By Peter Vitruk, PhD, MInstP, CPhys
ANSI Z136.3 Standard for Safe Use of Lasers in Health Care (2018 Edition) defines laser plume as one of the non-beam laser hazards since it contains viral, bacterial, and other cellular and aerosolized particulates, gaseous toxic compounds, etc. ANSI Z136.3 Standard also specifies safety measures to mitigate the laser plume hazards, i.e. the mandatory use of Local Exhaust Ventilation (LEV) device (e.g. wall suction devices in dental offices a.k.a. high volume evacuation devices and mobile/portable smoke evacuators in physicians’ and veterinarians’ offices) equipped with a proper filter (with ANSI Z136.3 Standard’s defined filtration at 0.12μm at 99.999% efficiency) and with wide aperture suction nozzle held as close as possible to the surgical site (no further than 2 inches per the CDC) to safely remove laser plume.
ANSI Z136.3 Standard does not address the safe removal of laser plume when water spray is directed at the laser plume. Such water spray uses may disperse the laser plume out of the reach of the LEV device and reduce the efficacy of laser plume capture by the LEV device. Currently available dental instruments generated aerosol hazard mitigation reviews (Harrel SK, Molinari J. Aerosols, and splatter in dentistry. JADA, Vol. 135, April 2004, pp 429-437; Emmons L, Wu C, Shutter T. High-volume evacuation: Aerosols—it’s what you can’t see that can hurt you. Published July 1st, 2017; Harrel SK. Dental Aerosols and Spatter Amidst Covid-19. Decisions in Dentistry, Vol. 6, No. 5, May 2020, pp 9-11) do not address the water spray dispersed laser plume hazard mitigation techniques that comply with ANSI Z136.3 Standard.
Therefore, in surgical laser uses that do not utilize water sprays, laser plume can be safely removed according to and in compliance with ANSI Z136.3 Standard for Safe Use of Lasers in Health Care. However, users of dental lasers that utilize water sprays should be aware that ANSI Z136.3 Standard for Safe Use of Lasers in Health Care does not address the safe removal of the laser plume dispersed by the water spray.