What is COSHH?

Brief introduction to COSHH regulations

Working in the healthcare environment you have a duty to keep your patients safe and free from harm. However, in doing so you need to know that your health is not being put at risk and you are able to work in a safe environment.

An important aspect of maintaining a safe working environment is ensuring the safe storage, handling, and disposal of chemicals and substances that are harmful to human health.

What COSHH stands for

COSHH stands for the Control of Substances Hazardous to Health. This is UK legislation that covers substances of varying formats that include all chemicals, fumes, vapours, dusts, gases, mists and biological agents.

When working within the healthcare sector it is important that you receive COSHH training (and updates) relevant to your role and responsibilities.

Health and safety is always thought of as a very ‘dry subject’ yet is there for a reason: to keep you safe. So, it’s important that you have an awareness of what’s involved.

Health regulations and COSHH

The Control of Substances Hazardous to Health (COSHH) Regulations 2002 (as amended) is just one of the acts of legislation in place to protect both the you and people you care for.

Other health and safety laws include:

• The Health and Safety at Work Act 1974.
• Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• The Management of Health and Safety Regulations (MHSWR) 1999.
• Manual Handling Operations Regulations 1992 (as amended) (MHOR).
• Lifting Operations and Lifting Equipment Regulations 1998 (LOLER).
• Provision and Use of Work Equipment Regulations 1998 (PUWER).
• Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR).

More details can be found on the Health and Safety Executive (HSE) website.

Identifying hazardous substances and associated risk

Exposure to hazardous substances should be minimised and you should receive training in how to handle these substances safely and how to deal with accidents and spillages according to the COSHH regulations.

It’s important that as a nurse or healthcare assistant you are aware of all substances used in your workplace and their associated risks to health. You should perform a COSHH risk assessment for every chemical or substance that you use or come into contact with during your working day.

• Go through the working day and walk around the ward or nursing home to identify any hazardous substances, i.e. ‘risks’, e.g. cleaning fluids, medicines, blood products, chemical waste.
• Identify how these risks could cause harm, e.g. burning if in contact with skin.
• Check the accident book to highlight any common risks.
• What jobs can lead to exposure? For example, cleaning up bodily waste with bleach.
• How can you reduce the risk of harm occurring?

All of these risks need to be assessed and policies drawn up, so that every member of staff knows how to act when they come into contact with such a chemical, substance or associated risk.

Checklist

The HSE have a helpful hazard checklist:

• Does any product you use have a danger label?
• Does your process produce gas, fume, dust, mist or vapour?
• Is the substance harmful to breathe in?
• Can the substance harm your skin?
• Is it likely that harm could arise because of the way you use or produce it?
• What are you going to do about it?

– Use something else?

– Use it in another, safer way?

– Control it to stop harm being caused?

What is exposure limit?

Exposure to any hazardous substance is when it enters the body via breathing it in, through the skin, via injection or swallowing.

Thousands of different substances are used in nursing and healthcare every day. There are 500 substances that have what is known as Workplace Exposure Limits. You can find out if your workplace uses any of these substances and how to manage them on the HSE website.

Accidents, incidents and emergencies

All wards or care home must have policies in place to manage and report accidents in the workplace. This means having the correct equipment to hand, the correct protective equipment, the trained staff to deal with such an incident, and the correct arrangements in place to safely deal with the safe removal of waste.

All accidents and incidents need to be documented in the accident book and relevant authorities informed as indicated by workplace policy and procedures.

What are biological agents?

The control and management of biological agents are particularly relevant within the hospital and nursing home environment.

Biological agents cover all bacteria, fungi, viruses, and prions. Biological agents have to be monitored and contained as they can be harmful to humans by causing disease.

It’s important that you quickly identify the bacteria or virus and to follow local policies and procedures to stop the spread of infection and to give treatment.

The role of health surveillance

This is a series of health checks that are carried out in a hospital or nursing home when there has been exposure to chemicals or substances that are harmful to health. For example, a viral outbreak on a ward that could expose both healthcare staff and patients to that virus and cause disease.

Health surveillance allows better control of the situation, helps to evaluate risks, and can help to shape further education and training.

COSHH for nurses and healthcare assistants

There are two main areas that are important for nurses and healthcare assistants, those of the safe disposal of sharps and the management of clinical waste

‘Sharps’ are items that may cut or puncture your skin, e.g. needles. 

• A sharps injury occurs when a needle or scalpel penetrates the skin.
• Sharps injuries are a major source of occupational transmission of bloodborne viruses, e.g. hepatitis B, hepatitis C and human immunodeficiency virus (HIV).
• If you have a sharps injury you must follow your organisational protocol, even if you think the risk of contamination is negligible.
• To prevent sharps injuries all sharps must be disposed of correctly into designated sharps bins. Needles must never be re-sheathed.

Management of clinical waste

• This can include blood, vomit and medical swabs and supplies that contain bodily fluids.
• All clinical waste must be disposed of in the correct clinical waste bin and is usually placed into labelled clinical waste bags that are tied securely with a clip.
• It’s important to closely read your clinical waste policy and follow all procedures for its safe removal.
• When dealing with bodily fluids and the removal of clinical waste, it is vital that personal protective equipment (PPE) is worn at all times. This includes gloves, aprons, mask and goggles, depending on the level of exposure and if the bodily fluids are infectious.

COSHH training opportunities

Skills for Health offer a range of health and safety training courses for nurses and healthcare assistants, working within the NHS and the private sector. COSHH training is incredibly important for everyone working in the healthcare sector, Training should cover everything from the law, right through to working safely on the ‘shop floor’, keeping you and your patients safe at all times.