Safety Eyewear Policy Template
A complete, editable written policy for a company-funded prescription safety eyewear program - covering the regulatory basis, who pays, eligibility, specification by hazard, ordering, replacement and record keeping. Written for EHS and HR teams who need a defensible policy without starting from a blank page.
What's Inside
The regulatory basis, stated correctly
OSHA 29 CFR 1910.133 and 1926.102, the 1910.132(d) hazard assessment duty, and ANSI/ISEA Z87.1 - written out so you can point to the specific rule behind each clause.
Who actually pays, with the exemption
The section most policies get wrong. 1910.132(h) requires the employer to pay for PPE, but there is a specific carve-out for non-specialty prescription eyewear. Both halves are set out.
A markings reference your team can use
Z87, Z87+, Z87-2, D3, D4, D5, W-shades and the U-scale, with when each one is required - so supervisors can verify compliance at the point of issue.
Specification by hazard
A table mapping each hazard - impact, splash, dust, welding, UV, temperature transitions - to the minimum marking and the practical specification notes.
Eligibility, ordering and replacement
Clauses covering who qualifies, how prescriptions are handled, the ordering route, and what happens when eyewear is damaged or lost.
A hazard assessment worksheet
Appendix A is a blank worksheet supporting the assessment 1910.132(d) requires - one row per work area or task.
Download the Template
Editable Word document, free to adapt for your own sites. No obligation.
Who it is For
Written for the person who has been asked to produce a written eyewear policy and needs it to survive an audit - typically an EHS manager, safety coordinator or HR benefits lead. It assumes you already know your hazards and need the policy scaffolding, the correct regulatory citations and a defensible specification table. If you are still working out what your people need, start with the industry breakdown instead, which sets out the hazards and recommended specification for thirteen sectors.
A note on scope
This is a drafting aid, not legal advice. It does not replace your own hazard assessment, and the finished policy should be reviewed against the regulations that apply to your sites before you adopt it.
Need the program, not just the policy?
We run company-funded prescription safety eyewear programs for over 700,000 employees - ANSI Z87.1 compliant, with an ordering platform and direct fulfilment.