The following Parts (I, II, III, IV, V, VI, and VII) must be completed before the WSU Laser Safety Template becomes the Laser Safety Program for Class 3 and 4 Lasers. Once all parts are complete, send a copy of Appendix Q to EH&S (Mail Stop 1172) and insert the forms into your WSU Laboratory Safety Manual. If further assistance is needed, contact EH&S at 335-3041.
LASER SAFETY PROGRAM– For Each Class 3 and 4 Lasers
Part I. AUTHORIZED PERSONNEL AND PERTINENT INFORMATION:
Responsible for Laser Safety (Refer to Responsible Parties in Appendix P):
Principal Investigator / Supervisor - Laser Safety Officer: _______________________________________>
Phone Number: ______________________
E-Mail: _______________________________________
Department: _________________________
Department Chair or Director: ____________________
Area(s) Covered by this Program (i.e., Building, Room Numbers, Construction Site, etc.): _____________
______________________________________________________________________________________
Part II. LASER INFORMATION: Used to determine Maximum Permissible Exposure Limit, Nominal Hazard Zone, and
Optical Density, please provide information in the requested units (i.e. Joules, Watts, etc.). The specific
information requested is usually found in the specification pages of the manuals supplied by the laser manufacturer.
Laser Class (Check one that applies): Class 1
Class 2
Class 3R Class 3B
Class 4
Continuous Wave: Maximum Average Power: _______ (Watts)
Exposure Time: _________ (Seconds)
Exposure Distance: _____________ (Meters) NOTE: For diffuse viewing Optical Density calculations,
the optical density analysis requires the magnitude of the distance from the scattering site to the
observer. Unless otherwise specified, a quarter of a meter (0.25m) will be used as the “viewing distance”.
Single Pulse: Pulse Energy: ________ (Joules)
Pulse Length: ____________ (Seconds)
Multiple Pulse: Pulse Energy: ________ (Joules)
Average Power: ___________ (Watts)
Beam Shape: Check One – Circular
Elliptical
Rectangular
Square
Beam Diameter at exit of Laser: _____________________ (mm) Beam Divergence: __________(mrad)
Used to determine the Nominal Hazard Zone for lens: Check One and Provide Information.
Non-Applicable (N/A)
Applicable: Focal Length: ________ (mm)
Beam Diameter at Lens: _________ (mm)
Used to determine Nominal Hazard Zone for fiber optics: Check One and Provide Information.
Non-Applicable (N/A)
Single Fiber Optics Mode Minimum Beam
Waist _________________ (µm)
Multiple Fiber Optics Mode Numerical Aperture:
___________________
Engineering Controls: Check all that apply.
Non-Applicable Interlocks
Beam Stops
Optpical System Attenuators
Remote Controls Emission Delays
Part III: SIGN AND SEND TO EH&S:
Once the information has been provided in Parts I and II, sign, date, and send the information to:
EH&S, Mail Stop 1172.
Part IV: EH&S CALCULATIONS - RETURN TO SENDER:
Once EH&S receives the information provided in Parts I, II, and III, the following will be determined for class
3B and 4 lasers only.
Maximum Permissible Exposure (MPE): __________________________________________________
Nominal Hazard Zone (NHZ): ___________________________________________________________
Optical Density (OD - Protective Eyewear): _______________________________________________
Part V: STANDARD OPERATING PROCEDURE / HAZARD ASSESSMENT
With the information provided in Parts I, II, III, and IV, complete standard operating procedure / hazard
assessment for all Class 3 and 4 Lasers (See SOP Example). If assistance is needed, contact EH&S at 335-3041.
Place a copy in the Laser Safety Program section of your Laboratory Safety Manual.
Introduction-- Descriptions of Laser (See label and Manufacturer’s Manual)
System Description: _____________________________________________________
Type and Wavelength: ___________________________________________________
Class: ________________________________________________________________
Intended Application: ____________________________________________________
Location: _____________________________________________________________
Hazards -
List all hazards associated with the laser.
Eye and skin hazards from direct and diffuse exposures: ________________________
_____________________________________________________________________
Laser Generated Air Contaminants: ________________________________________
_____________________________________________________________________
Other Recognized Hazards: ______________________________________________
Control Measures–
List control measures for each hazard.
Include the following:
Eyewear requirement, include wavelength and Optical Density: __________________________________
_____________________________________________________________________
Training Requirements–
State specific requirements
The specific training requirements for authorized personnel are: ________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Emergency Procedures -
List contact information and action to be taken.
In case of emergency:
Notify Laser PI / Supervisor ________________________________________ at ext. _____________
For Emergency Medical Response call ext. ____________________________
Action to be taken:
Report all incidents to ______________________________________ at ext. ___________
Additional Procedures: ________________________________________________________.
Approved Personnel-
All individuals approved to operate / maintain the laser.
ONLY trained and authorized personnel are allowed to operate and maintain laser.
Authorized Operators:
___________________________________
___________________________________
___________________________________
___________________________________
Authorized Maintenance /Service Personnel:
__________________________________
__________________________________
__________________________________
__________________________________
Part VI: ADDITIONAL INFORMATION
This section has been provided for the insertion of additional information pertinent to your Laser Safety
Program. Insert additional information in the WSU Laser Safety Program / Template. For example, Part VI
might include the following:
Laser Manufacturer’s Manual
Beam Alignment Procedures
Maintenance Instructions
ANSI Laser Standard
Personal Protective Equipment Information
Cleaning Manuals
Part VII: MEDICAL SURVEILLANCE
Has medical surveillance program for laser been implemented (Check Yes or No)?
Yes No
If yes, provide details with participants name and date of examination
______________________________________________________________________
______________________________________________________________________
EXAMPLE - STANDARD OPERATING PROCEDURE FOR LASER OPERATION
Introduction –
Descriptions of Laser
System Description: Model 1000 Nd:YAG laser marker system manufactured by the XYZ Company.
This is a Class 1 laser system with an embedded Class 4 Laser.
Type and Wavelength: 1.064 micro meters
Class: Class 1 with Embedded Class 4.
Intended Application: Research
Location: Webster Hall, Room XYZ
Hazards -
List all hazards associated with the laser.
Eye and skin hazards from direct and diffuse exposures: Eye Hazard from direct, reflected or scattered beam.
Skin hazard
Electrical Hazards: Inside power supply.
Laser Generated Air Contaminants: Target material.
Other Recognized Hazards: Fire hazard.
Control Measures –
List control measures for each hazard.
Include the following:
Eyewear requirement, include wavelength and Optical Density: Approved laser safety eyewear with OD=5.0+
@1064 nm is required for all personnel inside the controlled area.
Additional PPE: Lab coat, long pants, and closed-toed shoes.
Location of PPE: OD=5.0+ Glasses are stored in cabinet to left of door prior to entry zone.
Description of controlled area, nominal hazard zone and entry controls: Established controlled area
using laser barrier and warning signs, Nominal Hazard Zone is 100 meters = entire lab.
Reference to Equipment Manual: See Model 1000 Nd:YAG Laser Manual and ANSI Standard Z136.1
Alignment Procedures (or guidelines): (See C.2.Part IV, Additional Information - Manual for beam alignment
procedures. The following rules must be observed during the laser alignment: Only two trained personnel are
allowed in the area during alignment procedures. All other activities are prohibited in the same room, unless
appropriate protection is provided. Only essential personnel with the appropriate personal protective equipment
are allowed in the work area. Place Warning Signs at entrances informing visitors of the dangers. Use low power
visible lasers to simulate the path of the high power laser. When performing alignment procedures, reduce all
high power laser beams to the minimum possible power. Avoid beam paths that are at sitting or standing eye level.
Take off all reflective objects (e.g., rings, badges, watches) before performing any work involving the lasers.
Terminate laser beams and specular reflection on diffuse reflecting beam blocks. Keep all combustibles, tools,
and reflective surfaces away from the beam path. Make sure you know where the beam is and stay clear.
Maintenance Procedures: To be performed only by authorized maintenance personnel with the appropriate personal
protective equipment (See Unit’s Laser Safety Program, Part I for a list of Authorized Personnel).
Follow Manufacturer’s instructions (See Unit’s Laser Safety Program, Part VII Additional Information –
Manufacturer’s Manual).
Power Supply: Work involving access to the power supply is normally done with the system locked and tagged out.
Access to the energized power supply must be done only by qualified personnel using the buddy system. Workers are
directed to review the electrical safety and power supply sections of the manual before any activities involving
access to high voltage.
Exhaust System: When functioning normally, the exhaust system will remove all Laser Generated Air Contaminants
even with the protective housing open. Notify Dr. Doe at 555-5555 if you think there might be a problem or
contact EH&S at 335-3041.
Training Requirements–
State specific requirements.
The specific training requirements for authorized personnel are: Laser safety training is required before
personnel will be authorized to be in the controlled area while the beam is accessible
Emergency Procedures -
List contact information and action
to be taken.
In case of emergency:
Notify Laser PI / Supervisor: Dr. Doe at ext. 555
For Emergency Medical Response call ext. 911
Action to be taken:
Report all incidents to Dr. Doe at ext. 555
Additional Procedures: If accident or injury, complete incident report and submit to Benefit Services
Approved Personnel -
All individuals approved to operate / maintain
the laser
List all authorized operators:
Dr. Doe, Principal Investigator, Laser afety Officer
Jane Doe, Laser Assistant
Ms. ANSI, Research Tech
List all authorized service personnel: John Doe, Laser Tech
Certification of SOP / Hazard Assessment
Name of principal investigator/supervisor – Laser Safety Officer
John Doe Principal Investigator – Laser Safety Officer
