Eye on Safety: Bubbly Foam Injures party-goers' eyes

Foam Party (not subject incident)

On May 26, 2012, the Collier County Health Department was notified by law enforcement and hospital personnel that approximately 40 persons had sought care at local emergency departments because of severe eye irritation and pain. Patients reported that they had attended a foam party at a local nightclub the night before. Syndromic surveillance activities carried out by the Florida Department of Health identified 35 patients who had visited an emergency department in Collier County on May 26 with a chief complaint related to eye injuries.

Foam Party (not subject incident)

At foam parties, soapy foam is sprayed onto the dance floor while participants dance. The foam is distributed from blowers on the ground or attached to the ceiling, and several feet of foam can accumulate. Foam parties can last for several hours while foam is dispersed intermittently throughout the night. Products used at these events to produce foam contain ingredients similar to those in soaps and shampoos, such as sodium lauryl sulfate. Some formulations used at foam parties are proprietary, and chemicals, chemical compositions, and concentrations are unknown. For use at a foam party, the product is purchased in a highly concentrated form and diluted with water before use. This was the third foam party of the year at this nightclub.

An investigation was initiated by the Florida Department of Health to determine the extent and severity of the injuries. Using contact information obtained from medical records, patients were contacted and interviewed over the telephone. An incident-specific questionnaire was developed to obtain information on demographics, foam party attendance, foam exposures, potential risk factors, symptoms and injuries, medical care received, and previous foam party experiences. Additional attendees were identified by asking interviewees if they had attended the party with another person, and if so, were they willing to provide the contact information for them.

Foam Party (not subject incident)

Medical record abstractions in Collier County hospitals identified 30 cases of injury related to the foam party. Interviews, contacts provided by local law offices, and additional medical record abstractions from ophthalmology clinics, urgent-care centers, and neighboring county hospitals led to the identification of an additional 26 cases. A total of 56 persons meeting the case definition were identified during the investigation out of approximately 350 persons thought to have attended the party. Thus, an estimated 16% of attendees suffered eye injuries as a result of this event, and 43 (76.8%) of them received medical care.

In all cases, injured persons reported getting foam in their face, with 44 (96%) of interviewed persons reporting eye exposure. Almost 90% of interviewed persons reported rubbing their eyes after exposure to the foam. Eye irritation (94.6%), severe eye pain (91.1%), pink eye/redness (87.5%), decreased visual acuity (81.3%), and conjunctivitis (76.8%) were the most common injuries (Table). Of note, half of the cases (38) were diagnosed with abrasions of the cornea. For those persons who sought medical care, the average number of visits was 3.2. In 11 cases, patient's visual acuity could not be tested in at least one eye during their initial medical-care visit because they were unable to open their eye or read the first letter of the chart. Among persons interviewed, the average duration of symptoms was 7 days, ranging from less than 1 hour to more than one month. In seven cases, symptoms had not completely resolved at the time of the interview (i.e., more than one month after the injury).

Although some persons experienced minor eye irritations related to foam exposure, many experienced more serious eye injuries, such as decreased visual acuity (39), conjunctivitis (43), and corneal abrasions (28). This investigation highlights the range and potential seriousness of eye injuries that can result from exposure to foamed atmospheric effects used in the entertainment industry.

The entire report can be found at:  www.cdc.gov/mmwr/preview/mmwrhtml/mm6233a5.htm

Not discussed by the CDC, but equally important, is the likelihood of slip and fall injuries.  The foam can conceal trip hazards, and persons falling-over can strike hard edges or sharp corners of railings, tables, and chairs, and fall down stairways.  Additionally, someone that falls down may not be seen by other participants or Crowd Managers, and cold be trampled or create additional trip hazards.

Remember what your momma used to say:  It's all fun and games until someone gets their eye poked-out!

Ladder Safety now a smartphone application

NIOSH has released its first smart phone application (app) for mobile devices.  This free app is aimed at improving extension ladder safety by providing real-time safety information delivered via the latest technology.  Falls from ladders are a persistent source of workplace injuries.

Misjudging the angle at which an extension ladder is set-up is a significant risk factor that can be reduce and prevent falls. If an extension ladder is set too steeply, it is more likely to fall back or slide away during use, and if it is set too shallow then the bottom can slide out. The NIOSH Ladder Safety phone app has an angle of inclination indicator which uses visual and audible signals making it easier for workers and other users to set an extension ladder at the proper angle of 75.5 degrees.

The NIOSH Division of Safety Research tested and patented the concept of the app’s inclination indicator. They compared existing ladder positioning methods and found that the indicator improved both the accuracy and efficiency for extension ladder positioning. The Ladder Safety app also includes other information about ladder safety including ladder selection, inspection, accessorizing, and use. While it may seem obvious, we have to say it: for your safety, use the app to set the proper ladder angle before climbing an extension ladder.

 The app can help workers prevent falls and is also a tool for employers who want to ensure a safe workplace. The app is available through the NIOSH website, the Apple App-store, and Android Apps on Google Play. It works with most SmartPhones that have inclination sensors.