Business of Medicine
Eyewash Stations: Requirements and Use in Preventing Serious Injuries
Eyewash stations provide on-the-spot decontamination to employees who are exposed to hazardous chemical or biological materials. Delaying eyewash treatment even for a few seconds may cause serious injury to the employee. Understanding risks and taking the appropriate actions to protect employees, including regular training and proper provision of eyewash stations, is critical for healthcare organizations to reduce injuries and avoid financial penalties.
- Ensure that all employees regularly undergo hazardous training that includes first aid instructions for any potential exposure they could face in the workplace.
- Ensure that your healthcare organization has a hazardous workplace prevention policy in place and all employees understand this policy.
- Regularly review any new guidance published by OSHA regarding hazardous workplaces.
Many of us know the pain of accidentally rubbing an eye after touching a lemon or hot pepper, but what if it was something more harmful? What if you were accidentally splashed in the eye with a hazardous chemical or bodily fluid while at work?
According to the Centers for Disease Control and Prevention (CDC), 2,000 workers suffer job-related eye injuries in the United States every day. Employers are required to provide personal protective equipment and establish engineering controls to prevent injuries, but even with the best prevention, accidents happen. Ensuring that immediate and appropriate first aid is available can prevent serious injuries from developing.
The first course of action whenever someone gets a chemical or potentially infectious material in their eye is flushing — which is why it’s vital to have an unobstructed, functional and well-maintained eyewash station nearby.
Common Types of Eye Injuries to Healthcare Workers
Chemical exposure: Healthcare organizations typically use several caustic or corrosive hazardous chemicals that can severely irritate or burn the eyes and in some cases lead to scarring or blindness. A few chemicals that fall into these categories include autoclave cleaners, glutaraldehyde, Lime-A-Way®, drain cleaner and potassium hydroxide. Employers and employees need to be aware of specific hazards, precautionary statements and first aid instructions for every chemical they use in the workplace. That information is provided on the chemicals’ safety data sheet and should be readily available for consultation if an exposure occurs.
Bloodborne pathogen exposure: Healthcare workers can be exposed to blood and other potentially infectious materials while providing patient care. If the exposure route is through a mucous membrane such as the eyes, nose, or mouth, that employee should immediately irrigate the area with clean water or saline. Bloodborne pathogens include but aren’t limited to Hepatitis B, C and HIV.
First Aid Measures and Eye Wash Stations
For chemical exposures, consult the chemical safety data sheet. Many hazardous chemicals require immediate flushing of the eyes with water for at least 15 minutes, occasionally lifting the upper and lower eyelids, removing contact lenses if present, continued rinsing, then seeking immediate medical aid and/or calling a poison center.
For bodily fluid exposure exposures, current literature recommends immediately flushing the eyes with water or a saline wash for at least five minutes. If contact lenses are in place, they should be left in place while flushing because they are a barrier to the eye. Once the eye is thoroughly flushed, the contact lenses can be removed.
Eye Wash Station Requirements
The rule governing the requirement for employers is found in the Code of Federal Regulations at Title 29, Section 1910.151, and is enforced by the Occupational Safety and Health Administration (OSHA). It specifically states, “Where the eyes or body of any person may be exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within the work area for immediate emergency use.”
OSHA refers employers to The American National Standards Institute (ANSI) and the International Safety Equipment Association (ISEA) standard for minimum performance and use requirements for eyewash and shower stations under ANSI/ISEA Z358.1-2014.
Key eyewash station requirements include:
- Located within 10 seconds of hazardous materials
- Have a valve mechanism that protects the unit from contamination and opens in one second or less
- Free from hazards (unobstructed)
- Delivers at least 0.4 gallons of tepid water (60-100º F) per minute for 15 continuous minutes
Eye Wash Station Maintenance
If not properly maintained, water systems and eyewash stations can grow bacteria and other organisms like acanthamoeba, pseudomonas and legionella, presenting serious health hazards to employees. Infections arising from these organisms can affect the eyes, skin, lungs and other tissues with symptoms ranging from redness, drainage, pain, light sensitivity, fever, chills and confusion, and, in worst cases, require hospitalization or lead to death.
Organizations should follow eyewash station manufacturer instructions regarding the frequency and duration of flushing to reduce microbial contamination. At a minimum, eyewash stations should be activated once per week to ensure that water is flushed through the plumbing and the device is working properly. This will also allow fresh water to run through the lines and hardware, decreasing the chances of contamination from stagnant water.
Implementing an eyewash station testing log can ensure compliance and documentation of maintenance efforts. Depending on the environment, organizations might tailor this form to include water clearness, water temperature and any specific instructions from the manufacturer.
OSHA Standard: 1910.151Medical services and first aid.
ANSI/ISEA Z358.1-2014: Quick Compliance Guide
OSHA Info Sheet: Health Effects from Contaminated Water in Eyewash Stations
National Safety Council Article: Contaminated Water in Eyewash Stations
- Ensure that all chemical labels used in the workplace are kept readily available and are provided on the chemicals’ safety data sheet.
- Regularly check in with any employee who is injured on the job, even when they return to work.
- Maintain all documentation and employee communications when an injury occurs within the workplace.
Employers who fail to protect their employees by inadequately maintaining eyewash stations or who do not provide any eyewash stations could face a negligence lawsuit brought by the employee and/or an OSHA violation. Although relatively infrequent, these lawsuits can quickly add up, especially if the employee is found liable and must pay damages to the employee or any financial penalties for an OSHA violation.
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The information provided in this resource does not constitute legal, medical or any other professional advice, nor does it establish a standard of care. This resource has been created as an aid to you in your practice. The ultimate decision on how to use the information provided rests solely with you, the PolicyOwner.