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Toxins detected in laser hair removal plume


AT LASER 2013


Vitals

Major finding: During a laser procedure, the level of ultrafine particles rose to nearly 450,000/cc.

Data source: Gas chromatography and dust-sample analysis of smoke plumes from laser-destroyed hair samples.

Disclosures: The study was internally supported. Dr. Chuang reported having no relevant financial disclosures.

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BOSTON – Performing laser hair removal might be hazardous to your health.

Laser plumes emitted during the procedure contain "a cocktail of volatile organic compounds," at least 13 of which are known to be hazardous to human health, Dr. Gary S. Chuang, of the department of dermatology at Tufts Medical Center, Boston, said at the annual meeting of the American Society for Laser Medicine and Surgery.


Dr. Gary Chuang

 

The findings further highlight the potential for harm that have already been demonstrated in association with laser procedures in the absence of safeguards such as adequate ventilation, smoke evacuators, and adequate personal protection.

Dr. Chuang and his colleagues at Massachusetts General Hospital, Harvard School of Public Health, and Boston University subjected donor hair samples to a single pulse from a diode or Alexandrite laser, captured the plumes produced, and examined them with gas chromatography. They detected the presence of approximately 300 distinct chemical compounds, 40 of which occurred in higher concentrations and 13 of which have been shown to be harmful in human and animal studies.

The compounds included:

• Benzene, toluene, and ethylbenzene (commonly found in car exhaust, cigarette smoke, glue, paint, wax and detergents, and linked to leukemia and bone marrow abnormalities.

• 2-Methylpyridine, which can cause headache and nausea.

• Diethyl phthalate, used in cosmetics and fragrances, has been shown to cause birth defects in pregnant rats.

• Trimethyl disulfide, which is primarily responsible for the foul odor from singed hair.

• Various soap and perfume components of unknown toxicity.

The researchers also collected dust samples over time to look for the concentration of particles smaller than 1 micron with and without a high-efficiency particulate air (HEPA) equipped smoke evacuator.

Normal street-level concentrations of ultrafine particles are about 4,000/cm3 per cubic centimeter, Dr. Chuang noted. When the investigators took the dust counter into the laser center waiting room, the level jumped to about 16,000/cc. During a laser procedure, the levels rose to nearly 450,000/cc. The levels slowly declined over the next 20 minutes, but still remained about fourfold higher than normal concentrations, he said.

"The National Institute of Occupational Safety and Health recommends that with any surgical procedure that produces a plume, you want a capture velocity of about 100-150 ft/minute, and hopefully, (the evacuator) will have a HEPA filter or ultralow penetrance filter that can remove about 99.97% of airborne particulates up to 0.3 microns or greater," he said.

Additionally, the vacuum must be no farther than 2 inches from the source, because the suction velocity decreases at greater distances. All personnel in the treatment room should wear surgical masks with a NIOSH rating of N95 or greater, he recommended.

Continued...

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Repeated exposures could be hazardous

Neil Osterweil/IMNG Medical Media


Dr. Jeffrey Dover

I think these findings raise a significant concern about safety, especially for those who repeatedly perform laser hair removal procedures. My guess is that we and our staff are at risk when we do these procedures, and so probably are the patients in that room, and the patients in the neighboring room and the hallway. For those repeatedly performing the procedure, those risks are magnified.

Short of wearing a re-breather-type respirator such as those worn by workers who handle hazardous materials, masks and evacuators may not offer sufficient protection against prolonged, repeated exposures to the chemical constituents of laser plumes.

Dr. Jeffrey Dover is the president of ASLMS and a dermatologist in private practice in Chestnut Hill, Mass.