Laser safety management (medical, dental and cosmetic applications)
Health, Safety and Healthcare Regulation in Ireland
Sensible consideration of health and safety in the workplace of paramount importance for the following reasons:
a) Moral duty of care
b) Legal duty of care
c) Potential financial loss due to litigation and loss of reputation etc.
Changes in working practices due to health and safety considerations may also result in more efficient or effective ways or working. Ideally, health and safety should be an asset to an organisation.
Government health and safety regulator
The Health and Safety Authority (HSA) is the national regulator for hospitals and clinics. The HSA website is a large resource of information.
Health and Safety Authority (HSA) website
Summary of the main legal requirements (Ireland)
All businesses and public sector services must comply with the Safety, Health and Welfare Act 2005 (No. 10 of 2005). This includes requirements such as,
- risk assessment
- safety statements
- provision of PPE (e.g. laser safety eyewear)
- contingency plans
- Obtain services of competent person where necessary for risk assessments.
HSA Guide to the Safety,
Health and Welfare at Work Act 2005
HSA Guide to safety statement and risk assessment
List of acts and regulations
Three important requirements for lasers and intense light are:
- Suitable and sufficient risk assessment / management
- Provision of adequate training and information,
- Written policy and procedures - safety statement
The requirement for risk assessment and training is specifically reinforced in Safety, Health and Welfare at Work (General Application)(Amendment) Regulations 2010 (Artificial Optical Radiation) (S.I. No. 176 of 2010).
HSA guide to Optical Radiation Regulations 2010
These regulations have specific requirements with respect to;
Risk Assessment
The following must be included where applicable:
- measurements or calculations of the levels of optical radiation, if necessary
- consideration of the level, wavelength and duration of foreseeable exposure
- the exposure limit values
- effects of exposure on 'at risk' groups
- consideration of photosensitising chemical substances
- risk of temporary blinding, explosion or fire
- assessment of the availability of alternative equipment to reduce exposure
- appropriate health surveillance information
- manufacturers information
The assessment should also be reviewed,
- If there are any significant changes in the facility, equipment or activity.
- If there has been an incident/accident or failure of the safety controls.
- If there are any changes in the law that impact on the activity
- Periodically
Laser Safety Training
The The 'Artificial Optical Radiation Regulations' emphasise the requirement for optical radiation safety training and instruction and state that the following should be included where applicable:
- the measures taken to minimise risk
- exposure limit values
- an explanation of the findings of the risk assessment
- detecting and reporting adverse health effects
- health surveillance
- safe working practices
- proper use of personal protective equipment.
From the list above it is clear that much of the training and instruction is specific to the site and activity. Sending staff on a generic external course will not usually fulfill these requirements.
There is also a requirement for adequate training in the safe use of the equipment. For medical and cosmetic applications, training in the use of the machine and how to perform treatments is often referred to as 'applications training'. This type of training is typically carried out initially by the equipment supplier or specialist independent training companies. Further training (new staff etc.) can be cascaded down in-house.
A popular term to describe laser safety management training is 'core of knowledge'. This is not a legally recognised term and there's no set syllabus or content. However, insurance companies and other organisations may ask for 'core of knowledge certificates'. All training should ideally be tailored to the laser, applications and role of the learner, but as a rough guide, the UK MHRA have listed an example course content in their guidance publication (DB 2008(03) Guidance on the safe use of lasers, IPL systems and LEDs).
Healthcare Regulation in Republic of Ireland
Health Service Executive (HSE) hospitals are regulated by the Health Information and Quality Authority (HIQA), a ROI government agency, using 'National Standards'
Health Information and Quality Authority (HQIA) website
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Revision Questions 1. Three reasons for health and safety are? 2. List two applicable laws or regulations 3. List two applicable absolute legal requirements |
Seeking services of a safety consultant
For most areas of health and safety within a hospital, competence (to risk assess) often already exists in-house. However, for lasers, external specialist help will usually be required. It is therefore common for businesses using lasers (and other intense light sources) to appoint a specialist safety consultant, sometimes referred to as a laser protection adviser.
Laser protection adviser (LPA)Under Section 18 of the Safety, Health and Welfare at Work Act 2005, if the employer does not have access to a competent person 'in-house, they should obtain the services of someone from outside the organisation to assess and advise on the safety, health and welfare requirements.
The HSA recommend that "prior to engaging the services of a consultant, the employer should make reasonable enquiries that the person or company being employed has an adequate level of competence to address the work activities under consideration. This might involve checking the consultant’s qualifications and experience, to be assured that s/he has the requisite competence to address the issues of health and safety within the workplace. Generally a person specialising in safety consultancy will have, in addition to relevant experience, a certificate, diploma, degree or other qualification in the field of occupational health and safety. They might also be a member of a professional body specialising in occupational health and safety"
Enforcement notices
If a health and safety regulator inspectors a premises and it is deemed that legal health and safety requirements are not being met, an enforcement notice may be issued. This can take 2 forms;
- Improvement notice: The business is given a timescale in which to ensure compliance and may continue trading.
- Prohibition notice: The business must cease the activity until improvements are made.
Penalties
Criminal Court proceedings may result in fines and imprisonment.
Civil Court proceedings may result in financial compensation.
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Revision Questions 1. When should risk assessments be reviewed? 2. What enforcement action can a regulator take? 3. Who is the healthcare service regulator for hospitals? |
