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First aid for the eyes

By Linda Johnson
| www.cos-mag.com

About seven years ago, Dave Rogers was volunteering in a food service trailer at a rodeo near Victoria, when a malfunctioning extraction fan began blowing grease into his face. Another volunteer picked up a bottle of what he thought was water and poured it into his eyes. The liquid turned out to be vinegar.

Someone grabbed the bottles from the eyewash station in the trailer and started to wash the vinegar out of his eyes. When they had used the solution from both bottles, they continued flushing his eyes under running tap water until an ambulance arrived.

“It was very painful,” recalls Rogers, president of Victoria-based BCHAZMAT Management and an instructor at the University of Victoria. “The solution took the sting away right away. All I had left was the red eyes and irritation.”

Small and easily portable, eyewash bottles can be first on the scene at an eye injury. While they do not take the place of a permanent eyewash station, they are an important element of an effective emergency eye injury response.

The fluids in eyewash bottles are normally saline solutions or other isotonic solutions (a solution that causes cells to neither swell nor shrink), says John Morgan, occupational health and safety consultant in Service NL’s OHS Division in St. John’s, N.L. Bottles are used by opening the cap or removing the cover and by using gravity, or squeezing the bottle, to get the solution to flow into the eyes.

Eyewash bottles provide immediate first-aid treatment, allowing flushing of the eye to start within seconds of a substance entering an eye, says Ralph Chou, professor emeritus, School of Optometry and Vision Science at the University of Waterloo in Ontario.

The ability to start flushing fast is vital, he adds. Many substances begin damaging tissues almost immediately. Also, eyewash solutions are buffered to a pH of about seven and so they mitigate the acid or alkaline quality, partially neutralizing the chemical.

“With alkaline solutions, you don’t have time to delay. That stuff will chomp its way through the cornea or the white of the eye and get right into the inside of the eye in seconds,” says Chou.

How quickly someone is able to flush and dilute a harmful substance from the eye will make a big difference in terms of what vision loss he suffers, says Kelly Newhouse, an optometrist at Nelson Family Eyecare in Nelson, B.C.

“Anything that causes damage deep into the cornea can lead to significant vision loss,” she says.

In low-risk situations, where fine dust or smoke are the main hazards, bottles may be enough. According to John Cole, COR quality assurance, B.C. Construction Safety Alliance in New Westminster, B.C., bottles are often used in the construction industry, where workers are exposed to fine particles of dust, sawdust, soil and concrete powder.

“Even wearing a pair of glasses to protect your eyes isn’t going to keep dust out. They do have side shields, but they’re not designed to keep dust out,” he says.

Eyewash bottles are also useful for workers in remote locations, where they can be carried on the person, Newhouse says.

“Workers may not have access to plumbed stations or be able to carry a bigger (self-contained) station.”

Limitations

The main limitation of bottles is size, Chou says. Most hold no more than 1 to 1.5 litres, too little fluid to provide continuous flushing over the recommended length of time.

“The recommendation in standard first aid is that you irrigate the eye with a steady stream of water for a half-hour, minimum. You’re talking tens or even hundreds of litres that are flowing through an eyewash station,” says Chou.

Thus, he says, where eyewashing facilities are required, bottles alone do not meet the regulations employers must fulfill. Workers must have access to a plumbed station. (Length of flushing time depends on hazard severity. ANSI requires an eyewash deliver 1.5 litres of flushing fluid per minute for at least 15 minutes.)

The usefulness of bottles is limited, too, Newhouse says, because most of them have only one spout.

When both eyes are injured, it’s hard to hold the bottle, hold both eyes open and flush both eyes.

“It’s almost impossible for one person to do that,” he says.

Morgan says bottles also fall short of requirements because continuous use requires at least one hand, which restricts the use of both hands to hold the eye open. Also, many eyewash bottles must be held above the eye with the user’s head to the side for flushing to occur.

“This can result in the flushing solution, and any substance being flushed away, to run over the face or head and possibly into the other eye.”

Regulations

In Canada, legislation on eyewash stations tends to be vague, Chou says, leaving it up to safety professionals to determine what is needed. There is no Canadian standard on eyewash stations or specifically on eyewash bottles.

Organizations are generally guided by provincial regulations and the ANSI Z358.1 Emergency Eyewash and Shower Equipment standard. Local regulations generally require that eyewash facilities be provided based on hazards. They may also stipulate training and type and location of eyewash facilities.

Health Canada regulates the production, registration and labelling of solutions, says Ed Maloney, an agent for Kingston, Ont.-based A-Med Supply. Labels must include a lot number, expiry date and NPN (natural product number). Health Canada approval also guarantees the solution inside is sterile.

“(With the NPN), people can trust that Health Canada has approved the ingredients and strength of the ingredients and that it’s safe and effective,” he says.

Before selecting an eyewash solution, a proper hazard analysis should be done, Chou says. Identify the hazard and risk factor; this will help determine what solutions you choose. If the hazards include chemicals, consult the material safety data sheet (MSDS) for recommended first-aid procedures.

The first factor to consider before making a purchase is chemical composition, Chou says. Some solutions have more bacteriostatic qualities, which stop growth of bacteria. The right salt concentration in a saline solution will help prevent damaged tissue from becoming either dehydrated or swollen.

OHS professionals also need to consider bottle size. How big a bottle can easily be handled by a worker? How fast can the contents be applied to an injury? (See sidebar for more.)

The effective use of eyewash bottles requires training, Cole says. First, workers need to understand that bottles are an immediate first aid only. Workers also must know where the eyewash bottles are and how to use them on their own, or on another worker’s, eyes. The injured person will likely be in too much pain to apply the fluid herself.

“The eye has to be held open and the person has to be put in a position where the water will drain across the eye,” he says.

A big problem with bottles is lack of maintenance, says Rogers. It’s important to have a regular schedule of maintenance and inspection. Check solution manufacturers’ expiry dates and replace any bottle that has exceeded that date. Outdated solutions can lose their effectiveness. With bottles filled with water, record the day and time the water is changed, and refill the bottle every week, he says.

Ensure, too, bottles are clean. Rogers says he often finds bottles covered in dust and dirt.

“That’s not what you want when your eyes are injured. You don’t want more dirt in them,” he says.

In addition to checking expiry dates, it’s also important to follow manufacturers’ stipulations regarding the temperature and storage of the flushing solution set.

Linda Johnson is a freelance writer based in Toronto. She can be reached at lindajohnson@sympatico.ca.

BEFORE YOU BUY

Ask these important questions before purchasing eyewash bottles for your workplace.

• What size/volume of eyewash bottle is needed?

• What type of eyewash solution is needed?

• Where will the eyewash bottle be located and stored? This may necessitate the purchase of a wall-mounted holder or bracket.

• How dusty or dirty is the work area where the eyewash bottle is to be located? This may affect the type of holder to be purchased in order to keep the bottle clean.

• What is the expiry date of the preferred flushing solution?

• What design of eyewash bottle is best, given considerations including workers’ average size and the manual dexterity and strength needed to use a given eyewash bottle design?

• What is the normal temperature range of the area where the eyewash bottle will be stored? If necessary, it must be determined how the eyewash solution will be protected from getting too cold or hot.

This article originally appeared in the June/July 2015 issue of COS.


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Comments (1)

  • Supervisor - Paul
    0
    8/25/2017 11:07:01 AM
    Can saline eyewash be used for lime and concrete emergency wash or will lime and saline produce acid?