Eyewash Stations

When and where are eyewash stations required in a healthcare facility? That is one of the more frequent issues that healthcare professionals struggle with. There is a tendency to place them nearly everywhere, but in reality there aren’t as many locations that require eyewash stations than one may think.

Eyewash stations are required wherever there is a possibility that caustic or corrosive chemicals could splash into the eye of an individual. It is important to note that blood and body fluids are not considered to be caustic or corrosive. It is also important to note that the use of Personal Protective Equipment (face shields, glasses, goggles) does not exempt the need for an eyewash station.

Most accreditation organization’s position on whether or not an eyewash station (or an emergency shower) is required is based on the healthcare organization conducting a risk assessment of the situation. Working with corrosive and caustic chemicals does not necessarily require an eyewash station (or emergency shower) unless the possibility is present that the chemicals could be splashed into the eyes (or onto the skin).

For example: If an environmental services worker opens a 1 gallon container of a liquid cleaner that is considered caustic or corrosive, and inserts a suction tube for a mixer, that doesn’t really present much of a splash hazard and a risk assessment could state an eyewash station is not warranted. However, if the employee pours the same chemical from its original container to another container, now the risk of splash is much greater and a risk assessment would likely require an eyewash station. All risk assessments are conducted with the presumption that staff will not be wearing any personal protective equipment.

If there are no corrosive or caustic chemicals present, then there is no need to conduct a risk assessment and there is no need for an eyewash station. Whether the term “corrosive” or the term “injurious corrosive” is used to describe a chemical, it’s all the same. Both would cause an injury.

A portable squeeze bottle is not prohibited, but it is not a substitute for a plumbed ANSI Z358.1-2014 approved eyewash station. Portable squeeze bottles are a potential problem for healthcare organizations, since they are usually placed around an area where a potential hazard can or may occur. In other words, somebody decided there is some sort of risk of splash present, that a portable bottle would be of some use.

That can lead to an incorrect assumption that the portable bottles are an approved eyewash station. Also, they need to have their water changed every two years (or so) and that can also be overlooked at times which can lead to a citation. Also, be aware that they are a huge flag to a surveyor who would likely conduct a tracer once he/she sees the portable bottle.

If the possibility of a corrosive or caustic material can be splashed onto the skin then an emergency shower would be required. But if a risk assessment determines there is no possibility of the chemicals splashing onto the skin through normal use, then there would not be a requirement for an emergency shower. The risk assessment should also consider emergency spills as well.

In regards to the ANSI Z358.1-2014 standard for eyewash stations, this standard is based on recommendations from OSHA letters of interpretation. OSHA requires the employer to provide suitable facilities for quick drenching or flushing of the eyes and body when employees may be exposed to injurious corrosive materials. ANSI standards become mandatory OSHA standards only when, and if, they are adopted by OSHA. ANSI Z358.1 has not been adopted by OSHA; however, ANSI Z358.1 provides detailed information regarding the installation and operation of emergency eyewash and shower equipment. OSHA, therefore, has often referred employers to ANSI Z358.1 as a source of guidance for protecting employees who may be exposed to injurious corrosive materials. Accreditation organizations seem to have latched onto the ANSI Z358.1 standard as the standard to comply with.

The organization is expected to conduct a risk assessment (or survey) of their facility’s operation and process areas to determine if and where eye wash stations are needed. If the facility has determined that an eye wash station is needed, then it needs to conform to the ANSI standard Z358.1-2014, which has the following specifications:

  • Only eye wash stations that are capable of providing a flow of clean potable water at a rate of 0.4 gallons per minute at 30 psi for 15 minutes are permitted. It is possible that some self-contained eye was stations may provide this flow requirement, but normally only plumbed eye wash stations do.
  • The flow nozzles of the eye wash station must be mounted a minimum of 33 inches and a maximum of 45 inches above the floor, and a minimum of 6 inches from any wall, post or other barrier.
  • Activation of the eye wash station must occur in one (1) second or less of operating the control valve, so this typically eliminates the faucet mounted eye wash stations that require the operation of three (3) levers to obtain a balanced flow of water. The control valve must remain open on its own until it is intentionally turned off.
  • Approved eye wash stations are required to be located within 10 seconds travel time (or 55 feet) of the hazard and the path to get to an eye wash station must not be hindered or obstructed. The ANSI Z358.1-2014 standard has changed to allow one (1) door in the path to get to an eye wash station, provided the door cannot be locked and the door swings in the direction to the eye wash station.
  • While there is no standard that prohibits the small supplemental personal squeeze bottles, they cannot meet the flow rate requirements for a 15-minute flush, and therefore are not a substitute for a plumbed eye wash station. They can serve as a supplemental aid but the plumbed eye wash station needs to be located within 10 seconds travel time (or 55 feet) of the hazard. The presence of the small supplemental personal wash bottles may indicate a need for a plumbed eye wash station.
  • The temperature of the water is required to be tepid. The ANSI standard defines tepid water as being between 60°F and 100°F. In order to achieve this temperature range, the organization may have to install mixing valves. Water temperatures outside of the 60°F and 100°F range may be permitted provide a risk assessment is conducted by qualified individuals which analyzes the hazard and the temperature of the water to flush the hazard. Qualifying individuals must include an individual with clinical or medical training.
  • Weekly activation of the eye wash stations is required to clear any sediment or bacteria. There is no specified time that the water must flow. An annual inspection of the eye wash station is required to determine conformances with the installation requirements are maintained.

Here are some recommendations on evaluating your existing eyewash stations for compliance:

  1. In a healthcare setting, eye wash stations are typically found where cleaning chemicals are mixed (such as housekeeping areas), plant operations, kitchens, generator rooms, environmental services storage room for battery powered floor scrubbers, in-house laundries, dialysis mixing rooms and laboratories. Determine if a risk assessment has been conducted to conclude the need for eye wash stations.
  2. All required eye wash stations must be the plumbed type, which can operate in one (1) second or less. This means the faucet mounted type that requires turning the hot water lever and the cold water lever and then pulling a center lever is not permitted.
  3. Access to the eye wash station must be within 10 seconds (or 55 feet) of the hazard. The individual seeking an eye wash station may travel through one (1) door to get to an eye wash station, provided the door does not have a lock on it, and swings in the direction to the eye wash station.
  4. If an eye wash station is observed outside of an area where they are typically needed, ask the staff who works in the area why it is there. See if they have a risk assessment that requires it to be there. Advise them if there is no valid reason for the eye wash station to be there, it can be removed and may save them time and resources in maintaining it.
  5. Eye wash stations may need to have a mixing valve to maintain a flow of water in the 60°F and 100°F range. Ask to see the risk assessment to determine if a mixing valve is required.
  6. Every eye wash station needs to be tested weekly by flowing water to clear any sediment and bacteria. There is no requirement how long the water must flow. Every eye wash station must be inspected annually to determine the eye wash station still conforms to the installation parameters. The weekly test and annual inspections must be documented.
  7. The presence of eye wash bottles indicates someone in the organization decided it was needed. Investigate and ask why the bottles are located there. Determine if they need a plumbed eye wash station within 10 seconds travel time (or 55 feet) of the perceived hazard. Check the expiration date on the bottles.

Always check with your state and local authorities to determine if they have any additional requirements.

Brad Keyes
Brad Keyes, CHSP

Brad is a former advisor to Healthcare Facilities Accreditation Program (HFAP) and former Joint Commission LS surveyor. He guides clients through  organizational assessment; management training; ongoing coaching of task groups; and extensive one-on-one coaching of facility leaders. He analyzes and develops leadership effectiveness and efficiency in work processes, focusing on assessing an organization’s preparedness for a survey, evaluating processes in achieving preparedness, and guiding organizations toward compliance. 

As a presenter at national seminars, regional conferences, and audio conferences, Brad teaches the Keyes Life Safety Boot Camp series to various groups and organizations. He is the author or co-author of many HCPro books, including the best-selling  Analyzing the Hospital Life Safety Survey, now in its 3rd edition. Brad has also authored a variety of articles in numerous publications addressing features of life safety and fire protection, as well as white papers and articles on the Building Maintenance Program. Currently serving as the contributing editor of the monthly HCPro newsletter Healthcare Life Safety Compliance  gives Brad further insight into the industry’s trends and best practices.