Chemicals and medical gases

Chemicals are classified as non-hazardous or hazardous. In healthcare settings you may come into contact with several different chemical substances, for example cleaning agents, disinfecting and sterilising agents, laboratory chemicals.

In healthcare settings, you may come into contact with several different chemical substances during your work.

These include:

cleaning agents
disinfecting and sterilising agents
laboratory chemicals
medical gases
anaesthetic agents
cytotoxic drugs and pharmaceutical substances

Managing hazardous chemicals

Having a chemical management system helps you manage, handle and use hazardous chemical agents safely.

The system should:

review all chemicals
identify hazardous chemicals
identify and assess the risks
identify and implement controls
evaluate and monitor
consult with staff

Review chemicals in use

Inspect your workplace for the chemicals being used. Look at all activities and processes that produce chemicals.

Chemicals are classified as non-hazardous or hazardous.

Non-hazardous chemicals should be listed on an inventory. They must be stored and used in accordance with the manufacturer’s instructions. They do not need a risk assessment.

Hazardous chemicals must be listed on an inventory and undergo a risk assessment. You must put in place the control measures identified in the risk assessment.

Identify hazardous chemicals

Information about hazards can be found on the container label and the safety data sheet (SDS). This information is required to complete a suitable and sufficient risk assessment.

Chemical container labels

The chemical container label shows the name, address and telephone number of the supplier and product identifiers.

Where applicable it shows:

hazard pictograms
hazard statements
precautionary statements

Safety datasheet

An SDS must be provided from the supplier for each chemical and contains 16 headers

For more information see your steps to chemical safety - HSA.ie

Identify the risk

Once you've identified the chemicals and their hazards, you need to assess potential exposures.

You should review each hazardous chemical and consider:

who uses the chemical? (for example, how many people use the chemical)
how long is each user exposed the chemical? (for example, full shift or a few minutes)
how often is the chemical used?
how is the chemical used? (for example, sprayed, poured)
how will the user be exposed? (for example, skin contact, inhalation)
how much is used?
can non-users be exposed? (for example, people working near the task, patients, visitors, cleaning or maintenance staff)

Assess the risks

After identifying the chemical hazards and potential exposure, you must assess the risk.

You should review:

existing control measures
incidents that have occurred
audit findings

Assessing the level of risk (risk rating) involves:

the likelihood that a specified hazardous event may occur or reoccur
the potential impact of harm or loss to staff, service users, services, environment or the organisation as a result of the event occurring

To determine the risk rating, refer to HSE enterprise risk management policy and procedures 2023 (PDF, 1.4 MB, 76 pages)

Sample risk assessments

Sample bleach chemical agents risk assessment (PDF, 442 KB, 4 pages)

Chemical agents risk assessment sample formalin (Word, 77 KB, 7 pages)

Chemical agents risk assessment form (Word, 147 KB, 5 pages)

Chemical agents risk assessment fillable form template (Word, 112 KB, 4 pages)

Guidance on completing a cytotoxic drug risk assessment form (PDF, 237 KB, 4 pages)

Cytotoxic drug risk assessment form

Cytotoxic drug risk assessment fillable form template (Word, 72 KB, 4 pages)

Medical gases

Medical gases are used within hospital settings for many purposes.

A medical gas is defined as one that is manufactured, packaged, and intended for administration to a patient in anaesthesia, therapy, or diagnosis.

A chemical agent risk assessment must be completed where there is a risk of occupational exposure to a medical gas during use.

Examples of exposure to a medical gas during use include:

clinical administration
connection to medical device
connection to manifold system

The NHSF have developed a prompt sheet to help support mangers review and update the risk assessments in relation to the safe storage and handling of medical gas cylinders. Risk assessment - safe storage and handling of medical gas cylinders PS 048 00 (PDF, 921 KB, 17 pages)

Occupational exposure limit values (OELVs)

An occupational exposure limit value (OELV) is the maximum concentration of a harmful substance that a person can be exposed to without getting sick or hurt. OELVs are in place for some chemicals. These can be found in the approved code of practice 2024. They should be documented in your chemical inventory.

You should ensure that exposure levels to chemicals that contain OELVs are regularly monitored. This is to ensure that the occupational exposures values are not exceeded.

It is recommended that this monitoring is undertaken by a competent person such as an Occupational Hygienist also known as an Industrial Hygienist.

Occupational hygiene

Managers must complete risk assessments to establish if occupational hygiene monitoring is required. If monitoring is required, engage with an occupational hygienist.

For a list of occupational hygienists, contact the National Health and Safety Helpdesk on 1800 420 420.

Occupational hygienists improve workplace practices by identifying, evaluating and controlling exposure to chemicals and physical agents, for example, noise and dust.

Occupational hygienists usually operate as part of a multi-disciplinary team. This can include managers, safety professionals, occupational health professionals and employees. Occupational hygienists may also be known as industrial hygienists.

You must ensure that exposure to chemicals and physical agents does not exceed the occupational exposure limit.

Departments - chemical and physical agents

Theatres

Nitrous Oxide
Sevoflurane
Isoflurane
Desflurane
Halothane
Enflurane
Bone Cement (Methyl Methacrylate)
(Orthopaedic Theatre)
Formaldehyde

Maternity/Midwifery Led Unit/Early Pregnancy room

EntonoxO-phthalaldehyde

Laboratory

Formaldehyde
Xylene
Methanol
Ethanol

Fracture clinic

Isocyanates

Dental

Nitrous Oxide
Sevoflurane
Desflurane
Halothane
Enflurane
Acetic acid

Mortuary

Formaldehyde
Methanol
Hydrogen Peroxide

X-ray

Hydroquinone
O-phthalaldehyde

Catering

Noise

Endoscopy

Nu Cidex
Cytolote
Acetic acid
O-phthalaldehyde

Pulmonary Function labs

Acetic Acid

ENT Clinic

O-phthalaldehyde

Laundry

Sodium Hydroxide
Lint /Dust Levels

CSSD

Hydroquinone
Nu Cidex
Hydrogen Peroxide

Pharmacy

Ethanol

Emergency Department (ED)

Entonox

Repeat monitoring

When an employee’s exposure exceeds the OELV, additional controls to reduce exposure are required. Repeat monitoring is essential to ensure control measures to reduce exposure are effective.

Managers must ensure:

defined occupational exposure limit values are not exceeded
monitoring is done on a regular basis, or as prescribed

Occupational Hygiene Monitoring in the Workplace (PDF, 670 KB, 8 pages)

Implement controls

The best way to reduce risks from dangerous substances is by elimination or substitution. This is known as the STOP principle.

Replace the dangerous substance with a safer alternative. For example, using a pellet instead of a powder form of the chemical. This could significantly reduce the level of dust inhaled.

Use physical barriers to reduce risks from chemicals

You can reduce chemical exposure by placing barriers between employees and chemicals. These barriers could be fume cupboards, forced ventilation or a scavenging system.

Work practices that help to reduce risk from chemicals

Where possible, minimise employee exposure to chemicals. Try and identify work practices that may be altered to avoid exposure.

You should:

reduce the number of employees involved in a task
restrict access to an area where the chemical is being used
provide chemical safety training
store chemicals safely
put emergency procedures in place
provide washrooms and adequate waste disposal
provide health surveillance as appropriate
put in place a preventative maintenance programme for engineering controls

Personal Protective Equipment when working with chemicals

You should only use Personal Protective Equipment (PPE) when working with chemicals in an emergency. It is not an alternative to other suitable control measures. The PPE should provide adequate protection from the hazardous chemicals throughout the exposure.

Consultation

Other professionals can also help with chemical safety management.

These may include:

local safety representatives
safety professionals
National Health and Safety Function
occupational health
occupational hygienist

Occupational health

Occupational health provides health surveillance programmes.

Health surveillance is important for:

detecting ill-health effects at an early stage
providing data to help you evaluate health risks
enabling employees to raise concerns about how work affects their health
highlighting lapses in workplace control measures
training employees on health effects and use of protective equipment

Risk assessments should identify the need for health surveillance. Health surveillance will identify if more controls are required.

You should refer employees with symptoms of chemical exposure to Occupational Health.

Reporting risks to the service risk register

You must report risks that cannot be controlled locally to your service's risk register. Risks are reported in line with the integrated risk management policy (PDF, 927 KB, pages)

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