Protecting Employees from Work-related Eye Injuries

Occupational injuries to eyes involve the lowest median number of days away from work compared to injuries to other parts of the body, and they occur relatively infrequently with an incidence rate of 2.2 per 10,000 full-time employees.¹ Compare that to injuries to the upper extremities, with an incidence rate of 32.0, the lower extremities (24.9) or to back (18.5) or hands (12.7), and injuries to eyes can seem inconsequential.

Employers may reasonably ask, “Why should I focus my attention on work-related eye injuries when I have so much else to be concerned about?” That’s a good question.

Six Reasons for Employers to Focus on Eye Injuries

Desiring an unblemished occupational health and safety record is a good reason for employers to be interested in preventing eye injuries. Here are six other reasons.

1. OSHA requires it. In 2016, the federal Occupational Safety and Health Administration (OSHA) updated the Eye and Face Protection Standards. OSHA requires employers to ensure employees use appropriate eye and face protection when exposed to hazards from flying particles, molten metal, liquid chemicals, acids or caustic liquids, chemical gases or vapors, or potentially injurious light radiation.
2. Most eye injuries and resulting lost work time can be prevented. More than 65,000 work-related eye injuries are reported annually and 90 percent of those could be avoided by wearing proper eye protection.²
3. Eye injury can be a sign of employees who are at risk for other occupational injuries. A study by researchers at the University of Alabama-Birmingham found that the risk of eye injuries is not just a function of not wearing eye protection, but also often indicates employees who are distracted, unfamiliar with a task, feeling rushed or fatigued, or either lacking knowledge in use of a tool or using poorly maintained tools and equipment.³
4. Workplace eye injury offers a teachable opportunity. Another study by the same University of Alabama research team provided a silver lining. After an eye injury, employees are more likely to wear eye protection in the future – whether or not they were wearing it at the time of the initial injury – making this type of injury a teachable moment for clinicians and employers to help prevent future eye injuries to others.⁴
5. Certain industries and occupations are naturally at higher risk for eye injuries and require extra vigilance. The National Eye Institute, National Institute of Occupational Safety and Health (NIOSH), the Centers for Disease Control and Prevention (CDC), and the National Safety Council have concluded that industries and occupations at high risk for eye injuries include construction, manufacturing, mining, carpentry, auto repair, electrical work, plumbing, welding, and maintenance.5 These organizations recommend a combination of engineering and administrative controls, wearing proper eye safety protection, and conducting regular workplace assessments of hazard risks, as well as educational programs and training.
   
   NIOSH, which provides an Eye Safety Tool Box Talk and Instructor’s Guide, says that “even ‘minor’ eye injuries can cause life-long vision problems and suffering; a simple scratch from sawdust, cement, or drywall can cause erosion of the cornea (the clear front surface of the eye with five layers from front to back) that is recurrently painful.”6 In construction, the industry with one of the highest rates of eye injury, eye safety is at risk during hammering, grinding, sanding, and masonry work. In other occupations, handling chemicals and welding arcs and flashes are contributors to work-related eye injuries.
6. Eye injuries may be OSHA recordable. Maja Jurisic, MD, CPE, Concentra vice president and medical director for strategic accounts, provides a thorough explanation of OSHA recordable work injuries in a recent Concentra webinar . She says that if an injury (including eye injury) is limited to first aid treatment and there are no days away from work, job transfer or job restriction, and no loss of consciousness, there is no need to include the injury on the employer’s OSHA 300 log. Eye injury is defined as limited to first aid treatment when a foreign body is removed without using instruments, only a swab or irrigation.^{7, 8}

OSHA enforcement regularly imposes fines for failure to provide proper eye protection. There have been numerous instances in 2019, particularly in construction and manufacturing. Providing personal protective equipment (PPE), training employees in its use, and regularly inspecting PPE are important measures to follow.

Guidance for Selecting Eye Injury Protection

OSHA describes five types of eye injury protection for general industry, maritime, and construction. They are:

• Impact protection
• Heat protection
• Chemical protection
• Dust protection
• Optimal radiation protection

Employers can learn the vital design features of safety spectacles, safety goggles, and face shields by using OSHA’s Eye and Face Protection eTool for each of these types of eye injuries, as described here:

Impact injuries occur from flying or falling debris, objects or sparks. Even something as small as a pinhead can cause serious eye punctures, abrasions, and contusions. When there is a hazard from flying objects, employees are required to wear eye safety spectacles with side shields. Safety goggles also provide protection from flying objects, large chips and particles. A good fit and protective seal around the eyes are important. To protect employees from impact hazards, face shields must be worn in combination with safety spectacles or goggles; a face shield alone is not adequate protection. The OSHA site shows examples of acceptable protection.

Heat injuries occur when the eyes and face are exposed to hot temperatures. They can also occur when molten metal is splashed or around flying sparks. The OSHA eTool describes the special-purpose lenses and side shields needed to prevent eye injuries. Face shields must be heat-reflective and wire screens to protect the entire face. Face shields are described as “secondary protectors” not because they are secondary in importance, but because they are required to be used with safety spectacles or safety goggles.

Chemical injuries occur largely through direct contact with chemicals as a splash, mist, vapor, or fume. Chemical injuries can be serious and irreversible. Employers who use chemicals must provide emergency eyewash stations that can be accessed when vision is compromised. The eTool gives examples of acceptable eye protection to guard against chemical injury. “Chemical burns with alkali-containing products, that is, a pH of greater than 7, such as drain cleaners, cause more severe burns than acids,” says Dr. Jurisic. “The eyes must be irrigated right away in the workplace. With any significant ocular exposure to alkali or acid, continuous irrigation with water or saline is recommended until a natural pH is achieved in the eye. Irrigation that begins at the worksite is continued at the clinic. It may take 30 to 60 minutes to normalize pH for most eye exposures.”

Dust injuries are a risk in many work environments; woodworking is an example. Safety goggles are the primary protectors against a variety of airborne particles and harmful dust. Employers can find specifications for lens, frame, and ventilation of safety goggles by using the eTool.

Radiation injuries are a particular risk for welders and health care employees who work with lasers, among other occupations. Unprotected laser exposure can lead to burns on the retina (tissue at the back of the eye that processes light), cataracts, and blindness. The eTool provides the minimum protective shade of filter lenses for general industry, maritime industry, and construction. In welding, welding helmets are secondary protection to be used in conjunction with safety spectacles or safety goggles.

Can Eye Injuries Lead to Blindness?

Approximately 10 to 20 percent of work-related eye injuries will cause temporary or permanent vision loss. Partial blindness means there is still some limited vision. The leading causes of work-related vision loss are accidents or injuries to the surface of the eye, such as chemical burns or severe head trauma.¹⁰

Where can I go for eye injury treatment?

Concentra medical centers follow uniform standards and guidelines for the treatment of eye injuries. Vision acuity is checked using the Snellen chart. If either eye has been exposed to chemicals or has an unembedded foreign body, Concentra clinicians use the Morgan lens eye irrigation system after instilling anesthetic eye drops. Concentra treats work-related eye injuries from chemical burns, radiation burns, foreign bodies, contusions, lacerations, and projectile injuries. An employee with an eye injury may be referred to an ophthalmologist for additional care.

Find a local Concentra Medical Center

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Notes

1. “Type of injury or illness and body parts affected by nonfatal injuries and illnesses in 2014,” The Economics Daily, U.S. Bureau of Labor Statistics, December 2, 2015. Accessed November 4, 2019.
2. Peate WF. Work-related Eye Injuries and Illnesses. American Family Physician. April 2007. 75(7): 1017-1022. Accessed November 4, 2019.
3. Blackburn, J, Levitan EB, MacLennan PA, Owsley C, McGwin G. A Case-Crossover Study of Risk Factors for Occupational Eye Injuries. Journal of Occupational and Environmental Medicine. January 2012; 54(1): 42-47. Accessed November 4, 2019.
4. Blackburn JL, Levitan EB, MacLennan PA, Owlsley C, McGwin G Jr. Changes in eye protection behavior following an occupational eye injury. Workplace health and safety. September 2012; 60(9): 393-400. Accessed November 4, 2019.
5. “Preventing Work-related Eye Injuries.” Information sheet from National Eye Institute of the National Institutes of Health, National Occupational Safety and Health, Centers for Disease Control and Prevention, and the National Safety Council. Accessed November 4, 2019.
6. “Eye Safety,” The National Institute for Occupational Safety and Health. Accessed November 4, 2019.
7. Concentra’s “OSHA Recordable Injuries” Webinar, August 2019. Presented by Maja Jurisic, MD, CPE, vice president and medical director.
8. “Understanding and Applying the Definition of an OSHA Recordable,” October 2019.
9. Eye Safety at Work, Prevent Blindness. Accessed November 4, 2019.
10. “Blindness and vision loss,” MedicinePlus, U.S. National Library of Medicine. Accessed November 4, 2019.