BASIC PRINCIPLES OF INDUSTRIAL OPHTHALMOLOGY - 06/09/11
Résumé |
The basic principles of industrial ophthalmology had been developed as far back as September 25, 1913,43 when the National Safety Council was formed. The problem is that the basic principles, originally for the workplace, have not been thoroughly implemented in small businesses nor in the home, on the streets, and in other public places, even though the National Committee for the Prevention of Blindness initiated a nationwide study in the latter part of 1923.
In 1924 Resnick et al43 stated the following:
the greatest influence for the elimination of the eye hazards of industrial occupations is, of course, the general industrial safety movement. There were undoubtedly numerous plants where, because of several very costly eye accidents, greater attention was being given to the prevention of this particular type of accident than to the prevention of accidents in general. On the whole, however, the best results in the prevention of accidental injury to the eyes and in the conservation of vision through proper lighting and sanitation are to be found in those plants which are doing good all-round safety work.
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William Fellows Morgan, president of the National Committee for the Prevention of Blindness, reported in 1924 that the committee sought to bring the eye hazards of industrial occupations and the means of eliminating them to the attention of industry and of the country at large. The function of the committee was not only in the industrial field, but in general life as well. The objects of this committee were as follows: (1) to endeavor to ascertain, through study and investigation, any causes, whether direct or indirect, that may result in blindness or impaired vision; (2) to advocate measures that shall lead to the elimination of such causes; and (3) to disseminate knowledge concerning all matters pertaining to the care and use of the eyes.1
In 1950 Kuhn31 reported in her textbook that industrial ophthalmology as a special field had not been previously dealt with in a comprehensive treatise. She attempted to address much of the essential information relating to the various problems that confront industry and that also bear a special relationship to ophthalmology.
The contacts that the ophthalmologist had with industry at the time were of two types: (1) as a consultant to specific industries; or (2) as an oculist practicing in an industrial community. The ophthalmologist, therefore, has very real and immediate duty to the worker, for the following reasons: “To produce, one must see, have eyes, and use them effectively; to avoid waste, through errors and inaccuracies, one must see, have eyes, and use them effectively; and to have two eyes or even one eye, one must guard them by physical protective devices.”31
A research project, therefore, had to be, and was, started. What facts about eyes were important? When obtained, how were these facts to be interpreted? When interpreted, how could they best be used in rehabilitation? How could they be used in an effort to step up production? How could they be harnessed to reduce accidents?31
In 1945, Kuhn stated, “An essential and as yet hardly touched part of an intelligent appraisal of industrial eye problems (and actually that part on which all other steps of a program are based), was a detailed visual job analysis. To know what a given pair of eyes must be able to do in order to place new employees according to their visual skills; in order to correct any defect properly for that work (if refractive correction is indicated); in order to choose the right type of protective equipment; one must see each and every job and codify its essential characteristics.”31 We had to wait until 1990, however, when the Americans with Disabilities Act3 was enacted, to legally implement this analysis, yet no published document provides such analyses for all occupations.
Kuhn31 also stated that in establishing a testing procedure industry, three main objectives were required: (1) selecting adequate pre-employment tests; (2) providing periodic rechecks of special groups; and (3) conducting a practical visual survey of the plant.
In this broad discussion of an eye program for industry, the author seeks to open one more door that had been unfamiliar to the eye care professional. Information about a worker's visual skills, such as acuity, muscle balance, and visual performance at near-point distances, is of first importance to management as well as to the medical department. The constant and terrific effort for capacity-plus production, for speedy production, and for the elimination of the scrap heaps of spoiled material is often based squarely on these visual skills.
By and large, neither industry nor the eye care professional is properly informed on what actually constitutes a proper eye protection plan, and for this reason a rather complete discussion of an eye protection program is included. In the 1940s industrial eye programs included such questions as: What is proper illumination? What are a few of the medicolegal angles in the handling of eye cases? What are the problems of radiation, and “flashes?”31 Resnick's43 1924 statement is still true today: “There are still countless plants whose operations [involve] recent serious eye hazards in which no goggles are available for the workers who, on [their] own initiative, might apply for them. There are many plants where workers wear goggles on their caps or in their pocket except when `the boss is watching them.'” How can we renew the emphasis placed by Resnick and others in today's eye safety and conservation program? How can we renew the emphasis placed by Kuhn in job analysis, ocular screening, and job standards?
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| Address reprint requests to Bernard R. Blais, MD, Blais Consulting, Ltd., 4 Innisbrook Dr., Clifton Park, NY 12065–2809 This article originally appeared in the September 1999 issue (Volume 12, Number 3) as a part of an issue on Sports and Industrial Ophthalmology. |
Vol 13 - N° 2
P. 309-343 - juin 2000 Retour au numéro
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