Episode #20 Your Eyes are Priceless: Emergency Eyewash Stations

When treating patients, corrosive chemicals and debris and even splash and splatter from the patient’s oral cavity can end up in unprotected eyes. Because of this, it’s vital that an emergency eyewash station is nearby and up to OSHA’s standards. If you’re wondering if your practice even merits having one in the first place, OSHA answers you with a clear and resounding “YES”.

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SPEAKER_00 0:04

Welcome. I'm Leslie Cannum. I'm Mary Gavoni. I'm Linda Harvey.

SPEAKER_03 0:10

I'm Olivia Juan, and together we are the Compliance Divas. Hello, listeners. This is Olivia Wan, and I'm with the Compliance Divas. We had so much interest in our episode about vision safety and protecting your eyes. We thought it would be a great idea to follow up with emergency eyewash stations. Keep in mind that the compliance divas, our purpose is that we bring clarity and simplicity to compliance by navigating regulatory compliance to keep you on course. Please subscribe to the Compliance Divas podcast through your favorite podcast channel and on our website, the compliancedivas.com. Any resources that we mentioned during this episode will be available on our website, and you may submit questions to support at thecompliancedivas.com. When treating patients, we are at risk if our eyes are not fully protected, to being exposed to corrosive chemicals and having debris such as calculus, blood, saliva, contaminated water to end up in our eyes. Because of this, it is vital that an emergency eye wash station be nearby and up to OSHA's standards. We're going to consult with the individual divas about the requirements of an eyewash station to make sure that you align yourself with the requirements from OSHA. I'd like to start out by asking Mary a few questions. Mary, talk to us about OSHA's requirement in regards to the emergency eyewash station, please.

SPEAKER_01 1:56

Thanks, Olivia. Welcome to our listeners. The eye wash station is sort of that neglected piece of equipment that, you know, is attached to the faucet somewhere, maybe in the lab or the sterilization area. And we don't really think about it other than maybe we heard in a training it was required by OSHA. So there's actually three areas where OSHA requires an eyewash station for employee safety and treatment of injuries in the workplace. The first is under the general OSHA safety standard, way back from um 1970. Then we look at the hazard communication standard, because as Olivia mentioned, if we use any type of hazardous or corrosive chemicals that may get splashed in the eye, then OSHA says that we must have even drench stations or eye wash stations, depending on the amount or the type of chemicals that we may be exposed to. And then under the blood-borne pathogen standard, there is a requirement for an eyewash station to be able to rinse a blood or saliva splash from the eye to help prevent an infectious disease exposure. Now, OSHA relies on ANSI, the American National Standards Institute, for the specifics about what an eye wash station must consist of, how it needs to operate, and so forth. And so we will have those resources listed on the compliancedevas.com linked to this episode so that you can take a look at those standards. But I mentioned before that OSHA talks about drench stations. We are not required to have a drench station in a dental practice because we are exposed to small quantities of chemicals or a small splash of blood or saliva, perhaps into the eyes. And so in a dental practice, we are allowed to have an attachment on a faucet that can provide free-flowing water. And um, I believe Leslie and Linda are going to go into a little more specifics about that that meets that OSHA standard. So again, we will provide all the resources that you need, the specific language where OSHA requires these, and what are the ANSI standards that apply.

SPEAKER_03 4:20

Thank you, Mary. So those resources will be really helpful to our listeners. Linda, please explain to our listeners about the location of the eyewash station.

SPEAKER_02 4:32

I'd like to also say the comment that Mary just made about the eyewash station being a neglected piece of equipment in the office is so true. And I think our listeners today will pick that up as a glean, the tips and reminders that we share. So the first thing I think of when I think about location is that real estate phrase, you know, location, location, location. And that's exactly an important piece of where this neglected piece of equipment should be placed to the forefront. It should be roughly according to the ANSI standard Z 358.1, the eyewash station must be located in areas that are accessible within 10 seconds of the hazard, which is roughly 55 feet. And in the general industry, it's referred to as the 10-second rule. So what I would encourage our listeners to do is evaluate where their eyewish station is located in their office. For small dental practice, in a someplace central like sterilization or a lab, it may be central, maybe within 55 feet or 10 seconds of all the operatories and hazardous areas. But in a larger practice, where there are different hallways and there's doctor side of the operatories, the hygiene side of the operatories, it's, you know, this may not be sufficient enough. You may need multiple eyewash stations because you have to bear in mind that the injured worker is going to need additional time to get to the eyewas station. Just because we time it with a stopwatch while we're racing down the hall with our vision intact doesn't mean that someone who has something in their eye is going to be able to get there so quickly. So we have to keep that in mind. So we want it to be as close as possible. And unfortunately, many times over, one of the only options that a dental practice has is either the lab or sterilization. And neither one of those places can be the most ideal location because, of course, in the lab, it's a contaminated area. Pardon me, the sterilization primarily. But in the lab, we have the possibility of plaster getting into the eyewas station and crusting over the nice little valves and the caps get lost. So before you know it, the device becomes unusable. So there's many things we have to look at when we're placing this. The eye wash stations also have to be on the same level as the hazard and free from with a travel path that's free from obstructions. So you think about the same level, I'm not thinking of, you know, same distance from the floor. I'm thinking of multiple layers, you know, stairways in a dental office. So if you have an upstairs area where that's an admin or a meeting room, um, and I'm thinking of one of our practices where they actually have two stories. They're in their older house. So they really need an eye wash on both levels, both floors. Second, you know, dental offices are known for having a lot of supplies come in. Supplies get delivered and they get put into a you got boxes sitting on the counter, you have boxes on the floor. Even though they're temporary, the boxes are a hazard and they're blocking access to the eyewas station. So be careful that is not an obstruction for someone who may need to be hurriedly getting to an eye wash station. Also, I'd like this to bring this to our attention, listeners' attention, because I never thought about this until recently that a door is considered an obstruction. So if you have a door on your sterilization and your lab, that is an obstruction to this emergency piece of emergency equipment. Now, if the hazard is non-corrosive, then you're allowed to have a door. And the door has to swing in the direction that you're traveling. So what happens then if you consider this scenario of an eyewash station that's in the lab area, that the lab has a closable door. And what if the lights kept off primarily in that area because the office is working on, you know, they try to reduce the cost of electricity and you turn off lights in rooms that you're not in, you know, the restroom, the break room, or the or the lab. Now you have you're creating more of a hazard for someone who already can't see. So it's important to look at those areas as well. And so two last minute tips that I want to share with our listeners, Olivia, would be one, you just mentioned well-lit area. Is it a well-lit area when they walk into that lab or sterilization area? And last but not least is signage. The requirements are that you must have signage. So if you have a door or if a situation where it's going to be easier to put something on the outside of the room, so everybody knows where the eyewash station is, very important. So some interesting fit taps. We hope that our listeners will go back, Olivia, and check and see if they're within 10 seconds or roughly 55 feet of every hazard.

SPEAKER_03 9:03

Linda, great, great information. And I actually had a dental practice that was cited because their eyewas station was located inside of the lab, and the person, the OSHA representative, felt like there was obstruction getting to the emergency eye wash station. I also appreciated what you stated about the 10-second rule. A good exercise for safety coordinators would be to blindfold someone, and of course, be in attendance on either side, so there's not a workplace injury, and time, how long it would take to get to the eyewash station. So that would be a very sobering reminder that we might very well need more than one eyewash station. So great information, Linda. Absolutely. Leslie, what does it mean, tepid, and how do we accomplish having tepid water in our eyewash station?

SPEAKER_00 9:57

Thanks for asking, Olivia. Uh, this is a very uh, I'd say, uh, most frequently violated part of having an eyewash station that I come across. Uh, tepid water means that the it's defined as being between 60 and 100 degrees Fahrenheit. ANSI, the American National Standards Institute, recommends that the water of the eyewash station be flushed weekly to prevent sediment from uh water that has been stagnant in that eyewash station from coming in contact with the person who needs it in an emergency. But I'd like to go back to why that we need to have that water be temperature controlled. Remember that any chemical splash should be rinsed for a minimum of 15 minutes, but sometimes we need a longer period of time. And the temperature of water should be one that can be tolerated for at least 15 minutes. Water that's too cold or too hot will inhibit workers from rinsing as long as they should. And so when we're talking about uh blood or body fluid, uh, we rinse for the 15 minutes, which seems like an extraordinary amount of time. If you can imagine bending over an eye wash station for that length of time. But what I like our listeners to think about is think about if you ever get um shampoo in your eyes when you're showering and it stings, and you have to rinse until that sting goes away. Well, when you think about this with chemicals, sometimes they don't sting. And the temperature of the water can actually cause the chemicals to have greater harm to your eyes. So um it's actually uh the water temperature is so important for that length of time. Um, if I'm rinsing my eyes and and I have, let's say, regular shampoo, I'm going to rinse until the sting is gone. However, if I use baby shampoo and there's no sting, I might not rinse for long enough. The other thing that I'd like our listeners to remember is that water that's too cold as opposed to too hot can actually cause hypothermia to eye tissue. So we want to be careful not to have water that's too hot. We don't want to have feel like we have hard-boiled eyeballs, and we don't want to have water that's too cold because that can actually cause tissue damage as well. And just one other point about uh safety at the eye wash station is if you wear contact lenses, be sure and remove your contact lenses before you go to the eyewash station because contact lenses can actually hold either chemicals or if you happen to have been hit with particles that can hold that against your eye, uh butter body fluid may be absorbed within those contact lenses as well. And I I love Olivia's idea of having a dry run of seeing how long it takes you to get to the eyewash station, because I think most people don't realize what it's like to be in the dark, so to speak, and to find your way. And uh that would be a good practice. We don't do that enough when we do OSHA training as a practice for team members to get to the eyewash station from any workstation that they might be at in the dental practice.

SPEAKER_03 13:12

Thank you, Leslie, for those tips. We understand that the water in the eyewash station could create biofilm. Mary, help us with that. Talk to us about the maintenance and why it's so important.

SPEAKER_01 13:27

In dentistry, we spend a lot of time worrying about the quality of water from our dental units and the biofilm that might accumulate it. Well, biofilm is accumulating in the pipes that are connecting to the eyewash station. So the OSHA standard recommends that we maintain that um plumbing or maintain the eyewas station by running a flush for five minutes once a week to make sure that we're getting out not only any biofilm contaminants, but for um getting any other kind of contaminants that might be in the water, maybe some mineral particles or something, because we don't want to put something more harmful into the eye as well. There are some practices that do have handheld um bottles of sterile saline that they use for eye wash stations, but they don't typically meet the OSHA requirement for 15 minutes of free-flowing water. So if that's what you're depending on for an eye wash station, it could be maybe something for an immediate use, but then you need to go to the eye wash station. So maintenance needs to be done. I recommend in the practices that I work with that they all pick a day when they're, you know, coming to work. Maybe they're not putting their eye makeup on so that things don't get messy, but they practice using the eyewas station on themselves. So it feels a little bit familiar because the worst thing that could happen, say you get some acid etch solution in your eye, and it is stinging worse than shampoo, and you go and you put your head into the eyewash station and you maybe pull back because it's startling. You need to know what it feels like so you're comfortable with it to get that chemical washed out. And if you have only one eye affected, what you need to do is tilt your head slightly so that the water goes from your affected eye down the drain and not tilt it the opposite way so that the rinsing would go from your affected eye to your unaffected eye and now contaminate that and then go down the drain. So it's very important, I think, to practice that. And um, that doesn't need to be a weekly thing, but making sure that you are flushing those um water lines on a weekly basis, making sure that the there's nothing plugging the little fountain devices at the ends of the of this eye wash station and making sure that you log those um maintenance checks to make sure that um you have done them on a weekly basis.

SPEAKER_03 16:13

Thank you, Mary. So we want to emphasize how important that is, and and thanks for that information. You know, if you have a potential eye injury, the last thing you need to do is spray contaminated water on your eyes. So it is really important that you are flushing the eye wash station each week. And Mary, I love how you mentioned about having quality control records on that. So some kind of task sheet where someone is assigned to take care of that. I've also seen in practices where the caps were off, and obviously debris can settle on the eyewash unit if not properly protected. And if listeners prefer using saline solution that are made as an eyewash station, they can certainly supplement their program, but OSHA requires, as Mary beautifully stated, that we have a 15-minute or more flush. So keep that in mind. If you prefer, I personally would prefer saline solution, but we'll need to have the eyewash station in place. Linda, did you have a comment to supplement?

SPEAKER_02 17:19

Yes, Olivia. I have a couple of points that I'd like to expound upon it based on what our divas have already said. And that is one that I call fancy faucets. Many times over, when a practice is remodeling or they're building out a new location, they run with these ideas with more modern strategies. They've got a faucet, a spray hot nozzle on the end of the faucet, just like we have in our homes. And many times over, we're asked, can this serve as an eye wash station? And then as consultants, we're tasked with explaining to the rationale why not. And we have to help them find some suitable locations. And as Mary said earlier, this isn't a neglected piece of equipment. So wouldn't it be nice if when remodeling or building out a new practice, this was a consideration? Where's the eyewas station going to go? Just like we consider where are the restrooms going to be, where's the check-in, you know, where's the suction going to be placed? This would be a wonderful idea because it has to go into the plumbing. And there are other alternatives that can be plumbed into the side of the sink and placed on the side of the counter rather, and they plumbed into the sink, but that takes some space and some planning for. Um, and the second thing I wanted to mention about the caps that you that you brought up. We recently were in an office where the caps were missing. So I did some research and I found where they can buy some replacement caps. And off the top of my head, I think I just used the model and brand that they had and went to that website and located where they could purchase new caps. And that's very important because thankfully there was no plaster that had you know solidified over those valves and they were able to, you know, buy some additional uh caps. So just wanted to pass those tips along to our listeners.

SPEAKER_03 18:57

Leslie, do you have additional comments?

SPEAKER_00 19:00

Uh yes. Uh you know, when Linda was talking about the eyewash station itself, uh, in a dental practice where I was fortunate to be part of the build-out, we decided to have a separate faucet just for the eyewash station because they didn't want to have a temperature-controlled faucet where they wanted to have warm water at that location. So uh they had the plumber come in and do a separate faucet. It was very easy to do. It was just dedicated to the eyewash station. And in order to keep the eyewash station at Tepet Water, you can install anti-scalding devices or temperature control valves. And this is something that you can check with your dental dealer to find out if they can give you that kind of uh product, if they have that in their catalog. If not, you can go and Google eyewash stations in general industry, there's all sorts of different suppliers. But this way, you have a constant temperature and it also has that uh a constant flow rate. And the other thing I wanted to mention is on cleaning the eyewas station, because we have mineral buildups and different sediments in the water that can flow down the flow. Uh, if you can check with the manufacturer and see what the directions are for cleaning, if they do give you instructions, that's great. But I found that I use just household vinegar when I have to clean an eye wash station. And rather than soak the components of the eye wash station in something caustic, some other kind of chemical that you would use for cleaning other surfaces, uh, vinegar, if you uh would just simply take the appliance off of the faucet, uh clean it with a toothbrush, a clean toothbrush, uh, you know, scrub away any tough buildup on it and the gunk that builds that tends to build up. And then soaking it in vinegar overnight often softens up the mineral buildup. So you flush it thoroughly before you attach it, and voila, your eyewash station is working at maximum pressure again. And then just one other thing I wanted to mention, uh, Centers for Disease Control has a nice first aid kit, uh, or not kit, a first aid checklist. And on the first aid procedure checklist, uh they have four areas at the top that are dedicated to eye irrigation. So if you're exposed to chemicals or blood or body fluid or or even particles, uh it talks about the flushing being immediate, but also about lifting your upper and lower lids and of course getting medical attention immediately. So I wanted our listeners to know that when they do set up their own first aid plans for themselves, in addition to some training on where the eyewash station is, how to get to the eyewash station, but also what to do when they get there.

SPEAKER_03 21:55

Thank you, Leslie, for those tips.

SPEAKER_01 21:57

Mary, do you have something to share? I do. Just building on what Leslie and Linda just said and what you said as well. So we will make that resource available from the CDC on the Compliance Divas website. Um, so you can see that checklist from CDC. And that's a great point that you have to be able to um use your fingers to open your open your eye to make sure that you get anything from from underneath your your eyelids. But the other thing that tags on to what you said before, Olivia, put a blindfold on and have somebody guide you to the um to the eyewash station. Um I also think that if somebody happened to be the only person in the office at the time, that they may want to practice their route from at least a treatment room where they might be, or if nothing else, that they practice being able to get to the eyewash station and turn on the controls to rinse with a blindfold on or with their eyes closed so that they know how to feel their way to get to that eyewas station, because the sooner you get those chemicals rinsed out of your eyes, the less damage it's going to do. And again, to follow up with any kind of medical evaluation so you don't have permanent damage to your eyes. So again, we just think, well, the eyewas station's there. If we need to use it, great. But um once an injury occurs, panic sort of sets in, and we need to practice, just like a medical emergency.

SPEAKER_03 23:30

Great information, Mary. And I wanted to share with our listeners that uh have a dental office that we consulted with, and when we inspected the eye wash station, it was actually mounted backwards. So the water was flowing toward the wall and not towards the user's eyes. And so even if it's a brand new unit that was installed, we must check it and make sure it was installed properly. The other thing I wanted to mention in this discussion is that we think about the eyewash stations for employee safety because OSHA charges the employer to provide that safe place to work. But I had an incident that happened in an orthodontic office where the patient had to use the eyewash station. So emphasizing how important it is to protect the eyes of the worker, but also the eyes of the patient. And what happened in this situation? What chemical was in the nozzle shot out and sprayed into the patient's eye in the next bay? And so the patient who was a teenager had to access the eye wash station. It did cause a minor burn to the eye. However, when the patient was treated by a physician, that situation would have been much worse had they not used the eye wash station. So, really, really important for our listeners to see just how important that topic is. We really appreciate everyone tuning in to this episode on the emergency eye wash station. The compliance divas bring clarity and simplicity to compliance by navigating regulatory compliance to keep you on course. Please subscribe to the Compliance Divas podcast through your favorite podcast channel or on our website, thecompliancedeevas.com. We also accept questions, support at thecompliancedeevas.com. We will have the resources that we discuss during this episode on the website for your convenience. Thanks again for tuning in.