Health and Safety
Executive / Commission
Health services
This section contains a number of frequently asked questions to help illustrate the nature of some of the issues that HSE routinely gives advice on. The list is not exhaustive and further questions and answers will be added in the coming weeks.
HSE has a general responsibility to enforce the law, which requires employers to control risks to members of the public arising from work activities (Health and Safety at Work Act 1974).
Healthcare workers are a key risk group because of the nature of their work.We do not have accurate data on infections and ill health in this group - but data from physician reporting schemes indicates infection rates of about 30 per 100 000 workers per year amongst nurses and about 100 per 100 000 per year amongst care givers in residential homes. Most of these infections are diarrheal diseases. However, more serious infections do sometimes occur. For example, four health workers have died after having accidentally incurred needlestick injuries during work with HIV patients. Another nine are also known to be sero-positive as a result of this kind of accident.
The control of occupational exposure to biological agents in the healthcare setting is covered by the Control of Substances Hazardous to Health Regulations 2002 (COSHH). There is detailed guidance available from the Advisory Committee on Dangerous Pathogens (ACDP) or the Department of Health on the control of various micro-organisms such as blood borne viruses (e.g. HIV and hepatitis B), vCJD, viral haemorrhagic fevers and TB. The HSE's Health Services Advisory Committee (HSAC) also publishes guidance on clinical waste and post-mortem rooms. ACDP are currently preparing new guidance on biological agents in the laboratory and healthcare settings.
Healthcare-associated infection (HAI) is an important cause of morbidity and mortality amongst hospital patients, especially with the increasing resistance of many human pathogens to antibiotics (e.g. methicillin-resistant Staphylococcus aureus: MRSA). However, the HSE do not generally deal with clinical matters as these are more appropriately dealt with elsewhere. One exception to this is where there are management failures or failures of systems of work and in such cases HSE do sometimes become involved.
The Department of Health has produced several documents covering the control of infection in hospitals. Perhaps the most important of these are as follows:
Other sources of information on infection rates can be found at:
HSE’s advice is that mobile phones should not be considered as items of PPE as defined in the Personal Protective Equipment Regulations of 1992.
While mobile phones may be issued to visiting staff and lone working personnel to enable them to contact emergency services if required, the Regulations do not require employers to provide equipment for self defence or deterrent purposes, for example personal sirens / alarms or truncheons for use by security staff.
However, the regulations do apply to PPE (such as helmets or body armours) provided where staff are at risk from physical violence.
Employers have a duty under the Health and Safety at Work etc. Act 1974 (HSWA), to protect, so far as is reasonably practicable, the health, safety and welfare of their employees, including from any risks arising from exposure to environmental tobacco smoke (ETS).
Below are some ideas, which may be helpful. However, it is for the employer to decide how they tackle the problem of second hand smoke based on the findings of their risk assessment.
Examine possibilities of:
Consider educating those being cared for where possible. Smokers may be prepared to risk their own lives, but be more concerned about the damage they might cause others.
Free HSE guidance provides advice to employers on introducing effective smoking policies in the workplace. It recommends that policies should give priority to the needs of non-smokers who do not wish to breathe tobacco smoke.
HSE’s guidance is consistent with the British Government’s ongoing commitment to reduce people’s exposure to tobacco smoke, and the Government’s recognition that the introduction of smoke free workplaces will assist in this respect.
Following the total ban on smoking in enclosed public places and workplaces under public health legislation, HSC/E remains responsible for the consistent application of health and safety law across Great Britain, including ensuring the appropriate management of any risks arising from exposure to ETS in the workplace.
