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Safety and Complications

ASLMS recognizes the critical need for the implementation of safety measures and appropriate training for physicians and staff performing procedures with lasers and related energy-based devices.


John Hoopman, AAS, CMLSO
ASLMS Safety Director


H. Ray Jalian, MD
ASLMS Laser Safety Board Representative

ANSI Z136.3 (2018)

ASLMS members have been actively involved in developing the recommended guidelines for safe use of lasers in health care, known as American National Standard for Safe Use of Lasers in Health Care, ANSI Z136.3. The standard was last revised in 2018.

A copy of ANSI Z136.3 (2018) Safe Use of Lasers in Health Care can be purchased from the Laser Institute of America (LIA).

ASC Z136-2018 is the American National Standards Institute (ANSI) Accredited Standards Committee for the Z136 series of laser safety standards. These standards are the United States' national consensus standards for laser safety.   Developed and maintained by the committee, the standards describe procedural standards of practice for the patient and staff in order to control the safety hazards associated with laser utilization. The ANSI document also describes the safety requirements to include the required engineering and administrative control measures necessary to establish a facility-based Laser Safety Program.  In addition, methodologies for properly conducting a Laser Hazard Evaluation per laser system is included with a description of the Maximum Permissible Exposures (MPE), Nominal Hazard Zones (NHZ), and associated laser protective eyewear‘s Optical Density (OD) required to reduce the exposure risks to lasers and laser systems.

ASLMS Representatives for the Laser Institute of America Z136 Committee for Safety



Rebecca L. Sprague, RN, NP-C
Primary Representative 


Macrene R. Alexiades, MD, PhD
Alternative Representative 

Safety Videos

The ASLMS Safety Awareness Committee has developed a series of instructional videos and Instagram Live events to highlight laser safety. Check out this preview video featuring ASLMS Safety Director John Hoopman, CMLSO.

ASLMS members have access to all laser safety videos. Log in is required. 

ASLMS Safety Director John Hoopman, CMLSO, walks us through the Laser Safety Guide for Health Care Facilities, a comprehensive checklist. Recorded at the ASLMS 2022 Annual Conference. 

Other ASLMS Safety Resources

Laser Safety Guide for Health Care Facilities

The Safety Awareness Committee developed this safety checklist for facilities to use to set up and monitor their laser safety practices. Available for download in PDF format, as well as a Word document format to allow facilities to change as needed to meet their state/country requirements. 

PDF: Laser Safety Guide for Health Care Facilities
Word:  Laser Safety Guide for Health Care Facilities

ASLMS Laser Safety Guide in Dermatology and Plastic Surgery

This guide was developed through the ASLMS mentorship program. It provides information on safety standards, general safety precautions, eye hazards and ocular protection, skin hazards, plume hazards and precautions, and more. Read Now

Laser Plumes and Safety

The ASLMS Laser Safety Committee reports on the hazards of vaporized tissue plume and offers safety recommendations. ASLMS Laser and Energy Device Plume Position Statement

Recommendations to Reduce Surgical Fires and Related Patient Injury: FDA Safety Communication

The FDA is reminding health care professionals and health care facility staff of factors that increase the risk of surgical fires on or near a patient. The FDA is also recommending practices to reduce these fires from occurring, including the safe use of medical devices and products commonly used during surgical procedures. Read More


The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) developed the Fundamental Use of Surgical Energy™ (FUSE) program to meet the need for increased education and training in the principles and properties of operating electrosurgical instruments safely. FUSE is designed to certify that a successful candidate has the demonstrated knowledge fundamental to the safe use of surgical energy-based devices in the operating room, endoscopic suite and other procedural areas. Learn More

Laws and Regulations of Laser Operation in the United States

The laws and regulations governing laser operation in the United States are vague, complex, and vary state‐to‐state. A study, originally published in Lasers in Surgery and Medicine in 2018, presented an overview of the laws and regulations of laser operation in each of the 50 states. See study. The authors performed an extensive online search of the law in each of the 50 states by examining multiple state cosmetology boards, state legislative boards, state nursing boards, and state medical boards. The principal author, Catherine DiGiorgio, MD, compiled the laws and regulations into a chart with links to online resources by state, and categorized which states consider the use of lasers as the "practice of medicine." Laser regulations are best divided into three categories: delegation (who can delegate a laser procedure to another provider or individual), level of supervision required (to what extent the operation of a laser requires supervision and who is qualified to supervise), and operation (who can fire the laser).  

Laser Regulations 2019

Laser Litigation, Lawsuits, and Avoiding Complications

ASLMS offers education on complications and legal issues at the Annual Conference. In addition, members provide periodic video updates on these topics. 

Laser Litigation
Mathew Avram, MD, JD talks about 3 common reasons for lawsuits involving lasers.

Avoiding Complications with Lasers
Mathew Avram, MD, JD discusses avoiding complications with lasers by methodology, technology and to treat and recognize complications.

Lasers and Lawsuits
Mathew Avram, MD, JD discusses potential legal issues surrounding the use of laser technology.

Lasers, Lawsuits & HIPAA
H. Ray Jalian, MD discusses the increase in litigation involving injuries from laser surgery performed by non-physician operators in a non-medical setting.

The views expressed and materials presented in these videos represent the personal views of the individual speaker(s) and do not represent the opinion of the ASLMS. The ASLMS assumes no responsibility for the content of the videos made by the speaker or group of speakers.

The American Society for Laser Medicine and Surgery, Inc. is the world’s largest scientific organization dedicated to promoting research, education and high standards of clinical care in the field of medical laser applications. It provides a forum for the exchange of scientific information and participation in communicating the latest developments in laser medicine and surgery to clinicians, research investigators, government and regulatory agencies, and the public.

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