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CSA Z386:20 Safe use of lasers in health care
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CSA Z386:20
July 2020
Title: Safe use of lasers in health care
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CSA Z386:20
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ICS 91.040.10; 31.260
ISBN 978-1-4883-2893-0
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CSA Z386:20 Safe use of lasers in health care
Technical Committee on Perioperative Safety 3 Subcommittee on Laser Safety in Health Care 6 Preface 8
0 Introduction 9
General 9
Copyright permissions 9
Scope 9
Reference publications 10
Definitions 11
Classification of lasers 13
Risk assessment — Hazards, risks, and control measures 14
Risk assessment 14
General requirements for controlling exposure 14
Laser beam-related hazards, risks, and control measures 15
Ocular 15
Skin 17
Fire and explosion 17
Plume and laser-generated air contaminant (LGAC) 19
Non-beam-related hazards, risks, and control measures 20
Infection 20
Gases, dyes, and liquid coolants 21
Responsibilities, education, training, and credentials 21
General 21
Administrative laser personnel 21
Laser safety committee (LSC) 21
Facility administration 22
Laser-specific personnel 23
Laser safety officer (LSO) 23
Laser user (LU) 25
Laser operator 26
Allied health personnel (health care personnel, observers, and trainees) 27
Health care personnel 27
Observers 28
Trainees 28
Administrative controls 29
General 29
Documentation 29
July 2020 © 2020 Canadian Standards Association 1
CSA Z386:20 Safe use of lasers in health care
Indications for laser system shutdown 30
Other controls 31
NOHA delimitation 31
Laser-controlled area 31
Laser-controlled area procedures 31
Laser-controlled area surfaces 32
Laser storage 32
Laser-controlled area renovations and installations 32
Heating, ventilation, and air conditioning considerations 33
Laser equipment 33
Laser delivery devices 33
Laser instruments 33
Warning signs 33
Patient protection guidance 35
Acquisition, installation, and maintenance of health care lasers 35
Acquisition of health care lasers 35
Acceptance of health care lasers 37
Installation of health care lasers 38
Maintenance of health care lasers 38
Annex A (normative) — Calculation of the NOHA 45
Annex B (informative) — Standard operating procedures (SOPs) 50
Annex C (informative) — Purchase considerations for health care facility equipment 51
Annex D (informative) — Biological effects 53
Annex E (normative) — Education and training of laser personnel 55
July 2020 © 2020 Canadian Standards Association 2
CSA Z386:20 Safe use of lasers in health care
This is the fifth edition of CSA Z386, Safe use of lasers in health care. It supersedes the previous editions, published in 2014, 2008 under the title Safe use of lasers in health care facilities, and in 2001 and 1992 under the title Laser Safety in Health Care Facilities.
This Standard was prepared by the Subcommittee on Laser Safety in Health Care, under the jurisdiction of the Technical Committee on Perioperative Safety and the Strategic Steering Committee on Health and Well-being, and has been formally approved by the Technical Committee.
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July 2020 © 2020 Canadian Standards Association 8
CSA Z386:20 Safe use of lasers in health care
CSA Z386:20
General
Health care lasers present unique hazards and risks not associated with other types of medical or surgical equipment. This Standard provides laser team members with the engineering, administrative, procedural, and control measures, as well as guidance on the selection and use of PPE, which is necessary for ensuring a safe operating environment and positive patient outcomes.
Copyright permissions
Clause 4.7.3.2 (Clause 8.7.7 in this Standard) and Clause 4.7.4 (Clause 8.7.8 in this Standard), and Figures 1a and 1b (Figures 2, 3, and 4 in this Standard) are reproduced with permission from
ANSI Z136.3-2011,American National Standard for Safe Use of Lasers in Health Care. Copyright 2011, Laser Institute of America, Orlando, Florida. The Laser Institute of America disclaims any responsibility or liability resulting from the placement and use in the described manner.
1.1
This Standard provides guidance for the safe use of lasers in health care. It applies to all procedures in health care settings where health care lasers are used, including, but not limited to, the following:
health care facilities;
dental clinics, offices, and facilities;
veterinary facilities;
laboratories and other research facilities;
physician offices;
cosmetic and aesthetic treatment facilities;
medical teaching facilities;
medical professional exhibitions and trade shows; and
medical laser servicing organizations.
1.2
This Standard presents the engineering, procedural, personal protective equipment, and administrative controls necessary to ensure the safety of persons at risk in the vicinity of a health care laser, based upon a risk assessment.
Note: A risk assessment is a thorough analysis of the workplace to identify situations, processes, etc. that can cause harm. A risk assessment, performed before policies and procedures are developed, is useful for determining engineering, administrative, and procedural controls and work practices to reduce the risk of laser exposure through
identification of hazards;
analysis or evaluation of the risks associated with those hazards; and
determining appropriate ways to eliminate or control the hazards.
July 2020 © 2020 Canadian Standards Association 9