Page 7 - Mike's published articles

CLINICAL ARTICLE
Table 1: Example of a simple laser plume hazard risk assessment for a small hair reduction service provider
People at risk
How?
Existing controls
OK?
Risk factors
Action required
Laser operator
Extended exposure to mutagenic particulate and gases in laser plumes (disease cross-infection and allergies, etc)
► Extractor fan
to the outside that is switched on through the day to ensure air exchanges
► The patient always shaves the treatment area before the laser appointment (maximum 1 mm stubble)
► Using diode laser in skin contact with thermoelectric skin colling and minimum 2 mm thick refrigerated transparent gel
► All persons present in the treatment room use FFP2/ N95 respirator masks during
the treatment.
OK
OK
OK
OK
Low/very low
Always ensure that the extractor fan is turned on
Always ensure that the treatment area is clean shaven to reduce carbonising the hair follicles
Always ensure that transparent gel is refrigerated and applied 2 mm thick minimum
Always ensure FFP2/ N95 masks are used during treatments (except the patient if treating facial areas)
Patient/any observer who is present
Brief exposure to mutagenic particulate and gases in laser plumes (disease cross-infection and allergies, etc)
This risk assessment will be reviewed yearly or following any significant changes that are made (for example, new laser equipment or changes to the room’s layout)
Date of risk assessment: Name: Risk assessment perfomed by: Signature:
For example, this might include laser therapists, patients, an observer in the laser room, cleaners and contractors.
In each case, identify how they might be harmed (i.e. what type of injury or ill health might occur). For example, bloodborne pathogens from laser tattoo removal might transmit human immunodeficiency virus (HIV) and infect others, or airborne bacterial contaminants from ablative skin procedures might transmit and infect others with disease.
COVID-19 viral transmission aside, the risk of chronic disease transmission through airborne particulates during laser and IPL procedures is low. While many in vitro studies have shown the existence of viable airborne pathogens in surgical plume, a literature search produced only two cases, with the first detailing actual laryngeal papillomatosis transmission in a laser surgeon after repeated laser therapy to patients with anogenital condylomas (Hallmo and Naess, 1991), and the
second describing transmission of laryngeal papillomatosis in an operating room nurse (Calero and Brusis, 2003).
It has also been suggested that noxious gases from laser and IPL hair reduction odour might reach toxic levels and affect the health of regular users (see laser hair reduction plume risks below).
The long-term cumulative effects of inhaling potentially harmful plumes from laser and IPL use are unknown.
Evaluate the risks and decide on precautions
The law requires practitioners to do everything that is ‘reasonably practicable’ to protect people from harm. The easiest way is to compare current practice with established good practice.
The UK HSE published a list of workplace exposure limits for potentially harmful plumes for use with the Control of
Supplement 3 2021 ► Journal of AESTHETIC NURSING
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