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At OHC 3 people from different departments comes with Eye Itching and Redness of eye. What can be the cause and management

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"conjunctivitis"[MeSH Terms] AND treatment

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occupational health center multiple employees eye itching redness cause conjunctivitis outbreak workplace

Likely Causes

When 3 people from different departments present to the OHC around the same time with itching + redness, think outbreak/common-source rather than isolated occupational injury. The differential:
1. Viral conjunctivitis (most likely if contagious spread) Highly contagious adenoviral conjunctivitis - watery discharge, itching/burning, often starts one eye then bilateral, may have preauricular lymphadenopathy, and often follows a URI-like illness. Because employees mix at common areas (canteen, lifts, washrooms, meeting rooms, shared equipment/keyboards, door handles), one index case can seed people across departments (Goldman-Cecil Medicine; Tintinalli's Emergency Medicine).
2. Bacterial conjunctivitis Mucopurulent/purulent discharge, eyelids stuck together on waking, less itch, more irritation. Also spreads by contact (Harriet Lane Handbook).
3. Allergic conjunctivitis Intense itching is the hallmark, bilateral, watery discharge, cobblestone papillae on the palpebral conjunctiva. If all three cases share a common exposure - building dust, mold, new carpet/paint, pollen entering through vents, a new cleaning agent/perfume, or a poorly maintained AC/HVAC filter - this can affect people across departments simultaneously even without person-to-person spread (Harrison's Principles of Internal Medicine, p. relevant to Allergic Conjunctivitis section; Kanski's Clinical Ophthalmology).
4. Chemical/toxic/irritant conjunctivitis Fumes, dust, smoke, pesticide/fumigation spray, a chemical spill, or poor ventilation circulating an irritant building-wide. Redness with burning, tearing, less itching than allergic (Tintinalli's Emergency Medicine; Swanson's Family Medicine Review).
5. Other Photokeratitis (UV/welding flash exposure), digital eye strain/dry eye from screens (less likely to cause acute redness in 3 people simultaneously), or seasonal pollution/dust-storm days.
Since the cases are cross-departmental, an epidemiological "common exposure" (contagious spread through shared spaces, or a shared environmental trigger like HVAC/dust/chemical) is more likely than a department-specific occupational hazard.

Management at the OHC

A. Immediate assessment (triage each case individually)
  • History: onset/duration, one or both eyes, type of discharge (watery = viral/allergic, purulent = bacterial), itching (allergic) vs burning/foreign-body sensation (viral/irritant) vs pain/photophobia (red flag), contact with anyone with red eye, recent exposure to dust/fumes/chemicals/renovation/pest control, contact lens use, new cosmetics/eye drops.
  • Exam: visual acuity, pupil reaction, look for corneal involvement, preauricular node, papillae, foreign body, discharge character.
B. Red flags -> refer to ophthalmology urgently Reduced vision, severe pain, photophobia, corneal haze/opacity, chemical splash (especially alkali), no improvement in 48-72 hours, unilateral severe presentation.
C. Symptomatic/first-line treatment
  • Viral: supportive care - cold compresses, lubricating drops/artificial tears, strict hand hygiene, avoid antibiotics and avoid steroids unless directed by ophthalmology (a recent meta-analysis found steroids are used selectively in infective conjunctivitis and should not be routine first-line - Putri & Edwar, 2025, PMID 40059644).
  • Bacterial: topical antibiotic (e.g., chloramphenicol or a fluoroquinolone) if mucopurulent discharge is present. Note a Cochrane systematic review found antibiotics give only a modest benefit over placebo for acute bacterial conjunctivitis (faster clinical/microbiological cure but most cases self-resolve) - reserve for purulent/moderate-severe or high-risk cases (Liu et al., 2024, PMID 37482371).
  • Allergic: topical antihistamine/mast-cell stabilizer (e.g., olopatadine), oral antihistamine if needed, cold compresses, and most importantly remove/avoid the triggering allergen.
  • Chemical/irritant exposure: immediate copious saline/water irrigation for 15-20 minutes, remove contact lenses, check pH if a chemical is suspected, refer urgently if caustic/alkali or corneal involvement.
D. Infection control (if contagious cause suspected)
  • Advise affected staff to avoid touching/rubbing eyes, practice strict hand hygiene, avoid sharing towels/cosmetics.
  • Consider work exclusion/isolation until non-infectious (commonly ~5-7 days for viral, or until 24 hours of antibiotic treatment for bacterial, per your infection-control policy).
  • Disinfect shared surfaces (door handles, keyboards, phones), especially in common areas connecting the affected departments.
E. Since this looks like a cluster - investigate as an outbreak
  1. Line-list the 3 cases: exact onset time, department, symptoms, discharge type, workstation/seating area, and shared spaces visited (canteen, washroom, meeting rooms, transport, lift).
  2. Ask whether all three visited a common area or used a shared resource on the same day.
  3. Check for a building-wide trigger: recent painting/fumigation/pest control, HVAC/AC servicing or filter status, air quality/dust/pollen that day, a newly introduced cleaning agent or hand sanitizer.
  4. Monitor for additional cases over the next several days (viral incubation ~5-12 days) - if more cases emerge, it supports an infectious outbreak; if it stays at 3 and stops, a one-time environmental exposure is more likely.
  5. If an environmental/chemical source is identified, eliminate it (service the ventilation system, review the MSDS for any chemical used, provide PPE if a process is the source) and consider notifying HR/safety committee.
This mirrors the standard approach in occupational eye-exposure surveillance described in hospital-based studies, where contact history (workplace vs home vs other) and clustering pattern are used to identify whether cases are contagious-source or environment-source (as illustrated in a South Indian tertiary hospital's occupational eye exposure surveillance study).
Bottom line: Take a focused history from each of the three, look for red flags first, treat symptomatically based on discharge/itch pattern, and treat this as a potential mini-outbreak - investigate for a common contagious or environmental source across the affected departments rather than assuming three coincidental unrelated cases.
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