The law at work

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Chapter 2 The law at work

Simon Messer

CHAPTER CONTENTS

Introduction 11
The Health and Safety at Work etc. Act 1974 12
The Management of Health and Safety at Work Regulations 1999 13
The Ionising Radiations Regulations 1999 (IRR99) 13
The Ionising Radiations (Medical Exposure) Regulations 2000 [IR(ME)R] 14
The Data Protection Act 1998 18
The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR) 19
The Manual Handling Operations Regulations 1992 19
The Personal Protective Equipment at Work Regulations 1992 19
The Control of Substances Hazardous to Health Regulations (COSHH) 20

KEY POINTS

image The majority of the law involved with the workplace is related to health and safety.
image There are a number of acts of parliament and regulations that form the principal legislation of which you must be aware when working in a hospital.
image Underpinning British health and safety law is the Health and Safety at Work etc. Act 1974, which sets out general duties for both the employer and the employee.
image The Ionising Radiation Regulations 1999 and Ionising Radiation (Medical Exposure) Regulations 2000 are of particular interest.

INTRODUCTION

Whilst working in the hospital environment there are a number of key documents detailing regulations and acts of parliament that ensure the safety of the employee and the public as well as ensuring the safe function of the hospital for the employer.

The full text of each act or regulation is available on the Internet and the links are provided at the end of this chapter. You are strongly advised to read the actual regulations, using the sections below as guidance. This applies especially to those relating to ionising radiation.

THE HEALTH AND SAFETY AT WORK ETC. ACT 1974

The Health and Safety at Work etc. Act 1974 (HSWA) is the most important British health and safety law and is applicable to nearly every work activity. It is a huge document and its objective is to provide protection for people at work and for the general public. It does this by setting out general duties for both the employer and the employee. Failure to comply with these duties constitutes a criminal offence and both employers and employees can be prosecuted. It also provides the basis under which other health and safety regulations are enabled, the following of which are particularly relevant to radiographic work:

• Management of Health and Safety at Work Regulations 1999
• Ionising Radiations Regulations 1999 (IRR99) and the Ionising Radiations (Medical Exposure) Regulations 2000 [IR(ME)R], both of which are fundamental to radiographic practice.
• Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995
• Manual Handling Operations Regulations 1992
• Personal Protective Equipment at Work Regulations 1992
• Control of Substances Hazardous to Health Regulations (COSHH)

GENERAL DUTIES OF EMPLOYERS

Section 2(1) of the Act places a general duty on the employer:

To ensure so far as is reasonably practicable, the health, safety and welfare at work of all his employees1

To achieve this, the employer is required to:

• provide and maintain safe equipment and safe methods of working (systems of work)
• provide safe arrangements for the storage, movement and use of materials
• give employees adequate instruction, training, supervision and information
• provide and maintain a safe workplace, including safe entrances and exits
• provide and maintain a safe working environment and adequate welfare facilities.

Employers are also required to ensure that people not in their employment, but who may be affected by their business activities, are not exposed to risks to their health and safety. This is particularly relevant to the hospital setting where public access is high.

GENERAL DUTIES OF EMPLOYEES

Employees have a number of duties and responsibilities. These include:

• to take reasonable care to ensure the health and safety of yourself and others, including the patient and members of the public
• to adhere to the systems of work specific to the department you are working in and report any hazards
• to cooperate with the employer, or anyone else, in complying health and safety legislation.

Sections 7 and 8 of the Act should be key to daily working practices. Section 7 of the Act states:

It shall be the duty of every employee while at work to take reasonable care for the health and safety of himself and of other persons who may be affected by his acts or omissions at work.1

Section 8 of the Act states:

No person shall intentionally or recklessly interfere with or misuse anything provided in the interests of health, safety or welfare in pursuance of any of the relevant statutory provisions.1

Failure to comply with either section 7 or section 8 may result in a summary conviction and a fine not exceeding £5000!

NO COST TO EMPLOYEES

Provision is made under the Act whereby ‘no employer shall charge any employee in respectof anything done or provided in pursuance of any specific requirement of the relevant statutory provisions’.1

THE MANAGEMENT OF HEALTH AND SAFETY AT WORK REGULATIONS 1999

Whilst these regulations are not directly applicable to you as an employee, they are fundamental to all health and safety law and deal with an aspect which you will certainly be involved with; namely, risk assessment.

Under section 3 of these regulations, the employer is required to undertake ‘suitable and sufficient assessment of the risks to health and safety’ to which their employees are exposed while they are at work.2

Where a risk has been identified, the employer must then implement preventative or protective measures to avoid or minimise that risk. This is usually in the form of a thorough risk assessment.

THE IONISING RADIATIONS REGULATIONS 1999 (IRR99)

These regulations deal with the health and safety of those working with ionising radiation and are policed by the Health and Safety Executive (HSE). It is essential, as a radiation worker, that you are completely familiar with these regulations and you should therefore read them in their published form.

PART 1 INTERPRETATION AND GENERAL

The first section provides, amongst other things, definitions of terms such as ‘dose rate’.

PART II GENERAL PRINCIPLES AND PROCEDURES

This is an important section and deals with the need for risk assessment, the principle of restricting exposure to employees and the provision of personal protective equipment. It also covers the maintenance and examination of engineering controls, dose limitation and the need for contingency plans in the event of a reasonably foreseeable radiation accident.

PART III ARRANGEMENTS FOR THE MANAGEMENT OF RADIATION PROTECTION

This section deals with:

• the appointment and role of the Radiation Protection Advisor (RPA), whose main responsibility is to advise the employer and ensure these regulations are complied with
• the provision of information, instruction and training to employees working with ionising radiation
• the need for cooperation between employers.

PART IV DESIGNATED AREAS

The requirements for the designation and monitoring of controlled or supervised areas are detailed here, together with the need for Local Rules and the appointment of a Radiation Protection Supervisor (RPS). The RPS’s job is to ensure compliance with these regulations with respect to any work carried out in areas identified in the Local Rules. The RPS also has a role under the Ionising Radiations (Medical Exposure) Regulations 2000 as detailed below.

PART V CLASSIFICATION AND MONITORING OF PERSONS

This section deals with classified workers who are defined as any employee who is ‘likely to receive an effective dose in excess of 6 mSv per year or an equivalent dose which exceeds three-tenths of any relevant dose limit’.3 It also covers dose assessment and recording, medical surveillance and requirements in the event of an overexposure.

PART VI ARRANGEMENTS FOR THE CONTROL OF RADIOACTIVE SUBSTANCES, ARTICLES AND EQUIPMENT

This section deals with radioactive materials, their storage and transport and the need for accurate record keeping. There is also a requirement to notify the HSE in the event of certain occurrences including the spillage of a radioactive substance, which would give rise to a ‘significant contamination’.3 It also deals with installation, maintenance and quality assurance of equipment used for medical imaging.

PART VII DUTIES OF EMPLOYEES AND MISCELLANEOUS

The important part of this final section details the duties of the employee (you). In summary, these duties include:

• not to expose oneself or any one else to more ionising radiation than is reasonably necessary for the purposes of work
• to use personal protective equipment (PPE), such as lead rubber aprons, where provided
• to report equipment defects
• to look after PPE
• to comply with the employer’s dose monitoring and any request regarding medical surveillance.

THE IONISING RADIATIONS (MEDICAL EXPOSURE) REGULATIONS 2000 [IR(ME)R]

These regulations deal with the safe and effective use of ionising radiation used in clinical practice and they underpin all medical exposures.4 They are policed by the Department of Health. It is essential that you are completely familiar with these regulations.

The regulations impose duties on those responsible for administrating ionising radiation to protect people undergoing medical exposure. This would include:

• medical diagnosis
• treatment
• occupational health surveillance
• health screening
• medical research
• medicolegal procedures.

IR(ME)R DUTY HOLDERS

There are four identified duty holders, whose responsibility it is to enforce these regulations:

• Employer (‘Legal person’)
• Referrer
• Practitioner
• Operator.

The employer

The employer has to provide a written framework of procedures for medical exposures and ensure that they are complied with by the practitioner, operator and him/herself and must also ensure that written protocols are in place for every type of standard radiological practice for each piece of equipment.

The employer also has to establish:

• recommendations concerning referral criteria, including radiation doses, and make sure that these are available to the referrer
• quality assurance programmes for standard operating procedures
• diagnostic reference levels for radiodiagnostic examinations, having regard to European diagnostic reference levels where available
• dose constraints for research where no direct medical benefit for the individual is expected from the exposure.
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