Eye safety—You can make the difference

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  • GUEST EDITORIALAmerican Optometric Association Eye Safety Project Team:Gregory W. Good, O.D., Ph.D., Jeffrey L. Weaver, O.D., Steven A. Hitzeman, O.D.,Co .D. .D.

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    estimate for sports-related eye injuriesmay be 100,000. Similar eye injurynumbers are found associated with lawn

    ber of eye injuries each year is putting

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    complete list of all companies regis-tered in Ohio was obtained from theBureau of Workers Compensation.

    facturing or construction in its offi-

    152doint occur every workday.2 (This fig-was partially determined using data

    vision at risk for a large number of ourpatients.

    cial State of Ohio name was sent a13-question survey. One hundred

    9-1839/06/$ -see front matter 2006 American Optometric Association. All rights reserved.:10.1016/j.optm.2006.03.003t, on average, 2,000 occupational and garden products. Clearly, the num- Every sixth company that had manu-l. George L. Adams, III, O

    ye safetyYou can

    or the first time in its short hitory, the Healthy People Initia-tive1 has included vision objec-es to help reach its goal for creatingealthier American public. Some ofvision objectives are general in

    ture:1. Increase proportion of persons

    who have a dilated eye examina-tion at appropriate intervals.

    2. Increase the proportion of pre-school children ages 5 yearsand under who receive visionscreening.

    Several are related to specific dis-e entities:1. Reduce impairment from dia-

    betic retinopathy.2. Reduce impairment from glau-

    coma.

    It is easy for practicing optometristsunderstand their roles in helpingericans meet these particular objec-

    es. That is what we do every day inctice.

    There are 2 objectives that deal withe safety, with the goal of reducingventable eye injuries at work and

    me:1. Reduce occupational eye injury.2. Increase the use of appropriate

    personal protective eyewear inrecreational activities and haz-ardous situations around thehome.

    For these objectives, the practicingtometrists role is less obvious and, and William L. Lapple, O

    ake the differenc

    m the National Electronic Injuryrveillance System [NEISS], whichnitors injuries and illnesses treatedemergency rooms. Because the ma-ity of most injuries in the Unitedtes are treated in non-emergencym medical facilities, the originalISS estimate was increased by ap-ximately 2.5 times to arrive at the00 eye injuries per day figure.3)

    ithin industry, the majority of eyeuries occur to workers not wearingy eye protection. The Bureau of La-r Statistics found that in 60% ofcupational eye injuries, eye protec-n was not worn.4 Additionally, fores in which an injury occurred inte of wearing eye protection, mosturies occurred when the wrong typeprotector was used or was improp-y adjusted. When safety equipmentfit and used properly, it is estimatedt more than 90% of eye injuries canlessened in severity or prevented

    tirely.5The number of eye injuries each yearociated with sporting activities is alsoggering. Estimates from the NEISSgram indicate that more than 40,000

    injuries occur and are evaluatedthin emergency rooms each year fromrting activities.6 Because these esti-tes are only from emergency rooms, itogical to assume that the 40,000 num-

    underestimates the actual total byroximately 2.5 times as was de-

    ibed above. Therefore, a better yearlyoptometry doingough?

    th eye injury numbers like these it isy to see why it is so important for

    tometry to be involved in helping pre-t eye injuries whether at home or atrk. As the primary eye care profes-n, optometry should be participatingll levels to help maximize eye safety.

    To help determine how optometry isrrently participating in industrial eyeety, AOAs Eye Safety Projectam sent a short survey dealing withues surrounding safety glasses toarly 1,000 companies in Ohio. A

    Gregory W. Good, O.D., Ph.D.

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    202 Guest Editorialenty-five of the surveys (of 914 sur-ys sent), were completed and re-ned. The results present an interest-

    view of eye safety from thempanys perspective. The results arewn in Table 1.

    That only 34% of the respondingmpanies provide prescription eye-sses at no cost to workers may beprising to many readers. This maym exceptionally low to those of uso believe it is an OSHA require-nt for companies to provide pre-iption devices to all workers. This ist the case, of course. Providingno safety devices that fit over streetsses is sufficient to comply withHA requirements. Therefore, inny cases, if workers want to wearscription safety glasses, there is a

    od chance that they must purchaseglasses themselves. Many compa-

    s provide vision care plans that al-

    ble 1 Vision Survey of Industry

    oes your company provide PRESCRIPTION(Separate from glasses provided throug

    hen a worker requires PRESCRIPTION safetthe safety glasses?

    Specific Eye Doctor/Optical Shop that haWorker required to bring prescription frohere do workers choose, and get measureEyeglass dispensary ON-SITE within compEye Doctor/Optical Shop has signed agreWorkers private eye doctor completes orOtherhere do workers have safety glasses adjusEyeglass dispensary ON-SITE within compEye Doctor/Optical Shop has signed agreWorker is responsible to have this serviceOtherho determines what specific safety deviceIndividual workerSupervisor of individual workerCompany safety personnelAll workers just wear safety glassesuring the past year, have any employees r

    oes your company require pre-employmen

    o you have an eye doctor/vision consultanin your company?

    oes your company have a WRITTEN policy

    re there jobs within your plant for whichworking with chemicals and/or welding

    Note: The above numbers apply only to those* Numbers without % are raw numbers. Notworkers to obtain safety glasses asperiodic insurance benefit. This,wever, would use up the benefits

    that year and not allow coveragedress eyewear.

    The survey also shows that for thejority of cases, workers are responsi-for obtaining adjustments to eyeweartheir own. Although this is not unex-ted, it does illustrate that optometricces can be involved with eye safetyoss a variety of avenues. Determining

    safety glass prescription, orderingety glasses, or adjusting safety spec-les are all opportunities for optometryce personnel to discuss eye safety

    ues with patients at times other thanring comprehensive evaluations.

    e safety discussions

    at can we and our office staffs do tovince patients to wear personal pro-

    y glasses at no charge to employees?Vision Insurance Plan)sses, how does the employee obtain the p

    ned agreement to provide servicesvate eye doctor, prescription safety frames?

    t to provide servicesrm provided by company

    hen they get out of adjustment?

    t to provide servicesvided privately

    required for different jobs in plant?

    ed a safety briefing concerning the eyes a

    on screenings of applicants?

    at has given advice on vision requirements

    ding contact lens wear within your plant?

    earing of contact lenses is NOT allowed?rations.)

    anies that said that safety eyewear was requireuestions had the same number of total responstive equipment when it is appropri-? How can we modify behavior? Tot change health-related behavior for

    r own good, the Health Benefit Models first proposed in the 1950s.7,8 Thisdel explains how individuals must beroached on 4 different levels to insti-

    e long-term change. The model holdsether we are discussing smoking ces-ion, seat belt use, or the wearing ofety glasses. Our discussions with pa-nts should address the 4 levels dis-sed below.

    rceived susceptibility

    r individuals to make a conscious deci-n to routinely wear eye safety protec-s, they must accept the fact that they areceptible to eye injury. Individuals mustieve there is a real threat to their vision

    eye health. Educating patients andrkers on the large numbers of eye inju-

    YES 34.4%NO 65.6%

    iption for

    27.4%62.6%

    3*191621

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    ision? YES 52NO 41YES 8NO 86

    certain jobs YES 6NO 86YES 8NO 84

    involved YES 10NO 79

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    Guest Editorial 203s that occur in the United States eachr is a start; however, individuals need toieve it can happen to them and not justthe other guy. Personal knowledge ofincident is often necessary before indi-uals realize that they are at risk. Havingexample of an injury sustained byeone they know, someone within theirpany, or someone in their hometownbe very useful. Testimonials by celeb-

    es or sports figures can help individualsthat yes, it can happen to me!

    rceived severity

    lieving that the consequences of aninjury can be severe is required be-

    e a change in behavior will be accept-e. Patients and workers must under-nd the overall importance of vision tor everyday lives and that vision loss isssible from injury. Showing slides ofured eyes helps drive home this point.ividuals often dont understand howgile the eyes can be. A small scar to

    skin can have no consequences,ereas the same small scar to the cor-

    can steal vision needed for read-, driving, or working.

    rceived benefit

    ividuals must believe that eye pro-tion does work. No one will wearety glasses if it is generally believedt they serve no protective benefit.ividuals must have confidence thatety glasses can protect the eyesm injury. A demonstration of theghness of a polycarbonate lens can

    lp drive home this point.

    rceived barriers

    rriers to the general wearing of safetysses include cosmesis concerns, com-t, and interference with clear vision.ividuals not accustomed to wearingctacles will eventually adapt to dis-fort behind the ears or subtle visual

    tortions; however, cosmetic concernsll continue to impede compliance withety spectacle wear regardless of thee frame.Representatives of workers shouldinvolved in choosing safety eye-

    ar styles that are most acceptable.ere are hundreds of styles availableay from which to choose. The stylest are most appropriate will dependmany factors including the age andof the workers. A style that looks

    od is more likely to be worn when itneeded for protection.For recreational and home safety,tometrists should stock a wide rangesafety eyewear that is appropriatethe types of hazards that may be

    countered. Different styles are re-ired for basketball than for footballlacrosse. The American Society forsting and Materials (ASTM Section.07, www.astm.org) has developedndards for eye protective devices forcific sports to ensure that the device

    ll protect against the foreseeablezards for different sports.

    hat can I do?

    s important that eye safety issues arecussed with patients at each andery patient visit. Whether discussinge hazards at work, at school, at play,around the home, there are numer-s issues that can be addressed.Be a role model for your neighbor-od. Wear eye protection when work-in the yard or during athletic endeav-

    . Make safety devices available tour patients and try to make eye safetyt of everyday life. This is the methodroached by the U.S. Army in their

    mbat Eye Protection program.9rain as you will fight is the motto.fety glasses are now issued to all sol-rs deploying to southwest Asia andll soon be issued to all basic trainingdiers throughout the Army. Combat

    protection will become part of theiform and will be in place when they

    needed. The U.S. Army has hadmendous recent success in convincing

    manders and soldiers throughout theks of the benefits of routinely wearingtective eyewear.

    Help make the wearing of protectiveewear a habit. Only then can wesure that the protection will be ince when it is needed!mmarytometry can be the go to professionen questions concerning eye safety

    eye injury prevention are raised.lp your patients recognize the hazardsy face and help convince them thaty are at risk. This can be done on anividual patient basis or with generalcussions at safety talks at a local in-stry or school. Have your office per-nel bring up safety issues with everyient. It is our responsibility as THEmary Eye Care Profession to helpure that preventable eye injuries dontur. Do the right thing. Help Healthy

    ople 2010 reach its eye safety goals.u can make the difference.

    ferencesOffice of Disease Prevention and Health Pro-motion, U.S. Department of Health and Hu-man Services. Healthy People 2010. http://www.healthypeople.gov/. Last accessedMarch 1, 2006.National Institute for Occupational Safety andHealth. Eye safety. http://www.cdc.gov/niosh/topics/eye/. Last accessed March 1, 2006.Nonfatal occupational injuries and illnessestreated in hospital emergency departmentsUnited States, 1998. MMWR April 27, 2001;50(16):313-7. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5016a3.htm.U.S. Department of Labor. Accidents In-volving Eye Injuries. Report 597. Washing-ton, DC, Bureau of Labor Statistics, 1980.Prevent Blindness America, 2005. PreventBlindness America fact sheets. http://www.preventblindness.org/resources/factsheets/Preventing_Workplace_Injuries_MK33.PDF.Last accessed March 1, 2006.Prevent Blindness America, 2005. PreventBlindness America Fact Sheets. http://www.preventblindness.org/resources/fact_sheets.html#sports. Last accessed March 30, 2006.Rosenstock IM. Historical origins of thehealth belief model. Health Education Mono-graphs 1974;2(4):470-3.Becker MH. The health belief model andpersonal health behavior. Health EducationMonographs 1974;2(4):324-469.Bye-bye BCGs: The plan to dump those uglyglasses. U.S. Army Times: June 13, 2005, p.14. Army Times Publishing Company.

    rresponding author:

    egory W. Good, O.D., Ph.D., Theio State University, College of Op-etry, 338 West 10th Avenue, Co-bus, OH 43221

    od.3@osu.edu

  • 204 Guest Editorial