Vision Policy: Safety and Savings
Vision issues are safety concerns when an employee cannot see their work due to an incorrect prescription, improper lighting, affects of dry eye or age related factors. As an eyecare professional I have worked with prescription PPE for the past thirty years and recommended to my clients they establish a comprehensive vision policy for their workforce. To achieve maximum benefits in safety and savings; your vision policy should address 5 segments:
New and current employee prescriptions * Illumination * Contact lenses * Dry eye syndrome * Over age 40 workforce
As safety personnel; you consider many factors to identify and correct hazards which could increase the likelihood an employee suffers a work related injury. Among those factors are the individual’s biomechanics, the equipment operated, and how the job is executed. But when was the last time you considered how that employee sees his or her work? 20/20 is just a measurement of how clear and sharp (acuity) a letter 1 and 7/8 inch tall, projected on a surface, is viewed at a distance of 20 feet. Vision encompasses many aspects besides acuity. Vision includes eye teaming and focusing, color perception, ocular pressure, field of view, internal and external ocular health. Most of us just assume we can depend on our eyes to provide clear sharp vision. Unless our vision starts to fail us.
You have two distinct groups of employees whose vision issues must be addressed. First for new hires, incorporate a procedure in the hiring process in which the prospective employee presents their current eyeglass/contact lens prescription. The FTC mandates that eye doctors provide a copy of a patient’s eyeglass and contact lens prescription at the completion of the vision examination (1). As your prescription PPE professional I can advise you, based on the prescription, if special visual considerations must be addressed.
2. How does your employee’s visual work requirements compare:
Standard prescription lens design for seeing at a distance is normally past arm's length (approximately 32 inches)
Standard length for reading through a line bifocal is between 16 - 18 inches and a line trifocal is set for approximate distances of 18 - 22/23 inches
Progressive bifocals, depending on the prescription strength, will function between 16 and 24 inches
Viewing area for clear sharp vision through a line bifocal is usually between your shoulders while a progressive bifocal area is in between your ears
To ensure your current employee’s safety prescriptions are designed to satisfy the specific working distances (2) related to their job; incorporate into your PPE safety program my vision discovery tool: WIDE (3). Prescriptions which don’t match the job’s vision demands may reduce visual accuracy by as much as 38%. Employee productivity may decline by as much as 9%. For my clients who utilize my discovery tool WIDE, I see zero safety glass remakes (or cost) due to an incorrect eyeglass prescription. Translated; the employee has received the eyeglass prescription for optimum visual performance. Please understand with the over the age 40 group possibly more than one pair of prescription glasses may be required for an employee to execute all of their job responsibilities.
Our eyes see very efficiently in full spectrum light such as sunlight or incandescent lighting (4) However, when our workplace environment incorporates what is defined as partial spectrum lighting our effective visual performance is reduced. Gas discharge lights or fluorescent lights are two examples of partial spectrum lighting. The simple fact is the photoreceptive cones and rods inside our eyes respond to full spectrum sunlight, not to partial spectrum lighting. Workplace illumination is based on the OSHA regulation 1926.56 Illumination (5). Review foot candle illumination in common areas, stairways, hallways, and after individual assessments. I use a model 214 General Electric light meter to measure the existing foot candle levels. This meter is light powered and requires no batteries; the gauge is analogue. This meter can also measure reflectance and transmittance of materials.
At age 20 the Photopic pupil diameter is 5 mm the Scotopic pupil diameter is 8.0
Age 40 4mm 6.0
Age 50 3.5 5.5
Age 60 3.0 4.25
Photopic vision is the response of the eye to radiant energy (light). More specifically, this is the response of the cones in the eye to light. Scotopic vision is the response of the rods in the eye to light, Scotopic vision is the reception of light that regulates the opening of the pupil of the eye.
Dry, red, irritated eyes; we see them everyday. From the computer user to the machine operator and assembler; employees are seeking relief. Dry eye syndrome describes a condition when the eye cannot produce enough tears or tears that are lacking the proper composition. Normally healthy tears consist of three layers. The layers are often described as an outer oily layer, middle watery layer, and an inner mucus layer. Together the three layers are necessary for proper lubrication of the eye. What are the causes of dry eye?
During prolonged levels of concentration the normal blink rate of 20 - 30 times per minute drops to about 5 times . Like when you view a monitor. Environmental factors such as exposure to debris in the work area, or outside workers open to the wind, and effects of cold or heat (sweating). Other contributing factors include contact with chemicals, certain prescriptions and OTC medications reduce tear volume, and less than 6 hours of sleep. As we mature the eye’s natural process is to produce lower levels of tear volume.
How does a dry eye condition affect a business’s bottom line? Dry eye conditions cause blurred vision which in turn affects productivity levels. The dry eye employee may experience a foreign body sensation resulting in time away from work to seek treatment from company personnel and/or medical specialist. Dry eyes are more susceptible to infection affecting your health care treatment costs. Treatment options for dry eye conditions can be as simple as applying natural tears when eyes feel dry and uncomfortable. Consider adding natural tear lubricants in the first aid stations and discussion of dry eye syndrome in your safety training. I recommend the following over the counter natural tear products to relieve dry eye symptoms: Refresh Tears (Allergan), Blink Tears (AMO) , and Alaway (Bausch & Lomb) for allergy sufferers. Modifying work environment to minimize environmental factors is helpful. Employees may seek an eye doctor for corrective measures such as punctual plugs.
According to the US Bureau of labor statistics (6), 43.3% of today’s workforce is over age 44. For employees over the age of 40; visual performance is in decline. An employee over age 40 whose prescription doesn’t match their visual task will alter their posture and the distances vital to their job in order for them to see and complete their work. This results in the employee potentially exposing themselves to risk. In some instances they’re getting too close to their equipment to see their work. Prolonged upper torso bending and head tipping adversely affecting their musculoskeletal health and causing repetitive stress injuries in their backs, neck, or shoulders. I suggest you consider these 6 vision issues to reduce injuries in the over age 40 group:
Presbyopia begins in mid 40’s and progresses to a loss of accommodative function by 60.
Visual acuity is stable up to age 50 then declines
A 60 year old receives only 1/3rd of light to the retina compared to a 20 year old
Pupils become less reactive in low lighting/contrast conditions
Significant Dry eye signs and symptoms are prevalent among this age group
One in five over the age of 65 has impaired vision of 20/60 or less in the better eye (#2)
As of 2003(7); 32.4 million American adults wore contact lenses. Employers who permit employees to wear contact lenses in an industrial environment should consider these aspects. Currently only one general application OSHA standard is in force to specifically address contact lenses worn in an industrial environment. This rule/standard (8) recommends against contact lens use when working with acrylonitrile, dibromo, chloropropane, ethylene oxide, ethylene chloride, and ethylene dianiline chemicals. Your office should review the work environments in accordance OSHA 29 CRF 1910.132 (d) to assess the requirements for protective eyewear.(5).My recommendations is 3 factors should determine if contact lenses are inappropriate for any given area in an industrial environment. Does this area already have a documented history of eye injuries and thus pose a potential hazard to the contact lens wearer? Please note: chemical splashes currently account for 20% of eye injuries and flying debris 70% of eye injuries. Does wearing contact lenses place the eye at greater risk of eye injury? Do contact lenses conflict with any existing safety requirement or strategy? Be sure to identify to both employees and visitors any areas where the use of contact lenses is prohibited and restricted.
Whether you steer a fork lift truck, assemble parts, operate a machine, drive a company vehicle, or use a computer; your eyes are the guiding force. As professionals responsible for employee safety we shouldn’t take for granted employees are seeing as well as they should. The current OSHA 29CRF 1910.132(d) hazard assessment checklist for eye protection(5) doesn’t address if there are unique distances for near and/or intermediate lengths necessary for job execution. Nor is the issue of glare protection considered. My recommendation would be to also include an assessment of illumination requirements and safeguard measures against dry eye syndrome. Employers who permit contact lens usage should have a clear concise contact lens policy in force to guide their business operations and employees. First aid responders with proper training and resources should be capable of safely addressing contact lens issues in the event of an employee injury. An important fact to realize is that in the next seven years the number of employees from age 55 - 64 will increase by 36%. (9) So if your vision policy addresses the 5 segments I have discussed then your employees visual performance will not negatively impact their safety, individual achievement, physical health, or personality. In fact; I believe just the opposite.
Duane A. Perkinson Began private practice in 1974. Own Vision Xperts (613 S. 2nd St., St. Charles, IL 60174 708-686-5266) a practice dedicated to on site prescription PPE services Previous ophthalmic instructor Triton College. Participated in numerous FDA studies of both contact lenses and related solutions. Advisor with Allexperts.com. Have spoken before organizations as Rush Preventive Medicine Chicago, IL, Valley Industrial Safety Association Aurora, IL, Illinois Safety Council Chicago, IL. Website: www.wecare4eyes.com
1. ) The Contact Lens Rule (16 C.F.R. Part 315) and the Eyeglass Rule (16 C.F.R. Part 456).
3. WIDE updated form from www.wecare4eyes.com/WIDE.htm
4. Photopic and Scotopic Vision as Related to Lights by Bud Wood
5. OSHA website
6. US Bureau of labor statistics website from March 2009
7. Vision Council of America’s 2003 consumer barometer www.visionsite.org
8. NIOSH Pub.2005-139Contact lens use in a chemical environment CIB 59
9. Personal Touch by Theresa Y. Schulz June 2009 Occupational Health & Safety magazine
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