Maintaining A Robust Eye Safety Program During COVID-19
Overview
The pandemic has brought about many challenges for safety directors, and those involved in occupational, environmental and industrial hygiene. Precautions in the plant and workplace have been accentuated to comply with CDC guidelines to include social distancing, proper air flow, and the use of PPE equipment.
One area which can get overlooked is the importance of a comprehensive and compliant eye safety program. According to the CDC, https://www.cdc.gov/niosh/topics/eye/default.html¹ each day about 2000 U.S. workers sustain a job-related eye injury that requires medical treatment. About one third of the injuries are treated in hospital emergency departments, and more than 100 of these injuries result in one or more days away from work.
Many safety professionals realize the value of a well-planned vision strategy to protect their team members. However many remain less focused on this area leaving it to the judgement of the employees to determine their own needs for protective eyewear.
Those involved with higher risk jobs involving heavy equipment, large tools, material handling, and ladders can be most susceptible to an injury without the proper eyewear. That coupled with those individuals who need prescription and highly complex prescription lenses only adds to the possibility of a reduction in proper visual acuity. It can impact the individual’s ability to meet the requirements his or her job demands and effect their overall performance.
As regulatory and corporate guidelines change to meet the necessary precautions brought about by the coronavirus, a company’s eye safety program should not be compromised or short changed. Instead it should be a point of emphasis and maintained at the highest levels to prevent possible injuries, prevent potential legal ramifications, and maintain compliance with federal regulations. Following are several recommendations to provide a high-level of eye safety for all employees as the pandemic rolls on.
The elements of an excellent eye safety program
The operational parameters caused by the pandemic are influencing many changes in the plant and office. Employees are often asked to do more in less time. This can increase stress levels and increase the chances for an injury including the eyes. A robust eye safety program should address those issues. It should include thorough analysis and planning. It should do much more than simply provision safety glasses. In fact, safety glasses as personal protective equipment should be considered the last line of defense.
Consider eyeglass lenses sit 12 millimeters from a person’s eyeball. A potential threat should never reach the 12 mm mark. But in the fraction of a second should that threat move through that 12 mm space to the eye, it can create the difference between free and easy vision compared to a visual disability which can last weeks, months or a lifetime. In this case the eye safety program has already failed.
To avoid injuries, safety professionals should understand the environmental risks related specifically to eye safety. Workers on construction sites have different risks than workers in a healthcare facility. Those whose job requires them to transition between exterior and interior illumination have a different need than those who work entirely indoors or outdoors.
Outdoor workers may not have appropriate eye protection from the sun. Sudden bursts of light can lead to intense tearing which can temporarily obscure vision. Tradesmen on slopes and unimproved ground have different requirements than those doing the same job in a more controlled setting. Even those working side-by-side may have different job duties and therefore different needs with regards to safety eyewear.
Program planning and execution
A successful eye safety program includes several control points to include organization, buy-in, and establishment of guidelines to prevent injury.
First it should comply with the minimum standards set about by The American National Standards Institute (ANSI), a private, not-for-profit organization, https://blog.ansi.org/2020/04/ansi-isea-z87-1-2020-safety-glasses-eye-face/#gref². ANSI Z87. 1-2015, establishes the criteria for using, testing, marking, choosing, and maintaining eye protection to prevent or minimize injuries from eye hazards.
Secondly, safety professionals should make workers aware of risks especially during the COVID-19 outbreak. Employees should be educated on how to properly wear safety glasses and how to take them off. Appropriate mechanical safeguards and appropriate administrative safeguards should be developed so team members do not face undue risks by being in the wrong work area at the wrong time. It is not safe to assume all workers will be socially distanced and adorned with the proper equipment at all times.
The safety glasses should be appropriately fitted for their individual’s face, prescription and type of glasses, whether they be spectacle, full shield spectacle or goggle. Fit cannot be overestimated. Similar responsibilities exist even for safety glasses purchased at a retail store.
A high grade material, such as polycarbonate lenses, are best to encourage appropriate care and cleaning. Dusting off and self-care before removing safety glasses can help prevent some injuries.
Eye injuries often occur not from a specific act of the individual wearing them but what is going on in their environment immediately surrounding them. Buy-in should be sought from colleagues by discussing risk. They should be reminded eye injuries are for life. Vision issues extend beyond work to one’s personal life. Generating buy-in from thought leaders on the shop floor will go a long way to helping safety personnel accomplish their goals and objectives.
Considerations for safety glasses and computer use
Not all workers are at risk for a traumatic eye injury. Many work in an office setting or now, during the pandemic, from home. This requires long hours staring at a computer screen.
Eye stresses still occur in this environment and on the visual system. Anyone working at a computer has impaired blink function. The blink produces moisture and is an essential component of how the eye takes care of itself.
Regular blinking, according to an article in the American Association of Ophthalmology news, https://www.aao.org/eye-health/tips-prevention/computer-usage³ occurs about 15 times per minute. However studies indicate blinking only occurs about 5 to 7 times in a minute while using computers and other digital screen devices. It leads to dryness and irritation which can lead to loss of concentration, discomfort, and reduced vision. The end result can be reduced work efficiency and/or interrupted work.
One solution is to place the viewable area of the screen itself a little below the line of sight. Assuming good ergonomics at the desk and chair, the computer should be positioned for a slightly downward gaze. It is easier on the eye than looking straight across or viewing upwards.
A downward gaze helps bring the eyelid down and helps eliminate the chances of being affected by drafts, especially when an HVAC unit is in the room, and helps protect against dryness.
Light toxicity or discomfort glare is also a real consideration. It can impact one’s ability to perform their normal job function. A good test is to place a folder over your head as you look at your work terminal. If it becomes easier to read with the folder than the user may have problems with discomfort and disability glare.
Glare can be reduced by placing a screen on the computer terminal. Antiglare coating from an industrial safety eyewear perspective is not approved by ANSI and is not compliant. However, for someone who does not require these type of glasses, an antiglare coating may be a benefit to them in their work environment.
As computers become more modern and sophisticated, so does exposure to blue light. Blue light has immediate consequences including impact on long term macular health, the part of the eye that processes 20-20 vision. Also blue light can impair the sleep cycle. Filters and coatings can help reduce blue light exposure.
To best prevent computer related eye stress, users can take breaks, maintain mindfulness about blinking, position screens in right spot, and avoid multiple screens. Workstations should also built to permit ambient visual stimulation or eye activity going on in peripheral vision. Visual systems perform best when not focused on one item and blocked from seeing others. It can create eye strain as the eye stresses to see what is happening around it.
The downside of cheap and easy with prescription eyewear in the workplace
The law according to the Occupational Safety and Health Administration or OSHA, requires occupational and industrial eyewear to be wearable, usable and in a prescription that is comfortable for the wearer. https://www.osha.gov/lawsregs/regulations/standardnumber/1910/1910.133⁴ it is difficult to imagine that all these conditions can be met without expert fitting and dispensing of eyeglasses.
To maintain corporate compliance and comply with regulations, safety frames should carry the ANSI “Z87” marking to ensure their effectives.
Attention should be given to the size of the frame which also has a significant impact on the wearing of the safety glasses and job functionality. The nature of the prescription in highly important. Tolerances for those with a complex or high prescription are extremely tight. Small errors in fitting can lead to impaired vision, distortion and what is termed image swimming.
Amidst the challenges of the pandemic, many in a decision making capacity would find it easy and perhaps less costly to install a kiosk in the plant or lobby for ordering of safety eyewear. Employees may also be told to find an online service and order eyewear from that particular website without proper information or guidance. Both of these options place the burden on the employee to determine their own eyewear needs.
These options can at first seem more cost effective and efficient, but can easily end up being more time consuming and more expensive in the long run.
Most of these ordering portals offer no communication about job functionality, occupational environment and other precautions. Little or no help is given to fitting and wearability. Workers simply submit their prescription, which may be months or even years old, and select a frame they believe will work for them.
Once the eyewear is received, which can take a week or longer, the user may be disappointed in the end result. The worker’s eyesight could have changed over time and the submitted prescription is no longer viable. This can require the individual to schedule an appointment with an optometrist or eyewear professional to update their needs. It delays their ability to utilize the proper eyewear and can negatively impact their current visual acuity.
The frame design and material may also be different than what was anticipated. It can appear one way in an online graphic and of lesser quality when received. The frames many not be complaint with ANSI and federal regulations. The safety glasses may have to be returned to the seller, again delaying the use of the eyewear. Unlike playing the purchase and return game with home goods, clothing and shoes, the user’s safety and health are at stake and should be treated as such.
Solutions
Safety professionals should consider utilization of an on-site eye safety service as the best option to create, execute and maintain a robust and compliant eye safety program.
In this scenario a skilled optician, or eyecare professional trained in workplace safety and appropriate occupational eyewear, will visit the business, tour the facility and discuss specific job requirements with each individual employee. Those employees will then be fitted for the appropriate frames and lenses that best fit their job needs. All can be done within the company’s guidelines for compliance.
The optician can return to the facility and deliver the final pair of eyewear. They can refit the employee to ensure the prescription and marked frame are as delivered and work precisely as ordered.
Many companies were utilizing a similar on-site option prior to the pandemic. Due to guidelines and constraints many businesses had to curtail this practice. Still some have continued it and others are restarting the practice under the rules of social distancing, individual temperature testing, masks and other precautions.
A second option would be for a service that offers virtual fittings with a professional optician skilled in workplace eye safety. This type of service is new and serves as an “optician-on-demand” where workers can see an eyecare professional online and still get proper fitting for safety glasses.
The patient would have a small eye-care ruler with them to detail their measurements from eye to ear, nose width etc. They would also bring his or her prescription with them to the appointment. The optician can ask questions, analyze the worker’s job and vision needs, and make recommendations for the proper style and frame choice. The service is done remotely and is based on the day and time selected by the patient.
Summary
Education is the key to a robust eye safety program, no matter the situation. Workers operating in less than normal circumstances due to the coronavirus must still understand that eye injuries can happen in an instant. Many injuries are permanent. It will impact everything they do for the rest of their lives.
It is the responsibility of safety professionals and industrial and occupational hygienists to keep up-to-speed on eye safety issues in order to reduce risks and potential corporate liability. Continuing education for all involved is perhaps the most important injury prevention strategy of all.
Dr. Mark Kahrhoff is a founding member and serves as the Managing Director of Complete Eye Safety in St. Louis, MO. Complete Eye Safety is dedicated to helping companies develop a sustainable eye safety company, educate employees on safety and first aid, and help employees achieve maximum visual performance. A veteran of the US Air Force, Dr. Kahrhoff has developed contact lens education programs for Air Force optometrists and ophthalmologists and lectured military physicians on evaluation of eye trauma. He is a lead author and inventor on multiple patent applications filed with the US Patent Office for innovations in ocular drug delivery and regenerative ocular medicine. Dr. Kahrhoff was among the first optometrists to provide platelet rich plasma therapy to patients with dry eye diseases. He has also taught at the University Of Missouri College Of Optometry. For more information visit https://completeeyesafety.com.
¹ CDC archives-source The National Institute for Occupational Safety and Health
² ANSI/ISEA Z87.1-2020: Current Standard for Safety Glasses
³ Computers, Digital Devices and Eye Strain written by Kierstan Boyd and reviewed by James M. Huffman MD, March 2020
₄ OSHA-1910.133(a)(1)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.