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#192
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Eye Protection for Infection Control
Published: May, 2009Background
The Centers for DiseaseControl and Prevention (CDC)recommends eye protection for a variety of potential exposuresettings where workers may beat risk of acquiring infectiousdiseases via ocular exposure
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.Eye protection is intended to provide a barrier to infectiousmaterials entering the mucousmembranes surrounding theeye and is often used inconjunction with other personal protective equipment (PPE)such as gloves, gowns, andrespirators.
NIOSH Recommendations
The National Institute for Occupational Safety and Health(NIOSH) has provided thefollowing informationconcerning the use of goggles,face shields, safety glasses, andfull face respirators for infection control purposes intheir publication
EyeProtection for InfectionControl
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Goggles
NIOSH states “appropriatelyfitted, indirectly-ventedgoggles* with a manufacturer’santi-fog coating provide themost reliable practical eye protection from splashes,sprays, and respiratorydroplets. However, to beefficacious, goggles must fitsnugly, particularly from thecorners of the eye across the brow. While highly effective aseye protection, goggles do not provide splash or spray protection to other parts of theface”“* Directly-vented gogglesmay allow penetration bysplashes or sprays; therefore,indirectly-vented or non-ventedgoggles are preferred for infection control.”
Face Shields
Face shields can be a usefulcomplement to goggles in aninfection control situation.While goggles help protect awearer’s eyes from splashes,sprays, and droplets, a faceshield can help reduce theseexposures to the eyes and provide protection to other facial areas. Face shieldsshould have crown and chin protection and wrap around theface to the point of the ear.This will help reduce the possibility of splash, sprays anddroplets from going around theedges of the shield andreaching the eyes or other facial areas. NIOSH states “disposable faceshields for medical personnelmade of light weight films thatare attached to a surgical mask or fit loosely around the faceshould not be relied upon asoptimal protection.”
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Note, for chemical exposuresor industrial settings,faceshields must be used inaddition to goggles, not as asubstitute for goggles (ANSIZ87.1-2003 Practice for occupational and educationaleye and face protection).
Safety Glasses
Safety glasses can help provideeye protection from impacthazards; however, they do not provide the same level of splash or droplet protection asgoggles and generally shouldnot be used for infectioncontrol purposes.
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Full Face Respirators
In the event respiratory protection along with eye protection is needed a fullfacepiece respirator may beselected. A full facepiecerespirator can be used as primary eye protection for impact hazards, as well as,splashes, sprays, and dropletsthat may be encountered in aninfection control situation.
Technical Data Bulletin #192
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Eye Protection for Infection Control
3M Recommendations for workers exposed to patients with suspect or confirmed Influenza A(H1N1)
Unvented and indirectly vented goggles when used properly, can help provide eye protection from splashes,sprays and droplets. Face shields should have crown and chin protection and wrap around the face to the pointof the ear.
If a faceshield is used, a primary means of eye protection, such as goggles is recommended.
WHO and CDC Recommendations for Influenza A(H1N1)
The World Health Organization (WHO) has recommended protective eyewear for healthcare workers providingcare for confirmed or suspected A(H1N1) influenza patients. Additionally, the CDC has issued multipleguidances which included recommendations for protective eyewear for healthcare and emergency medicalservices workers providing care for confirmed or suspected H1N1 influenza patients and laboratory workers.These guidances specify goggles and faceshields as appropriate eyewear for infection control and laboratoryactivities. The complete WHO and CDC guidance documents should be reviewed carefully to understand allrecommendations.
www.who.int
andwww.cdc.gov/h1n1flu/ The following table summarizes the current WHO and CDC recommendations with respect to eye protectionfor personnel engage in activities that may potentially expose them to the influenza A(H1N1) virus.
WHO – Infection Prevention and Control in Health Care in Providing Care for Confirmed or Suspected A(H1N1)Swine Influenza Patients: Interim Guidance
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Situation Personnel WHO Eye ProtectionRecommendationSpecial Guidance
Staff providing care to patients Healthcarestaff “Face protection either a mask andeye visor or goggles or a face shield” NoneDuring Aerosol Generating Procedures Healthcarestaff “Eye protection (e.g. goggles)” None
CDC - Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Swine InfluenzaA (H1N1) Virus Infection in a Healthcare Setting
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Location PersonnelCDC Eye ProtectionRecommendation Special Guidance
Isolation Room Healthcare personnel“Standard and contact precautions plus eye protection should be used.”Donned upon roomentryIsolation Room Visitors “Eye protection” Instructed on use before entering the patient’s room
CDC - Interim Guidance for Emergency Medical Services (EMS) Systems and 9-1-1 Public Safety AnsweringPoints (PSAPs) for Management of Patients with Confirmed or Suspected Swine-Origin Influenza A (H1N1)Infection
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Location PersonnelCDC Eye ProtectionRecommendation Special Guidance
Treating or in close contact with patientswith suspected case of swine fluEMSProviders“Eye Protection (e.g., goggles; eyeshield)” NoneEngaging in aerosol generating activities(e.g. endotracheal intubation, nebulizer treatment, and resuscitation involvingemergency intubation or cardiac pulmonaryresuscitation)EMS personnel“Eye Protection (e.g., goggles; eyeshields)” NoneInvolved in the interfacility transfer of patients with suspected case of swine fluEMS personnel“Eye Protection (e.g., goggles; eyeshield)” None
CDC - H1N1 Influenza Virus Biosafety Guidelines for Laboratory Workers
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Location PersonnelCDC Eye ProtectionRecommendation Special Guidance
BSL2 laboratory Laboratoryworkers“Eye Protection (goggles or faceshields)” None
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