Dear Chris,
Thank you for bringing this paper to my attention. The Medscape
abstract, unfortunately, emits some important information, the
most important being that the study was conducted using a CO2
laser.
In the study, they exised papillomavirus-induced cutaneous
fibropapillomas from cattle and exposed the lesions to CO2 laser at
3 settings. The laser plume was collected in a bubble chamber
connected to suction. The suction tip was placed approximately 2
cm from the tumour. The laser plume content was analyzed and
shown to contain papillomavirus DNA. The collected material was
subsequently inoculated into the skin of calves. Tumours developed
at these sites and they were shown to be infected with the same
virus type as present in the laser plume. This shows that the laser
plume is able to transmit disease.
Perhaps it was worth mentioning that there is always risk of
contamination, although the investigators state that they were
careful to avoid this. Also, the authors concede that most HPV
lesions contain fewer lesions than those in the model studied. In
addition, collection was very close to the lesion and was removed
by the suction which is standard practice in such cases. So it is
not known whether staff are exposed to this material.
Notwithstanding, the study demonstrates that laser plume can
transmit disease.
The big difference between this study and hair removal is that hair
removal is not an ablative procedure. It works on the principle of
depositing heat within tissue rather than vaporising tissue.
Certainly, the smell of burning hair may be easily detected.
However, the study abstracted in Medscape describes a very
different situation and I don't think we may draw conclusions which
are applicable to laser hair removal.
Harry
Date sent: Thu, 5 Dec 2002 08:52:37 -0000
Send reply to: British Medical Laser Association <[log in to unmask]>
From: Chris Edwards <[log in to unmask]>
Subject: Re: hair removal and masks
To: [log in to unmask]
> Dear Harry
> You may be interested in the following extract. It is from a useful site
> called Medscape, in the dermatology section. I know this article does not
> directly address hair removal, but the principles are, I think, relevant to
> any plume-generating laser procedure.
> The article follows:
> "NEW YORK (Reuters Health) Dec 04 - The plume liberated by laser treatment
> from tissue infected with bovine papillomavirus can transmit the infection,
> according to a report in the October Archives of Dermatology.
>
> Laser treatment of targeted tissue can release a plume of smoke containing
> debris and vapor, the authors explain, and numerous
> microorganisms--including human and bovine papillomavirus, bacteriophages,
> and HIV--have been recovered from such plumes.
>
> Dr. Jerome Garden from Northwestern University in Chicago, Illinois and
> colleagues tested whether such plumes could transmit disease. They exposed
> bovine papillomavirus cutaneous lesions to carbon dioxide laser, suctioned
> the plume produced, and reinoculating the plume material into the skin of
> calves.
>
> All laser plume samples contained substantial amounts of BPV DNA, the
> authors report, and comparison of the DNA with that from control BPV virions
> confirmed that the viral DNA was intact.
>
> Two of 3 calves injected with control BPV concentrate developed lesions, the
> results indicate, and both of these calves also developed lesions at laser
> plume inoculation sites for a range of laser settings.
>
> By histology, the lesions produced by the inoculations were typical of BPV
> fibropapillomas, the researchers note, and DNA extracts from the tumors
> contained high levels of BPV DNA.
>
> "[Previous] studies and the findings in the present study increase the
> concern surrounding the use of aerosol-producing lasers in the treatment of
> virally induced lesions and virally infected (or potentially infected)
> patients," the investigators write. "With HPV and the human immunodeficiency
> virus already detected in laser plume, it is possible that other viruses,
> such as hepatitis, may also be liberated in the plume during laser use."
>
> Citing one report of the development of laryngeal papillomatosis in a
> surgeon who treats anogenital condylomata by laser, the authors conclude,
> "It is even more relevant, with the proved potential for disease
> transmission, that safety precautions during laser surgery be strictly
> maintained."
>
> Arch Dermatol 2002;138:1303-1307
> Reference: http://www.medscape.com/viewarticle/445659
>
> Chris Edwards
>
>
> -----Original Message-----
> From: Harry Moseley [mailto:[log in to unmask]]
> Sent: 03 December 2002 17:09
> To: [log in to unmask]
> Subject: hair removal and masks
>
>
> Dear all
>
> An issue has arisen regarding the need for the operator to wear
> masks during laser hair removal. The concern was with respect to
> hydrocarbons created in burning hair, and there may be other
> agents that practioners need protection against. Does anyone have
> any data that might inform this discussion? While I have no
> objection to anyone wearing a mask who wants to, this should only
> be a requirement if there is good reason to support this.
>
> Regards
> Harry
> Dr Harry Moseley
> Consultant Medical Physicist
> The Photobiology Unit
> University of Dundee
> Ninewells Hospital & Medical School
> Dundee DD1 9SY
> United Kingdom
>
> Tel. (0)1382 632240
> Fax. (0)1382 646047
> ---------------------------------------------------------------------------------------
>
> This e-mail (and any attachments) is confidential and may contain personal views which are not th
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Dr Harry Moseley
Consultant Medical Physicist
The Photobiology Unit
University of Dundee
Ninewells Hospital & Medical School
Dundee DD1 9SY
United Kingdom
Tel. (0)1382 632240
Fax. (0)1382 646047
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