Authors (including presenting author) :
Leung kk(1), Lam CKK (2)
Affiliation :
(1) Occupational Safety and Health Unit, Quality and Safety Department, Queen Mary Hospital
(2) Division of Haematology, Department of Pathology, Queen Mary Hospital
Introduction :
In the healthcare setting, chemicals are employed very commonly in procedures of mundane household nature to complex diagnostic purposes. Chemicals, when properly managed and used, can significantly contribute to the improvement of our quality of life, health and well-being. On the other hand, chemicals can adversely affect our health and environment if improperly managed. Having a chemical safety program in each workplace will reduce health and safety risks, lower environmental impact, and reduce operation cost.
Objectives :
To establish a programme that covers the entire management process for all chemicals – beginning with purchasing and including identification, labeling, inventory, use, storage, record-keeping requirements, and disposal.
Methodology :
Risk Assessment
A standardized chemical inventory system template with various unique features was developed and adopted in all workplaces in Hong Kong West Cluster (HKWC). The inventory template can indicate the ideal storage location to designated chemical safety cabinet. It can also indicate incompatibility of chemicals in the same storage facility or cabinet and quantity problems. The completed chemical inventories were reviewed by hospital chemical safety coordinator. Hazard Communication Plan
Departments in which chemicals are used have been asked to develop a hazard communication plan to communicate the pertinent information about the hazards of chemicals in use by the department and the relevant engineering control, and stress the importance of appropriate personal protective equipment (PPE). Minimizing risks of new chemicals
Departments are encouraged to examine carefully the justification of introducing new chemicals. All requests for new chemicals will be assessed before purchase and their hazard levels identified by vetting the corresponding material safety data sheet (MSDS) and the ordering quantity, etc. Storage location would be advised through the chemical inventory system to eliminate storage incompatibility and ensure legal compliance. Environmental and personal surveillance programme
From 2015 to 2018, around 1260 environmental and personal surveillance assessments were conducted annually for risk quantification, including personal exposure monitoring of anaesthetic gases and Cidex OPA for Operating Theatre colleagues, methanol and methyl methacrylate for Prosthetic & Orthotic (P&O) workshop technicians, formalin for medical technologists, and nitrous oxide for Labour Ward colleagues. Emergency Preparedness
Besides the regular refresher training and emergency spillage drills, all the chemical spill kits in the hospital departments within HKWC were managed and maintained by the Cluster Occupational Safety and Health Office to ensure the contents were appropriate for each department.
Result & Outcome :
Results
After implementation, the common chemical problems such as incompatible storage, excessive storage and incorrect hazard symbols were identified and rectified. All the newly introduced chemicals are allocated to a proper storage location through standardized chemical inventory system, which also allows convenient periodic monitoring and easy review should that be considered necessary. Since 4Q18, Queen Mary Hospital has been the first and only hospital which has developed an updated and sustainable central chemical inventory system. Conclusion
The awareness of chemical safety is variable in clinical departments owing to the busy daily routine. A comprehensive chemical safety programme incorporating appropriate IT features for inventory management, together with regular surveillance and measures to ensure emergency preparedness, will certainly enhance the chemical safety in HA hospitals. The ultimate goal, however, is to provide a tool conducive to development of safe behavior and inculcation of safety culture in the workforce.
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