Scope of medical laser safety standard broadened

Lasers are being used more frequently than ever in veterinary medicine for declawing, spay-and-neuter surgery, tumor removal, oral and ear surgery, and other applications. For the first time, the national standard for safe laser use in health care facilities covers the document’s possible use by veterinarians. As the AVMA liaison representative to the American National Standards Institute’s Z136.3 Subcommittee, Dr. Kenneth Bartels worked with his counterparts from other professional groups to develop voluntary standards that ANSI can adopt. State authorities and the federal Occupational Safety and Health Administration often use ANSI guidelines as the basis for promulgating regulations. “An appendix to ANSI Z136.3 Safe Use of Lasers in Health Care Facilities now covers veterinary medicine and the use of lasers,” he said.

Dr. Bartels worked diligently to ensure that AVMA and the veterinary profession had input into the veterinary provisions so that others were not writing standards for veterinary medicine, and that they remained guidelines and were not restrictive. He explained that the medical profession was reluctant to open the standard development to veterinarians, fearing it would lead to involvement by nonprofessionals. In early 2003, Dr. Bartels sent the AVMA Council on Veterinary Service a draft of the veterinary provisions proposed for the Z136.3 appendices. The council forwarded them that May to the Executive Board for approval, which was granted. The laser information, included in the AVMA Guidelines for Hazards in the Workplace, states the following:

The use of lasers in Veterinary Medicine is becoming more common and it is paramount that the operator of the laser as well as the employer and all employees be thoroughly versed in the use and hazards of the use of the laser.
Laser equipment must be maintained properly and used appropriately for the type of equipment and type of procedure. Veterinarians are referred to the ANSI Z136.3 Standards amended in Appendix B-B17, “Use of Lasers in Surgical and other Medical Specialties.”
Veterinarians who have class 4 surgical lasers in their practice should obtain a copy of the standards, Dr. Bartels suggests. It is valuable for training new members of the practice staff, and it is a document to refer to in the event of a visit from an OSHA or state health inspector.
Dr. Bartels is the McCasland Foundation Laser Surgery Professor and holds the Cohn Family Chair at the College of Veterinary Medicine, Oklahoma State University. Until June, however, he is deployed by the Army Veterinary Corps as interim commander for the Northeast Atlantic region.

The rapid change in the pattern of use of health care laser systems was the driving force behind the revision of Z136.3. Most medical laser systems are now found in private medical offices. They have expanded into cosmetic uses in areas that may have limited or part-time medical supervision, such as spas and beauty salons. Not only has the environment of laser systems greatly broadened, but also, the training of the operators has become far more diverse. The Z136.3 standard represents many compromises to fit their varied needs. Government and voluntary professional agencies rely on the standard to guide them in regulating the use of medical laser systems that intentionally expose patients to their output for medical or cosmetic purposes.

March 29, 2005

Original web page at JAVMA