The more you know: Laser classifications for therapeutic use

Have you been looking for a way to expand your patient base and scope of practice?

Adding laser therapy treatments to your list of services could do just that. There are a variety of ways to use therapeutic lasers, from accelerating wound healing to treating musculoskeletal inflammation and pain—and that list continues to grow.

Do your homework

Before deciding whether to add any kind of laser system to your practice, make sure you know what the research says, get proper, thorough training, and see if you can afford to make the financial investment.

You also need to know the difference between the various kinds of lasers. The U.S. Food and Drug Administration (FDA), which oversees the manufacture and sale of lasers at the federal level, has created a classification system based on two main factors:¹

Strength of the output

Potential to cause damage to the body

It is vital to understand this classification system to be certain that the laser system you’re considering falls within the proper therapeutic guidelines.

Laser Classification System

Lasers are classified and subclassified according “to the hazard posed by the amount and type of light they emit,” according to the FDA’s website. There are four classes (I to IV), with Class I being non-hazardous and Class IV being the most hazardous, and three subclasses (IIa, IIIa, and IIIb).^1-3

Class I. Class I lasers are approved for all standard use and are safe for viewing with the naked eye. They cannot damage the eye or body, as they are completely enclosed in a housing (such as for a CD or DVD player).

Class II. Class II lasers emit light within the visible spectrum (400 nm–700 nm). They are assumed to not cause damage from accidental viewing due to the eye’s natural blink defense against bright lights; however, prolonged eye exposure may cause damage. An example of Class 2 lasers includes laser pointers.

Class IIa. Class IIa lasers are considered safe for accidental viewing with the naked eye due to the blink defense but may not be safe for accidental viewing if seen with an optical device, similar to Class 1M.

Class IIIa. Class IIIa lasers are medium-powered and continuous wave, and they can emit up to five times the limit of either Class 1 or Class 2 lasers. It cannot exceed 5 megawatts (mW) within the visible range of light.

Class IIIb. Class IIIb lasers emit enough visible light to carry a serious risk of injury from any direct viewing, including with an optical device or from a reflective surface. Most lasers used in chiropractic fall into this category.

Class IV. Class IV surgical and industrial lasers are hazardous to view under all circumstances and may cause permanent damage. Class IV therapeutic lasers deliver significantly lower power and power density than surgical lasers and are a safe treatment modality. Patients may feel a mild warmth in the treatment area, and tissue temperatures will elevate less than five degrees F in the treatment area.

If you’re seriously considering whether to add lasers to your practice, look past the bottom line. Decide what you hope to treat with a therapeutic laser system, and make sure you understand the laser classifications to determine which will best suit the needs of you and your patients.

References
¹ U.S. Food and Drug Administration. “Laser Products and Instruments.” FDA.gov. http://www.fda.gov/radiation-emittingproducts/radiationemittingproductsandprocedures/homebusinessandentertainment/laserproductsandinstruments/default.htm. Updated April 2014. Accessed January 2015.
²U.S. Food and Drug Administration. “Important Information for Laser Pointer Manufacturers.” FDA.gov. http://www.fda.gov/Radiation-EmittingProducts/RadiationEmittingProductsandProcedures/HomeBusinessandEntertainment/LaserProductsandInstruments/ucm116373.htm. Updated March 2009. Accessed January 2015.
³ Lawrence Berkeley National Laboratory. “Laser Classification Explanation.” LBL.gov. http://www2.lbl.gov/ehs/safety/lasers/classification.shtml. Updated August 2014. Accessed January 2015.