EYES PROBLEMS

The Centers for Disease Control and Prevention (CDC) recommends eye protection for a variety of potential exposure settings where workers may be at risk of acquiring infectious diseases via ocular exposure. This document provides background information and specific details on eye protection that can be used to supplement eye protection recommendations provided in current CDC infection control guidance documents. It is intended to familiarize workers with the various types of eye protection available, their characteristics, and their applicable use. Workers should understand that regular prescription eyeglasses and contact lenses are not considered eye protection.
Infectious diseases can be transmitted through various mechanisms, among which are infections that can be introduced through the mucous membranes of the eye (conjunctiva). These include viruses and bacteria than can cause conjunctivitis (e.g., adenovirus, herpes simplex, Staphylococcus aureus) and viruses that can cause systemic infections, including bloodborne viruses (e.g. hepatitis B and C viruses, human immunodeficiency virus), herpes viruses, and rhinoviruses. Infectious agents are introduced to the eye either directly (e.g., blood splashes, respiratory droplets generated during coughing or suctioning) or from touching the eyes with contaminated fingers or other objects.
Eye protection provides a barrier to infectious materials entering the eye and is often used in conjunction with other personal protective equipment (PPE) such as gloves, gowns, and masks or respirators.
Topic Index
Eye Safety Eye Safety for Emergency Response and Disaster Recovery Eye Safety Tool Box Talk Contact Lens Use in a Chemical Environment

Other NIOSH Related Topics:

Avian InfluenzaProtecting Poultry Workers Bloodborne Infectious Diseases Emergency Response Resources: Personal Protective Equipment Healthcare Workers Infectious Aerosols Biological AgentsHistoplasmosis SARS Tuberculosis

Other CDC Related Topics:
Infection Control Home Caring for Avian Flu Patients Practices for Dentistry SARS (Healthcare, Home, & Community Settings)

Common eye protection devices are as follows:

Goggles
Appropriately fitted, indirectly-vented goggles* with a manufacturer’s anti-fog coating provide the most reliable practical eye protection from splashes, sprays, and respiratory droplets. Newer styles of goggles may provide better indirect airflow properties to reduce fogging, as well as better peripheral vision and more size options for fitting goggles to different workers. Many styles of goggles fit adequately over prescription glasses with minimal gaps. However, to be efficacious, goggles must fit snugly, particularly from the corners of the eye across the brow. While highly effective as eye protection, goggles do not provide splash or spray protection to other parts of the face.
* Directly-vented goggles may allow penetration by splashes or sprays; therefore, indirectly-vented or non-vented goggles are preferred for infection control.

Face Shields
Face shields are commonly used as an infection control alternative to goggles.** As opposed to goggles, a face shield can also provide protection to other facial areas. To provide better face and eye protection from splashes and sprays, a face shield should have crown and chin protection and wrap around the face to the point of the ear, which reduces the likelihood that a splash could go around the edge of the shield and reach the eyes. Disposable face shields for medical personnel made of light weight films that are attached to a surgical mask or fit loosely around the face should not be relied upon as optimal protection.
** In a chemical exposure or industrial setting, faceshields should be used in addition to goggles, not as a substitute for goggles (ANSI Z87.1-2003 Practice for occupational and educational eye and face protection).

Safety Glasses
Safety glasses provide impact protection but do not provide the same level of splash or droplet protection as goggles and generally should not be used for infection control purposes.
Full-face Respirators
Full facepiece elastomeric respirators and powered air-purifying respirators (PAPRs) are designed and used for respiratory protection, but because of their design incidentally provide highly effective eye protection as well. Selection of this type of PPE should be based on an assessment of the respiratory hazard in an infection control situation, but will also provide, as an additional benefit, optimal eye protection.

SKIN CANCER

Skin cancer is the most common form of human cancer. It is estimated that over 1 million new cases occur annually. The annual rates of all forms of skin cancer are increasing each year, representing a growing public concern. It has also been estimated that nearly half of all Americans who live to age 65 will develop skin cancer at least once.
The most common warning sign of skin cancer is a change in the appearance of the skin, such as a new growth or a sore that will not heal.
The term "skin cancer" refers to three different conditions. From the least to the most dangerous, they are:

basal cell carcinoma (or basal cell carcinoma epithelioma)
squamous cell carcinoma (the first stage of which is called actinic keratosis)
melanoma

The two most common forms of skin cancer are basal cell carcinoma and squamous cell carcinoma. Together, these two are also referred to as nonmelanoma skin cancer. Melanoma is generally the most serious form of skin cancer because it tends to spread (metastasize) throughout the body quickly. Skin cancer is also known as skin neoplasia.

ECZEMA
Rashes are a very broad topic, but this Advisory has a narrow focus: dry skin and eczematous rashes. Dry skin is a problem faced by almost all of us on occasion, but it’s always a problem if you have eczema.
What is Eczema?
Eczema is a term used for a group of skin conditions having several things in common: dryness, itching, inflammation and thickening of skin, and recurrence. See the table below for descriptions of the usual types.

What Causes It?

Nobody knows exactly why some people are affected by these rashes and others with the same exposure aren’t. Those with atopic dermatitis often have non-skin allergies (like hay fever and asthma) but their rashes aren’t caused by skin allergies. On the other hand, those with contact dermatitis do have true skin allergies, but usually not other allergic problems like someone with atopic dermatitis. Contact dermatitis occurs at all ages, whereas atopic dermatitis is most often a problem in kids. Hand dermatitis is caused by skin irritants such as detergents or chemicals. Dry (chapped) skin occurs because of lack of water in the stratum corneum (see diagram). If your skin surface doesn’t have enough oil, there’s more evaporation of water which contributes to the dryness

Scratching can actually trigger eczematous rashes. Initial mild itching makes you want to scratch, of course. But scratching damages the skin, worsens inflammation, irritates surface nerves, and leads to even more intense itching than you had before. This cycle aggravates and prolongs all of these rashes. In fact some eczematous rashes completely disappear without any treatment if you just stop scratching.
As you can tell, these rashes differ in many ways. So why do we lump them together? Because the underlying chronic inflammation makes them all look, feel and respond to treatment in the same ways.

PREVENTION

If you have eczema or dry skin, you’ll probably have it again unless you take preventive steps. Advice in the table below applies to all varieties of eczema and dry skin.

• Avoiding Eczema and Dry (chapped) Skin
• DO use moisturizers twice daily (more often on hands) to hydrate and soften skin, and reduce itching.
• try to determine what exposures aggravate your rash and avoid them (click here for Common Culprits of Skin Irritation/Allergy).
• humidify dry air, especially in your bedroom.
  clip fingernails short and even wear light cotton gloves to stop "sleep scratching."
• use soapless cleansers or non-alkaline (neutral) soaps (see Recommended Products section).
• wear gloves when washing dishes or clothing, and don’t allow your hands to be constantly wet.
  
  DONT...........................!
• scratch the itch!
• use regular bath soap.
• use any skin products or laundry products with added fragrances.
• shower daily. If you must, use recommended cleansers only (see Recommended Products section).
• allow wool clothing or blankets against your skin.
• expose your skin to very cold or hot air.

SKIN PROBLEMS: ROSACEA

SKIN PROBLEMS: ROSACEA
Rosacea
Characterized by facial redness and swelling, rosacea is a facial skin problem that usually afflicts adults with fair skin. It can appear at any age. Rosacea usually develops slowly at first, appearing periodically as a facial flush. The condition worsens over time and rarely resolves on its own. A cosmetic dermatologist can effectively treat rosacea with topical or oral medications, as well as facial skin treatments, such as laser therapy, to provide generally excellent results.

WARTS

Warts are benign growths that are caused by a virus. Although warts are generally raised, rough, and skin-colored, they can manifest in many forms and hues. Warts can appear almost anywhere on the body and can be an unsightly and sometimes painful skin problem. Although warts will usually disappear over time, the discomfort and cosmetic imposition they cause often motivates patients to seek effective wart removal treatment from a cosmetic dermatologist. Wart removal is a generally painless process that can be performed in a quick office visit.

WRINKLES

Wrinkles and lines on the skin are among the most common facial skin problems for women and men as they age. Lines and wrinkles appear where skin naturally folds and creases, becoming more and more permanent as time goes on. Sun exposure, smoking, and extreme dieting can hasten this effect, making skin look older than it is. A cosmetic dermatologist can prescribe professional skin care products and perform a wide variety of very effective procedures to smooth and rejuvenate skin