1.

Health and safety at work is an issue, which should be important to everyone in the hospital and healthcare sector. Taking action to prevent and protect against unnecessary injuries if properly carried out, will have a positive effect on resources;

2.

Health and safety of workers is paramount and is closely linked to the health of patients. This underpins the quality of care;

3.

The process of policy making and implementation in relation to medical sharps should be the result of social dialogue;

4.

HOSPEEM (European Hospital and Healthcare Employers’ Association) and EPSU (European Public Services Union), the recognised European Social partners in the hospital and healthcare sector, have agreed the following:

1.

Having regard to the Treaty establishing the European Community and in particular Articles 138 and 139 (2) thereof (1);

2.

Having regard to Council Directive 89/391/EEC of 12 June 1989 on the introduction of measures to encourage improvements in the safety and health of workers at work (2);

3.

Having regard to Council Directive 89/655/EEC of 30 November 1989 concerning the minimum safety and health requirements for the use of work equipment by workers at work (3);

4.

Having regard to Directive 2000/54/EC of the European Parliament and of the Council of 18 September 2000 on the protection of workers from risks related to exposure to biological agents at work (4);

5.

Having regard to the Community strategy 2007-2012 on health and safety at work (5);

6.

Having regard to the Directive 2002/14/EC of the European Parliament and of the Council of 11 March 2002 establishing a general framework for informing and consulting employees in the European Community (6);

7.

Having regard to the resolution of the European Parliament of 6 July 2006 on protecting European healthcare workers from blood-borne infections due to needle-stick injuries (2006/2015(INI));

8.

Having regard to the first and second stage consultation of the European Commission on protecting European healthcare workers from blood-borne infections due to needle-stick injuries;

9.

Having regard to the outcomes of the EPSU-HOSPEEM technical seminar on needle-stick injuries of 7 February 2008;

10.

Having regard to the hierarchy of general principles of prevention laid down in Article 6 of Directive 89/391/EEC as well as to the preventative measures defined in Articles 3, 5 and 6 of Directive 2000/54/EC;

11.

Having regard to the joint ILO/WHO guidelines on health services and HIV/AIDS and to the joint ILO/WHO guidelines on post-exposure prophylaxis to prevent HIV infection;

12.

With full respect to existing national legislation and collective agreements;

13.

Whereas action needs to be taken to assess the extent of the incidence of sharp injuries in the hospital and healthcare sector, scientific evidence shows that preventive and protection measures can significantly reduce the occurrence of accidents and infections;

14.

Whereas a full risk-assessment process is a precondition to take appropriate action to prevent injuries and infections;

15.

Whereas the employers, and workers’ health and safety representatives need to cooperate to prevent and protect workers against injuries and infections from medical sharps;

16.

Whereas healthcare workers are primarily but not exclusively concerned by sharp injuries;

17.

Whereas students undertaking clinical training, as part of their education, are not considered as workers under this agreement, they should be covered by the prevention and protection measures outlined in this agreement, with liabilities being regulated according to national legislation and practice;

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to achieve the safest possible working environment,

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to prevent workers’ injuries caused by all medical sharps (including needle-sticks),

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to protect workers at risk,

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to set up an integrated approach establishing policies in risk assessment, risk prevention, training, information, awareness raising and monitoring,

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to put in place response and follow-up procedures.

1.

A well trained, adequately resourced and secure health service workforce is essential to prevent the risk of injuries and infections from medical sharps. Exposure prevention is the key strategy for eliminating and minimising the risk of occupationally acquired injuries or infections;

2.

The role of health and safety representatives is key in risk prevention and protection;

3.

The employer has a duty to ensure the safety and health of workers in every aspect related to the work, including psycho-social factors and work organisation;

4.

It shall be the responsibility of each worker to take care — as far as possible — of their own safety and health and that of other persons affected by their actions at work, in accordance with their training and the instructions given by their employer;

5.

The employer shall develop an environment where workers and their representatives are participating in the development of health and safety policies and practices;

6.

The principle of the following specific preventative measures indicated in clauses 5 to 10 of the present agreement means never assuming that there is no risk. The hierarchy of general principles of prevention according to Article 6 of Directive 89/391/EEC and Articles 3, 5 and 6 of Directive 2000/54/EC is applicable;

7.

Employers and workers’ representatives shall work together at the appropriate level to eliminate and prevent risks, protect workers’ health and safety, and create a safe working environment, including consultation on the choice and use of safe equipment, identifying how best to carry out training, information and awareness-raising processes;

8.

Action needs to be taken through a process of information and consultation, in accordance with national laws and/or collective agreements;

9.

The effectiveness of awareness-raising measures entails shared obligations of the employers, the workers and their representatives;

10.

In achieving the safest possible workplace a combination of planning, awareness-raising, information, training, prevention and monitoring measures is essential;

11.

Promote a ‘no blame’ culture. Incident reporting procedure should focus on systemic factors rather than individual mistakes. Systematic reporting must be considered as accepted procedure.

1.

Risk-assessment procedures shall be conducted in compliance with Articles 3 and 6 of Directive 2000/54/EC, and Articles 6 and 9 of Directive 89/391/EEC;

2.

Risk assessment shall include an exposure determination, understanding the importance of a well resourced and organised working environment and shall cover all situations where there is injury, blood or other potentially infectious material;

3.

Risk assessments shall take into account technology, organisation of work, working conditions, level of qualifications, work related psycho-social factors and the influence of factors related to the working environment. This will:

1.

Where the results of the risk assessment reveal a risk of injuries with a sharp and/or infection, workers’ exposure must be eliminated by taking the following measures, without prejudice to their order:

2.

Having regard to the activity and the risk assessment, the risk of exposure must be reduced to as low a level as necessary in order to protect adequately the safety and health of the workers concerned. The following measures are to be applied in the light of the results of the risk assessment:

3.

If the assessment referred to in clause 5 reveals that there is a risk to the safety and health of workers due to their exposure to biological agents for which effective vaccines exist, workers shall be offered vaccination;

4.

Vaccination and, if necessary, revaccination shall be carried out in accordance with national law and/or practice, including the determination of the type of vaccines:

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to highlight the different risks,

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to give guidance on existing legislation,

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to promote good practices regarding the prevention and recording of incidents/accidents,

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to raise awareness by developing activities and promotional materials in partnership with representative trade unions and/or workers’ representatives,

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to provide information on support programmes available.

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the correct use of medical devices incorporating sharps protection mechanisms,

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induction for all new and temporary staff,

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the risk associated with blood and body fluid exposures,

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preventive measures including standard precautions, safe systems of work, the correct use and disposal procedures, the importance of immunisation, according to the procedures at the workplace,

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the reporting, response and monitoring procedures and their importance,

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measures to be taken in case of injuries.

1.

This includes the revision of the reporting procedures in place with health and safety representatives and/or appropriate employers/workers representatives. Reporting mechanisms should include local, national and European-wide systems;

2.

Workers shall immediately report any accident or incident involving sharps to the employers and/or the person in charge, and/or to the person responsible for safety and health at work.

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the employer takes the immediate steps for the care of the injured worker, including the provision of post-exposure prophylaxis and the necessary medical tests where indicated for medical reasons, and appropriate health surveillance in accordance with clause 6(2)(c),

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the employer investigates the causes and circumstances and records the accident/incident, taking — where appropriate — the necessary action. The worker must provide the relevant information at the appropriate time to complete the details of the accident or incident,

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the employer shall, in cases of injury, consider the following steps including counselling of workers where appropriate and guaranteed medical treatment. Rehabilitation, continued employment and access to compensation shall be in accordance with national and/or sectoral agreements or legislation.