Biological agents: Managing the risks

1. Biological agents:Managing the risks Steve Copping HM Specialist Inspector Health and Safety Executive

2. Managing safely?

3. HSE Biological Agents Unit What we do Changes in HSE Future working relationships Update Guidance and advice RIDDOR Hot topics Transport Waste Aims

4. Biological Agents Unit • Has primary inspection/enforcement responsibilities for all work with higher hazard pathogens and genetically modified organisms

5. What we do • Inspect work places • Investigate accidents and cases of ill health • Enforce good standards • Publish guidance and advice • Provide an information service • Tel:08701 545500 • Fax:02920 859260 • hseinformationservices@natbrit.com • Conduct and sponsor research

6. Inspection

7. The Carriage of Dangerous Goods (Amendment) Regulations Reporting of Injuries, Diseases and Dangerous Occurrences Regulations Control of Substances Hazardous to Health Regulations Health surveillance Risk assessment Containment measures Information, Instruction and training Management of Health And Safety at Work Regulations Genetically Modified Organisms (Contained Use) Regulations Competent advice Working with biological agents

8. Changes in HSE • 2004 Strategy has four key messages • Sensible health and safety is a cornerstone of a civilised society • Sensible health and safety is about managing risks, not eliminating them • The people best placed to make workplaces safer are the staff and managers who work in them.They do this best by working together; and • HSE is committed to being a good partner – working with others to improve health and safety

9. What this means for the Biological agents unit Key partner in managing the risks

10. HSE BIOLOGICAL AGENTS UNIT Biotechnology Portfolio (old ‘GM’) Knowledge Centre incl. Notifications Management Team Intervention Section Infectious Disease Portfolio (Old ‘DP’)

11. Future working relationships • Continue to inspect • Continue to investigate accidents • Continue to provide advice and support • Continue to enforce where appropriate • Continue to run training events/roadshows • Use of designated inspectors • Intervention plans

12. Designated inspectors • Allocated to larger centres • Maintains overview of all BA issues throughout centre • More interaction with senior management and employees • Coordinated inspections • Oversees BA intervention plan

13. Intervention plans • Developed in consultation with you • Prioritisation of topics based on risk • Identifying key risk control measures • Benchmark inspections- agree where improvements needed • Subsequent verification at inspection • Improved transparency- both know what is expected

14. Safety Management Policy Organisation Planning & Implementation Measuring & Reviewing Performance

15. “the people best placed to make workplaces safer are the staff and managers who work in them. They do this best by working together” Should promote positive safety culture - shared perception of the importance of risk-based safety management There is nothing that we do as HSE inspectors that you cannot do yourselves Safety Management

16. Update • Guidance and advice • Managing the risks • Sealability • Fumigation • CL4 • Funeral guidance • Spa Pools • RIDDOR

17. Management of Spa Pools:Controlling the risks of infection • Health and Safety Executive (HSE) and Health Protection Agency (HPA) • Raise awareness of the microbiological risks and to give advice on some of the control measures that can be used to manage these risks effectively

18. CL3: sealability & fumigation SEM M. tuberculosis Mtb isolated on Löwenstein-Jensen medium

19. Sealability • COSHH requires that at CL3 the workplace is sealable to permit disinfection • Web based guidance • Testing for sealability • What you can do

20. Testing for sealability • Smoke pencils • Room negative pressure • Look for leakage sites from inside the laboratory • Easy to use and simple to visualise • Readily available and inexpensive • Requires knowledgeable tester

21. Testing for sealability • Smoke generator to fill the room with smoke • Laboratory under neutral pressure • Look for smoke outside the laboratory • Advantage when detecting leaks into large areas in which smoke builds up over time e.g roof voids, cavity walls • Aided by use of a dust lamp

22. What you should do • Smoke test when commissioning laboratory • Smoke test following any major structural changes to the fabric of the room • Check for sealability following routine maintenance • Carry out visual inspections as part of an internal auditing programme

23. Why is this so important? • Accidental breakage or spillage outside of a microbiological safety cabinet • Breach of containment with potential for release of infectious agent • Nothing to prevent escape of toxic fumigant gas

24. Fumigation operations • Formaldehyde • Hydrogen peroxide

25. RIDDOR • Fundamental review • Discussion document • HSC Advisory Committees • Paper to HSC • Final decision on the way forward

26. Regulation 3 & 4 Schedule 1 para 8 & 10 Schedule 2 para 7 Incident contact centre (ICC) ICC Tel: 0845 300 9923 Fax: 0845 300 9924 riddor@natbrit.com www.riddor.gov.uk Open 0830 and 1700 Monday to Friday RIDDOR

27. Hot topics • Transport • Waste

28. Transport • Significant changes in transport regulations for dangerous goods • Regulations governing air and postal transfers changed in January 2005 • Regulations governing road and rail transfers changed in July 2005

29. Department for Transportis the Competent authority

30. The Law • The law means that laboratories need to work with all involved in the transfer chain so as to be confident about the safety and security of samples and packages they send and receive. • Laboratories have a duty of care to their own staff, to the patient and the public

31. Expectation • Familiar with new transport Regs for Category A/B • Staff trained • New procedures for Cat A transfers • Adapt existing transfer procedures to deal with transfers of Cat B material

32. Expectation • Ensure management overview of the whole transfer process • Carry out a security review of the transfer process • Transfer security plan • On clinical/security and safety grounds improve • Tracking and alerting • Emergency planning • Auditing • Documentation

33. Further information • Biological Agents: managing the risks Appendix 1.2 • http://www.hse.gov.uk/biosafety/biologagents.pdf • DH guidance from Inspector of Microbiology • DfT “transport of infectious substances” • Http://www.dft.gov.uk/roads/dangerousgoods • “Guidance on regulations for the transport of infectioussubstances.” WHO

34. WASTE • Changes • Key points • Guidance on best practice • Unified approach • Further information

35. Environment Agencyis the Competent authority

36. Key changes • The definition and classification of infectious waste in accordance with hazardous waste regulations • Clinical waste classification system using groups A-E no longer used • Changes in carriage regulation bought about by the amended transport regs • A revised colour coded best practice waste segregation and packaging system • The use of European Waste Catalogue (EWC) codes

37. Legislative requirements • Waste legislation • Licences and permits • Duty of care • Carriage legislation • Health and safety legislation • HSWA • MHSWR • COSHH

38. COSHH • Assess the risks to employees and others • Make arrangements for reviewing the assessment • Adequately control the risks • Provide suitable and sufficient information, instruction and training • Provide health surveillance and immunisation where appropriate

39. MHSWR • Suitable and sufficient risk assessment • New expectant mothers / young people • Effective planning, organisation, control • Monitoring and review of any precautions • Health surveillance where appropriate • Access to competent H&S advice • Information for employees • Co-operate with other employers

40. Unified definition • Clinical waste • Hazardous waste (H9) • Infectious substance class 6.2 • If an item of healthcare waste is considered to pose a risk of infection it should be considered clinical waste, it should be classified as hazardous waste and should be transported as an infectious substance

41. Unified Approach • Highly infectious waste • Known or suspected to be contaminated with Cat A pathogens • Should be treated on-site prior to removal to a disposal facility • In exceptional circumstances, e.g. autoclave malfunction, waste should be packaged and transferred to an incinerator ASAP

42. Unified approach • Yellow stream infectious waste • Disposal by incineration • Unautoclaved waste from clinical laboratories • Known or suspected to contain Cat B pathogens

43. Unified approach • Orange stream • Treated to render safe prior to final disposal • Known or suspected Cat B pathogens • May contain autoclaved Cat A waste

44. Further information • DOH (7th July 2005) • “The classification of waste as hazardous infectious waste is unlikely to alter the existing treatment/disposal route and further guidance should be sought from your waste contractor(s).” • Safe management of healthcare waste • Revised and updated HSAC guidance • DoH website consultation • www.dh.gov.uk/consultations/liveconsultations • Closing date 7th February 2006

45. Contact details • Tel: 0151 951 3964 • steve.copping@hse.gsi.gov.uk