A Brief History of Medical Imaging

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Welcome to an on-line health and safety training
package intended for staff and students working
within UofE buildings on the Little France campus
Information contained within these pages is for
use by University of Edinburgh staff and students
only.
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
This on-line training package is intended for
laboratory-based workers, but is not a substitute
for more detailed training which may be organised
by senior laboratory managers.
Last updated January 2012
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Please take time to view the following material,
and direct any urgent questions to your HS
Advisor, Senior Laboratory Manager, or the Little
France Buildings HS Manager (the contact details
for whom are shown on the last page of this
presentation).
Thank you
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Why Risk Assessment?
It is a general legal duty for employers, set out
in the Management of Health Safety at Work
Regulations 19991, to assess risks to the health
and safety of employees and anyone else who may
be affected by the employers activities2.
1. Section 3(1)(a) 2. Section 3(2)(b)
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Why Risk Assessment?
Notwithstanding the legislative imperative, you
may find it helpful to view risk assessment as an
opportunity and not merely an inconvenience ...
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Why Risk Assessment?
Preparing a suitable and sufficient risk
assessment often highlights important points
regarding good experimental design, and may help
expose weaknesses in previously accepted best
practice that would be far better weeded-out
before work commences.
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
What is Risk Assessment?
Risk assessment is a structured process intended
to help identify hazards associated with
activities in the workplace and evaluate the
potentially harmful consequences of these,
ultimately giving rise to a written Safe System
of Work, and aiming overall to reduce the risks
to levels that which are as low as reasonably
practicable.
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Some Relevant Definitions
Hazard A property of a substance, activity or
situation that has the potential to cause
harm. Risk The probability that the harm
linked to a hazard will actually occur, taking
into account also the severity of that harm.
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Some Relevant Definitions
Safe System of Work The principal end-product
of competent risk assessment, usually in the form
of written instructions, readily comprehensible
and capable of being followed, regarding the
means that have been agreed for a task to be
safely carried out with the minimum level of risk
to the health and safety of workers etc.
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Some Relevant Definitions
As Low As Reasonably Practicable (ALARP) Hinges
in part on the interpretation of what precisely,
in law, is reasonable, taking into account the
costs, in terms of time, trouble and money, of
removing or reducing risk. Differs from that
which is as low as reasonably achievable (ALARA),
which is a more absolute legal requirement.
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
So, since risk is a balance between probability
(or likelihood) and the likely severity of harm
(or impact) .
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Low Risk/High Risk
Anything that has been formally assessed as being
low risk is generally best managed by the
application of sound common sense and general
good practice for laboratory work. But, if the
risk is assessed at anything more than trivial,
formal risk assessment procedures must be carried
out.
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Risk assessment should be a routine activity,
very much part of normal laboratory management
processes, and must take account of the totality
of operations within the laboratory environment,
addressing all relevant aspects of people,
equipment, materials and the environment-related
factors. And it should be a cyclical process, in
that the assessment should be subject to regular
review and updating.
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Plan for and relate all hazards

• Technical measures
• Organisational measures
• Personal measures

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Plan for and relate all hazards
Local Rules (e.g. Late Lone Working)
Totality of process (e.g RA1)
Specific risks (e.g. COSHH HS2)
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
A free pdf guide on risk assessment is available
from the UKs Health and Safety Executive. 
Check the HSEs web site for the most
up-to-date information and legislation
updates http//www.hse.gov.uk/
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Look for hazards
Review periodically and revise as necessary
Who could be harmed. and how
Record your findings
Evaluate the risks, and design and implement
controls
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Five Steps to Risk Assessment

• Look for hazards.

Walk around your working area, reviewing what
work is being done, by whom, and using what
materials and methods. Check to see if the work
has already been risk assessed. If not, and you
can see that the risk is greater than trivial,
take steps to commence a formal Risk Assessment
leading to a written Safe System of Work.
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
The University has prepared a range of risk
assessment forms that have been designed to
ensure that the minimum statutory requirements
are met, but also to prompt those undertaking the
risk assessment to consider all relevant factors,
including aspects of good experimental design
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
http//www.ed.ac.uk/schools-departments/health-saf
ety/ risk-assessments-checklists/risk-assessments

• General Risk Assessment - Form RA1 and Notes for
  Guidance
• COSHH Hazardous Substances - Form HS1 and notes
  for Guidance  
• COSHH Hazardous Substances - Form HS2 and Notes
  for Guidance  
• COSHH Biological Agents - Form BA1 and Notes
  for Guidance
• Dangerous Substances and Explosive Atmospheres
  Regulations 2002
• (DSEAR) Form and Notes for Guidance
• Display Screen Equipment Workstations Form
• Fieldwork Assessment Form FA1 and Notes for
  Guidance
• Lone Working Risk Assessment Form and Notes for
  Guidance
• Manual Handling Operations Form
• New and Expectant Mothers Model Risk Assessment
  Form and Notes
• for Guidance

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Examples of Hazards

• Naked DNA
• Toxins
• TSE agents
• Animals
• Compressed gases
• Slip/trip hazards
• Working with sharps
• Manual handling
• Lone-working
• Out-of-hours working

• Chemicals
• Micro-organisms
• GMOs
• Radioactivity
• Clinical material
• Carcinogens
• Mutagens
• Allergens
• Asthmagens
• Pharmaco-active agents
• Display screen equipment (computers etc)

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Five Steps to Risk Assessment

• Decide who might be harmed
• and how.

Think not only of those who are handling
substances and equipment, but also about others
who share your working area, and how they could
be affected by what it is that you propose to do.
The number of people who could possibly be
affected by your work is potentially rather large

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Among those who may be at risk

• Staff
• Undergraduates
• Post-grad researchers
• Visiting workers
• Casual visitors
• Cleaners
• Any other people who, for whatever reason,
• might be at increased risk due to immaturity,
• inexperience, medical predisposition, etc.

• Contractors
• Maintenance workers
• Expectant mothers
• New starts
• Trainees
• Work experience
• students

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Five Steps to Risk Assessment

• Evaluate the risks and decide on
• precautions

• Can the hazard be eliminated entirely?
• (If it can, then it must).
• If not, how can I reduce the risk to a level
• that is as low as reasonably practicable?

It is important that these questions are seen to
be asked (as well as seen to be properly
answered), and that the answers are reliably
documented.
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Hierarchy of Controls (ERIC-PD)

• Elimination
• Reduce/Replace (substitution)
• Isolate/Innovate
• Control
• PPE (policy and procedures)
• Discipline

ERIC Prevents Death
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Hierarchy of Controls (ERIC-PD)
If you dont really need to use the harmful
substance, or undertake the hazardous activity,
health and safety regulations say, quite simply,
you should not proceed.
ERIC Prevents Death
Only if you can justify the risk should you
proceed.
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Hierarchy of Controls (ERIC-PD)
The next step, once youve justified the risk, is
to consider whether you could use a less harmful
substance, or a less energetic radioactive
source, or a less pathogenic micro-organism, and
still achieve the same desired effect. If you
can, the same Regulations say that you must. This
is the concept of Substitution.
ERIC Prevents Death
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Hierarchy of Controls (ERIC-PD)
And then health and safety regulations compel us
to consider how we might (re)design the
experiment to reduce risk even further. We might,
for example, separate ourselves from a harmful
substance by employing barriers and shielding
(Isolate). But what we really must be doing is
thinking about the work before even starting it,
and plan accordingly (Innovate).
ERIC Prevents Death
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Hierarchy of Controls (ERIC-PD)
Just because its always been done that way is
no reason to persist with a method that is
unjustifiably unsafe. Challenge the assumptions.
Do the research. Has someone else found a better,
safer way of doing the work? If not, can you
think of a way that might be better and
safer? Who knows? There might be a publication in
that aspect alone.
ERIC Prevents Death
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Hierarchy of Controls (ERIC-PD)
As regards controls, were well provided on this
site with a battery of engineered controls (fume
hoods and biological safety cabinets etc), but we
need to be sure that the tools that were
planning to use are correct for the job in hand
each has potential limitations, and we need to be
aware of these. Equally, controls may be
methodological and procedural rather than
engineered.
ERIC Prevents Death
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Hierarchy of Controls (ERIC-PD)
Note that Personal Protective Equipment comes a
long way down the hierarchy of controls. So,
donning a lab coat and snapping on nitrile gloves
is not, and must never be considered to be, the
first line of defence. Most of the risk should
have been designed out even before the first
exposure to a harmful substance.
That was meant to be a joke!
Why eliminate the hazard when you can buy PPE?
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Hierarchy of Controls (ERIC-PD)
The P in ERIC-PD also encompasses Policy and
Procedures, and local rules may dictate a
particular approach to management of a potential
risk (e.g. late and lone working policies may
include embargos on certain procedures being
carried out outside of normal working hours for
the buildings).
ERIC Prevents Death
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Hierarchy of Controls (ERIC-PD)
And, finally, buildings-wide policies and local
rules also set out the minimum expected standard
to be observed by all staff and students with
regard to health and safety arrangements, and
must therefore be read and understood, and all
workers must agree to comply with them.
ERIC Prevents Death
http//www.mvm.ed.ac.uk/LittleFrance/mvmhlthsaf.
htm
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Five Steps to Risk Assessment

• Record your findings

Written or computerised records are equally
acceptable, providing that workers have ready and
easy access to these. The University has a range
of forms for Risk Assessment, covering a range of
possibilities, each guiding the user through
relevant questions and suggesting sources of
further information http//www.ed.ac.uk/schools-
departments/health-safety/risk-assessments-checkli
sts/risk-assessments
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Five Steps to Risk Assessment

• Review periodically, and revise as necessary.

Take account of changes in personnel, equipment,
substance(s) and/or procedures changes in
legislation and guidance and records of
accidents, ill-health and near-miss occurrences.
So, probably review and at least annually, and
update whenever significant details change.
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
HSE also promote eight principles of good
practice related to risk assessment

• Design and operate processes safely
• Consider all relevant routes of exposure
• Control exposure
• Choose effective and reliable controls
• Choose suitable PPE
• Check and review regularly
• Inform and train
• Must not increase overall risk to HS

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Useful questions to be considered at the same
time
The cartoon reproduced in this presentation
originates with the HSE, which agrees to its use
for internal circulation within an organisation.
Attention is drawn to the HSE web site
(http//www.hse.gov.uk/index.htm), where further
details of the Myth of the Month (and previous
myths) highlighted by these cartoons may be
obtained.
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Chemicals and Biological Agents (COSHH
Regulations)

• COSHH risk assessments must be
• done.
• Consider less hazardous alternatives.
• Consult safety data sheets.
• Assess risks associated with use,
• storage and disposal.
• Use control measures as required.
• Plan for accidents in advance.

Control of Substances Hazardous to Health
Regulations 2002
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Radiation

• Justify use of radioactivity.
• Optimise experimental design to
• ensure that doses are as low as
• reasonable practicable (ALARP).
• Dose limits apply.
• Discharge authorisations apply.
• Plan for accidents in advance.
• Defer to your Radiation Protection
• Supervisor (RPS).

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Biological Hazards

• Undertake Risk Assessments
• http//www.docs.csg.ed.ac.uk/Safety/Policy/
• Part6.pdf (Para 3.4)
• Additional requirements for work involving
• genetically modified organisms
• http//www.docs.csg.ed.ac.uk/Safety/Policy/
• Part6.pdf (Para 4.5)
• Understand the rules and constraints associated
• with containment laboratories
• http//www.ed.ac.uk/schools-departments/health-saf
  ety/biosafety/policy/guidance-rules/lab-management

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Biological Hazards

• Understand the correct use of biological safety
• cabinets
• http//www.docs.csg.ed.ac.uk/Safety/bio/guidance/b
  lm/safety_cabs.pdf
• Seek advice if transporting pathogens etc
• http//www.ed.ac.uk/schools-departments/health-saf
  ety/biosafety/policy/guidance-rules/transport

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Safe System of Work (SSW)

• The principal end-product of the process of
• competent risk assessment.
• An easy-to-follow summary of the nature of
• a specific hazard, and how it has been
• planned that workers and other people will
• be protected from it.
• Those who will be handling the hazardous
• substance (for example) should sign the
• SSW to acknowledge that they have read it,
• understand it, and agree to comply with the
• arrangements.

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
In the event of an accident, questions will be
asked not least of which will be

• Had risk assessments been done?
• Were they suitable and
• sufficient?
• Were procedures being followed
• correctly (a Safe System of
• Work)?
• Were proper records being kept?

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Who should carry out a Risk Assessment?

• A competent person who is knowledgeable
• regarding the relevant substances and/or
• processes, and who has a good working
• knowledge of how to carry out a meaningful
• risk assessment (i.e. often the person
• routinely doing the task or handling the
• substance/equipment).
• Someone with the time to do it properly and
• also to maintain it over the longer-term.
• Some special training may be justified/
• necessary.

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT

• When conducting the RA, common errors are made by
  all types of organisation these include
• Not appointing competent people to carry
• out the risk assessment.
• Not providing the necessary information,
• training, resources, time and support to
• assessors.
• Not involving a team of people in the RA,
• and not including employees with practical
• knowledge of the process/activity to be
• assessed.

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT

• Other common errors include
• Overlooking collateral risk factors (e.g. late
• and lone working, implications for pregnant
• workers etc.)
• Not thinking about long-term hazards to
• health (e.g. risks caused by long-term
• exposure to dangerous substances).
• Overlooking other work that is being
• carried out in the workplace (e.g. cleaning).
• Controlling one risk by transferring it
• elsewhere.
• Failing to inform and adequately supervise
• workers.

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT

• For example, Reg. 12 of COSHH says that employees
  must be informed of
• Details of substances that they are liable to
• be exposed to in the workplace.
• Risks that these may present to health.
• Relevant Workplace Exposure Limits
• (WELs).
• Product safety data sheets etc.
• Any other relevant legislative provisions.
• Significant findings of risk assessment.
• Precautions and actions to be taken to
• safeguard workers.

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
In summary, the five steps to Risk Assessment are

• Identify the hazards.
• Decide who might be harmed and how.
• Evaluate the risks and decide on precautions.
• Record your findings and implement them.
• Review and update as necessary.

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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
Lindsay Murray Health Safety Manager, The
University of Edinburgh, College of Medicine
Veterinary Medicine (Chancellors Building,
Medical School and Queens Medical Research
Institute), Little France
Room SU215, Chancellors Building Ext
26390 lgm_at_staffmail.ed.ac.uk
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HEALTH SAFETY _at_ LITTLE FRANCE RISK ASSESSMENT
You have now completed this on-line training
package summarising the broad principles of risk
assessment used on the Little France site. Please
also attend any additional training that may be
organised by your senior laboratory manager.
Thank you