The nature and extent of the problem

It is estimated that, every day, 1000 eye injuries occur in American workplaces resulting in $300 million dollars per year in lost production time, medical expenses and worker's compensation. 70% of these injuries are caused by flying particles smaller than a pinhead and one fifth are caused by exposure to chemicals.^[1] While many of these injuries are a result of workers not wearing appropriate eye protection, a significant number of eye injuries are sustained by workers who are wearing appropriately approved eyewear. Of those workers who received eye injuries whilst wearing appropriate eye protection, more than 50% felt that another type of eye protection could have better prevented or reduced the injury suffered.

The Western Australian Department of Occupational Health, Safety and Welfare reported that in 1991-92, eye injuries occurred at the rate of 2.7 injuries per million hours worked, constituted 8.2% of all compensable injuries and resulted in an average of 4.9 working days lost per injury. The risk of eye injury was highest in the construction industry (8.3 injuries per million hours worked) and the manufacturing industry (7.5 injuries per million hours worked ). Power tools, especially abrasive, planing and cutting devices, accounted for 29.2% of reported cases ^[2].

In 1994, OSHA in the US updated its eye protection rules. A significant issue in the review was the recognition that injuries were still occurring when properly selected and approved protective equipment was worn.^[3] The American National Standard on Eye Protection (ANSI Z 87.1 1989) became due for its five year cyclic review in 1995. This is currently underway.

Australian workers' compensation data provide a limited picture of eye injury patterns because many eye injuries require relatively brief treatment, do not result in significant lost time, and do not reach the threshold for reporting in workers compensation statistics.

The Australian Institute of Health and Welfare's National Injury Surveillance Unit (NISU) studied eye injuries presenting to emergency departments of hospitals. This system is based on approximately 50 participating hospitals across Australia. The collection is not representative of a known population, so it was not possible to calculate injury rates. The analysis found a pattern of injury similar to the US. NISU detected 35,228 eye injuries reported in its sentinel injury surveillance system (ISIS) between 1986 and 1994. More than a third (13,595 cases) occurred while the person was on the job, or where the place was an area of production or commerce. Of these, 21% (2861 cases) indicated that eye protection had been worn at time of injury. Eye injuries were often associated with particular types of tools and tasks, namely grinders-where the operation was metal cutting or grinding-and welders. Some high severity incidents, requiring admission to hospital, involved hammering of metal, nail gun projectiles and chemical spillage into the eye.

The analysis showed that:

• Eye protection appeared to be effective in reducing the overall severity of injury with the risk of admission, or the need for follow up treatment, being greatest amongst those not wearing eye protection. There were, however, a number of cases detected where it appeared that relatively severe injuries occurred while protection was being worn.
• Eye protection was more likely to be worn in higher risk environments but that it was likely that, when eye protection was not worn, the injury was more severe due to the higher energy nature of the task involved.
• Portable grinders appeared to be more often associated with injury while wearing eye protection than did other tools. Bench grinders also exhibited similar patterns but not to the same extent.

It was not possible to determine from mass surveillance data the type of eye protection that was being worn at the time of injury or, if it was worn, that the correct eye protection for the task had been chosen. However, the descriptions of events suggested that, not infrequently, injuries occurred while appropriate eye protection was being worn.

Literature on work related eye injuries from the United States indicates that the problem is greatest for the automotive industry.^[4] This is mainly due to the types of exposures and tasks in this industry and suggests that failure to wear eye protection, or its incorrect selection, is the most frequent problem. Fong also argues that Australian Standard 1336 does not specify the correct type of eye protection for hammering operations.^[5] Larger studies in the US point to failure occurring due to particles by-passing the eyewear, rather than impact failure. ^[6] This has also been noted in a South Australian study.^[7] These issues are poorly researched, as the focus of most research is on wearing rates. It is important to ensure that eye protection is effective if greater commitment to wearing the correct protection is to be achieved.

Discussion with Occupational Health and Safety Staff at Mitsubishi Motors Australia (MMAL) and the Adelaide Refinery confirmed that eye injuries are occurring frequently even when approved eye protection is worn. MMAL indicated that up to 50 eye injuries were treated in a week. Adelaide Refinery indicated that eye injuries came in clusters, occurring during construction and maintenance operations when the Plant was shut down. Both companies agreed to participate in a detailed prospective study to determine the causes, and to search for design solutions.