Control of Substances Hazardous to Health Regulations 2002 (as amended)

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Morgan Francis
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1 Control of Substances Hazardous to Health Regulations 2002 (as amended) Background to the COSHH Regulations The Control of Substances Hazardous to Health Regulations (COSHH) place a duty on the employer or the self-employed to control substances hazardous to health that are associated with their work activities. For the purpose of the Regulations, a hazardous substance is most simply defined as any substance capable of causing an adverse health effect and may include chemicals, biological agents, and dusts. It is important to remember that many substances used in the dental laboratory may harm the health due to long-term usage. Many dental technicians can be complacent to the potentially harmful effects of substances that they work with every day. However there are several reported cases of dental technicians developing either health conditions particularly in relation to lung disorders due to years of exposure to harmful dusts. On the other hand occupational diseases such as asthma and dermatitis can develop after a relatively short time. Examples of some substances that could be hazardous in a laboratory that need to be controlled: Name of substance Methyl Methacrylate Monomer Molybdenum Cristobalite Carbon Tetrachloride Glutaraldehyd Phosphoric acid Bacteria/Viruses (eg Hepatitis B) May be Found in Denture base Chrome-cobalt alloys/stainless steel Investment materials Solvent Disinfectant Etching agents Blood Substances, which represent a danger to safety, i.e. which can cause injury as opposed to illness, as a result of their flammability or explosiveness etc are excluded from COSHH. However you may find that some substances (e.g. monomer) are flammable but are also classed as harmful or irritant. Note: The use of Beryllium, once a commonly-used substance in dental alloys, is now prohibited.

2 IDENTIFYING THE SUBSTANCES The first step of the assessment is to do some detective work and find out more information about the substances that you are using in the laboratory. There are two approaches you can take: 1. Look at each of the different types of work that you carry out in your lab, e.g. Acrylic Denture Production, Crown production, Chrome cobalt work. 2. For each of the different types of work carried out, you could map out from start of production to the end appliance, the substances that are used in each stage of the process. The latter seems a logical way to identify all the substances that you use in the laboratory. However you need to be careful to make sure that you do not miss out certain substances that are not directly involved in a particular work process such as substances used in cleaning or in office work etc. How can you find out more about the substances you use? Information on the type of substances being used in the laboratory and their associated risks should be available on or in the packaging. Suppliers and manufacturers of substances deemed as chemicals must comply with the Chemicals (Hazard Information and Packaging for Supply) Regulations 2002 (CHIP). Purchasers and users of chemicals must be given enough information on the hazards to protect their health and safety. Under section 6 of the Health and Safety at Work Act 1974, manufacturers and suppliers are obliged to provide safety data sheets for all substances which are classified as dangerous. The safety data sheets provide detailed information about the substance, including handling, storing, first aid and relevant supplier or manufacturers contact details. If you do not have safety data for a substance, which you suspect, may be potentially hazardous you should contact the supplier and request that this is sent to you. Packaging of Chemicals Chemicals are packaged in such a way, to provide instant information to the user. All containers should contain a warning label, which should be an orange square with an appropriate black symbol. The symbol may represent: Harmful or irritant the warning label on the packaging is like a cross Corrosive the warning label on the packaging is two horizontal dripping test tubes over a hand and workbench Toxic or Very Toxic the warning label on the packaging is a skull and crossbones

3 Just because a substance is not clearly marked as being hazardous, does not mean to say that it is not hazardous. The by-product could be hazardous (e.g. the dust generated when trimming and grinding alloys could contain harmful substances) Bacteria and Viruses present in blood and saliva may enter the laboratory Not all manufacturers and suppliers are complying with the Chemicals (Hazards Information and Packaging for Supply) Regulations They are still failing to provide appropriate warnings on packaging and hazard data sheets You may use some substances which have been in the laboratory for a number of years and the packaging is not up to date, or the product may have been decanted into some other container (not to be recommended!) ASSESSING SUBSTANCES POTENTIAL TO CAUSE HARM When you have carried out your research and identified the substances you are using in the laboratory that could be harmful to health - you should begin to be able to put together a list of the hazardous substances you use at work and where they are used. You then need to think about exactly how these substances could cause harm, and whether they could be causing harm at present: How can the substances enter the body can they be breathed in? Can they be soaked in through the skin? How likely is it that exposure can occur? Does it happen in routine use, or would it only happen if the substance was spilt in a large quantity? Who in the laboratory is exposed? Is everybody likely to be exposed or is it just one or two doing specific jobs. How often is exposure likely to occur? For example if you are mixing monomer all day, every day you will probably have more of a problem if you are only using it on the very odd occasion to do a repair. How much people are exposed to and for how long? You don t need to do exact scientific measurements. You can note what the routine of work is for example how many dentures are made per day, how much metal grinding takes place etc. ESTABLISHING CONTROLS When you have assessed what effects working with the various substances could have on the health of yourself and others working in the laboratory you need to decide what controls to introduce, to prevent any risk to health occurring. Issuing dust masks and safety goggles to combat the harmful effects of hazardous substances is not satisfactory. You have to demonstrate that you have followed a hierarchy of controls and that the supply of any PPE in your laboratory was only carried out as a last resort.

4 You first need to work through this hierarchy to ensure there is nothing else that can be done to remove or reduce the risk to health: Substitute Where possible substances that have serious risks attached should be substituted for a safer alternative. Safer Methods of Working For example dry trimming will produce more dust than wet trimming and consequently wet trimming is a safer method of working as it reduces the likelihood of breathing in harmful dusts. Enclosure Ideas include enclosing processes such metal melting by using furnaces (with extraction), instead of using hand methods using LPG and releasing metal fumes into the general working environment. Likewise monomer can be mixed in a fume cabinet instead of on a bench, so that the fumes are contained and extracted from the cabinet. Local Exhaust Ventilation (LEV) Dust extraction to be used at any bench and any piece of equipment where dust is generated. See separate advice on dust extraction. Personal Protective Equipment (PPE) Dust masks, respirators, gloves and goggles are to be used purely as a last resort and then only to back up other measures already in place. The key to effective use of PPE is making sure that it does the job and can offer the level of protection required. See separate advice sheet on PPE. OTHER MEASURES TO BACK UP CONTROLS: Written Guidelines Having to hand manufacturers instruction sheets, hazard data sheets and procedures on safe working with substances that you have written yourself. These can be available to all employees, or instruction sheets can be laminated and put up on the wall near where the substance is being worked on. Storage and Labelling All substances should be safely stored in appropriate types and sizes of containers that are properly labelled. Never decant substances into smaller containers that are then unmarked, store chemicals and acids in secure storage and put away after use. Do not leave lying around the bench ready to be knocked over or mistaken for something else.

5 Training All staff must be appropriately trained in the correct handling and use of materials used in the dental laboratory. As part of their training and at regular intervals afterwards, staff should be advised to practice COSHH policy; they must be aware of health risks from assessed substances; this training should be recorded in the COSHH assessment General Good Working Practice Good Housekeeping, wiping up spillages when they occur, making sure all materials are labelled and not being kept in unmarked containers, making sure staff are using all PPE and dust extraction that is available to them. Any assessment should be regularly reviewed to take into account the introduction of new materials into the dental laboratory or changes in staff. RECORDING YOUR ASSESSMENT An assessment need not be a lengthy complex written document, you can record the findings of your assessment on a series of forms as illustrated by the example COSHH assessment form. REVIEW The assessment must be reviewed as and when necessary, particularly if you introduce a new substance into the laboratory.

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