Vision Conservation and Readiness

 Local VCR Program Requirements for Vision Surveillance

Last Updated: April 01, 2021
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The decision to enroll a worker in a vision or sight conservation program (they are the same thing) is based on occupational health and safety regulations and guidance and, when established, hazardous exposures at or above the Action Level (usually one half of the Permissible Exposure Limit if an OSHA standard).  The decision may also be driven by other hazard based standards, policy or by the professional judgment of the IH, OEM, and Safety professionals themselves.  No matter what, the final decision to determine who belongs in a local vision surveillance program, unless mandatory, rests with the professionals at the local level.

 

The process for the decision usually starts with the Industrial Hygienist performing a site survey.  By doing a hazard assessment, they usually will make recommendations on the need for controls such as safety glasses as well as any recommendations regarding medical requirements for the processes involved including the need for medical surveillance and what medical surveillance programs should be included for that individual including Sight Conservation and Vision Conservation.   In making these recommendations, it is important to note that, in DOEHRS-IH, vision surveillance is not separate from medical surveillance and should not be.  The confusion is that the terms vision conservation and sight conservation applies to literally everyone in the workforce.   A Vision Conservation and Readiness Program, according to DA PAM 40-506, is “designed to prevent eye injuries, to promote visual efficiency, and to monitor vision readiness…”  However, it is recommended that, in DOEHRS-IH, the Vision Conservation and Sight Conservation should be utilized to recommend that the workers be placed in a vision surveillance program which means that they need to have some aspect of their vision evaluated on a periodic basis.  If you are currently doing so, you could continue to recommend that everyone be placed in a vision surveillance program but recognize the demand for screenings in Occupational Medicine would create a workload that simply cannot be accomplished.  That is part of the reason why checking the box in DOEHRS-IH is a recommendation.  The decision still rests with Occupational Medicine but it is important that the final determination is discussed between OH and IH so that both are consistent in their efforts.

There are three primary ways that workers at risk of work-related health problems inlcuding the need to be placed in a vision surveillance program are usually identified: by workplace; by individual exposure; and/or by job title.  Always remember that the final decision to determine who belongs in a local vision surveillance program rests is yours to make unless other guidance states that certain workers need to be in a vision surveillance program.  The guidance listed here represents items that have specific guidance that states that they need to be in a vision surveillance programs and lists that reference.


Based Upon Workplace

Identification by workplace characterizes the hazardous agents present in a workplace or building and assumes all workers assigned to that workplace are potentially exposed to the levels of hazards found at the time the workplace was evaluated.  Identification by Similar Exposure Groups (SEGs) is a subset of those workplace exposure assessments and assumes all workers assigned to that SEG are all potentially exposed to the levels of hazards.  Also, most local reasons, it may be decided that all assigned to a particular building or site need to be in a surveillance program.  The decision to include all workers in a workplace in a vision surveillance program due to exposures would, therefore, be a local one.

Based Upon Exposure

Identification by individual exposure quantifies job demands, stresses, and hazardous exposures for each individual.  For the following and for subsequent topics, the selection to be included was based on finding at least one reference that included some form of vision screening as a periodic requirement.  Medical surveillance procedures as well as the required vision surveillance procedures for most substances not otherwise regulated by OSHA, as well as most job categories, may be found in the Navy's Medical Matrix. The Medical Matrix is used by the Navy, and may be used by other Services when no other DoD or Service guidance is provided.  NMCPHC-TM OM 6260 MEDICAL SURVEILLANCE PROCEDURES MANUAL AND MEDICAL MATRIX (EDITION 12) can be found at: 

 https://nmcpeh-simweb.med.navy.mil/Content/medMatrix/MedicalMatrix.pdf External Link

To be included in this list, the reference had to specify more than just checking the eyes for redness such as requiring annual checks of visual acuities.  The following list of materials have requirements for those exposed to be placed in a vision surveillance program.

Material

Frequency

Reference

CARBON DISULFIDE

Preplacement and Annual

NMCPHC-TM OM 6260

HYDROQUINONE (DIHYDROXY BENZENE)

Preplacement and Annual

NMCPHC-TM OM 6260

METHYL BROMIDE

Preplacement and Annual

NMCPHC-TM OM 6260

MUSTARD AGENTS H, HD, and HT

Preplacement and Annual

DA PAM 40-173

NERVE AGENTS GA, GB, GD, and VX

Preplacement and Annual

DA PAM 40-8

2-NITROPROPANE

Preplacement, Annual and Termination

NMCPHC-TM OM 6260

ORGANOTIN COMPOUNDS such as Tin,

Tributyltin Oxide, Methyl Tin Mercaptide, Tribuylin Benzoate, Dibutylin Dilaurate and Tributyltin Flouride

 

Preplacement and Annual

 

NMCPHC-TM OM 6260

OTTO FUEL II AND OTHER ALKYL NITRATE PROPELLANTS AND EXPLOSIVES such as

Propylene Glycol Dinitrate, Ethylene Glycol Dinitrate and Ethylhexyl Nitrate

 

Preplacement and Annual

 

NMCPHC-TM OM 6260


Based Upon Job Title

Identification by job title and description characterizes the basic tasks, hazardous exposures, and health outcomes likely to be experienced by the majority of workers in a specific occupational group. This type of grouping assumes all workers will have similar job demands, experience similar stresses, have the same exposures to hazardous agents, and experience the same health effects.   The issue to remember is that the exposures and tasks listed in a worker's Position Description do not necessarily reflect all of the risks that the worker actually faces is their current work environment.  This is why it becomes very important for the workers, their supervisors, Safety, IH and OH to be in communication all of the time and that hazard assessments on sites be accomplished at least annually and whenever a new process is brought into the worksite.   The following are the Job Series where actual requirements for vision assessments have been found in the regulations and guidance currently available.  Again, only items that list requirements other than simply looking at a worker's eyes are included here.


Job Series

Job Title

Frequency

Reference

 

81

 

Firefighters

 

Initial, Annually, and Termination

DoD 6055-05M

NFPA 1582  Chapter 6

NMCPHC-TM OM 6260 DoD 6055.06-M

 

0083

0085

 

Police

Security Guard

 

Initial, Annually, and Termination

DoD 6055-05M

AFI31-122

AR 190-56, Appendix C NMCPHC-TM OM 6260

84

Nuclear Material Courier

 

DoD 6055-05M

 

Nuclear Field Workers

Initial, Up to 5 years up to age 50, 2 yrs - 50+

MANMED Article 15-103

0403        0404

(400 Series)

Microbiology

Biological Science Technician

Initial, Annually, and Termination

DoD 6055-05M DA PAM 385-69

1712

Divers - Instructors

Initial, Up to 5 years up to age 50, 2 yrs - 50+

MANMED Article 15-102

 

1811

 

Criminal Investigation

Initial, Periodic (Up to 37 - 3 yrs, 38-40 - 2 yrs, 41+ - annually)

 

NMCPHC-TM OM 6260

Anyone requiring an FAA medical certificate

1815-Air Safety Investigation 1825-Aviation Safety

2152-Air Traffic Control

2181-Aircraft Operators/Pilots

 

Initial, periodic (depending on age)

 

AFI48-123 AR 40-501

MANMED Articles 15-50 through 15-72

3703

Welder

Initial, Periodic and Terminal

NMCPHC-TM OM 6260

 

3705

 

Non-Destructive Testers

 

Initial and Periodic (Annual)

National Aerospace Standard 410 NAVAIR 01-1A-16-1

TM 1-1500-335-23

 

5703

 

Motor Vehicle Operator (Other than DOT)

 

Preplacement, every 4 yrs

NAS 410 (Latest Revision) Title 49 Subtitle B, Chapter III, Subchapter B Part 391

Form 649-F (6045)

 

5703

 

Commercial Driver (DOT)

Preplacement, Biannual

(normally - can be reduced to as often as every 3 mos depending on evaluation)

 

NMCPHC-TM OM 6260

 

 

Radiation - Ionizing

Preplacement, Periodic (Up to 49 - 5 yrs, 50-59 - 2 yrs, 60+ -

annual), and Termination

 

NMCPHC-TM OM 6260

 

6501

 

Ammunitions, Explosives and Toxic Matter Handler

Preplacement, Periodic (Up to 59 - 2 yrs, 60+-annual) for Vehicle Operator, every 5 years for Handlers

Defense Explosives Safety Regulation 6055.09

MANMED Article 107

NMCPHC-TM OM 6260

6907

Materials Handlers/ Forklift Operator

 

Every 5 yrs, 60+ annually

 

NMCPHC-TM OM 6260

 

 

 

Laser Workers

 

 

Preplacement and Termination

DoD 6055-05M

AFI48-139 TB MED 524

DA PAM 40-506

BUMEDINST 6470.23


Based Upon Process

The Defense Occupational and Environmental Health Readiness System - Industrial Hygiene (DOEHRS-IH) allows the Department of Defense (DoD) to manage occupational & environmental health risk data and actively track biological, chemical, physical health hazards and engineered nano-object processes to Service members worldwide.  As stated previously, identification by Similar Exposure Groups (SEGs) is a first step and assumes all workers assigned to that SEG are all potentially exposed to the same levels of hazards.  From that step, processes are identified that fall within that SEG and recommendations are made for types of controls such as recommendations for specific protective eyewear based upon requirements for the activity and whether or not a worker needs to be placed in some type of medical or vision surveillance program such as for Firefighters (Annual Health Screen).  It is recommended that, in DOEHRS-IH, you place the workers in all medical surveillance programs that are relevant to them.  For example, even though the annual firefighter assessment includes a vision screening, it is recommended that you also go ahead and check the boxes for inclusion in the Sight Conservation or Vision Conservation programs as well.  Remember that everyone does not need to be in a vision surveillance program just because eye protection is required.  While many of the processes listed here are based upon exposures and jobs previously listed where vision surveillance is mandatory, some included processes in this chart are recommendations based upon a review of the list of processes available in DOEHRS-IH by our Program and included some processes where there may not be a specific Job Title or a risk not listed in a regulation such as for glassblowing.

Common Process

Method

Common Process

Method

Aids to Navigation

Lighthouse

Crafts

Glass blowing

Aircraft Maintenance

Inspecting

Crafts

Glass cutting

Aircraft/Flightline Operations

Air traffic control

Crafts

Glazing

Aircraft/Flightline Operations

Flight Ops, all modes

Enforcement of Laws and Treaties

Drug interdiction, air

Aircraft/Flightline Operations

Flight Ops, landings

Enforcement of Laws and Treaties

Drug interdiction, surf

Aircraft/Flightline Operations

Flight Ops, takeoffs

Environmental & Remediation

Bio remediation

Aircraft/Flightline Operations

Flight Ops, taxi

Environmental Response

Biological response, contamination reduction zone (decon)

Aircraft/Flightline Operations

Launch and recovery

Environmental Response

Biological response, exclusion zone

Aircraft/Flightline Operations

Unmanned aerial vehicle ops

Environmental Response

Biological response, NOC

Brazing/Soldering/Welding/Cutting

Cutting, air carbon arc

Environmental Response

Chemical response, contamination reduction zone (decon)

Brazing/Soldering/Welding/Cutting

Cutting, arc

Environmental Response

Chemical response, exclusion zone

Brazing/Soldering/Welding/Cutting

Cutting, electron beam

Environmental Response

Chemical response, NOC

Brazing/Soldering/Welding/Cutting

Cutting, laser

Environmental Response

Radiological response, contamination reduction zone (decon)

Brazing/Soldering/Welding/Cutting

Cutting, multiple operations

Environmental Response

Radiological response, exclusion zone

Brazing/Soldering/Welding/Cutting

Cutting, NOC

Environmental Response

Radiological response, NOC

Brazing/Soldering/Welding/Cutting

Cutting, oxygen/oxyacetylene

Equipment Repair/Prev. Maintenance

NOC, life support/survival equipment

Brazing/Soldering/Welding/Cutting

Cutting, plasma

Ice Operations

Domestic ice breaking

Brazing/Soldering/Welding/Cutting

Cutting, thermal

Ice Operations

Ice operations, NOC

Brazing/Soldering/Welding/Cutting

Welding, air carbon arc

Ice Operations

International ice patrol operations

Brazing/Soldering/Welding/Cutting

Welding, arc

Ice Operations

Polar operations

Brazing/Soldering/Welding/Cutting

Welding, electron beam

Laboratory Operations

Radiation research

Brazing/Soldering/Welding/Cutting

Welding, flux core processes

Marine Safety

Welder qualifications

Brazing/Soldering/Welding/Cutting

Welding, gas metal arc (MIG)

Metal Foundry Operations

Casting, arc furnace

Brazing/Soldering/Welding/Cutting

Welding, gas tungsten arc welding (TIG)

Metal Foundry Operations

Casting, crucible furnace

Brazing/Soldering/Welding/Cutting

Welding, laser

Metal Foundry Operations

Casting, furnace melting

Brazing/Soldering/Welding/Cutting

Welding, multiple operations

Metal Foundry Operations

Casting, induction furnace

Brazing/Soldering/Welding/Cutting

Welding, NOC

Metal Foundry Operations

Casting, open hearth

Brazing/Soldering/Welding/Cutting

Welding, oxyfuel gas

Metal Foundry Operations

Casting, cupola

Brazing/Soldering/Welding/Cutting

Welding, plasma arc

Metal Foundry Operations

Foundry operations, babbitting

Brazing/Soldering/Welding/Cutting

Welding, resistance spot

Metal Foundry Operations

Foundry operations, multiple operations

Brazing/Soldering/Welding/Cutting

Welding, shielded metal arc welding (smaw/stick)

Metal Foundry Operations

Foundry operations, NOC

Brazing/Soldering/Welding/Cutting

Welding, solid state

Metal Foundry Operations

Furnance operation

Brazing/Soldering/Welding/Cutting

Welding, spot

Metal Foundry Operations

Sand casting

Brazing/Soldering/Welding/Cutting

Welding, stud

Metal Foundry Operations

Small melt/pour operations

Brazing/Soldering/Welding/Cutting

Brazing

Metal Foundry Operations

Transfer/pouring/cooling

Brazing/Soldering/Welding/Cutting

Desoldering

Miscellaneous Operations

Laser operations, chemical

Brazing/Soldering/Welding/Cutting

Hotwork helper/firewatch

Miscellaneous Operations

Laser operations, optical

Brazing/Soldering/Welding/Cutting

Soldering, electrical

Miscellaneous Operations

Ionizing radiation source use

Brazing/Soldering/Welding/Cutting

Soldering, gun

Non-Destructive Inspection/Testing

Laser inspection/test

Brazing/Soldering/Welding/Cutting

Soldering, heated iron

Non-Destructive Inspection/Testing

Multiple operations

Brazing/Soldering/Welding/Cutting

Soldering, NOC

Non-Destructive Inspection/Testing

Laser inspection/test

Brazing/Soldering/Welding/Cutting

Soldering, torch

Non-Destructive Inspection/Testing

Multiple operations

Brazing/Soldering/Welding/Cutting

Tinning

Non-Destructive Inspection/Testing

Weight test

Coating/Paint Removal

Coating/paint removal, laser

 

 

Common Process

Method

Common Process

Method

Port Security

Military operations, peace

Thermal Spraying

Electric arc spraying

Port Security

Port security, military

Thermal Spraying

Flame spraying

Port Security

Port security, NOC

Thermal Spraying

High velocity oxyfuel (HVOF) spraying

Port Security

Port safety

Thermal Spraying

Plasma spraying

Port Security

Sea marshall HIV boarding

Thermal Spraying

Thermal spraying, NOC

Protective Services-Fire

Fire training pit, JP-8

Transportation

Driving, paved roads

Protective Services-Fire

Fire training pit, propane

Transportation

Driving, taxi/bus

Protective Services-Fire

Firefighting

Transportation

Driving, tractor trailer

Protective Services-Fire

Firefighting training

Transportation

Driving, truck

Protective Services-Fire

Protective services, fire, NOC

Transportation

Driving, unpaved roads

Protective Services-Security

Correctional facility operations

Transportation

Small watercraft operation

Protective Services-Security

Guard operations

Transportation

Train operation

Protective Services-Security

Patrolling, bicycle

Transportation

Transportation, multiple operations

Protective Services-Security

Patrolling, foot

Transportation

Transportation, NOC

Protective Services-Security

Patrolling, vehicle

Transportation

Railroad yard operations

Protective Services-Security

Protective services- security, NOC

Weapons & Ordnance

EOD, explosives detonating

Protective Services-Security

Road patrols/guard duty

Weapons & Ordnance

Explosive production, detonation

Protective Services-Security

Security, multiple operations

Weapons & Ordnance

EOD operations, NOC

Protective Services-Security

Document shredding

Weapons & Ordnance

Explosive production, cleaning mixing equipment

Protective Services-Security

Dog handling

Weapons & Ordnance

Explosive production, mixing and pouring

Protective Services-Security

Emergency response

Weapons & Ordnance

Explosive production, multiple operations

Protective Services-Security

Firing range cleaning

Weapons & Ordnance

Explosive production, NOC

Protective Services-Security

Firing range pit cleaning

Weapons & Ordnance

Explosive production, premix operations

Protective Services-Security

Firing range supervision

Weapons & Ordnance

Explosive production, testing

Protective Services-Security

Small arms cleaning

Weapons & Ordnance

Inspection of ammunition

Protective Services-Security

Small arms firing

Weapons & Ordnance

Weapons/small arms firing, indoor range

Protective Services-Security

Tear gas exercises

Weapons & Ordnance

Weapons/small arms firing, outdoor range

Search and Rescue

SAR, air

 

 

Search and Rescue

SAR, cutter

 

 

Search and Rescue

SAR, NOC

 

 

Search and Rescue

SAR, small boat

 

 

Search and Rescue

SAR, support

 

 

Shipboard Duties

Shipboard watchstanding, flight deck

 

 

Shipboard Duties

Shipboard/submarine watchstanding, engineering

 

 

Shipboard Duties

Watchstanding

 

 

Shipboard Duties

Shipboard processes, multiple operations

 

 

Shipboard Duties

Shipboard/submarine watchstanding, bridge

 

 

Shipboard Duties

Shipboard/submarine watchstanding, other

 

 

Supplies/Materials Handling

Crane operation

 

 

Supplies/Materials Handling

Forklift operation

 

 


Summary

Remember that the decision to include workers in a vision surveillance program is a local decision between Safety, Industrial Hygiene and Occupational Medicine unless it is mandatory.  This page and the attached documents list the areas that are known to have some written requirement for checking vision other than simply a requirement to look for eye irritation and includes the references based upon a review of all regulations that are known to us.  As always, it is possible that we missed one or two so, if you find something that we have missed or simply have a question, please CONTACT US and let us know about it including a link to the reference if at all possible.   The plan is that these charts will be maintained on our website and will be periodically updated so any assistance is appreciated.