1. Risk management & legal liability of waste management in healthcare : Infection control / Occupational Health perspective. Nell Browne Risk Consultant proactiversk@mweb.co.za 083-444-8694

2. 2 National law Constitutional law Administrative law LRA BCEA OHSAct Health Act NEMA NEMA: Air quality Bill Act Regulations Codes of Practice / guidelines Public law / Private law Civil Claims

3. 3 Key terms Hazard source of, or exposure to danger Pure risk Probability injury / ill health / damage will occur Pollution

4. 4 Change in environment 1Substances 2 Radioactive or other waves 3Noise, odours, dust, heat Adverse effect –Human health / well being –Ecosystems –Materials valuable to man –Future

5. 5 OHSAct S 16 CEO duties Properly discharge duties Assign duty Sec 37 - retain liability

6. 6 OHSAct S 8 General duties of employers Provide & maintain safe & healthy working environment Remove hazards Reduce risk Control risk Monitor controls Medical surveillance Inform Train Not permit contravention Enforce

7. 7 OHSAct S 14 General duties of employees Reasonable care Co-operate Comply procedures Report unsafe conditions Report incidents / injury to self - same shift S 15 Duty not to interfere / misuse

8. 8 Unrecognised legal liability Noise – > 85dB Waste anaesthetic gases Disposal of packaging materials –PVC packing sterile goods – > Growth thermoplastic polyesters –Low density polyethylene

9. 9 Chemicals Duties of persons exposed –Prevent release –PPE –Personal monitors –Health evaluations Air monitoring Medical surveillance Records – 30 years.

10. 10 Hazardous biological agents Any micro-organism, cell culture, human endo-parasite, genetically modified May cause infection, allergy, toxicity, or create hazard to human health

11. 11 HBA regulations - 1 Classification Information & training Duties of persons exposed Risk assessment - employer Monitoring exposure Medical surveillance Records – 40 years

12. 12 HBA regulations - 2 Control of exposure PPE & facilities Maintain control measures Prohibitions Labelling, packaging, transport & storage Special measures Disposal Offences & penalties

13. 13 OHSAct S 37 Acts / Omissions Employer / Employee - both may be convicted Criminal & Civil Liability

14. 14 OHSAct S 38 Offences & Penalties Employer - R100,000 / 2 years or both Employee - R50,000 / 1 year or both Additional fines – regulations CRIMINAL RECORD

15. 15 There is always more than one right answer. Our challenge is to find the best right answer for each unique situation!