Laser use and safety.

This Guidance Article is an update of an article published in a special issue of Health Devices entitled "Lasers in Medicine--An Introduction" (13[8], June 1984). Although surgical lasers have a good overall safety record, they do expose patients, physicians, and other clinical staff to serious risks. Laser hazards can cause injury, disability, or even death: hospital staff have been burned by misdirected laser beams, technicians and maintenance personnel have received eye injuries while working on lasers and have been exposed to hazardous chemicals while changing laser dyes, and patients have died from injuries resulting from fires ignited by laser energy. Laser accidents most commonly result from misdirection of the laser beam. Direct or reflected radiation can burn skin, hair, or, more seriously, the cornea or retina, causing permanent damage. Misdirected laser energy can also cause ignition of surgical drapes, tracheal tubes, or the patient's hair. Also, a frequent by-product of laser-tissue interactions is laser plume, or smoke. Its acrid smell and particulate matter irritate the eyes, nose, and lungs and cause nausea; it is also a suspected vector for transmitting infectious materials, such as the human papilloma virus (HPV) associated with condyloma (a wartlike lesion) and cervical cancer. The risks are not limited to patients and those directly involved in using and maintaining lasers. Many laser procedures are performed in areas outside the controlled environment of the surgical suite; patients in a waiting area or even passersby could conceivably walk into an accessible laser treatment room, such as a doctor's office, and inadvertently be exposed to a direct or reflected beam.(ABSTRACT TRUNCATED AT 250 WORDS)