Use Of Protective Eyewear Research Articles

Knowledge, beliefs and attitudes of squash venue operators relating to use of protective eyewear

Sports venues are in a position to potentially influence the safety practices of their patrons. This study examined the knowledge, beliefs and attitudes of venue operators that could influence the use of protective eyewear by squash players. A 50% random sample of all private and public squash venues affiliated with the Victorian Squash Federation in metropolitan Melbourne was selected. Face-to-face interviews were conducted with 15 squash venue operators during August 2001. Interviews were transcribed and content and thematic analyses were performed. The content of the interviews covered five topics: (1) overall injury risk perception, (2) eye injury occurrence, (3) knowledge, behaviors, attitudes and beliefs associated with protective eyewear, (4) compulsory protective eyewear and (5) availability of protective eyewear at venues. Venue operators were mainly concerned with the severe nature of eye injuries, rather than the relatively low incidence of these injuries. Some venue operators believed that players should wear any eyewear, rather than none at all, and believed that more players should use protective eyewear. Generally, they did not believe that players with higher levels of experience and expertise needed to wear protective eyewear when playing. Only six venues had at least one type of eyewear available for players to hire or borrow or to purchase. Operators expressed a desire to be informed about correct protective eyewear. Appropriate protective eyewear is not readily available at squash venues. Better-informed venue operators may be more likely to provide suitable protective eyewear.

Protective eyewear promotion: applying principles of behaviour change in the design of a squash injury prevention programme.

Eye injuries in squash have the potential to be severe. Although these injuries can be prevented through the use of protective eyewear, few players wear such eyewear. The aim of this paper is to outline the behavioural principles guiding the design of a squash eyewear promotion initiative, the Protective Eyewear Promotion (PEP). Ecological principles of behaviour change were used to provide a comprehensive perspective on intrapersonal factors, policies and physical environmental influences of protective eyewear use. Results of baseline player surveys and venue manager interviews were used to provide relevant and specific intervention content. At baseline, protective eyewear was not found to be readily available, and players' behaviours, knowledge and attitudes did not favour its use. The main components of PEP involved informing and educating both players and squash venue operators of the risk of eye injury and of appropriate protective eyewear, as well as assisting with the availability of the eyewear and offering incentives for players to use it. A structural strength of PEP was the strong collaborative links with the researchers of different disciplines, the squash governing body, eyewear manufacturers, squash venue personnel, as well as players. Attempts were made within the project structure to make provision for the future dissemination and sustainability of more widespread eye injury prevention measures in the sport of squash.

Have the attitudes of Australian squash players towards protective eyewear changed over the past decade?

Objective: To assess indicative trends in the use of protective eyewear by Australian squash players and their attitudes towards its use since 1989. Methods: Data were extracted from three Australian...

Improved compliance with universal precautions in the operating room following an educational intervention.

Observation of surgical personnel in four specialties (cardiothoracic, general, gynecologic, and orthopedic) in the operating room was performed prior to implementation of an educational intervention designed to improve compliance with Universal Precautions and at 1- and 2-years post-intervention. Use of protective eyewear and double gloving increased following the intervention, whereas the incidence of documented blood and body fluid exposures decreased.

Corneal Foreign Bodies—First Aid, Treatment, and Outcomes

Eye injuries from foreign body incidents remain prevalent in the workplace setting. Often the professional nurse provides the first line of treatment. The informal class presented at the authors' facility offered a comprehensive, organized presentation of a common injury encountered in the practice of occupational health nursing. Strenghts of the presentation included handouts demonstrating eye eversion technique and a flip chart summarizing the content to be placed in each medical station as quick reference. One challenge involved presenting the information to all nurses. The site encompasses four locations and some nurses function as the only staff in the plant for a given shift. With the support of administration and some creative scheduling, 10 of 17 nurses attended one of three classes offered in one morning, and the remaining 7 were able to view the class on videotape. Videotaping the presentation also provided material for future orientation, as well as an opportunity for review. Overall analysis found this a worthwhile offering relevant to practice. A brief formal written evaluation indicated the objectives for the class were achieved and elicited subjects for future topics. Informal chart reviews to check for documentation of visual acuity testing and eversion of the upper lid for foreign body injuries is another outcome measure currently in progress. In addition, a performance improvement project could be accomplished easily by retrospective chart review of assessment and treatment documentation, and tracking of revisits and referrals. Knowledge of current standards in the assessment, first aid, and treatment of eye injuries is every occupational health nurse's responsibility. However, prevention of foreign body injuries is far superior to any treatment modality available. As highly visible leaders within the occupational setting, nurses can be advocates and role models for safe work practices. Occupational health nurses may promote safe eye practices by actively seeking collaboration with safety departments to continuously monitor and improve eye injury and outcome statistics and use of protective eye-wear. By consistently wearing proper safety eyewear, such as approved goggles or prescription safety glasses with side sheilds, during each and every venture into the work area, occupational health nurses provide a strong role model and have the opportunity to educate employees and encourage safe work practices. It is important to encourage shared responsibility and awareness between workers and management for prevention of foreign body incidents and prompt, accurate treatment when necessary to promote optimal outcome.

Ocular sports injuries: the current picture

Objectives—To determine the recent incidence of eye injury due to sport in Scotland, identify any trend, and establish which sports are responsible for most injury? The type of injury and...

A protocol for eliminating virtually all eye injury accidents in laser products and experimental laser systems

A general design Protocol is proposed to essentially eliminate a major cause of laser injury accidents. The use of protective eyewear for primary protection is discouraged by requiring that systems be designed to be Class I in all operating modes. The Protocol applies primarily to the laser product manufacturer. However, the Protocol may be applied in the laboratory where “open beam” optical systems are being developed. To minimize the likelihood of laser injury accidents in these systems, additional protective rules must be followed. For controlling the injury potential environment, an alternative to the standard operating procedures (which has never been standardized), called a sequence of events, is proposed to support the Protocol application.

Evaluation of a Preclinical, Educational and Skills-Training Program to Improve Students' Use of Blood and Body Fluid Precautions: One-Year Follow-up

Background. Little is known about long-term improvements in medical students' knowledge, attitudes, and use of blood and body fluid precautions following preclinical training.Methods. We evaluated an educational and skills-training program emphasizing double gloving for high-risk surgical procedures. Baseline surveys measuring knowledge, attitudes, and readiness to use specific precautions were completed by second-year (experimental) students before skills training and by third-year students (control) after their first clinical year. Follow-up surveys were completed 1 year later. Use of double gloves and protective eyewear during surgery clerkships was observed at baseline and follow-up.Results. Of 149 students returning both surveys, the experimental group (n = 91) showed improvements in attitudes toward double gloving (P = 0.038) and use of double gloves during surgery at follow-up (relative risk = 1.95, 95% confidence interval = 1.06, 3.59). They expressed better attitudes toward (P = 0.003) and greater readiness to use (P = 0.020) double gloves compared with controls at follow-up. They expressed better attitudes toward (P = 0.002) and greater readiness to use (P = 0.001) double gloves compared with controls when each had completed their first clinical year.Conclusion. The intervention was associated with improved attitudes toward and use of double gloves during surgery. The experimental group also expressed better attitudes and readiness to use double gloves compared with controls at follow-up.

Demography and prognostic factors of ocular injuries in South India.

To evaluate the extent of visual recovery after multi-disciplinary approach of treatment in serious ocular injuries; to determine the prognostic factors associated with poor final visual outcome and suggest adequate precautionary measures. A retrospective analysis of 325 consecutive patients with direct ocular trauma who were examined and treated at a tertiary eye care centre in South India over a 3-year period was undertaken. Males (86.8%) outnumbered the females (13.2%) and children (< 16 years) constituted 46.8% of the total affected population. Anterior segment was involved in 51.1%, the posterior segment in 8.9% and both anterior and posterior segments were involved in 31.4% of patients. Prompt and meticulous surgical treatment restored useful vision (better than or equal to 6/18) in 60.5% of patients. Post-treatment, a reduction in blindness and visual impairment rates in the affected eye with respect to WHO classification was 66.7 and 54.1% respectively (P < 0.0001). Two eyes needed prompt enucleation. The factors associated with visual impairment (visual acuity less than 6/18) were poor initial visual acuity, full chamber hyphema, endophthalmitis, retinal detachment, and vitreous haemorrhage. Direct ocular trauma remains an important potentially preventable cause of ocular morbidity, but the advent of modern surgical techniques can often restore useful vision in such situations. Mandatory use of protective eye wear at work, public health education including awareness on the part of parents to the potential dangers of some childrens' toys can to an extent help reduce ocular morbidity due to direct ocular trauma.

EYE SAFETY IN THE PEDIATRIC POPULATION

A certain number of severe eye injuries in children always will occur on a random basis that are both unpredictable and unpreventable. Every ophthalmologist has seen the tragic results of a sharp stick thrust at a playmate, a carelessly thrown stone, or the inadvertent slip of a sharp knife. Sadly, we have no way to prevent these types of unfortunate accidents. The majority of eye injuries in children and adolescents, however, are both predictable and preventable. They represent needless suffering and loss of vision that is often avoidable, and, in reality, most of these injuries should not occur. Every responsible adult, whether a physician, parent, teacher, or coach would agree with a simple and universal statement regarding our children's safety: All children deserve to live in a safe environment. 5 Individually, and as the group ultimately responsible for our children's well-being, we encourage an active lifestyle for them, beginning in early childhood and, hopefully, continuing through their adolescence, as adults, and into their senior years. In our role as ophthalmologists, we have an obligation to help make this active lifestyle as safe as possible, with particular emphasis on the protection of vision and promotion of eye safety. 10 Recent statistics reveal an alarming increase in sports-related eye injuries over the last 3 years, with the incidence increasing from 41,000 in the mid-1990s to over 100,000 in the latest report. 1 Obviously, there were many other abrasions, contusions, and foreign body injuries that were never seen in emergency rooms and therefore not reported, but that may have also involved serious eye injury. Parents, teachers, and coaches need to be aware of the potentially dangerous situations at home, in school, and with sports activities, and must gain an understanding and knowledge of the safeguards available to prevent eye injuries. It is estimated and generally accepted that 90% of these eye injuries could have been prevented by the use of protective eye wear. Because eye injuries are the leading cause of blindness in children, and sports are the major cause of eye injuries in school-age children, the challenge is clear. The sports most commonly associated with eye injuries in children and young adults are baseball, basketball, soccer, football and hockey. Baseball causes the greatest number of eye injuries in children between the ages of 5 and 15 (21%), whereas in basketball, injuries occur more frequently in older teens and the young adult population between 15 and 24 years of age (32%). 3 It is alarming that nearly three fourths of sports injuries were to patients under age 25, and 40% were to patients under age 15. Not surprisingly, the majority of these injuries were in young males who are particularly susceptible to injury because of their fearless manner of play and athletic immaturity. For example, although a 12-year-old boy does not have very good aim or control, he can throw a baseball at 70 miles per hour. Ophthalmology has played an important role in helping to reduce the incidence of ocular injuries in sports, beginning with the efforts to require the use of face and eye protection in ice hockey in Canada in the early 1970s. Appropriate protective masks or goggles are now recommended for any sport with small balls moving rapidly or with force and include primarily baseball, racquet sports, hockey, and lacrosse. Injuries from elbows, hands, and fingernails are also very common in basketball and other contact sports. Use of protective helmets for batters in baseball was initiated around 1980, and the modification and enforcement of game rules and the required wearing of certified eye protection have been shown to dramatically decrease the incidence of eye injuries in this and other sports. Cooperation between ophthalmologists and manufacturers when identifying the mechanisms of injury have helped to develop eye protection devices that are effective and interfere minimally with play. 12

Head and face injuries in scholastic women's lacrosse with and without eyewear.

The use of protective equipment has been absent or inconsistent in scholastic women's lacrosse leading to increasing concern for eye and head injury. There is a paucity of field data, however, on which to base strategic decisions on how best to prevent head injuries in young athletes. This study examined the effects of protective eyewear on injury rates in scholastic women's lacrosse in a cohort of approximately 700 varsity and junior varsity players in central New York studied prospectively for 2 yr during a transition from sparse to almost complete eyewear use. The overall head/face injury rate was 0.71 injuries per 1000 exposures (games and practices) and was 16.5% lower in goggle wearers. In games alone, where more aggressive play and stick use prevails, the rate associated with protective eyewear use was markedly lower (51%). Considering specific regions, the rates for peri-orbit and forehead injuries among goggle users were substantially lower than for nonusers (6% and 13%, respectively). Cheek and scalp injury rates tended to be higher among goggle wearers, but not statistically significantly so. Significant compensatory increases with goggle wear at other sites were not observed. Only a few injuries appeared to be mediated by the goggles themselves and potentially could have been more serious if the goggles had not been present. No direct eye (orbit) injuries were reported throughout the study period. On balance, then, the use of eyewear in women's lacrosse appears to be beneficial when users are compared with nonusers.

Baseball hardness as a risk factor for eye injuries.

Baseball is the leading cause of sports-related eye injuries in young persons. It is known that softer baseballs reduce the potential for brain and cardiac injury, but it has been speculated that softer baseballs may increase eye injuries by intruding more into the orbit. It also has been claimed that softer baseballs would change the "feel" of the game. To determine the orbital intrusion and eye injury potential of baseballs of varying hardness, and whether a player can feel the difference between these different baseballs. Orbital force and penetration of baseballs of various hardness into an artificial orbit. Ability of subjects of varying age and baseball experience to determine the hardness of baseballs. The peak orbital force and force onset rate from softer baseballs, at all impact velocities, were less than the force and force onset rate from baseballs that had hardness equal to, or greater than, major league baseballs. The softest (10% of major league hardness) baseballs intruded into the orbit significantly more than balls that were 15% of major league hardness or harder. Children younger than 14 years could not differentiate balls 15% of major league hardness or harder, and adults could not differentiate 20% of major league hardness or harder from each other or from major league balls. The potential for injury to the unprotected eye from soft baseballs is significant, but not greater than that from a major league baseball. Baseballs that are 15% to 20% of major league ball hardness are recommended for youth baseball because these balls feel like major league balls, reduce the potential for brain injury and commotio cordis, cause less pain on impact, and do not increase the potential for eye injury to the unprotected player. Eye injuries in youth baseball could be minimized by the use of protective eyewear that conforms to the standard specifications of the American Society of Testing and Materials (Philadelphia, Pa), standards F910 (for batters and baserunners) and F803 (for fielders).

Hepatitis B prevalence and infection control among dental health care workers in a community in South Korea.

The objectives of this study were to investigate the prevalence of hepatitis B vaccine and use of infection control procedures by dental health care workers in Taegu, South Korea. Information was obtained with a mailed questionnaire sent to 300 private dental practices. Surveys were received from 177 dentists, 104 dental hygienists, and 46 dental assistants. All dental health care workers were asked to donate a blood sample for analysis of hepatitis B surface antigen (HBsAg) and antibody (anti-HBs). Vaccination against hepatitis B virus was reported by 63 percent of the respondents. About 40 percent of all participants answered that they were anti-HBs positive, while another 43 percent did not know their status. About 89 percent of dentists reported that they wore a mask with all patients, while hygienists (13.6%) and assistants (13.0%) were less likely to do so. Reported use of gloves (4.5%) and protective eyewear (14%) with all patients was extremely low in every group. Among the 56 dentists who were tested for HBV markers, 23 did not receive the vaccine against hepatitis B, and 13 percent (3 of 23) were positive for HBsAg as carriers. About 37 percent (120 of 327) of dental health care workers surveyed in this study in Korea did not receive the vaccine against HBV infection. Basic barrier techniques to prevent cross-contamination were not being used consistently. Nationwide guidelines for barrier techniques and hepatitis vaccinations should be developed and disseminated to dental personnel.

Ocular trauma following penetrating keratoplasty: incidence, outcome, and postoperative recommendations.

The surgical wound after penetrating keratoplasty is more vulnerable to contusive trauma than the intact cornea. To assess the incidence of ocular trauma following penetrating keratoplasty, and to evaluate its causative factors, management, and visual outcome. Tertiary referral facility in a fairly closed population. Retrospective study assessing ocular injuries of all 559 patients who underwent penetrating keratoplasty in the center between September 1986 and March 1993. Fourteen (2.5%) of 559 patients who underwent penetrating keratoplasty, over a period of 78 months, suffered surgical wound dehiscence because of contusive ocular trauma. The mean age of the patients (30.6 years) was significantly lower (P<.001) than that of the total number of patients who received transplants (49 years). The interval between transplantation and trauma ranged from 2 weeks to 2 years (mean interval, 6.7 months). In 11 of the 14 patients the trauma occurred prior to removal of sutures. Globe rupture occurred at the donor-recipient interface in all of the patients, accompanied by vitreous and lens loss in 8 patients (57%). In 2 patients (14%) trauma included disruption of retinal tissue resulting in poor visual outcome. The trauma occurred most often at home (in 7 patients). After follow-up periods of 1 to 6 years (mean, 29 months), the corrected visual acuity ranged from 20/120 to 20/20 in 12 patients (86%). Ocular injury following penetrating keratoplasty is not a rare event. Since corneal graft wound is vulnerable to ocular trauma, we recommend the constant use of protective eyewear and periodically instruct the patients on the long-term vulnerability of the graft wound. Patients should be repeatedly cautioned against high-risk environments and strenuous activity.

What do adult squash players think about protective eyewear?

OBJECTIVE: To determine the attitudes of adult squash players towards protective eyewear. METHODS: A survey of 197 competition and social squash players from seven squash centres in the outer eastern...

Improved compliance with recommended infection control practices in the dental office between 1994 and 1995

Objective: To investigate changes in Ontario dentists’ infection control practices between 1994 and 1995. Methods: Data from responses of 4003 dentists to a 1994 survey and responses of 987 dentists to a 1995 survey were compared by using descriptive statistics from all respondents and McNemar’s test for paired data from those participating in both surveys. Results: Response rates were 70% (1994) and 62% (1995). There were improvements in reports of routine use of gloves (92% to 94%); masks (73% to 79%); and protective eyewear (83% to 84%); vaccination for hepatitis B virus (HBV) or naturally acquired immunity of dentists (93% to 94%); HBV vaccination of clinical staff (64% to 77%); heat sterilization of handpieces (83% to 95%); and no extra precautions for patients with HIV (13% to 48%). Pairwise comparison of data for 788 dentists participating in both surveys showed statistically significant increases in reports of all practices except use of protective eyewear. The 1995 follow-up data also indicated low compliance with handwashing (74% before treating each patient; 62% after removing gloves); flushing water lines after treating each patient (54%); and using postexposure protocol for needlesticks and cuts (36%). Conclusions: Dentists’ reports of compliance with recommended infection control practices and universal precautions against HBV and HIV infection increased between 1994 and 1995, but most dentists apparently have not adopted universal precautions. More education is needed to promote universal precautions, HBV vaccination for clinical staff, handwashing, and postexposure protocol. (AJIC Am J Infect Control 1998;26:24-28)

Noncompliance with universal precautions and the associated risk of mucocutaneous blood exposure among Danish physicians.

To study the compliance, and reasons for noncompliance, with Universal Precautions and the associated circumstances of mucocutaneous blood exposure (MCE) among Danish physicians. A nationwide questionnaire survey. All Danish hospitals. All hospital-employed physicians. Of 9,384 questionnaires, 6,256 (67%) were returned, and 6,005 were eligible for analysis. Only 35% of respondents were compliant with the basic principle of Universal Precautions. Compliance with specific barriers in the preceding week among "surgeons and pathologists" and "other physicians" was as follows: gloves, 63.0% and 23.4%; masks, 55.2% and 17.6%; and protective eyewear, 11.5% and 4.0%, respectively. Common arguments for non-compliance were "interferes with working skills," "forget," "wear spectacles," "not available," "too much trouble to get," or "gloves do not fit." Detailed descriptions of 741 MCEs were obtained. Blood splashes in the eyes (n = 320) was the most common MCE in surgical specialties and pathology, whereas blood on the hands (n = 290) was most common in other specialties. In 20% of MCEs of the eyes, the exposure occurred despite the use of spectacles. An estimated 84% to 98% of MCEs potentially would have been preventable had appropriate barriers been worn. More than one half of MCEs were preventable by two interventions only: compulsory use of protective eyewear during operations and use of gloves during insertion of peripheral intravenous catheters. Compliance with Universal Precautions is unacceptably low, as reflected by the circumstances of MCE. Increased efforts to ensure education in Universal Precautions, easy accessibility of protective barriers, and improved design of the barriers are necessary to improve compliance and reduce the risk of MCE.

Eye trauma in children: Epidemiology, management, and prevention

Eye injuries in children are frequently evaluated by nurse practitioners. The child with serious eye trauma is quickly assessed and referred to an ophthalmologist. However, many of the cases are managed in the ambulatory setting. Appropriate and swift management of eye trauma is essential to ensuring optimal outcome for the child. In addition, pediatric nurse practitioners play a critical role in educating children, families, and the public about the prevention of eye trauma, particularly the use of protective eyewear. This article discusses the epidemiology, assessment, and prevention of eye trauma in children.

Projectile Metallic Foreign Bodies in the Orbit: A Retrospective Study of Epidemiologic Factors, Management, and Outcomes

Intraorbital projectile metallic foreign bodies are associated with significant ocular and orbital injuries. The authors sought to evaluate epidemiologic factors, the incidence of associated ocular and orbital injury, and the nature and necessity of surgical intervention in these cases. Charts of all patients with projectile intraorbital metallic foreign bodies seen at our institution (27) over the preceding 7 years were evaluated with respect to age, sex, type of injury, associated ocular and orbital injuries, location of the projectile (anterior, epibulbar, or posterior), postinjury visual acuity, and surgical intervention. The majority of patients were male, between the ages of 11 and 30, and had BB pellet injuries. Thirteen projectiles were lodged anteriorly, 4 were in an epibulbar position, and the remaining 10 were posterior to the equator. Twelve of 13 anterior, and 4 of 4 epibulbar foreign bodies were removed surgically, whereas only 2 of 10 posterior foreign bodies required surgery. No case of surgical intervention resulted in a decrease of visual acuity. Associated ocular injuries were both more common and severe in patients with posteriorly located foreign bodies. Final visual acuity was better at presentation and at discharge in patients with anteriorly located foreign bodies. Intraorbital projectile metallic foreign bodies can be a source of significant ocular morbidity. Management of these cases is dependent on the location of the projectile. Ancillary radiographic studies can be helpful. Surgery to remove the projectile should be considered in each case, but foreign bodies that are not readily accessible often may be left safely in place. Closer regulation of the pellet gun industry, with an emphasis on education and protective eyewear use, would be helpful in reducing these injuries.

Visual Fields with Protective Eyewear

Sports-related eye injuries are quite common, yet the number of athletes who utilize protective eyewear is extremely low. The purpose of this study was to determine if there is a significant visual field loss associated with wearing eye protection. One of the authors was subjected to standard kinetic visual field testing with and without eye goggles. No significant difference was revealed. Physicians, physical therapists, and trainers should promote the use of protective eyewear and reassure athletes that they will not lose visual field.