Presentation on theme: "Pregnancy Risk Assessments"— Presentation transcript:
1Pregnancy Risk Assessments Vanessa DaviesHead of Occupational HealthHywel Dda NHS TrustCarmarthenIntroductionRCN UK Safety Representative ConferenceOctober 2011
2Personal history Head of OH for Hywel Dda Health Board Joint Chair of Welsh NHS OH Forum for 6 yearsTwelve years OH experience both in and outside of NHSAwarded by RCN Best OH Nurse 2006Personal history
3How do you become a occupational health nurse? Usually by accident……
4Qualifications… Minimum: Registered Nurse (Adults) Occupational Health qualification, i.e. Diploma or Degree in OH, ideally Specialist Practitioner qualificationMasters for nurse managersEssential – A sense of humourtogether with lots of life skills& experience!
5What is Occupational Health….. DEFINITION: Occupational Health is the promotion and maintenance of the highest degree of physical, mental and social well- being of workers in all occupations by preventing departures from health, controlling risks and the adaptation of work to people, and people to their jobs. (ILO/WHO 1950)
6That is the accepted definition, what do we do? We are advisors … on just about everything that relates to people and their jobs. What ever job that may be… And that includes any employee who becomes pregnant!
7Initially….Lets confirm the obvious….. Pregnancy, just had a baby or breastfeeding are not illnesses!! It is a perfectly normal event, however…….
8Pregnancy risk assessment The legal responsibility for health and safety rests primarily with the employer……It is important to remember some hazards are particular to pregnancy or breastfeeding mums,Pregnancy risk assessment
9Pregnancy risk assessment Aims of today's workshop:To provide a brief overview of pertinent legislationProvide an opportunity to explore the issues relevant to you?Conclude by identifying a framework for PRAA very brief overview!Pregnancy risk assessment
10First thing…. Lets start by: Form groups & in 5 – 10 minutes:Identify the present practice in relation to pregnancy risk assessment in your organisationIdentify what works?Identify what are theproblems?
11Relevant legislation /Directives Equality Act 2010European DirectiveManagement of Health and Safety at Work Regulations Health and Safety at Work etc Act 1999Control of Substances Hazardous to Health regulationsEmployment rights Act 1996
12To whom do the regulations apply? “Any woman who is, or in the future could be, a new or expectant mother”Which is women of child bearing agewho are or in the future could bepregnant, have given birth withinthe previous six months, or arebreastfeeding” (HSE, 2004)Given birth:is defined in MHSW Regs as ‘delivered a living child or, after 24 weeks of pregnancy, a stillborn child’
13Equality Act 2010 Pregnancy and maternity discrimination: work cases Section 19(5) identifies:A person discriminates against a woman if in the protected period in relation to a pregnancy of hers, A treats her unfavourably:Because of the pregnancy, orBecause of illness suffered by her as a result of itBecause she is on compulsory maternity leaveIs seeking or has exercised the right to ordinary or additional maternity leaveThese directions are fairly general and need to be more closely considered and it is easy to fall foul of these! Discuss
14Management of Health and Safety at Work Regulations 1999 These require an assessment of risk:Where there are persons in an undertaking which include women of child bearing age andThe work is of a kind which could involve risk by reason of her condition, to the health and safety of a new or expectant mother, or to that of her baby, from any processes or working conditions, or physical, biological or chemical agents…… to encourage improvements in the safety and health at work of pregnant workers and workers that have recently given birth or are breastfeeding.. (Management of Health and work, 1999)You are required to assess risks to your employees and do what is reasonably practicable to control those risks, however identifying specific risks and establishing the level of hazard posed can be difficult. Despite undertaking a literature review there is little empirical evidence of pregnant women on which to base the assessment in some cases; for example night shift working!
15Management of Health and Safety at Work Regulations 1999 by regulation 3 (1) an “assessment of such risk” Which is part of routine occupational health surveillance……Well, that sound simple …. Doesn’t it? Or is it in an environment as diverse as the NHS?What does that mean……
16health surveillance is…. “Identification and assessment of the risks from health hazards in the workplace. Which involves surveillance of the factors in the working environment and working practices which may affect the workers’ health. It also requires a systematic approach to the analysis of occupational accidents and occupational diseases” ILO 1985health surveillance is….
17What do you need to do?A competent person is required to undertake a risk assessment! In most organisations that is not the OH nurse or the H&S manager, however most managers are always a little apprehensive of undertaking the assessment!Stage one- initial assessmentNOYesAre there any hazards present?Inform employee of outcomeTake into account any hazards and risks to females of childbearing age;Assess risks, reduce or remove if possibleThis is a good place to start……… HSE’s guidance
18On notification of pregnancy… Specific risk assessmentNO YES YesNoYes NoNo yesHas a risk been identifiedCan the risk be removedRemove the riskMonitor and reviewAction 1Can the mothers hours/conditions of work be adjustedAdjust conditions /hoursGive suitable alternative work on same terms and conditionsAction 3Suspend her from work on paid leave for as long as necessary to protect her or/+ childAction 2Can she be given suitable alternative workThis is the specific risk assessment; decide who might be harmed and how bearing in mind that the risks may vary between pregnancy and breast feeding; note any medical advice received on the health of the employee;Consult and discuss these issues with the employeeOn notification of pregnancy…
19The range of potential hazards & risks to health is truly awesome in a NHS environment….. There are the obvious….Health surveillance…
20And the not so obvious…… Chemicals use and storageWorkload, demands and stressWorking relationshipsEnvironmental risksManual handling of people and objectsAggression and violenceRadiologyInfection control issues…..
21How are the hazards identified…. Epidemiological evidence, we know some products have been found to be potentially hazardous to health and that their use needs to monitoredAnnual health surveillance programmes to look at respiratory sensitizers‘ and other hazardsHealth issues identified during day to day collaboration between different agencies in the Health Board i.e. Health and safety manager, infection control department, the staff or a manager raises a concernHow are the hazards identified….
22The European directive lists the following hazards Physical risksMovements & posturesManual handlingShocks and vibrationsNoiseRadiationChemical agentsToxicMercuryCytotoxic drugsBiological agentsInfectionWorking conditionsFacilitiesMental/physical fatigueStress (inc postnatal depression)TemperatureWorking with visual display unitsWorking aloneTravellingViolenceWorking and PPEnutritionThe HSE provide a comprehensive list of potential hazards and how to manage them
23Please form groups and for about 10 minutes consider the following scenarios!
24For the pregnant, newly delivered or breast feeding woman: There are the responsibilitiesof the:EmployeremployeeHow are they managed….
25EmployeeTo notify the employer that she is: pregnant, newly delivered or breastfeeding Or Advise further if she continues to breastfeed beyond six months May need to provide certificate from midwife or general practitioner
26Employer responsibilities: To ensure that appropriate and current policies related to staff health and safety are formulated and implementedCompetent person to undertake the risk assessment to identify hazards ideally in collaboration with the employeeTo implement any adjustments to address any identified hazardsThe employee should be offered a health assessment during her pregnancyRe-evaluate any risk assessments if there are any changesWhen an employee is breastfeeding, the employer should ensure she has access to appropriate facilities and be protected from identified hazardsIf in doubt then contact your occupational health serviceEmployer responsibilities:
27Employer : Management of health and safety regulations 1999 If following risk assessment, these hazards cannot be avoided, the employer will need to:Alter working conditions or hours of work, if notIdentify and offer suitable alternative work, if not then the employee is to be suspended on full paid leave from work!
28Special considerations….. BreastfeedingProvide appropriate rest areas for pregnant employeesRecommended to provide an appropriate environment for mothers to express and store milkNight workany new or expectant mother who works at night, who has a medical certificate stating that night work could affect her health and safety:Offer suitable alternative daytime work orSuspend her from work, on paid leave as long as is necessary to protect her health and safetyIf the risk arises from work!Special considerations…..
29The Management of Health & Safety at Work Regulations 1992 and 1999 specify these responsibilities: All employers have a statutory responsibility under Section 2 (1) of the Health and Safety at Work Act (1974) 1 to create as safe an environment as is reasonably possible.
30Summary … The relevant legislation requires: Safe environment for pregnant employeesEnsured by a risk assessment undertaken by competent personIf suitable adjustments or an alternative role cannot be identified, suspend on full payDocumented and evaluated as needed by responsible managerSummary …
32HSE (1992) Management of health and safety at work, management of health and safety regulations Approved code of practice and guidance, HSEHSE (2002) New and Expectant mothers at work. HSELubick, N (2011) Advising parents in the face of scientific uncertainty: An Environmental Health Dilemma. Environmental Science and Technology, Nature and EarthHSE: Biological agents: Managing the risks in laboratories and healthcare premises: The advisory Committee on dangerous pathogensReferences