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Use of lasers in hospitals in the Netherlands : Safety aspects for medical treatments

Gebruik van lasers binnen ziekenhuizen : Veiligheidsaspecten bij medische behandelingen


Independent regulation is not effective. Hospitals often use lasers belonging to the highest risk categories, especially in the specialisms of ophthalmology and dermatology. The use of these types of high-powered lasers requires a sound safety system which appears to be lacking in many Dutch healthcare institutions. Setting up such a system through selfregulation has not been sufficiently effective up to now. This has become clear from a survey held in twenty Dutch hospitals by the National Institute for Public Health and the Environment (RIVM) as commissioned by the Dutch Health Care Inspectorate (IGZ). Careless use of laser apparatus can lead to fires or to severe physical injury in patients, treating professionals, and bystanders. Insufficient compliance with current safety frameworks. There are few laws and regulations that target the use of medical lasers. For example, in the Working Conditions Decree of 2010, only the protection of employees against the risks of exposure to laser beams is regulated. This Decree states that employers are obliged to make risk inventories and risk evaluations. However, this still does not take place in all hospitals in the Netherlands. The Dutch foundation Laser Safety in Health Care (SLG), has drawn up safety recommendations for lasers but compliance with them is largely poor. Hospitals do, however, have safety rules with regard to treatment rooms and the timely maintenance of laser equipment. Moreover, most hospitals do have safety instructions for laser users and any incidents that occur are registered. Recommendations for laser safety. The RIVM has advised hospitals to introduce sound and reliable systems for laser safety. This should conform to the basic requirements of the safety management system that must be introduced in all Dutch hospitals by the end of 2012. For this purpose, health care institutions may apply the recommendations of the SLG. According to the RIVM, safety is secured when there is proof that a number of essential measures have been taken. Examples of this are: a clear laser safety policy has been formulated, a competency register has been drawn up, protocols for treatments have been made and the quality of safety goggles checked. The RIVM calls for the flexible application of such systems in hospitals that links up with their organizational structure.

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