Contributing factors to fires in clinical settings during medical laser applications

An estimated 650 fires occur in the surgical environment annually in the U.S.; a figure which may be severely underreported. Any fire in the surgical environment can have devastating implications for patient safety and is clearly an occupational risk to healthcare personnel. Literature searches of the PubMed and Rockwell Laser Industries Laser Accident Databases were performed in order to (1) identify factors and sources affecting the risk of fire in the medical environment, namely, oxidizers, ignition sources, and fuels, and (2) to identify areas of future research for prevention. All papers relevant to the flammability of commonly used medical supplies when subjected to laser radiation, including clinical case reports and publicly available incident data, were identified, reviewed, and summarized. There are numerous materials that are ubiquitous within the medical setting that can ignite when accidentally contacted with laser radiation, including gauze, drapes, sponges, adhesive tapes, and gowns, skin preparatory solutions and ointments, and endotracheal tubes. Future research is warranted to determine the dependence of the ignition potential of the various fuels on laser type and operational parameters. The purpose of this analysis is to summarize and present all of the seminal published literature pertaining to medical laser-related fires and their prevention in order to understand the contributing factors and extent to which these hazards exist, to inform the medical laser community about these hazards, and to prioritize future areas of occupational health and safety research.