anaesthetics in dental practice there has been an increase in the number of practices off ering relative analgesia. It is important that gas scavenging


systems are properly serviced and maintained to prevent leakage and transient escape into the working space. Exposure to nitrous oxide gas for patients is intended to be at (relatively) high concentrations for short periods of time. Exposure for staff at much lower concentrations for prolonged periods has a completely diff erent impact – which may cause problems especially for staff of childbearing age who could be at increased risk and whose potential exposure must be assessed and managed appropriately.


sight


the incoming patients? Are your domestic cleaners routinely disinfecting the taps in patient area washrooms or are they leaving a trap for the unwary? If your standards are not communicated


eff ectively to everyone in the business there could be a risk of disease transmission. T e British Dental Association (BDA) recognises that all members of the dental team have a responsibility to follow infection control guidelines to ensure safe practice. T ey have published detailed guidance, including topics such as surgery design, cleaning and disinfection. In addition, the Department of Health has published a technical memorandum on decontamination. T ese should be translated into clear, simple policies and staff guidance written in language your whole team can understand.


Gas scavenger systems Following the cessation of general


AUTUMN 2014


Skin problems – occlusive gloves How well do you manage skin care measures in your practice? Have you or any of your staff suff ered problems from itching, fl aking and reddening skin? Have you ever even asked the question? Severe allergic reaction to the wearing of natural rubber latex gloves is (thankfully) now far less common than it used to be as manufacturers introduce ever-safer unpowdered, low-free-protein formulations. Nitrile and vinyl gloves are available that are suitable for some tasks but even these can cause allergic skin reactions for some people and are certainly not the answer for all applications. Perhaps the bigger problem – the one


more commonly overlooked – is the need for a good skin-care regimen whatever glove is worn. Wearing any impermeable (occlusive) glove for prolonged periods can cause hyperhydration and a predisposition to subsequent skin problems including infection and/or physical damage. Th e science of skin care is developing rapidly. How much time do you have to keep up with developments outside your own specialism, and how do you ensure the standards you are working to conform to best practice? Access to an external advice and update service will oſt en be easier and less costly.


Amalgam toxicity T e debate over chronic toxicity of mercury dental amalgam may have some distance to go. With the increasing availability of social media, just two or three vociferous campaigners can make (and have made) a huge impact on the public perception – and it seems the calls for removal of dental amalgam will not go


away any time soon. However, regardless of any potential impact on health, what is your policy on waste segregation and management? T e Landfi ll Directive introduced in July


2004 made it almost impossible to legally dump mercury or mercury contaminated products in the UK, resulting in a massive growth in recycling and consultancy services. How accurately do you measure your inventory – and how confi dent are you that you are fully compliant with your waste management obligations?


Clinical sharps It seems redundant to emphasise that sharp blades and needles can cut or puncture staff as easily as they cut and puncture patients undergoing treatment. Yet sharps injuries do still occur, with all the consequential risks. Last year the UK introduced laws specifi cally requiring health workers to manage the risk. Do you know your obligations under the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013? Have you reviewed your policies and practices to ensure that collection bins are never overfi lled? And who handles these from fi rst opening to fi nal collection? Do you need to do anything more to prevent reduce or manage the risks of accidental inoculation or laceration?


Trivial hazards, serious incidents T ankfully, for most practices, these risks will never be realised. No one will be injured, there will be no catastrophic fi res and everyone will assume the place is safe. Unfortunately, the absence of consequence does not mean the absence of risk. If any workplace simply assumes it is safe because no one has yet fallen victim to an unidentifi ed risk then it can only be a matter of time before the luck runs out. Even apparently trivial hazards can cause serious incidents. A specialist health and safety service,


such as the one available at Law at Work, can assist in the identifi cation and management of a whole range of issues. Dentistry does not need to be high risk, but sometimes things go wrong and it can be reassuring to know you have done all you can to prevent harm.


n Steve Ashton is head of health and safety services at Law at Work


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