Tuesday, December 10, 2019

Primary Care Clinics in Office Practice

Questions: 1. What are the four most common physical occupational hazards to the eye? 2. What are four common complications resulting from an industrial eye injury? 3. Is there any particular danger from wood particles aside from eye injuries and what industrial hygiene measures are need to protect employees from eye and other types of injuries from wood particles? Answers: 1. Eye injuries are a common occurrence in the industries and at workplaces and they vary in their way of occurrence and degree of severity. Different strategies have to be developed for protection of the eyes against irritating mists, optical radiation and flying fragments. The four most common physical occupational hazards to the eye are impact, heat, chemicals and dust (Journal of Occupational and Environmental Medicine,54(1), 42-47, 5). The hazard of impact includes flying fragments like dirt, sand, particles, fragments and chips. This hazard is common for the tasks of sanding, riveting, powered fastening, chiseling, drilling sawing and wood-working. These sparks and objects are small but can lead to serious damage to the eye like contusions, abrasions and punctures. The hazard of heat includes the injuries due to burns that the eyes suffer when they are exposed to hot sparks, molten metal splashes and high temperatures. The workplace operations that make the eyes to these hazard s are the activities of furnace operations, hot dipping, casting and pouring. The hazard of chemicals is due to direct contact with them and occurs mainly due to the inappropriate selection of personal protective equipment (Workplace health safety,62(10), 400, 2). This occurs mainly in the form of fumes or vapors, mists and splash. The hazard of dust is very difficult to avoid and it is prevalent at the most in the operations of buffing and woodworking. A dusty environment can result in eye injuries and can cause hazards especially to the wearers of contact lens. Protection from these eye hazards can be obtained by wearing safety spectacles having side shields and goggles. Face shields can provide additional protection when the hazard is much more severe. Anti-fog coatings can provide better-viewing facilities in case of vapors and high-temperature situations. However, in case of any eye accident, first aid relief should be provided immediately to prevent any further damage to the eyes. 2. A workplace eye injury can happen due to the occupational hazards of impact, heat, chemicals and dust. It can range from a minor symptom to loss of the eye or permanent loss of vision. The four common complications resulting from an industrial eye injury are subconjunctival hemorrhage, corneal abrasions, traumatic iritis and hyphemas with orbital blowout fractures. Subconjunctival hemorrhage or bleeding accompanies any eye injury where blood collects on the sclera of the eye. The intensity of subconjunctival hemorrhage is not necessarily related to the degree of injury. Corneal abrasions result in a traumatic defect or scratch on the corneal surface. Patients suffering from corneal abrasions experience the feeling of being poked in the eyes with pointed objects (Primary Care: Clinics in Office Practice,42(3), 363-375, 4). They may also develop that feeling that they might have worn their contact lens for a long time. Traumatic iritis occurs in a similar manner as of corneal abrasi on but can result from the hitting of a blunt object. The iris of the eye is inflamed and can result in significant pain with reduced movement of the eye. Hyphemas with orbital blowout fractures is caused due to the significant hitting of a blunt object to the eye and affects the surrounding structures. This injury can also result from a sudden fall and can result in laceration of the sclera and cornea. Bleeding with pain due to the fracture are caused due to this injury and can severely damage the eye. Most of these industrial eye injuries share few common symptoms that include sensitivity to light or photophobia, distorted or blurred vision, increased production of tears in the eyes, inflamed and red eye with deep pain (Indian journal of ophthalmology,61(9), 497, 6). Superficial injuries to the eyes are usually minor injuries, however, the area surrounding the eye is easily bruised and therefore, they may appear to be worse than actually they are. 3. Apart from eye injuries, wood particles and dust can have several other hazards that include serious health problems like asthma. Dust of hardwood can cause nose cancer on prolonged periods of inhalation of the dust and settled dust is comprised of fine particles that are prone to damage the lungs. Cutting and sanding releases the maximum amount of wood particles and can cause mucosal with allergic and non-allergic respiratory symptoms. The invisible fine dust continues to float in the air and lingers even after stopping the tools from running. These invisible wood particles enter the lungs by inhalation and can cause tiny scarring and wounds to the lungs (Journal of aerosol medicine and pulmonary drug delivery,28(4), 237-246, 8). Immediately, the effects are not noticeable, however, over a long duration of time, the lung capacity significantly decreases and can lead to a number of issues of health. The primary symptoms of inhalation are coughing, sneezing, itching, rashes and bre athing problems. Several industrial measures are in place to protect the employees from eye and other injuries caused by wood particles and these are based on good work practices and local exhaust ventilation (Annals of occupational hygiene, mes 112, 3). These measures aim at protecting the employees against health hazards and controlling the exposure to wood dust. The employees should avoid the unnecessary inhalation of wood dust and should use a dust respirator. Skin problems can be avoided by good personal hygiene and wearing of gloves can significantly reduce splinters and skin abrasion. The species of the wood should be well known to avoid allergenic problems and the employees should be well trained and receive safeguards for working with hazardous chemicals (Comprehensive Analytical Chemistry, 133, 4). The cutting tools should be kept sharp and in good working condition for avoiding excess burning and friction of the wood. Unnecessary stirring and blowing of dust during cleani ng operations should be avoided and suction or vacuum collection devices are preferable for blowing operations. References Ahmed, F., House, R. J., Feldman, B. H. (2015). Corneal abrasions and corneal foreign bodies.Primary Care: Clinics in Office Practice,42(3), 363-375. Blackburn, J., Levitan, E. B., MacLennan, P. A., Owsley, C., McGwin Jr, G. (2012). A case-crossover study of risk factors for occupational eye injuries.Journal of Occupational and Environmental Medicine,54(1), 42-47. Darouiche, M. H., Baccari, T., Hammami, K. J., Triki, L., Masmoudi, M. L. (2014). Keratitis after corneal projection of biological fluids: a possible occupational prejudice?.Workplace health safety,62(10), 400. Hagstrm, K., Schlnssen, V., Eriksson, K. (2016). Exposure to Softwood Dust in the Wood Industry.Comprehensive Analytical Chemistry, 133. Magagnotti, N., Nannicini, C., Sciarra, G., Spinelli, R., Volpi, D. (2013). Determining the exposure of chipper operators to inhalable wood dust. Annals of occupational hygiene, mes112. Muala, A., Nicklasson, H., Boman, C., Swietlicki, E., Nystrm, R., Pettersson, E., ... Lndahl, J. (2015). Respiratory Tract Deposition of Inhaled Wood Smoke Particles in Healthy Volunteers.Journal of aerosol medicine and pulmonary drug delivery,28(4), 237-246. Serinken, M., Turkcuer, I., Cetin, E. N., Yilmaz, A., Elicabuk, H., Karcioglu, O. (2013). Causes and characteristics of work-related eye injuries in western Turkey.Indian journal of ophthalmology,61(9), 497.

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