PROTECTING EYES: WHAT?

WHAT KIND OF EYEWEAR SHOULD YOU BE WEARING?


BY NOEL BRANDON KELSCH, RDHAP

I watched her put her "readers" on as she sat down with the patient. The glasses that she pushed up over her nose with her gloved hand did not serve a purpose in infection control. They made it easy for her to read. They did not protect her from the debris that may fly into her face and injure her eyes, or protect her from the microorganisms that she was being exposed to during the appointment. I quietly handed her a pair of protective eyewear.

She looked at me sideways and said, "What?"

The Centers for Disease Control and Prevention (CDC) states that all dental health-care professionals (DHCP) should wear protective eyewear. Eyewear should have solid side shields or a face shield. During procedures and patient-care activities likely to generate splashes or sprays of blood or body fluids, DHCP must wear eye protection.

Protective eyewear protects the mucous membranes of the eyes from contact with microorganisms. Infectious diseases can be transmitted through various mechanisms, among which are infections that can be introduced through the mucous membranes of the eye (conjunctiva). These include viruses and bacteria that can cause conjunctivitis (for example, adenovirus, herpes simplex, S. aureus) and viruses that can cause systemic infections, including blood-borne viruses (for example, hepatitis B and C viruses, human immunodeficiency virus), herpes viruses, and rhinoviruses.

Infectious agents are introduced to the eye either directly (for example, blood splashes, respiratory droplets generated during coughing or suctioning) or from touching the eyes with contaminated fingers or other objects. Eye protection provides a barrier to infectious materials entering the eye and is often used in conjunction with other personal protective equipment.1

EYEWEAR FOR THE DHCP

The Organization for Safety and Health Administration requires that all employers supply eye wear or face shield protection for all their employees. They must be impact resistant plastic that is ANSI Z87.1-1989/ ANSI Z87.1-2003 that complies with "American National Standard Practice for Occupational and Educational Eye and Face Protection regulations.2 ANSI is the organization that establishes the performance standards, safety, and effectiveness of the protection that the eyewear has. Side protection must be included in the design and should not be removed. The product should be impact resistant in case sharp or hard debris hits it during procedures.

Each of us needs to look at the equipment we are choosing in infection control. In knowing the "whats" about eye protection, we can keep our patients and ourselves safe.


Some things to remember about eyewear

• Clean and disinfect between every patient and when visibly soiled. If there is the chance of blood or body fluids an intermediate level disinfectant must be use.
• Anytime there is the chance of splash or splatter of blood, body fluids, chemicals, or debris, safety glasses must be worn.
• If ultraviolet irradiation is used, glasses or shields designed for protection must be utilized.
• Look for antifogging properties. This is vital when doing procedures that involve overspray and cavitation.
• Masks that have attached eye protection and clip-on shields can but utilized in place of safety glasses.
• Goggles that fit over glasses are very effective and allow the clinician to utilize their prescription lenses. Employers are not required to provide prescription lenses, only the protective eyewear to fit over the lenses.
• Magnifying loupes can function as eye protection. It is important to have a pair professionally fitted.
• It is vital to choose a pair that is functional and comfortable. Compliance in wearing the protective equipment will largely be determined by the comfort and function. Make sure they do not slip when you are leaning forward and do not need to be adjusted once you are gloved up.
• Eyewear must be clearly marked to facilitate identification of the manufacturer.2 This will allow the DHCP to find out if this is an ANSI accepted product.
• The patients should be supplied with protective eyewear in the dental setting too. This step can protect their eyes from spatter or debris generated during dental procedures.1
• Reusable protective eyewear should be cleaned with soap and water, and when visibly soiled, disinfected between patients.3


REFERENCES

1. www.cdc.gov/niosh/topics/eye/eye-infectious.html.
2. www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9778. accessed 4/2/2012.
3. www.cdc.gov/oralhealth/infectioncontrol/faq/protective_equipment.htm. accessed 4/2/2012.


NOEL BRANDON KELSCH, RDHAP, is a syndicated columnist, writer, speaker, and cartoonist. She serves on the editorial review committee for the Organization for Safety, Asepsis and Prevention newsletter and has received many national awards. Kelsch owns her dental hygiene practice that focuses on access to care for all and helps facilitate the Simi Valley Free Dental Clinic. She has devoted much of her 35 years in dentistry to educating people about the devastating effects of methamphetamines and drug use. She is a past president of the California Dental Hygienists' Association.

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