Contact Lens Management Safety Brief

Current Practice. Recently, a number of groups have issued new guidelines that remove most previous restrictions for wearing contact lenses in the industrial environment. NIOSH has reviewed these new guidelines as well as the limited literature on the use of contact lenses in a chemical environment and the potential absorption and adsorption of chemicals by contact lenses.

Experimental Studies. In general, injury data are lacking to clearly indicate that contact lens wear should be restricted during work with hazardous chemicals; however, appropriate eye protection is always necessary. Only limited research has been conducted on the hazards of wearing contact lenses when working with specific chemicals. Several laboratory studies have focused on absorption and adsorption of acids, bases, and other solvents by contact lenses

In these experimental studies, various lens materials were exposed to chemicals for extended periods using either vials or animals. The results suggest that contact lens uptake and release of chemicals to eye tissue is not likely to be a significant issue for workers wearing contact lenses. However, one similar laboratory in vitro study indicates that isopropyl and ethyl alcohol may pose risks to exposed workers wearing contact lenses.

In all of these studies, researchers examined the resistance of contact lenses to chemical exposures under test conditions. They did not examine actual chemical exposures in workers and did not examine the use of appropriate eye protection simultaneously with contact lens use.  Wearing contact lenses under some circumstances provides workers with a greater choice of eye and face protection (such as goggles or full-facepiece respirators without prescription inserts) as well as better visual acuity. However, the risk is unknown for contact lens wearers compared with non-wearers working with chemicals. Currently, OSHA recommends against contact lens use when working with acrylonitrile, methylene chloride, 1,2 dibromo-3-chloropropane,ethylene oxide, and methylene dianiline. These recommendations are presumably based on best professional judgment, as no specific bases are provided in the OSHA standards.

Recommendations. Current NIOSH recommends that workers be permitted to wear contact lenses when handling hazardous chemicals provided that the safety guidelines listed here are followed and that contact lenses are not banned by regulation or contraindicated by medical or industrial hygiene recommendations. However, contact lenses are not eye protective devices, and wearing them does not reduce the requirement for eye and face protection. The following guidelines for contact lens use in a chemical environment will help occupational safety and health professionals and employers safely implement the contact lens use policy:

1. Conduct an eye injury hazard evaluation in the workplace that includes an assessment of the following:

• Chemical exposures
• Contact lens wear
• Appropriate eye and face protection for contact lens wearers

The eye injury hazard evaluation should be conducted by a competent, qualified person such as a certified industrial hygienist, a certified safety professional, or a toxicologist. Information from the hazard evaluation should be provided to the examining occupational health nurse or occupational medicine physician.  The chemical exposure assessment for all workers should include, at a minimum, an evaluation of the properties of the chemicals in use —including concentration, permissible exposure limits, known eye irritant/injury properties, form of chemical (powder, liquid, or vapor), and possible routes of exposure. The assessment for contact lens wearers should include a review of the available information about lens absorption and adsorption for the class of chemicals in use and an account of the injury experience for the employer or industry, if known.

　

2. Provide suitable eye and face protection for all workers exposed to eye injury hazards, regardless of contact lens wear.

Wearing contact lenses does not appear to require enhanced eye and face protection. For chemical vapor, liquid, or caustic dust hazards, the minimum protection consists of well fitting nonvented or indirectly vented goggles or full-facepiece respirators .Close-fitting safety glasses with side protection provide limited chemical protection but do not prevent chemicals from bypassing the protection. Workers should wear face shields over other eye protection when needed for additional face protection; but they should not wear face shields instead of goggles or safety glasses —regardless of contact lens wear.

3. Establish a written policy documenting general safety requirements for wearing contact lenses, including the eye and face protection required and any contact lens wear restrictions by work location or task.

In addition to providing the general training required by the OSHA personal protective equipment standard provide training in employer policies on contact lens use, chemical exposures that may affect contact lens wearers, and first aid for contact lens wearers with a chemical exposure.

4. Comply with current OSHA regulations on contact lens wear and eye and face protection.

5. Notify workers and visitors about any defined areas where contact lenses are restricted.

6. Identify to supervisors all contact lens wearers working in chemical environments to ensure that the proper hazard assessment is completed and the proper eye protection and first aid equipment are available.

7. Train medical and first aid personnel in the removal of contact lenses and have the appropriate equipment available.

8. In the event of a chemical exposure, begin eye irrigation immediately and remove contact lenses as soon as practical.

Do not delay irrigation while waiting for contact lens removal.

9. Instruct workers who wear contact lenses to remove the lenses at the first signs of eye redness or irritation.

Contact lenses should be removed only in a clean environment after the workers have thoroughly washed their hands. Evaluate continued lens wear with the worker and the prescribing ophthalmologist or optometrist. Encourage workers to routinely inspect their contact lenses for damage and/or replace them regularly.

10. Evaluate restrictions on contact lens wear on a case-by-case basis.

Take into account the visual requirements of individual workers wearing contact lenses as recommended by a qualified ophthalmologist or optometrist.