Laser System Qualification

There are multiple laser systems at the CFN. Users who will work with the following class 3b or 4 laser systems are required to complete the Laser Safety (TQ-LASER) training and comply with Occupational Medical Clinic (OMC) Laser Medical Surveillance:

• Createc Low Temperature Scanning Tunneling Microscope,
  Proximal Probes Facility, Room 1L39, or
• Amplified Ti:Sapphire Laser System,
  Ultrafast Optical Facility, Room 1L01B
• Time Correlated Single Photon Counting Spectroscopy and Microscopy,
  Soft/Bio Materials Facility, Room 1L01B

Laser Medical Surveillance Form

The purpose of the Laser Medical Surveillance form is to provide BNL-OMC with information necessary to determine that an individual to be cleared as a laser user at BNL has met the medical requirements of ANSI Standard Z136.1-2000 governing the safe use of lasers.

This standard requires each Class 3b and 4 laser user to have a pre-assignment eye examination by an ophthalmologist, which is recorded on Part B of the Laser Medical Surveillance form.

Instructions to Laser Users

1. As soon as possible, contact one of the contracted local ophthalmologists from the list below and request an appointment for a “laser eye exam for Brookhaven Lab.” (Note: You may also obtain this exam from a Board Certified ophthalmologist other than those listed. However, for BNL employees, BNL cannot guarantee payment. Consult with your BNL supervisor to discuss payment issues.)
2. Complete Part A of the form. This provides BNL-OMC with needed contact and medical information. The ophthalmologist will record his/her examination on Part B.
3. The ophthalmologist will then fax the form to BNL-OMC at (631)344-7366. This is a secure, clinic fax that can receive confidential medical information. BNL-OMC’s voice number for problems or questions is (631)344-3670. If unable to fax, mail as soon as possible to BNL-OMC at Brookhaven National Laboratory, Building 490, Upton, NY 11973.
4. After receipt of the form, BNL-OMC will contact the user if additional information or a skin examination is required.

A laser user who has already had a laser eye exam can submit this exam to BNL-OMC in lieu of a new laser eye exam.  BNL-OMC will then consider whether the submitted exam is acceptable, or whether a new exam will still be required.  Generally, to be acceptable, the submitted exam must

• be performed by a Board Certified ophthalmologist;
• provide substantially the same information that is requested in Part B of the attached form;
• have been performed within the last 3 years, with no laser eye accidents or changes in vision subsequent to the exam.

The laser user who wishes to submit a recent laser eye exam for consideration by BNL-OMC must do the following:

1. Fill in Part A of the form.
2. Fax Part A of the form to BNL-OMC at (631)344-7366, along with the written record of the laser eye exam.  (If unable to fax, mail as soon as possible to BNL C at Occupational Medicine Clinic, Brookhaven National Laboratory, Bldg. 490, Upton, NY  11973-5000.)
3. BNL-OMC will contact the laser user if additional information or examinations are required.

Contracted Local Ophthalmologists