May 21, 2020

NIH Issues Alert on Preventing SARS-CoV-2 Eye Exposures

A new health and safety alert (PDF) from the National Institutes of Health raises awareness about the need to protect workers’ eyes from exposure to SARS-CoV-2, the virus that causes COVID-19. The document describes the connection between the tear ducts and the nasal cavity, which allows tears to drain into the back of the throat, the trachea, and then the lungs. Patients with COVID-19 symptoms often have inflamed eyes or conjunctivitis, the document notes.

Over 57 percent of all blood and body fluid exposures to healthcare workers involved the eyes, according to a surveillance system established by the International Safety Center. Only 6.4 percent of workers involved in those incidents were wearing eye protection.

NIH notes that little guidance exists for when and where healthcare workers should use eye protection.

OSHA’s standard for personal protective equipment has been interpreted by the agency to apply to biological hazards such as SARS-CoV-2, according to Amber Mitchell, DrPH, MPH, CPH, who participated in an April 1 webinar on COVID-19 held by the National Institute of Environmental Health Sciences. “The eye is extremely rich in blood vessels and mucous membranes,” Mitchell said during her presentation. She noted that conjunctivitis was also observed in some patients during the Severe Acute Respiratory Syndrome outbreak in 2003.

No specific standard exists for the design or performance of goggles or face shields for biological hazards, Mitchell said, though an ANSI standard is in development through the International Safety Equipment Association. The standard will address biological hazards to the eyes and equipment that can protect against them, Mitchell said.

Mitchell, who is affiliated with the International Safety Center, noted the low usage of eye protection among healthcare workers and voiced concern that the eyes were a weak link at a time when much attention has been paid to respiratory protection. “We know that eye protection is not readily used on a regular basis,” Mitchell said. “I cannot overemphasize the importance of protecting the eyes during this time.”