The eyes have it

Feb. 1, 2003
Eye and face protection are required whenever there is a reasonable probability of injury that can be prevented by such equipment.

By Charles John Palenik

Eye and face protection are required whenever there is a reasonable probability of injury that can be prevented by such equipment. It is the employer's responsibility to ensure that employees are properly protected. This may involve several types of eye/face protectors. The goal is to always match the protective equipment with the hazard or hazards present in the workplace.

Protective devices do not provide unlimited protection. All types of personal protective equipment (PPE) have performance limitations and no PPE should be considered a substitute for engineering and work practice controls. Complete protection combines the proper use of PPE with the application whenever possible of effective engineering and work practice controls and the use of machine guards.

Supporting workplace safety and health plans is appropriate for employee training and qualification. When employees are trained to work safely, they should be better able to anticipate and avoid injury from many work-related hazards.

Types of hazards

For dental hygienists, five basic types of occupational hazards require eye/face protection. These include impact, chemicals, dust, heat, and biohazards.

The majority of impact injuries result from flying or falling objects, or sparks striking the eye. Although most of these objects are smaller than a pinhead, they can cause serious injury such as punctures, abrasions, and contusions. Many rotary and hand instrument procedures performed by hygienists place them at risk for impact injuries and/or possible occupational acquisition of disease.

A large percentage of eye injuries are caused by direct contact with chemicals. These injuries often result from the use of improper or ill-fitting PPE. Serious and irreversible damage can be caused by exposure to chemical splashes, mists, vapors, or fumes. When working with chemicals, it is important to always know the location of the nearest emergency eye/face wash stations.

Dust may be present in the workplace during certain operations or with malfunctioning equipment. Working in a dusty environment can cause eye injuries and present additional hazards to contact lens wearers. Fortunately, dusty conditions are uncommon in most dental environments.

Heat injuries may occur to the eye and face when workers are exposed to high temperatures. Burns to eye and face tissue are the main concern when working with heat hazards. The operation of instrument sterilization and certain dental laboratory procedures may place dental workers in proximity to elevated temperatures.

Biohazardous materials, including blood or saliva in the form of spatter, can enter the eye during procedures and can result in both localized and systemic infections. Viruses such as hepatitis B and C can be transmitted due to blood contact with the conjunctiva of the eye. Organisms present in the dental environment can also theoretically cause either viral or bacterial conjunctivitis.

Guidelines for devices

The Occupational Safety and Health Administration (OSHA) requires eye and face protection that meets the American National Standards Institute (ANSI) Standard Practice for Occupational and Educational Eye and Face Protection, ANSI Z87.1-1989 (revised in 1998). ANSI is a private, non-profit organization that administers and coordinates the United States' voluntary standardization and conformity assessment system.

ANSI sets performance standards for eye/face protectors. Tests include cleanability, corrosion resistance, penetration, flammability, light transmission, and three types of impact resistance. The entire protector is evaluated, not just the lenses. Each acceptable component is labeled or identified with an ANSI Z87.1 compliant label.

To assist end users, ANSI offers guidelines for assessing eye/face hazard situations for various occupations and matching protective devices to particular hazards. This information (American Society of Safety Engineers. American National Standard - Practice for Occupational and Educational Eye and Face Protection ANSI Z87.1-1989 [R-1998], 1998, ASSE) is available at books/standards/3322.htm.

Eye and face protection

For dental hygienists there are three types of protectors: safety spectacles, faceshields and goggles.

Safety spectacles are intended to shield the wearer's eyes from hazards, especially impact and chemicals. Employees are required to use eye safety spectacles with side shields when there is a hazard from flying objects. Employers must ensure that employees who wear prescription lenses or contacts use PPE that incorporate the prescription or use eye protection that can be worn over prescription lenses.

Safety spectacles are considered to be primary protectors. They can be worn alone or in conjunction with a secondary protector. Safety spectacles with side and top shields are essential PPE for dental hygienists.

Faceshields are designed to protect all or part of the wearer's face in addition to the eyes. When worn alone, face shields do not protect employees from impact hazards.

Faceshields are considered to be secondary protectors, which means they must be used in combination with primary protectors. Faceshields best protect hygienists from spatter.

Goggles are devices designed to fit the wearer's face immediately surrounding the eyes and form a protective seal. Goggles are primary protectors that are effective against all types of hazards mentioned. Because of comfort, appearance, and ease of use, safety spectacles are usually preferred over goggles.

OSHA has developed a very useful Web page called "Eye and Face Protection eTool" ( htm). The page carefully reviews the selection of eye/face protectors in relation to specific workplace hazards. It also reviews employers' responsibilities concerning eye and face protection.

More information concerning eye and face protection is available from the Organization for Safety & Asepsis Procedures (OSAP). Visit the OSAP website ( icguide97.htm#eye) for a list of internet-accessible resources.

Charles John Palenik, MS, PhD, is an assistant director of Infection Control Research and Services at the Indiana University School of Dentistry. Dr. Palenik has authored numerous articles, book chapters and monographs, and is the co-author of the popular Infection Control and Management of Hazardous Materials for the Dental Team. He serves on the Executive Board of OSAP, dentistry's resource for infection control and safety.Questions about this article or any infection control issue may be directed to [email protected].

Eye and face protection definitions*
ANSI Z87.1-1989 (R-1998) — American National Standards Institute's Standard Practice for Occupational and Educational Eye and Face Protection

engineering controls — controls that isolate or remove hazards from the workplace

faceshield — a protective device usually designed to shield a wearer's face or portions thereof, in addition to the eyes, from certain hazards; faceshields are secondary protectors and should only be used with primary protectors

goggles — primary protective device intended to fit the face immediately surrounding the eyes in order to shield the eyes from a variety of hazards

impact resistance — the ability of a device to withstand impact as required by ANSI Z87.1

personal protective equipment (PPE) — protects employees from serious workplace injuries or illnesses resulting from exposure to a variety of hazards, required when engineering or workplace controls are not feasible or wholly effective; examples include spectacles, goggles, and faceshields

primary protector — a device that may be worn alone or in conjunction with a secondary protector

secondary protector — a device that may be worn only in conjunction with a primary protector

side shield — a device, commonly attached to spectacles, that provides side exposure protection to the eye

safety spectacles — primary protective device that shields the wearers' eyes from a variety of hazards

work practice controls — controls that reduce the likelihood of exposure by altering the manner in which a task is performed

*modified in part from: American Society of Safety Engineers. American National Standard - Practice for Occupational and Educational Eye and Face Protection ANSI Z87.1-1989 [R-1998], 1998, American Society of Safety Engineers.