Health & Safety Policy Personal Protective Equipment · Personal Protective Equipment Policy ......

Health & Safety Policy Personal Protective Equipment

V4.0

September 2016

Personal Protective Equipment Policy

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Summary Purpose of the document: This document is intended to outline the management arrangements within the Trust to describe how the Trust will comply with The ‘Management of Health and Safety at Work Regulations 1999’, which place a requirement on the employer to make a suitable and sufficient assessment of the risks to health and safety of employees and other people who may be affected by the activities of their work. Posts with specific responsibly identified: The Chief Executive The Chief Operating Officer All Directors and Senior Managers Managers and Supervisors Staff Contractors Patients and Accompanying Visitors Site Visitors Key points in the document This document outlines the Trust Procedure for the Assessment, Training and Reduction of Risks as regards the use of Personal Protective Equipment. Use of Risk assessments to identify needs for control measures. Describes the hierarchy of control for selection of risk reducing control measures Outlines the roles and responsibilities of staff.


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Table of Contents

1. Introduction ................................................................................................................... 5

2. Purpose of this Policy/Procedure .................................................................................. 5

3. Scope ........................................................................................................................... 5

4. Definitions / Glossary .................................................................................................... 5

5. Ownership and Responsibilities .................................................................................... 6

5.1. The Chief Executive .............................................................................................. 6

5.2. The Chief Operating Officer ................................................................................... 6

5.3. Role of All Directors and Senior Managers ............................................................ 6

5.4. Role of Managers and Supervisors ....................................................................... 6

5.5. Staff ....................................................................................................................... 7

5.6. Contractors and Contractor Sites .......................................................................... 7

5.7. Patients and Accompanying Visitors ..................................................................... 7

5.8. Site Visitors............................................................................................................ 8

6. Standards and Practice ................................................................................................ 8

6.1. The Hierarchy of Risk Controls .............................................................................. 8

6.1.3. Personal Protective Equipment Assessment ..................................................... 9

6.1.4. Hazard and risk identification ............................................................................. 9

6.1.5. Ergonomics of the task ...................................................................................... 9

6.1.6. Fit to the wearer ............................................................................................... 10

6.1.7. Quality .............................................................................................................. 10

6.2. Main Types of Personal Protective Equipment Available .................................... 10

6.2.2. Protective clothing for the body ........................................................................ 10

6.2.3. Eye and Face Protection .................................................................................. 11

6.2.4. Head protection ................................................................................................ 11

6.2.5. Hand Protection ............................................................................................... 12

6.2.6. Safety footwear ................................................................................................ 12

6.2.7. Respiratory protective equipment (RPE) .......................................................... 13

6.2.8. Hearing protection ............................................................................................ 14

6.3. Limitations of Personal Protective Equipment ..................................................... 15

6.4. Availability, Accommodation and Maintenance of PPE ....................................... 15

6.5. Record Keeping ................................................................................................... 15

6.6. Charges for PPE .................................................................................................. 15

6.7. Exceptions ........................................................................................................... 15

7. Dissemination and Implementation ............................................................................. 15

7.1. Training ............................................................................................................... 15


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8. Monitoring compliance and effectiveness ................................................................... 16

9. Updating and Review .................................................................................................. 17

10. Equality and Diversity .............................................................................................. 17

10.2. Equality Impact Assessment ............................................................................ 17

Appendix 1. Governance Information ................................................................................ 18

Appendix 2. Initial Equality Impact Assessment Form ....................................................... 20

Appendix 3. PPE Assessment Form .................................................................................. 22

Appendix 4. Details of EN Standards for PPE ................................................................... 23


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1. Introduction

1.1. The ‘Management of Health and Safety at Work Regulations 1999’ place a requirement on the employer to make a suitable and sufficient assessment of the risks to health and safety of employees and other people who may be affected by the activities of their work. The process of risk assessment enables employers to identify control measures they need to implement.

1.2. Where the risk assessment identifies that protection against the exposure to hazardous substances is required a hierarchy of controls will be implemented. The final control will be the provision of Personal Protective Equipment - this must always be the last such control. All other control measures must always be considered before resorting to Personal Protective Equipment.

1.3. The legislative requirement for issuing Personal Protective Equipment is set by the ‘Personal Protective Equipment at Work Regulations 1992 (as amended)’. These require that all Personal Protective Equipment must be assessed for suitability, well maintained, and compatible with each other if used in combination. The Regulations also require that employees using such equipment must receive training, information and instruction in the safe use of personal protective equipment.

1.4. This version supersedes any previous versions of this document.

2. Purpose of this Policy/Procedure

2.1. The purpose of this policy is to outline the steps to be taken by Royal Cornwall Hospitals NHS Trust (RCHT) to assess, manage and implement the provision of Personal Protective Equipment.

3. Scope

3.1. The aim of this policy is to ensure the safety of all people affected by the Trusts activities by ensuring that where Personal Protective Equipment is issued as a control measure it is suitable and sufficient. This policy also shows the principles of Personal Protective Equipment Assessment and how to complete them.

4. Definitions / Glossary

The Trust The Royal Cornwall Hospitals NHS Trust.

Trust sites All areas, sites, buildings or premises owned, occupied or controlled by the Trust.

Staff All persons who are employed by the Trust whether on permanent or temporary contracts (Written or implied), paid or unpaid, and shall include persons employed through recruitment and employment agency providers to assist the Trust in delivery of services, but excluding contractors and third parties undertaking works for or on behalf of the Trust.

Contractors Any person employed by or working for a third party organisation working for or acting on behalf of the Trust.

Personal Protective Equipment (PPE) All equipment which is intended to be worn or held by a person at work that protects them against one or more risks to their health or safety i.e. safety helmets, gloves, eye


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protection, high visibility clothing, safety footwear, safety harnesses and any addition or accessory designed to meet that objective.

Risk assessment The careful examination of what could cause harm, and the likelihood of the harm occurring; in order to decide on precautions to prevent that harm occurring.

Compatibility The ability of two or more pieces of personal protective equipment to be used in conjunction and still remain effective.

CE Mark All PPE issued at the Trust must have a CE mark affixed. The CE mark indicates that the PPE meets essential safety requirements tested to a set standard by an ‘approved body’.

EN Standard A reference given to PPE to state that it been tested and passed a specific series of tests. The standard is that of the harmonised European Standard.

RPE Respiratory Protective Equipment – specific equipment required to protection to the users Respiratory system.

CoSHH The Control of Substances Hazardous to Health Regulations 2002.

4.1. For the purpose of this document, unless otherwise stated, any reference to the masculine shall apply equally to the feminine and the singular to the plural.

5. Ownership and Responsibilities

5.1. The Chief Executive

Has overall accountability for ensuring that RCHT meets its statutory obligations and that effective arrangements for the management of health and safety are put in place.

5.2. The Chief Operating Officer

The Chief Operating Officer is the nominated Executive Director with responsibility for Health & Safety across the organisation.

5.3. Role of All Directors and Senior Managers

5.3.1. The Senior Management Team are responsible for ensuring that systems are in place for the suitable and sufficient assessments of risk are undertaken and reviewed in their areas or responsibility. The assessment will include, where appropriate, the identification of suitable PPE.

5.3.2. Management systems will be implemented and local enforcement undertaken of the use of PPE;

5.3.3. Senior Managers will also ensure that there is adequate provision of training, resources, equipment etc.

5.4. Role of Managers and Supervisors

5.4.1. All Managers are responsible, within their sphere of influence, for ensuring that PPE is provided and used where it has been indicated by risk assessment that it should be employed as a control measure.


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5.4.2. They are also responsible for ensuring that a suitable and sufficient assessment has been made of PPE employed and that it is suitable for the hazards it is to control.

5.4.3. Trust Managers must also ensure that where PPE is specified for use the individual who is required to wear it receives the necessary training, information and instruction on its use.

5.4.4. Where employees refuse to wear PPE their reasons should be discussed and resolution sought, with the support of the Trust Safety Fire & Security Management and Occupational Health teams. Any continuation to refuse to wear PPE must be dealt with through disciplinary action.

5.4.5. Managers must ensure that where PPE is of the non-disposable kind, adequate storage facilities are provided, along with materials for cleaning and maintenance.

5.5. Staff

5.5.1. Where PPE has been issued as a control measure through risk assessment; it is the employee’s duty to wear that PPE in accordance with training, information and instruction given.

5.5.2. It is also the employee's duty to keep non-disposable PPE clean and well maintained and store it in the facilities provided.

5.5.3. Staff must report any loss or defect in all PPE to their manager.

5.5.4. There is no provision for staff to sign a “disclaimer” or other document to exempt them from using appropriate PPE.

5.5.5. Where there is a specific reason, such as medical or religious grounds for not wearing PPE the manager must be notified and suitable alternative equipment or controls implemented.

5.5.6. Failure to utilise the PPE provided, or the failure to report lost, missing or defective PPE could result in disciplinary action.

5.6. Contractors and Contractor Sites

5.6.1. The Trust will not provide PPE for use by contractors, except in emergency situations.

5.6.2. When visiting a site under full or part control of a contractor, all Trust staff will adhere to the PPE requirements of the site. If the individual does not have access to appropriate PPE; site managers will usually have a stock of visitor PPE available for loan.

5.6.3. Where frequent or prolonged visits to a contractor site are anticipated the Trust will provide staff with appropriate PPE.

5.7. Patients and Accompanying Visitors

5.7.1. Patients and visitors will not normally require PPE, except where a clinical procedure requires additional protection, i.e. during x-ray or dental procedures.

5.7.2. In such cases PPE will be provided, where practicable this will be single use.


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5.7.3. Where single use PPE is not practicable the local manager will ensure that there is a suitable cleaning regime developed to reduce the potential for cross infection.

5.7.4. Where appropriate a range of sizes or adjustable PPE will be stocked locally to ensure that the most appropriate fit is facilitated for the patient.

5.8. Site Visitors

5.8.1. Official visitors to the Trust will be provided with suitable loan equipment required to access the appropriate areas.

6. Standards and Practice

6.1. The Hierarchy of Risk Controls

6.1.1. The risk assessment process will identify factors (hazards), including substances and by-products with the potential to cause harm. The assessment will also identify control measures to minimise the risks of the harm from the hazard being realised.

Risks should be reduced to the lowest reasonably practicable level by taking preventative measures, in order of priority. The table below sets out an ideal order to follow when planning to reduce risk from activities. Consider the headings in the order shown, do not simply jump to the easiest control measure to implement.

1. Elimination: Redesign the job or substitute a substance so that the hazard is removed or eliminated. For example, dutyholders must avoid working at height where they can.

2. Substitution: Replace the material or process with a less hazardous one. For example, use a small MEWP to access work at height instead of step ladders. Care should be taken to ensure the alternative is safer than the original.

3. Engineering controls: Use work equipment or other measures to prevent falls where you cannot avoid working at height. Install or use additional machinery such as local exhaust ventilation to control risks from dust or fume. Separate the hazard from operators by methods such as enclosing or guarding dangerous items of machinery/equipment. Give priority to measures which protect collectively over individual measures.

4. Administrative controls: These are all about identifying and implementing the procedures you need to work safely. For example: reducing the time workers are exposed to hazards (eg by job rotation); prohibiting use of mobile phones in hazardous areas; increasing safety signage, and performing risk assessments.

5. Personal protective clothes and equipment: Only after all the previous measures have been tried and found ineffective in controlling risks to a reasonably practicable level, must personal protective equipment (PPE) be used. For example, where you cannot eliminate the risk of a fall, use work equipment or other measures to minimise the distance and consequences of a fall (should one occur). If chosen, PPE should be selected and fitted by the person who uses it. Workers must be trained in the function and limitation of each item of PPE.

Personal Protective Equipment DOES NOT REMOVE THE HAZARD.


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6.1.2. Personal Protective Equipment Assessment

6.1.2.1. PPE must only be issued when all other control measures have been exhausted. Guidance on other control measures is given in The Trust Risk Assessment and Risk Register Policy and Control of Substances Hazardous to Health Policy and Procedures.

6.1.2.2. As PPE is the last control measure to prevent exposure to hazards it is vital that the equipment selected is:

Appropriate for the hazards and risk it is intended to control and does not create an additional risk itself.

Takes into account the ergonomics of the task and the health of the individual.

Is capable of being adjusted to fit the wearer correctly and is compatible with other PPE being used.

Meets the appropriate quality requirements (to BS/EN standard).

6.1.2.3. Before PPE is selected it must be assessed using the Personal Protective Equipment Assessment Form.

6.1.2.4. Guidance on completing the form is given in Appendix 3. Details of what must be considered when completing the assessment are given in the subsections that follow.

6.1.3. Hazard and risk identification

6.1.3.1. Correct PPE selection can only be achieved by knowing the hazards and risks it is intended control. The Hazards and Risks of the tasks can only be identified by completing a suitable and sufficient Risk or CoSHH assessment. Guidance on completing such assessments can be found in The Trust Risk Assessment and Risk Register Policy and The Control of Substances Hazardous to Health Policy and Procedures.

6.1.3.2. Those who do the job the PPE is required for are best placed to know what the hazards and risk are. Therefore they should always be consulted before any PPE is selected.

6.1.4. Ergonomics of the task

6.1.4.1. There are factors to consider that may make PPE inappropriate or restrict the wearer’s ability to perform the task. For example heavy or bulky protective suits will restrict movement or make existing musculoskeletal disorders worse. Workers with latex allergies will not be able to wear latex gloves. Workers with beards may not be able to wear certain respirators. The aim of selecting PPE should be to ensure that it provides maximum protection with minimal discomfort.

6.1.4.2. Factors to be considered when selecting PPE are:

The physical effort required to do the job.

How long the PPE is required for.

The requirements for visibility and communication.

The health of the wearer.


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Environmental conditions such as working outside, heating, noise, etc.

6.1.4.3. Taking such considerations into account will mean it is more likely people will wear them.

6.1.5. Fit to the wearer

6.1.5.1. People come in a range of shape and sizes so one size of PPE will not fit all. It is therefore sensible that before any PPE is selected samples of it are obtained for evaluation by staff before a decision is made.

6.1.5.2. A range of PPE in different sizes or PPE that can be adjusted to fit the wearer must be provided in all areas that require such.

6.1.5.3. Fit is particularly important in the case of Respiratory or Hearing Protection where a poor fit may seriously reduce the effectiveness. Factors that can adversely influence the protective efficiency of such items can include beards, sideburns or long hair, or the need to wear glasses.

6.1.5.4. Most types of close fitting Respiratory Protective Equipment are unsuitable for bearded staff, as a close fit cannot be achieved.

6.1.6. Quality

6.1.6.1. Where selected for use Personal Protective Equipment must be manufactured to a high quality. It is a requirement of the Personal Protective Equipment Regulations that all PPE selected must be CE marked.

6.1.6.2. For the Trust (and to ensure the safety of the wearer) PPE must also comply with the relevant European (EN) standard for that equipment. The details of relevant EN standards for different PPE are given in Appendix 4.

6.1.6.3. Effectiveness and quality of PPE may also be determined by reference to manufacturer's literature. Advice is also available from the Safety, Fire & Security Management Team.

6.2. Main Types of Personal Protective Equipment Available

6.2.1.1. The following are all examples of personal protective equipment that is available. However the list is not exhaustive and should only be used as guidance. The full protection offered will depend upon the style and quality of the PPE, the working environment and competence of the individual user.

6.2.2. Protective clothing for the body

6.2.2.1. Any clothing that is intended to protect the entire body or part of the body. This can include boiler suits, coveralls, warehouse coats, outdoor coats, aprons etc. They may be used to protect against hot and cold environments, chemical and biological hazards, mechanical hazards or a combination of hazards. High visibility clothing is also considered to be protective equipment.

http://www.rcht.nhs.uk/RoyalCornwallHospitalsTrust/OurServices/AZServices/H/HealthAndSafetyServices/HealthAndSafetyServices.aspx


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6.2.3. Eye and Face Protection

6.2.3.1. Eye and face protection can be offered by a variety of goggles, spectacles or face shields. The exact nature of the risk will need to be identified but protection can be against:

6.2.3.2. Safety spectacles with side shields will provide impact protection. Two grades of protections are available (Grade I and Grade II). Staff needing to wear corrective spectacles to carry out a task where impact protection is required can be provided with a pair of safety spectacles to their current prescription. These spectacles can be obtained either from a local optician or from manufacturers who provide a prescription service. Over shields should also be considered for short duration and low frequency tasks requiring eye protection.

6.2.3.3. Certain types of goggles will also provide impact protection but will in general be less comfortable to wear.

6.2.3.4. Face shields can sometimes be used as an alternative to spectacles or goggles.

6.2.3.5. Dusts, mists, gases, vapours and chemical or biological splash Safety goggles will provide protection from dusts, mists, vapours and chemical or biological liquid splashes. There are styles available that can be worn over normal spectacles.

6.2.3.6. Safety spectacles can provide protection against liquid splashes and are more comfortable to wear than goggles. However, the protection level is not as high.

6.2.3.7. Indirect ventilation goggles will protect against dusts and liquids but not against gas or vapour.

6.2.3.8. Face shields may be used to protect the face from chemical and liquid splashes but additional eye protection will be required to protect against dusts, mists or gases.

6.2.3.9. Spectacles, goggles or face shields can be used to protect against non-ionising radiations (Ultra-violet, Infrared, Lasers, Welding) but they must be selected in accordance with the wavelength of the radiation and should be clearly marked to indicate the protection afforded.

6.2.4. Head protection

6.2.4.1. Head protection can be provided by a basic Safety Helmet with a peak on the front. It can also be provided by bump caps or other styles of Safety Helmet. Note that a bump cap is not a replacement for a Safety helmet as it does not offer the same level of protection.

6.2.4.2. Different styles of the basic Safety Helmets can be obtained so that eye protection, face shields, vision lighting, chinstraps and/or ear defenders can be used in conjunction. This should be considered when selecting PPE.

6.2.4.3. Where face or respiratory protection is also required then it may be appropriate to use a powered helmet with integral visor.


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6.2.5. Hand Protection

6.2.5.1. Hand protection is provided by a range of different gloves. The style and material of the glove selected will depend upon the nature of the Hazard.

6.2.5.2. Rubber, latex, nitrile, and vinyl gloves can be used for protection when contact with chemical or biological hazards is possible.

6.2.5.3. However, the exact nature of the hazard will need to be considered, along with the breakthrough time of the gloves.

6.2.5.4. The material safety data sheet for any chemical used should also be reviewed. The EN Standard should not be relied on as a sole method for determining the suitability of the glove. For example:

Nitrile gloves offer effective protection against solvents and some acids but are unsuitable for Ketones.

Latex gloves offer good protection against biological agents but cannot be used by certain people who may suffer an allergic reaction.

Rubber gloves may offer suitable protection against chemical and biological hazards but the wearer may suffer restricted dexterity and mobility in the hands.

Vinyl gloves only offer limited protection against biological and chemical hazards so should only be used when the risk of contact is minimal.

6.2.5.5. Leather/cotton or ‘Rigger’ gloves can be used in manual handling operations to provide extra grip and protection against cuts and abrasions. However, they should only be used as a last resort as other control measures such as avoidances of manual handling and the use of lifting aids should be implemented first. Such gloves will also restrict hand movements.

6.2.5.6. Leather or Kevlar gloves can be used for protection against contact with surfaces with high temperatures.

6.2.5.7. Specially insulated gloves can be used for working in cold environments or for protection against cold surfaces.

6.2.6. Safety footwear

6.2.6.1. Safety footwear may be constructed from firm leather with a steel or composite toe-cap to protect against falling objects. A steel or composite midsole may also be incorporated to protect against the risk of standing on exposed sharp objects. Where such risks are being identified then safety footwear must be worn.

6.2.6.2. Steel capped or mid-soled footwear is not suitable in certain environments such as in the proximity of an MRI scanner. In such locations footwear with composite toe and sole protection must be used.

6.2.6.3. Safety footwear is also available for protection against electric shock, chemicals and biological hazards. Overshoes that offer limited biological protection are also available.


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6.2.6.4. Where foot protection is required in locations where there is potential explosion risk footwear with anti-static properties should be selected.

6.2.6.5. There is a variety of footwear with anti-slip soles available. However, caution is recommended with such footwear as the nature of the floor surface and contamination also needs to be considered before such shoes are recommended to prevent slips.

6.2.7. Respiratory protective equipment (RPE)

6.2.7.1. There is a variety of respiratory protective equipment (RPE) available and it is vital that a suitable type is selected. Therefore, where RPE is required as a control measure, the Safety Fire & Security Management Team must be consulted before any choice is made.

6.2.7.2. There are three main varieties of RPE: Respirators, Fresh Air Fed Equipment and Self Contained Breathing Apparatus (SCBA).

6.2.7.3. Due to the high level of competence and legal requirements for using the latter two, Trust Employees must not use Fresh Air Fed Equipment or Self Contained Breathing Apparatus unless specifically trained to do so (e.g. HAZOP suit used for decontamination). Where RPE is required respirators must be used.

6.2.7.4. Respirators are any RPE that takes in contaminated air and filters it before it is inhaled. As these rely on the breathing mechanism to work they should only be used in areas where there is sufficient Oxygen. There are several styles of respirators available:

6.2.7.5. Filtering Face Pieces: These fit over the mouth, nose and chin and are used for filtering airborne particulates and should be disposed of after each shift. There are three levels of protection with 1 being the lowest and 3 being the highest.

6.2.7.6. Disposable Half Masks: These can be used to filter both gases and airborne particulates. They can be reused but the filter elements are not replaceable. If they are kept for use for more than 28 days, they become subject to examination and record keeping under Regulation 9 of CoSHH.

6.2.7.7. Half masks: Theses are reusable masks manufactured from rubber or silicone. The filter can be changed to meet the requirements of the wearer for gases, vapours and/or particulates.

6.2.7.8. Full Facemasks: As above but the mask covers the entire face and has a transparent visor.

6.2.7.9. Powered Hoods/Helmets: These devices use a constant flow of filtered air across the breathing zone to provide protection. Protection is provided against particulates, gases and vapours.

6.2.7.10. Powered Assisted Face Masks: These offer protection against particulates, gases and vapours by the use of a constant filtered airflow. They may include half or full masks and will still offer protection equivalent to a standard respirator if the power fails.

6.2.7.11. It is now mandatory when working with Asbestos and under the Control of Substances Hazardous to Health Regulations 2002 for fit testing


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of the Respirators to be completed before use. There are two types of fit testing Qualitative and Quantitative; Fit Testing is a way of testing the efficiency of the face to mask seal.

6.2.7.12. Qualitative Fit Test: This gives a Pass or Fail result depending on the RPE wearer’s ability to be able to detect (taste or smell) an aerosol when sprayed under controlled conditions.

6.2.7.13. Quantitative Fit Test: This test requires specialist equipment to be able to detect the amount of leakage through a worn mask. This gives a figure known as a Fit Factor.

6.2.7.14. Only a competent person can carry out Fit Testing as the different methods are only suitable for certain masks. The Safety, Fire & Security Management Team will provide more information on Fit Testing requirements when necessary.

6.2.7.15. A face fit test is model and manufacturer specific – the test will only be applicable to the same type as used in the test. Any other model of RPE will require another test. Test certificates are valid for 1 year – the test should be renewed annually.

6.2.8. Hearing protection

6.2.8.1. Hearing Protection must reduce the noise level at the wearer’s ear to at least 85dB (A) and ideally to around 80dB (A). Therefore where there is a significant noise hazard, noise measurements will need to be completed as part of a risk assessment, so that the correct level of hearing protection can be selected.

6.2.8.2. Hearing protection comes in three main varieties; each will reduce the noise levels by different amounts:

6.2.8.3. Ear Plugs: These fit into the ear canal and are manufactured in a variety of materials such as plastic, rubber, silicone, glass down or a combination of these materials. They work by totally blocking out all noises. However, they are not ideal ear protection, as they tend to move out of place with jaw movements.

6.2.8.4. Ear Valves: These also fit into the ear canal but allow ordinary conversation to continue while preventing harmful noise reaching the ear. This is achieved by the presence of built-in baffles that filter out louder noises. However, they can still move out of place and it needs to be assured that the valves are filtering out the correct sound frequency of noise.

6.2.8.5. Ear Defenders: These cover the whole ear and can reduce exposure by up to 50dB at certain frequencies. They may also incorporate built-in baffles to filter out certain frequencies of sound. They can be uncomfortable in hot conditions and may not be compatible with spectacles or goggles.

6.2.8.6. Where a safety helmet and ear defenders are required helmet mounted ear defenders should be selected.


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6.3. Limitations of Personal Protective Equipment

6.3.1. Personal Protective Equipment only protects the person wearing it. It takes no account for other individuals who may be exposed in the environment. Controlling hazards and risks at the source will protect everyone so this is always chosen in preference to providing PPE

6.3.2. Maximum levels of protection from PPE are rarely achieved in practice. This is because suitable protection can only be achieved if the PPE is well maintained, fitted correctly and the wearer is well trained and supervised.

6.3.3. PPE may also restrict the wearers movement, ability to see or hear and so may cause additional risks.

6.4. Availability, Accommodation and Maintenance of PPE

6.4.1. All PPE should be available at the point of use or there should be clear instructions as to where it can be obtained. No work where PPE is required is to take place until such is provided.

6.4.2. When not in use suitable accommodation for PPE must be provided in a place that provides protection from contamination and/or damage.

6.4.3. Where required there should be suitable systems in place to ensure that such PPE is well maintained, inspected and tested regularly in accordance with manufacturers guidelines.

6.4.4. Staff should report any defect or issues with PPE to their Manager as soon as is practicable.

6.5. Record Keeping

Records must be kept with respect to the following:

All training in the use of PPE.

Any inspections and maintenance of multiple use PPE.

Any reported defect in PPE.

6.6. Charges for PPE

6.6.1. Where PPE is required as a control measure it will be issued free of charge to the user.

6.7. Exceptions

6.7.1. Uniform provided for the purpose of identification and corporate image or purposes other than protection against hazards will not be considered to be PPE, the requirements of this policy will not apply.

6.7.2. Equipment required under non- health and safety legislation is excluded from this policy; for example a motorcycle helmet. Unless the Trust explicitly provides or requires the staff member to use a motorcycle for work purposes.

7. Dissemination and Implementation

7.1. Training

7.1.1. Training required to fulfil this policy will be provided in accordance with the Trust’s Training Needs Analysis. Management of training will be in accordance with the Trust’s Statutory and Mandatory Training Policy’.


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7.1.2. Specific Training not covered by Mandatory Training

7.1.3. Ad hoc training sessions based on an individual’s training needs as defined within their annual appraisal or job description.

7.1.4. Only competent people must use PPE. Therefore, all Trust employees who have to use PPE must be informed of the reasons why PPE is necessary, what it will protect against and what its limitations are.

7.1.5. Employees must also be informed of what action they have to take in order for the PPE to remain effective. This is particularly important in the case of Respiratory Protective Equipment. Anyone involved in maintaining, repairing and testing of PPE will also need specific training.

7.1.6. The level of the training required will depend upon the nature of the hazards, severity of risks and the type of PPE used. Training for the safe use of PPE must cover both the theoretical and practical aspects.

7.1.7. Theoretical aspects of training must include:

An explanation of the hazards and risks present and why PPE is needed.

The effectiveness and limitations of the equipment.

Instructions on the selection, use, maintenance and storage of the PPE.

Information of factors that can adversely affect performance.

Instruction on how to recognise defects and information on how to report losses or defects.

7.1.8. Practical training should include:

Demonstrations and practise in putting on, adjusting and removing the equipment.

Instruction, demonstrations and practice on inspection and, where applicable, testing equipment prior to use.

Demonstrations, practise and instruction in the cleaning, maintenance and replacing of component parts where required.

7.2. Document to be disseminated to the Health and Safety Committee for distribution throughout divisions and stored in the Trust Document Library with unrestricted access for all staff. 7.3. Notification of the publication of the policy will be made via the “One and All” email bulletin.

8. Monitoring compliance and effectiveness Element to be monitored

Compliance with the policy will be monitored, in particular:

PPE Risk Assessment.

PPE related incidents.

Periodic audit of PPE compliance.

Lead Health and Safety Committee.

Tool Reports to the Health and Safety Committee from both divisions and specialist advisors.

Frequency In accordance with the Committee Terms of Reference Reporting arrangements

Divisional monitoring through existing committee structures, summary report to Health & Safety Committee.


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Acting on recommendations and Lead(s)

The Health and Safety committee will lead on any recommendations accordingly.

Change in practice and lessons to be shared

Required changes to practice will be identified and actioned within a month. Lessons will be shared with all the relevant stakeholders.

9. Updating and Review

9.1. This policy will need to be reviewed every 2 years, or subject to any industry and Government guidance and best practice updates.

9.2. Revisions can be made ahead of the review date when the procedures section requires updating. Where the revisions are significant and the overall policy is changed, the author should ensure the revised document is taken through the standard consultation, approval and dissemination processes.

9.3. Where the revisions are minor, e.g. amended job titles or changes to the procedures in the Appendices, approval can be sought from the Executive Director responsible for signatory approval, and can be re-published accordingly without having gone through the full consultation and ratification process.

9.4. Any revision activity is to be recorded in the Version Control Table as part of the document control process.

10. Equality and Diversity 10.1.This document complies with the Royal Cornwall Hospitals NHS Trust service Equality and Diversity statement which can be found in the 'Equality, Diversity & Human Rights Policy' or the Equality and Diversity website.

10.2. Equality Impact Assessment

10.3. The Initial Equality Impact Assessment Screening Form is at Appendix 2.

http://www.rcht.nhs.uk/GET/d10268876

http://www.rcht.nhs.uk/RoyalCornwallHospitalsTrust/OurOrganisation/EqualityAndDiversity/HumanRightsEqualityAndInclusion.aspx

http://www.rcht.nhs.uk/RoyalCornwallHospitalsTrust/OurOrganisation/EqualityAndDiversity/HumanRightsEqualityAndInclusion.aspx


Page 18 of 26

Appendix 1. Governance Information

Document Title Health and Safety Policy and Guidance for Personal Protective Equipment

Date Issued/Approved: Date signed

Date Valid From: October 2016

Date Valid To: 1st October 2018

Directorate / Department responsible (author/owner):

J Robin Gatenby, Health & Safety Manager

Contact details: 01872 252266

Brief summary of contents Policy procedures and guidance for the assessment, provision use and management of personal protective equipment.

Suggested Keywords: Personal Protective Equipment, PPE, Health & Safety, footwear, safety equipment, gloves, boots, safety shoes, eye protection, safety helmet.

Target Audience RCHT PCH CFT KCCG

Executive Director responsible for Policy:

Chief Operating Officer

Date revised: 16-09-16 P E Freeman (H&S Auditor)

This document replaces (exact title of previous version):

HSP16 Operational health and safety policy on the workplace and personal protective equipment (PPE) V3.

Approval route (names of committees)/consultation:

Health & Safety Committee

Divisional Manager confirming approval processes

Director of Estates

Name and Post Title of additional signatories

Not Required

Signature of Executive Director giving approval

{Original Copy Signed}

Publication Location (refer to Policy on Policies – Approvals and Ratification):

Internet & Intranet

Intranet Only

Document Library Folder/Sub Folder

Estates/Health & Safety

Links to key external standards Health and Safety at Work etc. Act 1974 Personal Protective Equipment Regulations 1992


Page 19 of 26

Control of Substances Hazardous to Health Regulations 2002 Asbestos Regulations 2012 Construction (Design & Management) Regulations 1997 CQC 10, HSE guidance

Related Documents:

H&S Policy Risk Assessment Policy COSHH Policy Noise at Work Policy

Training Need Identified? Yes

Version Control Table

Date Version No

Summary of Changes Changes Made by

(Name and Job Title)

25 Aug 13 V1 Original Len Welch

20 Dec 09 V2

Minor changes to sentences to add clarity and change from directorate to divisional structure. Removal of the paper system of risk assessment and the inclusion of the DATIX risk module.

Len Welch

29 Dec 13 V3.0 Complete re-write of document into new format, including update.

J. Robin Gatenby, Health and Safety Manager

16-09-16 V4.0 Minor additions and changes to clarify and correct spelling/grammar.

Paul Freeman, H&S Auditor

All or part of this document can be released under the Freedom of Information Act 2000

This document is to be retained for 10 years from the date of expiry.

This document is only valid on the day of printing

Controlled Document

This document has been created following the Royal Cornwall Hospitals NHS Trust Policy on Document Production. It should not be altered in any way without the

express permission of the author or their Line Manager.


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Appendix 2. Initial Equality Impact Assessment Form

Are there concerns that the policy could have differential impact on: Equality Strands: Yes No Rationale for Assessment / Existing Evidence

Age X

Sex (male, female, trans-

gender / gender reassignment)

X

Name of Name of service, strategy, policy or project (hereafter referred to as policy) to be assessed: Health and Safety Policy and Guidance for Personal Protective Equipment

Directorate and service area: Estates Is this a new or existing Procedure? New

Name of individual completing assessment: Robin Gatenby

Telephone: 01872 252266

1. Policy Aim* Who is the strategy / policy / proposal / service function aimed at?

State how the provision and use of personal protective equipment will be managed by the Trust

2. Policy Objectives* Ensure compliance with Statutory instruments, industry best practice guidance.

3. Policy – intended Outcomes*

Suitable and sufficient assessment and selection of personal protective equipment Competent use, storage and maintenance

4. *How will you measure the outcome?

Regular reports to Health and Safety Committee

5. Who is intended to benefit from the policy?

All staff and stakeholders

6a) Is consultation required with the workforce, equality groups, local interest groups etc. around this policy? b) If yes, have these *groups been consulted? C). Please list any groups who have been consulted about this procedure.

Yes Yes Health and Safety Committee

7. The Impact Please complete the following table.


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Race / Ethnic communities /groups

X

Disability - Learning disability, physical disability, sensory impairment and mental health problems

X

Religion / other beliefs

X

Marriage and civil partnership

X

Pregnancy and maternity X

Sexual Orientation, Bisexual, Gay, heterosexual, Lesbian

X

You will need to continue to a full Equality Impact Assessment if the following have been highlighted:

You have ticked “Yes” in any column above and

No consultation or evidence of there being consultation- this excludes any policies which have been identified as not requiring consultation. or

Major service redesign or development

8. Please indicate if a full equality analysis is recommended. Yes No X

9. If you are not recommending a Full Impact assessment please explain why.

Signature of policy developer / lead manager / director J Robin Gatenby

Date of completion and submission

Names and signatures of members carrying out the Screening Assessment

1. 2.

Keep one copy and send a copy to the Human Rights, Equality and Inclusion Lead, c/o Royal Cornwall Hospitals NHS Trust, Human Resources Department, Knowledge Spa, Truro, Cornwall, TR1 3HD A summary of the results will be published on the Trust’s web site. Signed _______________ Date ________________


Page 22 of 26

Appendix 3. PPE Assessment Form Site Division

Location of use Assessor

Date

Brief Description of Activity

Task Risk Assessment Datix Ref

Task Risk Assessment Review Date:

Hazards Identified

Chemical Biological Cold

Heat Noise Sharps

Falling Objects Radiation Poor visibility

Other (specify)

Part of Body Requiring Protection

Head Eyes Hearing

Torso Hands Legs

Feet Other: (specify)

Further Details of Risk or Ergonomic Considerations

Type of Personal Protective Equipment Required

Coveralls Safety Helmet Goggles

Safety Glasses Hearing Protection Respiratory Protection

Gloves High Visibility Safety footwear

Other: (specify)

Details of PPE Selected

Item Manufacturer Supplier Model CE mark BS/EN

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Compatibility Issues

Training, Storage and Maintenance Requirement

Overall Assessment of PPE (explain how PPE will protect the wearer)

Review Date:

Review of this assessment will be required yearly of if the activity changes


Page 23 of 26

Appendix 4. Details of EN Standards for PPE Protective Clothing for the Body Protective clothing for the body can give protection against chemicals, heat and cold. High visibility clothing may also be required in certain areas. The relevant standards for these are as follows:

EN340 – General requirement for protective clothing in relation to material, size, ageing, performance, markings, instructions for use, and fitness for purpose.

EN342 – Clothing for protection against the cold.

EN533 – Clothing for protection against heat and flame.

EN470 – Protective clothing for use in welding etc.

EN471 – High visibility and reflective clothing.

EN465: Type 4 – Clothing for the protection against chemicals (Spray Type).

EN466: Type 3 – Clothing protection against chemicals (Liquid Type).

Head Protection EN397 – Safety Helmets and head protection.

Eye and Face Protection

Eye and face protection can be achieved by the use of spectacles, goggles or face shields. The relevant standards are:

EN170 – For eye protection against light sources at UV wavelength.

EN171 – For eye protection against light sources at IR wavelength.

EN207 – For eye protection against lasers.

EN379 – For eye and face protection for welding activities.

EN166 – For eye protection against impacts, dusts, mists, gases and chemical or biological splash. EN166 standard can include the following sub numbers/letters for different properties:

Frame Lens

Optical class

Refractive tolerance +0.16dio 1

Refractive tolerance +0.12dio 2

Refractive tolerance +0.12/0.25dio 3

Mechanical Strength

General Purpose S

Low-energy Impact (Grade 2 - 125ft/s) F F

Medium –energy Impact (Grade 1 – 360ft/s) B B

High-energy Impact (570ft/s) A A

Field of use

Basic Liquids (chemical) 3

Large Dust Particles (dust) 4

Gas and fine dust Particles (gas) 5

Short Circuit Electric Arc 6 6

Molten metals and Hot Solids 9 9

Optional requirements

Resistance to misting N

Resistance to surface damage K


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Hand Protection

EN374 – Gloves for the protection against chemical and biological hazards. This standard is rated from 1-6 with 1 being the lowest performance rating.

EN388 – Gloves for the protection against mechanical risks. This includes:

Abrasion (rated 1-4)

Blade cut (rated 1-5)

Tear (rated 1-4)

Puncture (rated 1-4)

EN659 – Fire fighting gloves.

EN421 – Gloves for protection against ionising radiation and radiological contamination.

EN407 – Gloves for the protection against thermal sources (heat and/or fire). This includes protection against:

Flammability (rated 0 – 4)

Contact heat (rated 0 – 4)

Convective heat (rated 0 – 3)

Radiant heat (rated 0 – 4)

Small splashes of molten metal (rated 0 - 4)

Large splashes of molten metal (rated 0 – 4)

(With 0 being the lowest performance rating in each category. Each test is optional; an X appears in sequence where no test was carried out)

EN511 – Gloves for the protection against the cold. This includes resistance to:

Convective cold (rating 0 – 4)

Contact cold (rating 0 – 4), and

Permeability to water (rating 0 – 1)

(With 0 being the lowest performance rating in each category)

Foot Protection

EN345 – Safety footwear for mechanical protection. Contain a metal or composite toecap for protection against impact and crushing. This standard has two classes:

Class 1: All materials except natural or synthetic polymers. This class has three subsections:

S1 Basic properties, anti-static properties, heel energy absorption

S2 As S1 and Waterproof

S3 As S2 and anti-puncture sole

Class 2: Natural and Synthetic Polymers. This class has two subsections:

S4 Basic properties, anti-static properties, and heel energy absorption.


Page 25 of 26

S5 like S4 and anti-puncture sole.

EN347 – Safety footwear, but with no metal toecap for protection against impact and crushing. This contains three categories:

O1 Basic properties, hydrocarbon resistant sole, anti-static properties, heel energy absorption

O2 As O1 and Waterproof

O3 As O2 and anti-puncture sole.

Safety footwear may also have lettering to indicate the following:

Letter Protection

A Antistatic

AN Ankle Protection

CI Cold Insulation

CR Cut Resistant

E Energy Absorption of seat region

HI Heat Insulation

HRO Heat Resistant Outsole

M Metatarsal Protection

ORO/FO Oil Resistant Outsole

P Penetration Resistance (Standard for S3 code)

WR Water Resistance

WRU Water penetration/absorption


Page 26 of 26

Respiratory Protective Equipment (RPE)

EN Standard Respirator Class or Filter Assigned Protection Factor

EN149 Filtering Face Pieces FFP1

FFP2

FFP3

4

10

20

EN405 Disposable Half Masks FFGASxP1

FFGASxP2

FFGASxP3

4

10

10

EN140 Half masks P1

P2

P3

GAS

GAS +P3

4

10

20

10

10

EN136 Full Facemasks P2

P3

GAS

GAS +P3

10

40

20

20

PrEN12941 Powered Hoods/Helmets TH1

TH2

TH3

10

20

40

PrEN12942 Powered Assisted Face Masks

TM1

TM2

TM3

10

20

40

Hearing Protection

Hearing Protection is provided by equipment marked with EN352

Note that this list is not exhaustive – for more standards see: https://ec.europa.eu/growth/single-market/european-standards/harmonised-standards/personal-protective-equipment_en

https://ec.europa.eu/growth/single-market/european-standards/harmonised-standards/personal-protective-equipment_en

https://ec.europa.eu/growth/single-market/european-standards/harmonised-standards/personal-protective-equipment_en

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