All ETDs from UAB

Advisory Committee Chair

Gerald McGwin

Advisory Committee Members

Emily Levitan

Paul Maclennan

Cynthia Owsley

Douglas Witherspoon

Document Type

Dissertation

Date of Award

2011

Degree Name by School

Doctor of Philosophy (PhD) School of Public Health

Abstract

Eye injuries are a leading cause of monocular blindness, with approximately 2 million Americans sustaining an eye injury annually. Occupational eye injuries resulting in at least one missed day of work total nearly 28,000 each year. Eye injuries have many different etiologies, although most are "minor" injuries such as corneal abrasions and foreign bodies. Chemical-related eye injuries have not been described epidemiologically. The most widely advocated prevention method for eye injuries is protective eyewear, but evidence to support this is surprisingly absent. Furthermore, the use of eye protection among workers who have previously sustained an eye injury remains a question of interest to understand changes in prevention habits. Data from the emergency department of a free-standing eye hospital was used to address three research questions. A descriptive study identified 640 consecutive cases of chemical eye injuries. Patterns of chemical eye injuries were observed to differ by gender, age, and by months of the year. Based on visual acuity data, chemicals did not generally threaten sight. Opportunities to prevent chemical eye injuries may exist by improving product labeling and design. Patients of 201 occupational eye injuries were contacted to participate in a case-crossover study to evaluate transient risk factors. Eye protection was observed to reduce the incidence of eye injury (IRR 0.5, 95% CI 0.4 to 0.7), while risk factors included the use of tools (IRR 3.9, 95% CI 3.0 to 4.9), tool malfunction (IRR 2.6, 95% CI 1.5 to 4.5), performing an unfamiliar task (IRR 1.8, 95% CI 1.6 to 2.1), being rushed (IRR 3.8, 95% CI 2.4 to 5.9), being distracted (IRR 12.7, 95% CI 6.9 to 23.2) working overtime (IRR 2.9, 95% CI 1.9 to 4.4), and feeling fatigued (IRR 3.1, 95% CI 1.8 to 5.4). A follow-up study of 77 workers that sustained occupational eye injuries permitted the evaluation of eye protection habits before and after their eye injury. Overall, the use of eye protect increased following an eye injury, but appear to be limited to those who previously were not in the habit. Clinician's could make use of opportunities to increase appropriate use of eye protection when treating eye injuries.

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