions in the purchase cost, physical size, and power supply requirements have influenced how the effects are used. Ten years ago, a typical music concert touring application would employ a single digit number of laser effects projectors, with output powers ranging from 3W to 10W. The same types of installation in 2017 are typically using 30 to 40 fixtures, with a range of output powers up to 30W or more. The greater number of lasers being used on single installations has increased the need for better awareness of the exposure risk, and
The greater number of lasers being used on single installations has increased the need for better awareness of the exposure risk, and requirement for a robust installation protocol. In a change to earlier practice where a dedicated laser operator and control system were used to operate the laser effects, many of the latest generation laser lighting effects are designed to operate directly from the same control systems as normal stage lighting effects. This has benefits from a creative perspective, in that that a lighting designer no longer needs to interface through a third party dedicated laser system operator. But the downside is that the lighting designer may not necessarily be familiar with the risks in using Class 4 laser products.
A lack of familiarity of exposure risk also exists for another new group of users, which with laser projectors costing only a few hundred dollars, and being widely available online through disco / stage lighting distributors, can install laser effects in small venues and for mobile discotheques. At the budget end of the market are multicolour laser effects projectors that produce moving beams and pre-programmed animated graphics and text. These devices typically output 1W – 2W, and operate automatically in sound-to-light mode.
Exposure potential from laser lighting effects can be considered when the characteristics of how the effects are produced is understood. The majority of lighting effects created at laser installations are through movement of two mirrors placed orthogonally, so as to move the beam freely about an imaginary x and y-axis. The maximum extent of beam deflection is typically between 50° – 60° optical. In practice this leads to typical scan across-the-pupil exposure durations of a few µs to several hundred milliseconds, depending on the content material. Stationary beam creation is also possible if the control signal is held constant, or fails.
The other popular method of creating laser effects is achieved by passing a laser beam through a transmissive diffractive optical element (DOE), (also referred to as a diffraction grating), that splits and deflects the beam creating arrays of lesser-powered beams creating a geometric pattern. The DOE is normally attached to a motorized substrate, typically able to rotate from stationary through to 10rpm – 20rpm. The characteristics of the DOE determine the visual appearance of the laser effect produced. The time it takes a diffracted beam to scan across-the-pupil distance typically varies from a few milliseconds to being stationary.
The majority of exposures occur in the millisecond and microsecond domain, meaning for MPE comparison radiant exposure expressed in J·m-2 is used, however, for the purposes of risk assessment, it is more convenient to consider the exposure having been converted to a peak irradiance.
The hazard distance (NOHD) of most lasers used for lightshow applications normally exceeds the length of the working, (and viewing), space they are being used at. Table 1 shows the NOHD, along with the irradiance at five distances that may be representative for four typical laser output powers used in this sector. For each distance, a 0.25s and 1ms dose are considered, to give an indication of how many times in excess of the MPE such an exposure may be at that distance.
Laser Power
3
10
20
30
W
NOHD
387
707
1,000
1,225
m
Exposure Distance
5m
Irradiance
60
199
398
597
kW·m-2
250ms dose
2,345
7,815
15,630
23,446
Excess
1ms dose
590
1,966
3,931
5,896
Excess
10m
Irradiance
23
75
151
226
kW·m-2
250ms dose
888
2,960
5,919
8,879
Excess
1ms dose
223
744
1,489
2,232
Excess
30m
Irradiance
4
12
23
35
kW·m-2
250ms dose
138
459
919
1,378
Excess
1ms dose
35
116
231
347
Excess
50m
Irradiance
1.4
5
9
14
kW·m-2
250ms dose
54
178
356
534
Excess
1ms dose
14
45
90
134
Excess
100m
Irradiance
0.4
1.2
2.4
3.6
kW·m-2
250ms dose
14
47
94
141
Excess
1ms dose
3.6
12
24
36
Excess
Table 1 A comparison of exposure potential of four laser output powers typically used in lightshow applications
The figures in Table 1 demonstrate how the irradiance present at the exposure distances is significantly higher than the 25W·m-2 and 101W·m-2 MPE limits (0.25s and 1ms respectively). Areas within several metres of the source are particularly high risk exceeding the MPE by several hundred, if not, thousand times, depending upon the laser power and duration. Such viewing conditions could occur for lasers positioned on, or directed at the stage from the vicinity during a poorly managed performance or rehearsal. It is also possible that the exposure could occur when the scanning position of the lasers are being lined up during the installation phase, where a stage may be occupied by technicians and crew unaware of the exposure risk.
With laser effects capable of producing exposures with peak irradiances of several kW·m-2 over a considerable distance from the source, controls are necessary to limit exposure to levels considered safe for viewing. In the first instance, the user and those sharing the environment lasers are being used in, need some appreciation of the risk and what precautions should be typically adopted. As with most projects, spending time at the early stages of development helps to identify and address issues that could become more significant if left unchecked. In an ideal world, the laser provider would be contacted early on in a production’s development, be provided with a full brief from the client, and full information about the rest of the production’s implementation. It is recognised that events rarely function like this, which is no fault of the laser provider, but instead the nature of the sector. This means the successful laser provider has to remain alert, and often has to anticipate factors that could affect safe laser use. Even the best planned productions can be dynamic environments with tweaks and changes happening right up to the last moment. Basic rules however help to keep a laser install on track and minimise the risk to workers and audience alike. At no point should users neglect the fact that laser lighting effects are a special effect, and should be regarded as such, needing appropriate precaution to be taken for their safe use.
Presently, two major standards organisations have working groups producing specific guidance for this sector. ANSI through Z136.10 – Safe Use of Lasers in Entertainment, Displays and Exhibitions (currently under development), and IEC through IEC/TR 60825-3 – Guidance for Laser Displays and Shows, will each address the issues that have become apparent as laser light show technology has become more accessible, and is being used in ways that would have just a few years ago been impractical. It is hoped that when the new guidance is available that it will provide end users and safety advisers alike with an authoritative reference to best practice for this application of lasers.
James Stewart works for LVR Optical, based in the UK, as laser safety practitioner with a keen interest and experience in managing entertainment applications using lasers. He is the project lead for IEC/TR 60825-3.
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Interested in Laser Safety? To learn more about Laser Institute of America’s International Laser Safety Conference, visit the conference website.
As part of our continued celebration of National Safety Month, we are raising awareness on the value of becoming a Certified Medical Laser Safety Officer (CMLSO) with this next blog in the June Laser Safety series. Click here to read about becoming a Certified Laser Safety Officer (CLSO).
Oftentimes the position of medical laser safety officer (MLSO) goes unrewarded, overlooked as long as the individual with that responsibility does the job correctly – after all, done right nothing happens.
Elevate your status by proving your knowledge of laser safety protocols and requirements through certification by the Board of Laser Safety. Whether you are an RN, OR supervisor, or technician with the desire to add to your job designation, MLSO certification will demonstrate your value to the organization that employs you.
“Certification has validated my credibility and allowed me to work with different laser companies to assist in their training programs as well,” said Terri Clark, a Registered Nurse at SpaMedica in Toronto, Canada.
Certification can also help to confirm your employer’s commitment to a safe working environment. One way to avoid workplace accidents is to follow AORN’s Guidelines for Perioperative Practice. Evidence-based guidance for nursing, it not only helps to standardize perioperative practice, but promotes patient and worker safety as well. In the recommendations for personnel working in a laser environment, the guidelines call for a thorough understanding of laser procedures, formal education (medical laser safety AND MLSO), and attainment of certification as a MLSO.
One of your first steps to becoming certified is by taking LIA’s Medical Laser Safety Officer Training. This training meets one of the four requirements to sit for the Certified Medical Laser Safety Officer (CMLSO) exam. For your convenience, this training is available as an online course as well as in the classroom. Education is an essential element of laser safety and LIA is committed to making the opportunity to deepen laser safety knowledge widely available. These MLSO training courses meet the requirements outlined by ANSI, OSHA and The Joint Commission.
To obtain certification, you must pass the 100-question CMLSO exam, which is based on the 2011 edition of the ANSI Z136.3 Safe Use of Lasers in Health Care standard and covers eight areas of practice related to medical laser safety. You may take the CMLSO exam at a computer-based testing location or by pencil-and-paper following most LIA MLSO classroom courses.
For more information on becoming a CMLSO, visit www.lasersafety.org or call 407-985-3810.
