Thousands of employees are blinded and countless lives transformed each year as a result of work-related eye injuries that could have been prevented. Eye injuries are not just tragic; they’re expensive to the tune of more than $300 million each year in lost production time, medical expenses, and workers’ compensation costs.

This Compliance Report offers a bird’s-eye view of compliance and best practices, including a review of current OSHA and consensus standards, innovations in eye and face protection, and a physician’s views on injury prevention. It’s a good time to share this information, as March is Workplace Eye Health and Safety Month.

The facts and the risks

According to the most recent data from the U.S. Bureau of Labor Statistics (BLS), there were nearly 21,000 eye injuries in private industry in 2014. About 14,000 were caused by contact with objects or equipment, and some 6,000 resulted from exposure to a harmful substance or condition in the environment.

The American Academy of Ophthalmology (AAO) reports some 300,000 emergency room visits each year due to workplace eye injuries. Forty percent of these injuries occur in manufacturing, construction, and mining, though eye hazards are also present in offices, hospitals, laboratories, and other types of workplaces. The academy cites two major reasons workers experience eye injuries on the job—either they were not wearing eye protection, or they were wearing the wrong protection for the job. A BLS survey found that among workers who suffered eye injuries, nearly three out of five were not wearing eye protection at the time of the incident. These workers often reported that they believed protection was not required for the situation or task.

To break it down further, every day, nearly 2,000 American workers suffer the pain of avoidable workplace eye injuries that require medical treatment. According to The Vision Council, a nonprofit trade association, 90 percent of eye injuries are preventable, and vision loss is among the top 10 disabilities for American adults.

The Vision Council identified four primary causes of eye injuries:

• Projectiles (dust, concrete, metal, wood, and other particles);
• Chemicals (splashes and fumes);
• Radiation (especially visible light, ultraviolet (UV) radiation, heat, or infrared radiation and lasers); and
• Bloodborne pathogens (hepatitis or human immunodeficiency virus (HIV)) from bodily fluids, including blood.

Jobs with elevated risk of eye injury and associated risks include:
Auto repair. Hazards include contact with objects and equipment, sparks from cutting torches, and airborne pieces of metal launched from bench grinders.
Carpentry. Carpentry and general repairs pose the threat of eye injury from flying wood, metal, and concrete chips. Other risks include hammering, chiseling, drilling, stripping paint, splitting tiles or concrete slabs, painting ceilings, and laying insulation.
Construction. More than 100,000 eye injuries occur in construction each year. Nails, tiny pieces of metal, splinters, and cut wire ends can land in the eye. Other hazards include dust and grit from cement mixing, sawing, grinding, and chipping.
Driving. Hazards to drivers include harmful UV rays, glare, and airbag injuries to the eye.
Electrical work. Due to the nature of overhead work, electrical workers are at risk from flying particles like nails, bits of metal, and cut wire ends, as well as falling objects, sparks, and burns.
Health care, laboratory, and janitorial. Infectious diseases—from minor to serious—can be transmitted through the eye’s mucous membranes as a result of direct exposure like splashes or from touching the eyes with contaminated fingers or other objects.
Manufacturing. Injuries result from work that generates flying particles, fragments, sparks, dust, hazardous substances, or radiation.
Plumbing. Chemical and material exposure are common eye hazards for plumbers, as are burns from hot equipment, steam lines, and the release of water or steam. Cutting or grinding can also lead to injuries from flying particles.
Welding. Chemical burns from splashes are common among welders, as are thermal burns. Welders are also at risk for radiation burns (welder’s flash).

Eye on compliance

OSHA’s general industry requirements for eye and face protection are at 29 CFR 1910.133, which states, “The employer shall ensure that each affected employee uses appropriate eye or face protection when exposed to eye or face hazards from flying particles, molten metal, liquid chemicals, acids or caustic liquids, chemical gases or vapors, or potentially injurious light radiation.”

The standard requires that employers provide each affected employee with eye protection that offers side protection when there is a hazard from flying objects. Detachable side protectors that meet the requirement are acceptable. Also, employees who wear prescription lenses during hazardous work must wear eye protection that incorporates the prescription in its design or protection that can be worn over the prescription lenses.

OSHA is currently reviewing a proposed revision to the agency’s eye and face protection standards that updates personal protective equipment (PPE) requirements to reflect current national consensus standards and ensures that employers use up-to-date eye and face protection.

The most relevant of those national standards is American National Standards Institute (ANSI) Z87.1-2015, the newest version of a consensus standard first published in 1968. Since the 2010 version, the ANSI standard has been organized according to the nature of the hazard—impact, optical radiation, droplet and splash, dust and fine dust, and mist. In the past, the content had a product focus. The proposed OSHA revised standard incorporates references to the 2015 ANSI standard.

What else does OSHA require?

The OSHA standard addresses PPE such as safety glasses, goggles, face shields, and welding shields. The equipment must be selected on the basis of hazards. Training must be provided to employees who are required to use eye and face protection. At a minimum, training must cover:

• Why the protection is necessary and how improper fit, use, or maintenance can compromise protection;
• Limitations and capabilities of the protection;
• Effective use in emergency situations;
• How to inspect, put on, and remove PPE;
• Maintenance and storage;
• Recognition of medical signs and symptoms that may limit or prevent effective use; and
• General requirements of the standard.

Employers must establish and implement a written eye and face protection program with site-specific procedures and elements for required PPE use. Provisions of the program include procedures for selection, medical evaluation, fit testing, training, and use and care of the PPE. The program must be administered by a trained individual who is qualified and knowledgeable in eye and face protection.

Protection and prevention

The first line of defense against eye hazards is protective eyewear. Choose PPE based on a hazard assessment of each activity. Options include:
Nonprescription and prescription safety glasses. While they may look like regular glasses, safety eyewear features much stronger lenses and frames. Safety glasses must meet ANSI standards, indicated by a Z87 mark on the lens or frame. They provide protection for general working conditions where dust, chips, or flying particles may be present. Side shields or wraparound glasses provide additional side protection. Polycarbonate lenses are considered the most protective.
Goggles. Safety goggles protect the eyes and immediate area of the face around the eyes from impact, dust, and chemical splash. They provide a secure shield around the entire eye and guard against hazards coming from any direction. Goggles can be worn over prescription glasses and contact lenses.
Face shields and helmets. Face shields protect a worker's entire face when exposed to severe chemical hazards, heat, or bloodborne pathogens and are worn over safety glasses or goggles. Helmets are used for welding or working with molten materials.
Special protection. Other types of protection, such as helmets or goggles with special filters to protect the eyes from radiation exposure, are used for tasks like welding or when working with lasers. Full-face respirators are ideal for protection from hazards like sanding dust, paint spray, and other respiratory irritants.

While contact lenses do not safeguard against hazards, the improvement in vision they provide can have a positive impact on safety. The American Optometric Association explains, “Contact lenses can’t provide significant protection from eye hazards in the workplace. However, there is no evidence that the wearing of contact lenses increases the risk of eye injury.”

10 ways to prevent injury

The national nonprofit organization Prevent Blindness (http://www.preventblindness.org) says 90 percent of all workplace eye injuries can be avoided. The organization recommends a 10-step approach:

• Assess. Inspect all work areas, access routes, and equipment for eye hazards. Study eye accident and injury reports and identify hazardous operations.
• Test. Because uncorrected vision problems can cause accidents, provide vision testing during routine employee physical exams.
• Protect. Select eyewear designed for the duty or hazard.
• Participate. Create a mandatory eye protection program in all operational areas of your site. This helps prevent injuries and is easier to enforce than a program that limits eye protection to certain departments or areas.
• Fit. Workers need protective eyewear that fits well and is comfortable. Eye protection should be fitted by a professional or someone who is specially trained. Provide repairs for eyewear, and require all workers to be in charge of their own gear.
• Plan for an emergency. Set up first-aid procedures for eye injuries. Make eyewash stations easy to access, especially in areas where chemicals are in use. Train workers in basic first aid, and identify those with more advanced training.
• Educate. Conduct frequent training and education among your workers to highlight the importance of protective eyewear.
• Support. Management support is key to a successful eye safety program. Leaders can show their support for the program by wearing protective eyewear whenever and wherever it is required.
• Review. Like any worker protection initiative, your eye safety program should be regularly reviewed and updated, with the goal of no injuries or accidents.
• Put it in writing. Your written program and policy should be displayed in work and employee gathering areas. Review the policy during new employee orientation.

He’s seen it all

As an eye physician and surgeon, Philip Rizzuto, MD, sees the range of work-related eye injuries from minor issues to significant injuries involving tissue damage and eye loss. Rizzuto, who practices in Providence, Rhode Island, is a clinical spokesperson for the AAO.

“We have a lot of industry and a lot of agriculture in the region, so we may see anything from an injury to a landscaper caused by rocks or other flying objects, to injuries caused by particulate matter flying into the eye in an office, or an industrial chemical splash.” He says work-related injuries frequently involve more than one hazard—such as a laceration plus a chemical splash.

Rizzuto advises safety professionals and employees to improve their awareness of the ocular (eye) hazards of various tasks and the safety measures, including appropriate eye protection, that can prevent injury. He recommends that a safety officer or other individual be trained to understand the risks and to respond in an eye emergency.

The goal is to triage and evaluate the injury by determining if the individual is bleeding, in pain, having difficulty seeing, or if one eye is moving differently from the other. The individual should be trained in OSHA’s eyewash protocols and in chain of command if emergency responders or medical care is needed.

If a foreign body or anything else has lodged in the eye, make no attempt to intervene, do not apply pressure to the eye, and get the individual to an eye doctor immediately, Rizzuto advises.

Innovation in sight

Eye and face protection is constantly evolving. Among innovators in the field is Honeywell, whose Eye and Face Protection Group manufactures and sells a variety of premium products worldwide. Phil Johnson is director of technology for the group. One current industry initiative is to globally harmonize requirements for protection. Johnson explains that an important step toward harmonization was the recent establishment of a standard head form to simplify sizing and testing.

Honeywell continues to make improvements to the surface coatings on lenses of the products it sells. Johnson says company research has found that scratching and fogging of lenses is a top complaint among employees. Fogging can occur on humid summer days when moist, warm air builds up or during cold weather.

“We’re always looking for coatings to perform better and it boils down to two things,” explains Johnson. “Does the eyewear prevent fogging, and after you’ve put them on do you have to take them off after 10 minutes to de-fog them?” Fogging is significant because it causes workers to remove the eyewear and wipe the lenses clear, which can expose them to potentially serious injury. It also reduces productivity.

To address the issues, Honeywell has introduced Uvex HydroShield antifog lens coating, said to deliver up to 60 times longer fog-free protection and twice as much scratch resistance as Honeywell’s previous antifog coated products. Another recent innovation is Uvex Livewire with HydroShield, which offers fog-free visibility to workers who require the added protection of a goggle.

Livewire offers style, says Johnson, another Honeywell and user priority. The product features a solid black frame and can be worn with exchangeable temples or a headband, producing a smaller-profile goggle. A related product, the Uvex Sub-Zero Safety Goggle blends style, antifog capability, and cold-climate features, including a layer of foam between the face and the cold plastic of the goggle.

Johnson says Honeywell will continue to produce industry-leading eye and face protection that blends performance, comfort, and style.