GUIDANCE NOTES ON RISK ASSESSMENT

Transcription

1 GUIDANCE NOTES ON RISK ASSESSMENT The Highland Council, Corporate Services, Health & Safety Team

2 CONTENTS Page 1 Introduction 3 2 Legislation 3 3 The Risk Assessment Process 4 4 Risk Assessment in Highland Council 5 5 Monitoring 6 6 Training 6 7 Five Steps to Risk Assessment 7 8 Serious & Imminent Danger 11 9 New & Expectant Mothers Monitoring & Review Management Checklist 12 Appendix 1 - Risk Assessment Sheet Appendix 2 - Risk Assessment - Summary of Process Appendix 3 - Risks to new and expectant mothers 2

3 1 1.1 Introduction The process of risk assessment underpins all current Health & Safety legislation. It no longer applies only to specific risks such as noise or hazardous substances but to all work activities. It is a process of determining what hazards exist in the work place, the likelihood of harm occurring and the need for appropriate control measures. The following guidance has therefore been produced to give practical advice on the implementation of the risk assessment process throughout the range of Highland Council Services Legislation The need for an employer to carry out risk assessment has been a requirement of health & safety legislation for many years. A summary of the risk assessment requirements is as follows: a) The Health & Safety at Work etc Act 1974 Sec 2 - Requires an employer to ensure the health, safety and welfare of his employees so far as is reasonably practicable. The process of risk assessment has therefore to be applied to determine what is reasonably practicable action in controlling any particular hazard. b) Control of Asbestos at Work Regulations 1987 Reg 5 - Requires an employer to carry out an adequate assessment of the exposure of employees to working with asbestos. c) The Control of Substances Hazardous to Health Regulations 1988 & 1994 Reg 6 - Requires an employer not to carry out any work liable to expose any employee to any hazardous substance unless a suitable and sufficient assessment of the risks created by that work has been undertaken and appropriate control measures are identified and implemented. d) The Noise at Work Regulations 1989 Reg 4 - Requires an employer to ensure that a competent person carries out a noise assessment when employees are exposed to noise levels above the action levels prescribed. Suitable control measures should be identified and implemented to reduce the risk of hearing damage. e) The Personal Protective Equipment at Work Regulations Require an employer to ensure that personal protective equipment (PPE) is suitable for its purpose (regulation 4), which implies that a risk assessment should be carried out to match the level of protection provided with the hazard present. f) The Health and Safety (Display Screen Equipment) Regulations Call on the employer to perform a suitable and sufficient analysis of the workstation for the purpose of assessing the risks to health and safety from its use. g) The Manual Handling Operations Regulations Require an employer to carry out a suitable and sufficient assessment of the risk of injury from manual handling, where it is not reasonably practicable to introduce mechanical handling. 3

4 h) The Provision and Use of Work Equipment Regulations 1992 while not explicitly requiring a risk assessment, call on the employer to ensure that work equipment is suitable for the purpose for which is intended. Selection of work equipment therefore involves identifying the task and any associated hazard, and selecting any equipment that will either overcome or control that hazard. In addition, the equipment must not introduce further hazard. i) The Workplace (Health, Safety and Welfare) Regulations 1992 identify a number of hazards in the workplace which must be controlled, such as vehicles, the working environment, maintenance of the fabric of a building, etc. The Regulations expect an employer to look at a particular situation, carry out a risk assessment and choose the appropriate control measures to reduce the risk of injury to an acceptable level. j) The Management of Health and Safety at Work Regulations 1992 require the employer to make a suitable and sufficient assessment of the risks to which employees are exposed whilst at work and the risks to the health and safety of non-employees arising from that undertaking. The purpose of this risk assessment is to ensure that those hazards not yet identified, eliminated or controlled under prior regulations should be addressed in an all embracing assessment. It is therefore not necessary to repeat assessments made under the aforementioned regulations, unless there is reason to believe the assessment is no longer valid. Amendments to the Management Regs in 1994 introduced a specific requirement to take particular account of risks to new and expectant mothers. 3 The Risk Assessment Process 3.1 There is no precise process defined in the regulations or guidance for carrying out risk assessments. It is left to individual employees to determine the method which best suits their work activities. In its advisory leaflet 5 steps to risk assessment, the HSE promotes the use of the following 5 step approach: Step 1: Look for the hazards. Step 2: Decide who might be harmed and how. Step 3: Evaluate the risks and decide whether existing precautions are adequate or whether more should be done. Step 4: Record your findings. Step 5: Review the assessment and revise it as necessary. 3.2 A detailed description of how to carry out this process is contained in Section 7 of this guidance. It is recommended however that only persons who have received the appropriate training, be required to carry out assessments. 4

5 4 Risk Assessment in Highland Council 4.1 To ensure that all work activities and premises are covered, Service Directors, Area Managers and Area Service Managers must arrange for sufficient numbers of their staff to be trained to carry out the process of risk assessment 4.2 Persons selected for training as assessors should be familiar with the premises and work activities to be assessed and be aware of the types of hazard likely to be present. 4.3 Although Management may delegate responsibility for carrying out assessments to other members of staff they must retain over-all ownership of the process. 4.4 It is important therefore that all Service Directors, Area Managers and Area Service Managers: a) Are familiar with the process of risk assessment. b) Support those staff delegated with the responsibility of carrying out risk assessments (see paragraph 4.5). c) Discuss the significant findings with assessors. d) Determine and where appropriate implement the necessary control measures to reduce or eliminate a particular risk. This is particularly important where cost implications have been identified. 4.5 To ensure that the risk assessment process is carried out effectively it is essential that appropriate support is provided to assessors by their line managers. It is recommended that a debriefing meeting be arranged on the persons return from assessor training. The purpose of the meeting being to determine the extent of the task and organisation of the assessors normal workload to ensure sufficient time is allocated to enable assessments to be carried out. 4.6 Assessors should be encouraged to report any significant findings to their line managers as soon as they come to light during the assessment process. This should help ensure that high risk areas and activities are dealt with without delay. 4.7 Further discussion between line manager and assessor should take place on completion of the assessment process. At this meeting, proposed actions and priorities should be determined in relation to areas or activities where additional control measures are required to reduce or eliminate a particular risk. 4.8 Assistance and advice on the range of options for control measures and/or prioritisation can be obtained by contacting the Health & Safety Team. 5

6 4.9 Service Directors should identify a suitable member of their staff to act as a Health & Safety Co-ordinator. This persons role would be to assist in the development of Service specific health & safety policies and monitoring the implementation of Corporate policy and guidance on issues such as risk assessment. In relation to risk assessments the Co-ordinator should: a) Ensure that assessments are carried out in each of the 8 Council Areas and in respect of Headquarters staff. b) Ensure that results of the assessments are recorded and collated. c) Ensure that the follow-up action identified as a result of the assessments is undertaken. d) Ensure that assessments are reviewed as necessary. 5 Monitoring 5.1 To be effective, this policy and guidance must be: a) Implemented and b) Monitored to determine its effectiveness. 5.2 The Service Health and Safety Co-ordinators will have a monitoring role as outlined in para Service Directors should also monitor the extent to which risk assessments have been carried out at Service Management team meetings. 5.4 Area managers should monitor the implementation of this policy and guidance by requiring progress reports to be submitted to Area management team meetings 5.5 Members of the Health & Safety Team will monitor the extent to which risk assessments have been carried out and recorded during inspection and audits of premises. 6 Training 6.1 Training will be provided for all persons given the responsibility of carrying out risk assessments (paragraph 4.1). 6.2 Line managers of those staff who are carrying out risk assessments should also receive risk assessment training. This will ensure that they understand the need for the process and have sufficient knowledge to determine appropriate control measures. 6

7 6.3 Attendance at training courses can be arranged by contacting the Training and Development Team, Corporate Services, Dochfour Drive, Inverness. Tel: The course will take the form of a half day workshop, led by an Adviser from the Health and Safety Team. 6.5 The workshop training concentrates on practical issues and case scenarios designed to enable participants to carry out risk assessments on their return to the workplace. 6.6 In addition, attendance at the course will enable participants to: a) Understand the legislative requirements for risk assessment. b) Understand the terms Hazard and Risk. c) Undertake a process of risk estimation as outlined in HSE s booklet HS(G)65 Successful Health and Safety Management. d) Understand the hierarchy of control measures. e) Keep appropriate records. 7 Five Steps to Risk Assessment 7.1 In its advisory literature, the HSE promotes the use of a 5 step approach to the process of risk assessment. 7.2 Before commencing the process it is important to understand the meaning of the terms Hazard and Risk as follows: HAZARD - is anything that can cause harm (eg electricity, fire, chemicals). RISK - is the likelihood of harm occurring. 7.3 STEP 1 - Look for the Hazards 7.4 In the initial stage of the process the assessor would be expected to walk around the workplace and take a fresh look at what could reasonably be expected to cause harm. Effort should be concentrated on hazards which could result in significant harm or may affect several people. All hazards should be listed at this stage however. 7.5 When listing hazards it is useful to consult with other employees in the workplace who may have noticed things which are not immediately obvious. 7

8 7.6 Reference should also be made to manufacturers operating instructions, hazard data sheets etc, which should clearly indicate the hazard a particular machine or chemical may present. 7.7 Accident and/or ill health records may also help to identify particular hazards associated with a workplace or work activity. 7.8 In general terms however the following examples may prove useful: Slipping/tripping hazards (eg poorly maintained floors or stairs) Fire (eg from flammable materials) Electricity (eg poor wiring) Chemicals (eg Battery Acid) Dust (eg from grinding) Moving parts of machinery (eg blades) Fumes (eg welding) Work at height (eg from mezzanine floors) Manual handling Ejection of material (eg from plastic moulding) Noise Pressure systems(eg steam boilers) Poor lighting Vehicles (eg fork-lift trucks) Low temperature 7.9 An example of the form for recording this and other information in the risk assessment process is given in Appendix Step 2 - Decide who might be harmed and how 7.11 When considering who might be harmed there is no need to list individuals by name. It is more appropriate to list groups of people doing similar work or who may be similarly affected by a particular work activity It is important to consider people who may not be in the workplace all the time eg visitors and contractors etc Particular attention should be given to those who may be more vulnerable eg staff with disabilities and lone workers etc The following list may therefore prove useful at this stage: Office Staff Maintenance Personnel Contractors Operators Cleaners Members of the public (including clients and pupils) People sharing the workplace Staff with disabilities Visitors Young or inexperienced staff Lone workers 8

9 7.15 Step 3 - List existing controls 7.16 At this stage information should be provided on the steps that have already been taken to control a particular risk It may be necessary to provide details of information, instruction or training provided in relation to a safe system of work. In this respect reference may need to be made to written procedures and operating manuals etc When considering the adequacy of existing control measures it is important to determine whether: a) They meet the standards set by a legal requirement (ie prevent access to dangerous parts of machinery). b) They comply with a recognised industry standard. c) They represent good practice. d) They reduce the risk as far as is reasonably practicable The effectiveness or even lack of existing control measures will have a bearing on the calculation of residual risk in Step Step 4 - Calculate the Residual Risk 7.21 In guidance booklet HSG (65), the Health and Safety Executive outline the following simple method of qualifying risk or Risk Rating The method involves making two judgements, one on the potential SEVERITY of any possible injury and the other on the LIKELIHOOD of harm occurring. Both judgements are on a scale of 1 to 3 as follows: SEVERITY SCALE 1 SLIGHT all injuries not defined as Major or Serious 2 SERIOUS injuries that are not Major but are likely to prevent someone working normally for more than 3 days. 3 MAJOR death or major injury eg fracture of a bone, amputation, serious damage to an eye etc. 9

10 LIKELIHOOD SCALE 1 LOW unlikely to happen 2 MEDIUM could well happen 3 HIGH certain or near certain to happen 7.23 The risk rating is then calculated by multiplying the severity and likelihood figures The figure at which a tolerable level of risk is set is to some extent arbitrary. Obviously the higher the risk rating the more significant the risk and the greater will be the need to control that risk. For Highland Council assessment purposes however risk ratings of 4 or more are considered significant and will demand action Risk ratings of 3 or below can normally be discounted, however consideration should be given to reducing the risk to the lowest possible level, particularly if this can be achieved at little or no cost Step 5 - Determine Control Measures 7.27 The final stage of the process is the determination of appropriate control measures necessary to eliminate or reduce a risk to an acceptable level Risk ratings of 4 or more will require some action to be taken in respect of additional control. The higher the risk factor the greater is the priority for action When considering the effectiveness of control measures, the following principles should be applied. 1. Remove the risk completely MOST EFFECTIVE 2. Try a less risky option 3. Prevent access to the hazard (eg by guarding) 4. Organise work to reduce exposure to the hazard 5. Issue personal protective equipment LEAST EFFECTVE 7.30 Reference should be made to recognised good practice, HSE guidance and legal requirements when determining whether a particular method of control is adequate Further information and advice on control measures and access to codes of practice etc can be obtained by contacting the Health and Safety Team. 10

11 8 Serious and Imminent Danger 8.1 As part of the risk assessment process, written procedures must be prepared to deal with situations of serious and imminent danger. 8.2 In most instances this will relate to emergency procedures to be followed in the event of a fire or bomb threat. The aim should be to provide clear guidance on when employees and others at work should stop work and how they should move to a place of safety. 8.3 People who work with machinery and other work equipment must be informed of the procedure to be adopted should a fault develop which may place them in a situation of serious or imminent danger. In such circumstances the most appropriate course of action would be to stop work and if possible switch off or immobilise the machine and report the fault immediately to the line manager. 9 New and Expectant Mothers 9.1 During the risk assessment process there is a specific requirement to take account of risks to new and expectant mothers. 9.2 If risks cannot be avoided by other means then it may be necessary to make changes to working conditions or hours, offer suitable alternative work, or if that is not possible give the worker paid leave for as long as necessary to protect her health and safety or that of her child. 9.3 The regulations define the phrase new or expectant mother as a worker who is pregnant, who has given birth in the previous six months, or who is breastfeeding. 9.4 Details of some of the Hazards, Risks and ways of avoiding them are contained in Appendix 3. Further information relating to other specific chemical risks can be obtained by contacting the Health and Safety Team 10 Monitoring and Review 10.1 It is essential that the effectiveness of control measures identified by the risk assessment process is monitored. This is particularly important where a safe system of work has been established to ensure that everyone carries out the task in accordance with the recognised safe procedures. It is also important in relation to mechanical controls (ie guards) to ensure that they are correctly fitted and in place when equipment is operating Service Directors, Area Managers and Area Service Managers should therefore ensure that the results of risk assessments and the appropriate control measures are reported to the staff affected and their line managers. 11

12 10.3 Line managers and supervisors should monitor the effectiveness of control measures and in particular ensure that safe systems of work are adhered to at all times Progress on the risk assessment process itself should also be monitored, see paragraph Risk assessments should be reviewed every 5 years if there are/have been no significant changes to the job task and location etc The introduction of new machinery, substances or working procedures could well lead to new hazards. The risk assessment must therefore be reviewed whenever these circumstances arise. 11 Management Checklist 11.1 Service Directors may wish to refer to the following checklist when determining compliance with the Risk Assessment Policy and Guidance: 1. Has a Health and Safety Co-ordinator been appointed for your Service? (see 4.9) 2. Have sufficient numbers of staff been identified to carry out assessments? (see 4.1) 3. Have assessors received appropriate training? (see sec 6) 4. Have assessment sheets been completed? (see sec 7) 5. Have significant risks been identified? 6. Have arrangements been made for suitable control measures to be introduced? 7. Has the Service Health and Safety policy been revised as a result of the exercise? 11.2 Further information and advice on risk assessment and other health and safety matters can be obtained by contacting the Health & Safety Team, Corporate Services, Dochfour Drive, Inverness. Tel:

13 13

14 APPENDIX 1 THE HIGHLAND COUNCIL RISK ASSESSMENT SHEET SHEET No: SERVICE AREA LOCATION List potential hazards here: DESCRIPTION OF WORK ACTIVITY OR AREA OF THE WORKPLACE ASSESSED NAME OF ASSESSOR DATE COMPLETED DATE OF REVIEW STEP 1 STEP 2 STEP 3 STEP 4 STEP 5 List groups of people who are List existing controls or Calculate the residual risk taking the at risk from the hazards you note where the information presence and effectiveness of control have identified: may be found: measures into account: Severity X Likelihood = Risk Rating * (1 to 3) (1 to 3) List further control measures necessary to reduce risk to an acceptable level AND date of introduction of these measures: * NOTE - RISK RATINGS OF 4 OR MORE ARE SIGNIFICANT AND REQUIRE ACTION

15

16 NEW AND EXPECTANT MOTHERS APPENDIX 3 HAZARDS, RISKS AND WAYS OF AVOIDING THEM List of agents/working conditions What is the risk? How to avoid the risk Other legislation PHYSICAL AGENTS - Where these are regarded as agents causing foetal lesions and/or likely to disrupt placental attachment, and in particular: Shocks, vibration or movement Regular exposure to shocks, low frequency vibration for example driving or riding in off-road vehicles, or excessive movement, may increase the risk of a miscarriage. Long-term exposure to vibration does not cause foetal abnormalities but often occurs with heavy physical work, so there may be an increased risk of prematurity or low birth weight. Pregnant workers and those who have recently given birth are advised to avoid work likely to involve uncomfortable whole body vibration, especially at low frequencies, or where the abdomen is exposed to shocks or jolts. Breastfeeding workers are at no greater risk than other workers. None specific Manual handling of loads where there is a risk of injury Pregnant workers are especially at risk from manual handling injury - for example hormonal changes can affect the ligaments, increasing susceptibility to injury; and postural problems may increase as the pregnancy progresses. There can also be risks for those who have recently given birth, for example after a caesarean section there is likely to be a temporary limitation on lifting and handling capability. There is no evidence to suggest that breastfeeding mothers are at greater risk from manual handling injury than any other workers. The changes an employer should make will depend on the risks identified in the assessment and the circumstances of the business. For example, it may be possible to alter the nature of the task so that risks from manual handling are reduced for all workers including new or expectant mothers. Or it may be necessary to address the specific needs of the worker and reduce the amount of physical work, or provide aids for her in future ro reduce the risks she faces. 1 Manual Handling Operations Regulations 1992 require employers to: avoid the need for hazardous manual handling, so far as is reasonably practicable. assess the risks from those operations that cannot be avoided; and take steps to reduce these risks to the lowest level reasonably practicable.

17 List of agents.working conditions What is the risk? How to avoid the risk Other Legislation Noise There appears to be no specific risk to new or expectant mothers or to the foetus, but prolonged exposure to loud noise may lead to increased blood pressure and tiredness. The requirements of the Noise at Work Regulations 1989 should be sufficient to meet the needs of new or expectant mothers. Noise at Work Regulations 1989 apply to all workers exposed to loud noise where there is a risk to hearing. No particular problems for women who have recently given birth or who are breastfeeding. 2

18 Ionising Radiation Significant exposure to ionising radiation can be harmful to the foetus and this is recognised by placing limits on the external radiation dose to the abdomen of the expectant mother for the declared term of her pregnancy. Work procedures should be designed to keep exposure of the pregnant woman as low as reasonably practicable and certainly below the statutory dose limit for pregnant women. Ionising Radiations Regulations 1995 and supporting Approved Codes of Practice. If a nursing mother works with radioactive liquids or dusts, these can cause exposure of the child, particularly through contamination of the mother s skin. Special attention should be paid to the possibility of nursing mothers receiving radioactive contamination and they should not be employed in work where the risk of such contamination is high. Also, there may be a risk to the foetus from significant amounts of radioactive contamination breathed in or ingested by the mother and transferred across the placenta. The working conditions should be such as to make it unlikely that a pregnant women might receive high accidental exposures to radioactive contamination. List of agents.working conditions What is the risk How to avoid the risk Other Legislation Non-ionising electgromagnetic radiation (NIEMR) Optical radiation: Pregnant women or breastfeeding mothers are at no greater risk than other workers None specific 3

19 Electromagnetic fields and waves (eg radio-frequency radiation): Exposure to electric and magnetic fields within current recommendations is not known to cause harm to the foetus or the mother. However, extreme overexposure to radio-frequency radiation could cause harm by raising body temperature Exposure to electric and magnetic fields should not exceed the restrictions on human exposure published by the National Radiological Protection Board Extremes of cold or heat When pregnant, women tolerate heat less well and may more readily faint or be more liable to heat stress. The risk is likely to be reduced after birth, but is is not certain how quickly an improvement comes about. Pregnant workers should take great care when exposed to prolonged heat at work, for example when working near furnaces. None specific. Breastfeeding may be impaired by heat dehydration. Rest facilities and access to refreshments would help. No specific problems arise from working in extreme cold, although clearly for other health and safety reasons, warm clothing should be provided. List of agents.working conditions What is the risk? How to avoid the risk Other Legislation 4

20 Movements and postures, travelling either inside or outside the establishment - mental and physical fatigue and other physical burdens connected with the activity of new or expectant mothers. Fatigue from standing and other physical work has long been associated with miscarriage, premature birth and low birth weight. Excessive physical or mental pressure may cause stress and can give rise to anxiety and raised blood pressure. Pregnant workers may experience problems in working at heights, for example ladders, platforms, and in working in tightly fitting workspaces or with workstations which do not adjust sufficiently to take account of increased abdominal size, particularly during the later stages of pregnancy. This may lead to strain or sprain injuries. Dexterity, agility, coordination, speed of movement, reach and balance may also be impaired, and an increased risk of accidents may need to be considered. Ensure that hours of work and the volume and pacing of work are not excessive and that, where possible, the employees themselves have some control over how their work is organised. Ensure that seating is available where appropriate. Longer or more frequent rest breaks will help to avoid or reduce fatigue. Adjusting workstations or work procedures may help remove postural problems and risk of accidents. List of agents/working condtions What is the risk? How to avoid the risk Other legislation 5

21 WORKING CONDITIONS Work with Display Screen Equipment (VDUs)` Although not specifically listed in the Pregnant Workers Directive, HSE is aware that anxiety about radiation emissions from display screen equipment and possible effects on pregnant women has been widespread. However, there is substantial evidence that these concerns are unfounded. The HSE has consulted the National Radiological Protection Board, which has the statutory function of providing information and advice on all radiation matters to Government Departments, and the advice below summarises scientific understanding:- The levels of ionising and non-ionising electromagnetic radiation which are likely to be generated by display screen equipment are well below those set out in international recommendations for limiting risk to human health created by such emissions and the National Radiological Protection Board does not consider such levels to pose a significant risk to health. No special protective measures are therefore needed to protect the health or people from this radiation. There has been considerable public concern about reports of higher levels of miscarriage and birth defects among some groups of visual display unit (VDU) workers, in particular due to electromagnetic radiation. Many scientific studies have been carried out, but taken as a whole their results do not show any link between miscarriages or birth defects and working with VDUs. Research and reviews of the scientific evidence will continue to be undertaken. In the light of the scientific evidence pregnant women do not need to stop work with VDUs. However, to avoid problems caused by stress and anxiety, women who are pregnant or planning children and worried about working with VDUs should be given the opportunity to discuss their concerns with someone adequately informed of current authoritative scientific information and advice. Display Screen Equipment Regulations List of agents/working conditions What is the risk? How to avoid the risk Other Legislation 6

22 BIOLOGICAL AGENTS Any biological agent of hazard groups 2, 3 and 4 (Categorisation of biological agents according to hazard and categories of containment - Advisory Committee on Dangerous Pathogens) Many biological agents within the three risk groups can affect the unborn child if the mother is infected during pregnancy. These may be transmitted through the placenta while the child is in the womb, or during or after birth, for example through breastfeeding or through close physical contact between mother and child. Examples of agents where the child might be infected in one of these ways are hepatitis B, (the AIDS virus), herpes, TB, syphilis, chickenpox and typhoid. For most workers, the risk of infection is not higher at work than from living in the community, but in certain occupations, exposure to infections is more likely, for example laboratory workers, health care, people looking after animals and dealing with animal products. Depends on the risk assessment, which will take account first of the nature of the biological agent, how infection is spread, how likely contact is, and what control measures there are. These may include physical containment, hygiene measures, use of available vaccines if exposure justifies this. If there is a known high risk of exposure to a highly infectious agent, then it will be appropriate for the pregnant worker to avoid exposure altogether. Control of Substances Hazardous to Health Regulations 1994; Approved Code of Practice on the control of biological agents; approved list of biological agents. Biological agents known to cause abortion of the foetus, or physical and neurological damage. These agents are included in hazard groups 2, 3 and 4. Rubella (German measles) and toxoplasma can harm the foetus, as can some other biological agents, for example cytomegalovirus (an infection common in the community) and chlamydia in sheep. The risks of infection are generally no higher for workers than others, except in those exposed occupations (see above). See above. See above. 7

23 List of agents/working conditions CHEMICAL AGENTS What is the risk? How to avoid the risk Other legislation The following chemical agents in so far as it is known that they endanger the health of pregnant women and the unborn child: Substances labelled R40, R45, R46 and R47 under Directive 67/548/EEC [since amended or adapted on a number of occasions] There are about 200 substances labelled with these risk phrases: R40: R45: R46: R47: R61: R63: R64: Possible risk of irreversible effects May cause cancer May cause heritable genetic damage May cause birth defects this is due to be replaced in 1994/95 by the risk phrases: May cause harm to the unborn child Possible risk of harm to unborn child May cause harm to breastfed babies The actual risk to health of these substances can only be determined following a risk assessment of a particular substance at the place of work ie although the substances listed may have the potential to endanger health or safety, there may be no risk in practice, eg if exposure is below a level which might cause harm. With the exception of lead (see below) and asbestos these substances all fall within the scope of COSHH. For work with hazardous substances, which include chemicals which may cause heritable genetic damage, employers are required to assess the health risks to workers arising from such work, and where appropriate prevent or control the risks. In carrying out assessments employers should have regard for women who are pregnant, or who have recently given birth. Control of Substances Hazardous to Health Regulations (COSHH). Chemicals (Hazard Information and Packaging) Regulations 1993 (CHIP). 8

24 List of agents/working conditions What is the risk? How to avoid the risk Other legislation Chemical agents and industrial processes in Annex 1 to Directive 90/394/EEC The substances, preparations and processes listed in Annexe 1 of the EC Directive on the Control of Carcinogenic Substances are also covered by COSHH (see above). COSHH (see above) Mercury and mercury derivatives Organic mercury compounds could have adverse effects on the foetus. Animal studies and human observations have demonstrated that exposure to these forms of mercury during pregnancy can slow the growth of the unborn baby, disrupt the nervous system, and cause the mother to be poisoned. No clear evidence of adverse effects on developing foetus from studies of humans exposed to mercury and inorganic mercury compounds. No indication that mothers are more likely to suffer greater adverse effects from mercury and its compounds after the birth of the baby. Potential for health effects in children from exposure of mother to mercury and mercury compounds is uncertain. Guidance Notes EH17: Mercury health and safety Precautions MS12: Mercury medical surveillance give practical guidance on the risks of working with mercury and how to control them. Mercury and mercury derivatives are covered by the requirements of COSHH. 9

25 List of agents/working conditions What is the risk? How to avoid the risk Other legislation Antimitotic (cytotoxic) drugs In the long term these drugs cause damage to genetic information in sperm and eggs. Some can cause cancer. Absorption is by inhalation or through the skin. There is no known threshold limit and exposure must be reduced to as low a level as is reasonably practicable. Assessment of the risk should look particularly at preparation of the drug for use (pharmacists, nurses), administration of the drug, and disposal of waste (chemical and human). COSHH Those who are trying to conceive a child or are pregnant or breastfeeding should be fully informed of the reproductive hazard. HSE s Guidance Note MS21 Precaustions for the safe handling of cytotixic drugs gives information about the health hazards and advice on avoidance/reduction of risk. 10

26 List of agents/working conditions What is the risk? How to avoid the risk Other legislation Chemical agents of known and dangerous percutaneous absorption (ie that may be absorbed through the skin). This includes some pesticides. The HSE guidance booklet EH40 Occupational exposure limits, updated annually, contains tables of inhalation exposure limits for certain hazardous substances. Some of these substances can also penetrate intact skin and become absorbed into the body, causing ill-health effects. These substances are marked Sk in the tables. As with all substances, the risks will depend on the way that the substance is being used as well as on its hazardous properties. Absorption through the skin can result from localised contamination, for example from a splash on the skin or clothing, or in certain cases, from exposure to high atmospheric concentrations of vapour. Take special precautions to prevent skin contact. Where possible, use engineering methods to control exposure in preference to personal protective clothing, such as gloves, overalls or face shields. For example perhaps you could enclose the process or redesign it so that less spray is produced. Where you must use personal protective equipment (either alone or in combination with engineering methods), ensure that it is suitable. The Control of Pesticides Regulations 1986 (COPR), sets out general restrictions on the way that pesticides can be used. In addition all pesticides must be approved before they can be advertised, sold, supplied, used or stored. Conditions can be put onto the approval, which may for example limit the way the product can be used (for example restrict the way that it can be applied), require that certain safety precautions are followed, and restrict who may use it (for example professionals or amateurs). These conditions are reflected on the product label. Failure to comply is an offence. COSHH (see above) Control of Pesticides Regulations 1986 (COPR). 11

27 List of agents/working conditions What is the risk? How to avoid the risk Other legislation Carbon Monoxide Carbon monoxide readily crosses the placenta and can result in the foetus being starved of oxygen. Data on the effects of exposure to carbon monoxide on pregnant women are limited but there is evidence of adverse effects on the foetus. Both the level and duration of maternal exposure are important factors in the effect on the foetus. HSE s guidance note EH43: Carbon monoxide gives practical advice on the risks of working with carbon monoxide and how to control them. It warns that pregnant women may have heightened susceptibility to the effects of exposure to carbon monoxide. None specific except for the general requirements of COSHH in relation to hazardous substances. There is no indication that breastfed babies suffer adverse effects from their mother s exposure to carbon monoxide, nor that the mother is significantly more sensitive to carbon monoxide after giving birth. 12

28 List of agents/working conditions What is the risk? How to avoid the risk Other legislation Lead and lead derivatives in so far as these agents are capable of being absorbed by the human organism. Occupational exposure to lead in the early 1900s, when exposure was poorly controlled, was associated with high frequencies of spontaneous abortion, stillbirth and infertility. More recent studies draw attention to an association between low-level lead exposure before the baby is born from environmental sources and mild decreases in intellectual performances in childhood. The effects on breastfed babies of their mothers lead exposure have not been studied. However, lead can enter breast milk. Since it is thought that the nervous system of young children is particularly sensitive to the toxic effects of lead, the exposure of breastfeeding mothers to lead should be viewed with concern. The Approved Code of Practice associated with the lead regulations Control of lead at work sets out the current exposure limits for lead and the maximum permissible blood lead levels for workers who are exposed to lead to such a degree that they are subject to medical surveillance. It gives a blood lead level for men and a lower level for women of reproductive capacity. This lower level is set to help ensure that women who may become pregnant have low blood lead levels. This is to help protect the foetus from injury in the weeks before a pregnancy is confirmed. Once their pregnancy is confirmed, women who are subject to medical surveillance under the lead regulations will normally be suspended from work which exposes them significantly to lead, by the Employment Medical Adviser or Appointed Doctor carrying out the medical surveillance. Control of Lead at Work Regulations 1980 (CLAW) (Currently under review). 13

29 ASPECTS OF PREGNANCY THAT MAY AFFECT WORK Apart from the hazards listed in the table, there are other aspects of pregnancy that may affect work. The impact will vary during the course of the pregnancy and their effects should be kept under review, for example the posture of expectant mothers changes to cope with increasing size. ASPECTS OF PREGNANCY Morning Sickness Backache Varicose Veins Haemorrhoids Frequent visits to the toilet Increasing size Tiredness Balance Comfort FACTORS IN WORK Early shift work Exposure to nauseating smells Standing/manual handling/posture Standing/Sitting Working in hot conditions Difficulty in leaving job/site of work Use of protective clothing Working in confined spaces Manual Handling Overtime, Evening Work Problems of working on slippery, wet surfaces Problems of working in tightly fitting workspaces Dexterity, agility, co-ordination, speed of movement, reach may be impaired because of increasing size. 14