Orienterend onderzoek naar het gebruik van lasers in de extramurale gezondheidszorg
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Series / Report no.
Open Access
Type
Report
Language
nl
Date
2000-11-13
Research Projects
Organizational Units
Journal Issue
Title
Orienterend onderzoek naar het gebruik van lasers in
de extramurale gezondheidszorg
Translated Title
An inventory on laser use among health-care
practitioners
Published in
Abstract
Naar aanleiding van de overweging of bepaalde medische
lasertoepassingen moeten worden aangemerkt als voorbehouden handeling
volgens de Wet BIG is een orienterende inventarisatie verricht van beroepen
in de individuele gezondheidszorg waar lasers worden gebruikt en van de aard
en omvang van de toepassing ervan. Hierbij is vooral aandacht besteed aan
toepassingen buiten het ziekenhuis. Op basis van deze orienterende
inventarisatie wordt geconcludeerd dat degenen die een beroep uitoefenen
vermeld onder Art. 3 van de Wet BIG, zoals artsen en tandartsen, lasers uit
de klassen 2, 3 en 4 gebruiken. Beoefenaars van niet geregistreerde
beroepen in de individuele gezondheidszorg gebruiken relatief minder vaak
lasers en gebruik van klasse 4-lasers is in deze beperkte inventarisatie
niet vastgesteld. Dit zou betekenen dat de kans op nadelige effecten bij
laatstgenoemde toepassers in principe kleiner zal zijn en de effecten minder
ernstig. De drempel om klasse 4 lasers aan te schaffen verlaagt echter
voortdurend, omdat lasers steeds meer mogelijkheden bieden en minder
kostbaar worden. In het licht hiervan verdient het aanbeveling om
ondeskundig gebruik van risicovolle klasse 4 (en eventueel klasse 3B) lasers
te voorkomen. De observatie dat de laserveiligheid zowel intramuraal als
extramuraal op kwalitatief uiteenlopende manieren wordt geregeld en ernstige
incidenten niet zijn uitgesloten, ondersteunt dit standpunt. De
evenwichtige onderbouwing van deze stelling en dus een geheel te
rechtvaardigen antwoord op de vraagstelling uit dit onderzoek, vereist
evenwel een meer diepgaande inventarisatie van extramurale toepassers en
toepassingen.
A limited inventory was taken among Dutch health-care practitioners on the use of lasers, including the type and extent of their applications. This inventory arose from the consideration on whether certain medical laser applications should be reserved for treatment according to the Act on Occupations in individual health care (BIG Act). Here, the focus was on applications used outside hospitals. On the basis of this inventory it can be concluded that practitioners, like physicians and dentists, who are registered according to the BIG Act, use class 2, 3 and 4 lasers. Practitioners from non-registered occupations in individual health care use lasers relatively less frequently. Since the use of class 4 lasers was not recorded in this inventory, the chance of harmful effects from the non-registered use will, in principle, be smaller and the effects less serious. The threshhold for using class 4 lasers is, however, being constantly lowered since lasers are becoming more versatile and less costly. In view of this development it would be wise to avoid incompetent use of the high-risk class 4 lasers (and possibly class 3B). The observation that laser safety heterogeneously, both in intramural and extramural use, is regulated and that their use is not insensitive to serious consequences, was found to support this standpoint. The balanced support given to this standpoint, leading to a completely justifiable solution to the research problem will, nevertheless, require a more extensive inventory on the extramural use and applications of lasers.
A limited inventory was taken among Dutch health-care practitioners on the use of lasers, including the type and extent of their applications. This inventory arose from the consideration on whether certain medical laser applications should be reserved for treatment according to the Act on Occupations in individual health care (BIG Act). Here, the focus was on applications used outside hospitals. On the basis of this inventory it can be concluded that practitioners, like physicians and dentists, who are registered according to the BIG Act, use class 2, 3 and 4 lasers. Practitioners from non-registered occupations in individual health care use lasers relatively less frequently. Since the use of class 4 lasers was not recorded in this inventory, the chance of harmful effects from the non-registered use will, in principle, be smaller and the effects less serious. The threshhold for using class 4 lasers is, however, being constantly lowered since lasers are becoming more versatile and less costly. In view of this development it would be wise to avoid incompetent use of the high-risk class 4 lasers (and possibly class 3B). The observation that laser safety heterogeneously, both in intramural and extramural use, is regulated and that their use is not insensitive to serious consequences, was found to support this standpoint. The balanced support given to this standpoint, leading to a completely justifiable solution to the research problem will, nevertheless, require a more extensive inventory on the extramural use and applications of lasers.
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