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Changes to the practice?

If a dental practice has extended or changed the layout of its premises, set up a separate decontamination area or introduced new equipment and procedures, practice health and safety risk assessments should be reviewed. To do so, you should first look through the existing health and safety risk assessments to check if the changes have introduced significant new hazards. Do not over-complicate but do involve other members of staff to help you decide if there are enough sensible precautions already in place.

The most straightforward way is to work area by area (or room by room). Begin at the entrance and reception area and move through the building. Think about the activities that take place in each area to: identify the hazards; decide who might be harmed and how; and evaluate the risks and decide on sensible precautions. If you have an employee with a disability, consider any risks that might affect them especially because of their disability. Then record your findings, implement them, review your assessment and update if necessary.

Chemical products

Assessing chemical products under the Control of Substances Hazardous to Health (COSHH) should be easier now because of clearer labelling and material safety data sheet (MSDS) information, which you should keep for reference and as a source of information when doing a COSHH assessment. The MSDS will tell you the dangers of the product and about first aid, fire-fighting, accidental release (spillage), handling and storage, exposure controls and the personal protective equipment (PPE) you need to provide.

Make sure relevant staff are aware of the risks and the precautions they need to take: in particular, the risks from products they work with daily, such as cleaning and disinfectant products. Provided the products are used in accordance with the directions for use and the relevant controls and PPE are in place, the overall risk should be low.

Display-screen equipment

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Use of display-screen equipment has been linked to upper-limb disorders, headaches and eye-strain. Such workstations (including equipment and the environment) should be assessed, taking into account the work being done and the needs of individual staff. Adjustable chairs and suitable lighting should be provided.

Expectant mothers

The risks to female employees of childbearing age should have already been covered in your overall practice risk assessment so you should not have to carry out a separate risk assessment when a member of staff notifies you she is pregnant. It would, however, be appropriate to review the assessment with the woman, taking into account her work activities and checking throughout the pregnancy to ensure her comfort and safety.

Fire safety

If you have extended or altered the layout of your practice, think again about your fire-risk assessment and fire-evacuation plan. Remember to ensure flammable stock is stored safely away from sources of ignition. Do not ignore the possibility of fires being caused deliberately, so store waste (including ‘empty’ flammable-product containers) appropriately.

Inoculation injuries

Sharps and inoculation injuries are always a risk and their prevention should be considered during all clinical and decontamination procedures. Appropriate eye protection should be worn by staff and patients whenever necessary during operative dentistry and/or decontamination work. The practice risk assessment should refer directly to the practice infection control policy for further details on measures to prevent infection. If your principal is a member of the British Dental Association (BDA), detailed advice on infection control can be found on the BDA website at www.bda.org/infectioncontrol. You can also read articles on infection control on Vital's online archive.1,2,3

Young people and trainees

Induction training for all staff should include telling them how to work safely. Young people and trainees in particular may be unfamiliar with the everyday risks at the practice, so thorough training and initial supervision is particularly important for them. Those involved in decontamination (trainee dental nurses and decontamination assistants) will need training in inoculation prevention as soon as possible after they begin employment.

An experienced dental nurse or the practice's decontamination lead should be able to help with this.

Radiation

A suitable risk assessment should be carried out in consultation with your radiation protection adviser if you have introduced new X-ray equipment or new procedures. Regular maintenance and testing of X-ray equipment (mechanical and electrical) is important. An update on radiation protection will be published in the winter issue of Vital; you can read past articles on this topic in the Vital archive.4,5,6

Stress

The Health and Safety Executive believes stress at work to be a major health issue. It can affect any member of the team. Staff should feel able to voice concerns about stress at work and put forward ideas that could help alleviate stressful situations.

Working alone

It is a myth that staff cannot work alone for health and safety reasons: it depends on the risks involved. For clinical staff treating patients, there must be another person (preferably a registered team member) available who is trained to deal with medical emergencies. When treating a patient in an out-of-hours emergency or on a home visit, the treating dentist is responsible for assessing the possible risk to the patient of continuing with treatment in the absence of a second trained person. Do not forget to include cleaning and occasional staff in the practice risk assessment as they may work alone.