The following information summarises the main laws applicable to employers with regard to health and safety in the workplace, with particular regard to work with blood-borne viruses (BBVs).
The Health and Safety at Work etc Act 1974 (HSW Act) is the primary piece of legislation covering occupational health and safety in the UK. It places a duty on employers to provide a safe place of work and protect the health and safety of both their employees and anyone who may be affected by their work activities. Employees also have a duty to co-operate with their employer in meeting these duties, under the HSW Act and any other relevant legislation.
The Management of Health and Safety at Work Regulations 1999 list the responsibilities of employers in all general aspects of health and safety management.
The main legislation relevant to controlling the workplace risks of exposure to BBVs is the Control of Substances Hazardous to Health Regulations 2002 (COSHH) – see the COSHH Approved Code of Practice and guidance (ACOP). However, employers also have health and safety responsibilities under other regulations that overlap with COSHH, as the following table demonstrates:
|Health and safety management systems
|Health and safety policies
|Access to competent advice
|Co-operation and co-ordination
|Control risk of exposure to hazardous substances
|Maintenance of control measures
|Information, instruction and training
|Handling incidents / emergency plans
Sector and task-specific regulations
In addition to the main overarching regulations mentioned above, there are a number of other regulations relating to specific aspects of work with BBV. These are referenced, where relevant, in the other pages of this website.
Injuries and dangerous incidents in the workplace
Employers are legally required to report any infections and dangerous occurrences with biological agents at work under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR).
Health surveillance and records
In addition to their responsibilities under the Management of Health and Safety at Work Regulations 1999, employers are legally required to keep health records in relation to work involving risk of exposure to BBVs under COSHH regulation 11(3).
For further information, see: Health surveillance and occupational health.
Employer guidance for monitoring occupational exposure to BBV
The following summarises the main laws applicable to employers with regard to work with blood-borne viruses (BBV), and the health checks / record keeping these require. For further information, see the Control of Substances Hazardous to Health Regulations (COSHH), which are explained in detail in the COSHH Approved Code of Practice and guidance (ACOP).
- Employees likely to be exposed to BBV, for which an effective vaccine is available (eg Hep B vaccine)
Fitness to work (FTW) assessments – for work with BBV, infected patients or specimens – should be conducted by an occupational health professional for these employees (eg laboratory and healthcare workers). Health records must be kept by the employer and include review dates where relevant (eg when FTW assessments need updating following additional booster doses).
This is a requirement for employers under COSHH regulation 11(3). See also the COSHH ACOP (paras 215 and 235b).
- Employees likely to be exposed to organisms capable of causing persistent or latent infections, long incubation periods or which may have serious long-term consequences
Employers are required to keep health records for these employees, for all jobs involving risk of exposures to BBV, which are Hazard Group 3 biological agents.
Since such work comes under the criteria for health surveillance under COSHH regulation 11(3), the employer is required to complete and keep historical health records to include any jobs undertaken during this period of employment. This is not limited to those jobs involving Hazard Group 3/4 biological agents and could include any hazardous substances listed under COSHH Schedule 6.
For further guidance, see the COSHH ACOP (paras 21, 23 and 235(a), and Appendix 2: 'Additional provisions relating to work with biological agents'). NB: Appendix 2 applies only to deliberate work with biological agents (as defined in para 48).
- Actual exposures of employees to the body fluids (or specimens from) patients who are BBV infected, including carriers
Employers must keep a list of all employees exposed at work to BBVs in Hazard Group 3 or 4, which could pose a significant risk to their health, as required under COSHH (Schedule 3, para 4).
For further information, see the COSHH ACOP para 235(a) and Appendix 1: 'Control of carcinogenic and mutagenic substances' (NB: For paras 25 and 27 of Appendix 1, Hepatitis B and C are only considered as Cat. 1 carcinogens).
See also COSHH regulation 7(10) and COSHH ACOP Schedule 3: 'Additional provisions relating to work with biological agents' (para 4).
- New entrants to the NHS who will undertake exposure-prone procedures.
New entrants should be assessed for fitness to work in exposure-prone procedures by an occupational health (OH) professional. While there is no record-keeping requirement for doing so, the Health and Safety at Work Act (HSW Act) requires direct communication regarding fitness to work between the OH professional and the manager responsible for deploying the worker.
For further information, see HSW Act and Health clearance for tuberculosis, hepatitis B, hepatitis C and HIV: New healthcare workers.
Compliance Criteria 9 of the Health and Social Care Act also states that employers should '…ensure, as far as reasonably practicable, that healthcare workers are free of, and protected from, exposure to communicable infections during the course of their work'.