Waste strategy
contained in the ControlledWaste Regulations 2012. This is the first time that ‘offensive waste’ has been defined in UK law.
New legislation:
The EU Sharps Directive The European Council Directive 2010/32/EU (the Sharps Directive) came into legal force in June 2010, and has been implemented bymember states since 11 May this year. The new regulations that apply from11 May 2013 only contain those requirements not specifically addressed in existing legislation. Imminent EU law requires all healthcare organisations to implementmandatory safety standards to protect healthcare workers fromsharps injuries, and the subsequent risk of infection. The EU Directive applies to EU member states and non-EUmember states of the European Economic Area; each member state is required to introduce national legislation, or legally binding agreements, to implement the Directive. Many of the requirements contained in the Directive already formpart of health and safety law in Great Britain. The Sharps Directive aims to prevent
sharps injuries to healthcare workers by establishing an integrated approach to risk assessment, risk prevention, awareness raising and training, and implementing response and follow-up procedures.
Key requirements In a nutshell, the Directive requires that:
Employers and workers’ representatives work together to identify and reduce risks.
A formal risk assessment is conducted for exposure determination.
Where a risk of injury or infection is found, it must be eliminated by: Specifying safety procedures for using and disposing of medical sharps.
Providing medical services incorporating safety-engineered protection mechanisms.
Banning the recapping of needles.
It also requires that employers provide workers with information on the different risks, existing legislation, good practice in preventing/recording incidents, and support programmes. The Directive also applies to all workers
in the hospital and healthcare sector, as well as those under the managerial authority and supervision of the employer. Employers will need to ensure that any sub-contractors follow the same provisions.Workers must receive training, with policies and procedures to reduce their risk – including in the correct use of medical devices incorporating sharps protection mechanisms, and must also report all incidents involving ‘sharps’.
46 Health Estate Journal September 2013
The SRCL automated wash line, one of several key elements of the company’s Sharps Management Service.
Implementing the Directive The European Biosafety Network has a practical toolkit to aid the effective implementation of the Directive on the prevention of sharps injuries in the hospital and healthcare sector. The document illustrates best practice via a wide range of practical experiences, combined with relevant existing advice and independent studies.
and emerging figures The Health and Safety Executive (HSE) rightly points out (no pun intended) that sharps injuries are a well-known risk in the health and social care sector, and a valid cause for concern. Sharps contaminated with an infected patient’s blood can transmit more than 20 diseases, including hepatitis B, C, and human immunodeficiency virus (HIV). Because of this transmission risk, sharps injuries can cause worry and stress to the many thousands who receive them. More recently, reports claim that
The risk of sharps injuries
hepatitis C cases in the UK have increased by more than a third in two years. Figures released by Public Health England (PHE) state that there were 7,882 cases confirmed in England in 2010, rising to 10,873 in 2012. For hospital healthcare workers (HCW) this increase in cases is something to be aware of when it comes to the risk of a sharps injury. Hepatitis C is an infectious disease caused by the hepatitis C virus, which causes inflammation of the liver, and, if left untreated, can result in chronic liver disease, liver failure, or even death. As the liver can still operate even when damaged, many people are unaware they have the disease at first, because they have no symptoms. It is often only when the liver becomes seriously damaged that
symptoms occur, and people report to their doctor. Experts estimate there are around 160,000 people in England living with chronic hepatitis C. (Source: PHE).
Putting things in place Employers can implement changes in order to control the risk of exposure to a sharps injury to workers. They are required to have policies and procedures in place should a sharps injury occur, in accordance with national/regional legislation. Employers must also care for injured workers by providing necessary medical tests, post-exposure prophylaxis, counselling, rehabilitation, continuing employment, compensation, and confidentiality. The incorrect disposal of sharps is one
of the main causes of sharps injuries (HSE, online). Guidance on the Health and Safety Executive’s (HSE) website states: “Evidence shows that sharps injuries often occur when the used medical sharp is... disposed of incorrectly. Most sharps injuries to ancillary and support staff usually involve disposable medical sharps that have not been placed in an appropriate sharps container or have been placed in an overfull container.” Advice on the HSE website
(
www.tinyurl.com/ovcb75e), under the section, ‘Sharps injuries –What you need to do’, also states that: “Ideally sharps bins should be designed to prevent overfilling and accidental spillage of contents. They should be easy to close temporarily and permanently, and there should be no risk of puncture of the container.” In a situation where healthcare workers
are exposed to the risk of sharps injury, given the type of work they undertake, measures should be undertaken to minimise the exposure to this risk.
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