Eye Protection for Infection Control

The Centres for Disease Control and Prevention (CDC) recommends eye protection for a variety of potential exposure settings where workers may be at risk of acquiring infectious diseases via ocular exposure. This provides background information and specific details on eye protection that can be used to supplement eye protection recommendations provided in current CDC infection control guidance documents. It is intended to familiarize workers with the various types of eye protection available, their characteristics, and their applicable use. Workers should understand that regular prescription eyeglasses and contact lenses are not considered eye protection.

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 (e.g., adenovirus, herpes simplex, Staphylococcus aureus) and viruses that can cause systemic infections, including blood borne viruses (e.g. hepatitis B and C viruses, human immunodeficiency virus), herpes viruses, and rhinoviruses. Infectious agents are introduced to the eye either directly (e.g., 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 (PPE) such as gloves, gowns, and masks or respirators.

The eye protection chosen for specific work situations depends upon the circumstances of exposure, other PPE used, and personal vision needs. There is wide variety in the types of protective eyewear, and appropriate selection should be based on a number of factors, the most important of which is the nature and extent of the hazard. Eye protection must be comfortable and allow for sufficient peripheral vision and must be adjustable to ensure a secure fit. It may be necessary to provide several different types, styles, and sizes. Selection of protective eyewear appropriate for a given task should be made from an evaluation of each activity, including regulatory requirements when applicable. These hazard assessments require a clear understanding of the work tasks, including knowledge of the potential routes of exposure and the opportunities for exposure in the task assessed (nature and extent of worker contact). Exposure incident reports should be reviewed to identify those incidents (whether or not infection occurred) that could have been prevented by the proper use of protective eyewear.

Eye protection should be selected in the context of other PPE use requirements. Safety goggles may not fit properly when used with certain half-face respirators, and similarly, face shields may not fit properly over some respirators. Once PPE requirements have been established for a specific infection control situation, the selected PPE should be pre-tested to assure suitable fit and protection when used as an ensemble. Elastomeric, full face piece respirators and powered air-purifying respirators (PAPRs) have the advantage of incidentally providing optimal eye protection. In situations where all combinations of PPE may not be readily available to workers, judicious selection of complementary PPE is important to allow for appropriate protection.

Source: CDC/NIOSH/Workplace Safety & Health