Types of laser injury by occupation and their prevalence: a systematic review

Authors

  • Thanwaporn Chaweepoonpermsin Raj Pracha samasai Institute, Department of Disease Control
  • Ian Litchfield the Institute of Applied Health Research, University of Birmingham

DOI:

https://doi.org/10.14456/dcj.2021.62

Keywords:

lasers, prevalence, laser injury, laser injury prevalence, occupational laser injury

Abstract

This study explores the types of occupational laser injury and their prevalence in each occupation which occurred from 2010 to July 2019 by using a combination of search terms in 10 sources (seven from bibliographic databases - Ovid MEDLINE and In-Process, EMBASE, HMIC, PsycINFO, CINHAL Plus, NIOSHTIC, and PubMed MEDLINE, plus two from the grey literature - UBIRA ETheses and EThOS, and the last one from a reference list of all included studies). The final selected papers were assessed for quality by a different form of checklist depending on study type. At least average or above-average quality studies were extracted using a self-created data extraction form and were then analysed by deductive thematic analysis. From a total of 2,056 identified papers, 29 were retrieved for data extraction. Some 69% of the retrieved studies were accounted for by healthcare workers (HCWs), 17.2% by aviation, 6.9% by office work, 3.4% by entertainment, and 3.4% by the military. Type of laser injury was themed among each occupation. Laser-generated air contaminants (LGACs) were the main type of injury among healthcare workers, accounting for 85% of HCWs’ studies (17 out of 20 papers), while ocular injury was the only published injury type in aviation (all 5 papers). In terms of prevalence, few studies were obtained, making it impossible to perform a meta-analysis. However, it could be concluded that the main concerned health effect of surgical smoke was human papillomavirus (HPV) transmission. There were five articles related to this topic, most showing a low risk of HPV contamination in the air and protective equipment. Only one paper mentioned that the prevalence of gastrointestinal mucosal HPV type was found among 5.8% of 156 employees who had been exposed to LGACs due to their involvement in the procedure of laser treatment of patients with genital warts, compared to 1.7% of 115 of those with no history of exposure to LGACs as a result of the procedure (p=0.12). Essentially, most laser incident reports were commonly known as ocular and skin injuries. Nonetheless, this result reveals that the highest number of studies was published in LGACs exposure among healthcare workers. Although there is a growing trend of laser use, the number of published papers related to this area was too small and could not meet all this study’s research objectives. Therefore, further study in this area could help to develop more knowledge.

Downloads

Download data is not yet available.

References

Shaik M. Laser [Internet]. India. Physics and Radio-Electronics. 2014 [cited 2019 Apr 19]. Available from: https://www.physics-and-radio-electronics.com/physics/laser/applicationsoflasers.html

Overton G, Nogee A, Belforte D, Wallace J, Gefvert B. Annual laser market review & forecast 2019: What goes up [Internet]. LaserFocusWorld. 2019 [cited 2019 Apr 27]. Available from: https://www.laserfocusworld.com/articles/print/volume-55/issue-01/features/what-goes-up.html

Barat K. Laser Safety Management. Boca Raton, Fla: CRC Press/ Taylor & Francis Group, ; 2006. p. 15–27.

Henderson R, Schulmeister K. Laser safety. New York: Taylor & Francis Group; 2004. p.

–63.

Oregon State University. Laser hazards-general [Internet]. 2021 [cited 2019 Jul 7]. Available from: https://ehs.oregonstate.edu/laser/training/laser-hazards

Oregon State University. Non-beam laser hazards [Internet]. 2021 [cited 2019 Jul 7]. Available from: https://ehs.oregonstate.edu/laser/training/non-beam-laser-hazards

Laser hazards [Internet]. USA. Occupational Safety and Health Administration. [cited 2019 Jul 7]. Available from: https://www.osha.gov/laser-hazards

Crtitical Appaisal Skills Prpgramme (CASP). CASP Checklist: 12 questions to help you make sense of a Cohort Study [Internet]. 2018 [cited 2019 Jul 15]. Available from: https://casp-uk.net/wp-content/uploads/2018/01/CASP-Cohort-Study-Checklist_2018.pdf

Crtitical Appaisal Skills Prpgramme (CASP). CASP Checklist: 10 questions to help you make sense of a Systematic review [Internet]. 2018 [cited 2019 Jul 15]. Available from: https://casp-uk.net/wp-content/uploads/2018/01/CASP-Systematic-Review-Checklist_2018.pdf

Downes MJ, Brennan ML, Williams HC, Dean RS. Development of a critical appraisal tool assess the quality of cross-sectional studies (AXIS). BMJ Open. 2016;6(12):e011458.

CARE case report guidelines. 2013 CARE checklist [Internet]. 2013 [cited 2019 Jul 15]. Available from: https://www.care-statement.org/checklist

The University of Auckland. Thematic analysis: a reflexive approach [Internet]. [cited 2019 Dec 21]. Available from: https://www.psych.auckland.ac.nz/en/about/thematic-analysis.html

Alsulaiman SM, Al-Qahtani A, Mousa A, Ghazi NG. Laser pointers: how much does the general medical community know? Graefes Arch. Clin. Exp. Ophthalmol. 2017;255(3):635.

AlTaleb RM, Alsharif HM, Younis AS, Alsulaiman SM, Abouammoh MA. Adherence to optical safety guidelines for laser-assisted hair removal. Photodermatol Photoimmunol Photomed. 2019;35(5):313-17.

Ilmarinen T, Auvinen E, Hiltunen-Back E, Ranki A, Aaltonen LM, Pitkaranta A. Transmission of human papillomavirus DNA from patient to surgical masks, gloves and oral mucosa of medical personnel during treatment of laryngeal papillomas and genital warts. EUR ARCH OTO-RHINO-L. 2012;269(11):2367–71.

Kofoed K, Norrbom C, Forslund O, Moller C, Froding L, Pedersen A, et al. Low prevalence of oral and nasal human papillomavirus in employees performing CO2-laser evaporation of genital warts or loop electrode excision procedure of cervical dysplasia. ACTA DERM-VENEREOL. 2015;95(2):173–6.

Weyandt GH, Tollmann F, Kristen P, Weissbrich B. Low risk of contamination with human papilloma virus during treatment of condylomata acuminata with multilayer argon plasma coagulation and CO2 laser ablation. Arch. Dermatol. 2011;303(2):141–4.

Goon PKC, Goon PKY, Tan EKH, Crawford RAF, Levell NJ, Sudhoff H. Virus-induced cancers of the skin and mucosa: Are we dealing with “smoking guns” or “smoke and nirrors” in the operating theatre?. Dermatology and therapy. 2017;7(2):249–54.

Manson LT, Damrose EJ. Does exposure to laser plume place the surgeon at high risk for acquiring clinical human papillomavirus infection?. Laryngoscope. 2013;123(6):1319–20.

Mowbray N, Ansell J, Warren N, Wall P, Torkington J. Is surgical smoke harmful to theater staff? A systematic review. Surg. Endosc. 2013;27(9):3100–7.

Lewin JM, Brauer JA, Ostad A. Surgical smoke and the dermatologist. J Am Acad Dermatol. 2011;65(3):636–41.

Pierce JS, Lacey SE, Lippert JF, Lopez R, Franke JE. Laser-generated air contaminants from medical laser applications: A state-of-the-science review of exposure characterization, health effects, and control. J Occup Environ Hyg. 2011;8(7):447–66.

Pierce JS, Lacey SE, Lippert JF, Lopez R, Franke JE, Colvard MD. An assessment of the occupational hazards related to medical lasers. J. Occup. Environ. Med. 2011;53(11):1302–9.

Rioux M, Garland A, Webster D, Reardon E. HPV positive tonsillar cancer in two laser surgeons. J OTOLARYNGOL-HEAD N. 2013;42(1):1-4.

Ball K. Surgical smoke evacuation guidelines: compliance among perioperative nurses. AORN J. 2010;92(2):e1-e23.

Brace MD, Stevens E, Taylor SM, Butt S, Sun Z, Hu L, et al. ‘The air that we breathe’: assessment of laser and electrosurgical dissection devices on operating theater air quality. J OTOLARYNGOL-HEAD N. 2014;43(1):1-9.

Chuang GS, Farinelli W, Christiani D, Herrick RF, Lee NC, Avram MM. Gaseous and particulate content of laser hair removal plume. JAMA Dermatol. 2016;152(12):1320–6.

Edwards BE, Reiman RE. Comparison of current and past surgical smoke control practices. AORN J. 2012;95(3):337–50.

Eshleman EJ, LeBlanc M, Rokoff LB, Xu Y, Hu R, Lee K, et al. Occupational exposures and determinants of ultrafine particle concentrations during laser hair removal procedures. Environmental Health. 2017;16(1):1–7.

Neumann K, Cavalar M, Rody A, Friemert L, Beyer DA. Is surgical plume developing during routine LEEPs contaminated with high-risk HPV? A pilot series of experiments. ARCH GYNECOL OBSTET. 2018;297(2):421–4.

Steege AJ, Boiano JM, Sweeney MH. Secondhand smoke in the operating room? Precautionary practices lacking for surgical smoke. Am J Ind Med. 2016;59(11):1020–31.

Tremaine AM, Avram MM. FDA MAUDE data on complications with lasers, light sources, and energy-based devices. Lasers Surg. Med. 2015;47(2):133–40.

Boyd AD, Naiman M, Stevenson GW, Preston R, Valenta AL. Technical and operational users’ opinions of a handheld device to detect directed energy. Aviat Space Environ Med. 2013;84(5):528–33.

Dietrich KC. Aircrew and handheld laser exposure. Aerosp. med. hum. perform. 2017;88(11):1040–2.

Nakagawara VB, Montgomery RW, Wood KJ. Laser illumination of flight crewmembers by altitude and chronology of occurrence. Aviat Space Environ Med. 2011;82(11):1055–60.

Palakkamanil MM, Fielden MP. Effects of malicious ocular laser exposure in commercial airline pilots. Can. J. Ophthalmol. 2015;50(6):429–32.

Waggel SE, Hutchison EJ. Design and acceptability of the aviation laser exposure self-assessment (ALESA). Aviat Space Environ Med. 2013;84(3):246–51.

McGarry P, Morawska L, He C, Jayaratne R, Falk M, Tran Q, Wang H. Exposure to particles from laser printers operating within office workplaces. Environ. Sci. Technol. 2011;45(15):6444–52.

Pirela SV, Martin J, Bello D, Demokritou P. Nanoparticle exposures from nano-enabled toner-based printing equipment and human health: state of science and future research needs. Crit. Rev. Toxicol. 2017;47(8):683-709.

Durukan AH, Gokce G, Guven S, Koylu T, Erdurman FC. Macular injury resulting from a high-powered tank laser telemetry device. BMJ Mil. Health. 2015;161(4):348–50.

Muslubaş IS, Hocaoğlu M, Arf S, Ozdemir H, Karaçorlu M. Macular burns from nonmedical lasers. Turk. J. Ophthalmol. 2016;46(3):138.

Downloads

Published

2021-09-29

How to Cite

1.
Chaweepoonpermsin T, Litchfield I. Types of laser injury by occupation and their prevalence: a systematic review. Dis Control J [Internet]. 2021 Sep. 29 [cited 2024 Nov. 18];47(Suppl 1):700-13. Available from: https://he01.tci-thaijo.org/index.php/DCJ/article/view/238224