- OSHA Healthcare Advisor - http://blogs.hcpro.com/osha -

Ask the expert: Eyewash stations and expectorating the unexpected

Q: Are hospitals required to have eyewash stations in areas where patients are cared for? I work at a hospital and a patient with mouth MRSA spit directly into my eye. I am now permanently partially blind in that eye due to the infection that set in. Immediately after the incident, I yelled at a nurse to direct me to an eyewash station. The nurse responded that the hospital does not have eyewash stations. I had to find a sink, take my gloves off, wash my hand, and then splash as much water as possible into my eye. It apparently didn’t help. Any advice would be appreciated!

A: Hospitals, similar to all businesses/employers, are required to have suitable emergency facilities for quick drenching or flushing of the eyes and body within the immediate work area where an employee may be exposed to injurious corrosive materials, according to the Medical and First Aid standard (1910.151). [1] The interpretation of suitable facilities usually means plumbed emergency eyewash stations or showers.

The specific requirement for plumbed facilities under 1910.151 is not, however, applied by OSHA to blood or OPIM exposures. The Bloodborne Pathogens standard [2] would apply to in those situations, and the standard does have provisions requiring employers to provide protection from and training for responding to exposures, when there is reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other OPIM that may result from the performance of an employee’s duties. This include flushing mucous membranes, according to 1910.1030(d)(2)(vi) of the standard, but there is no specific requirement for a plumbed eyewash station.

Whether it is reasonably anticipated that a MRSA-infected patient would spit in your eye is the matter up for interpretation.

My opinion is that it is not, and that the absence of an emergency eyewash station in that patient care area is not an OSHA violation.

Now, it is another matter if spitting and assaults were associated with that patient or in that patient care area. OSHA could analyze that chain of facts and determine the employer was not compliant in taking measures to protect workers.

Your employer, however, should have on hand personal eyewash devices—squeeze bottles, for example—for such exposures and provide training for how to use them. After such an event, the exposure control plan should be amended to address even such an unusual situation.