Hazardous chemical substances: risk assessment in the healthcare industry.

The European Reach agreement (CE 1907/2006), which came into force in June 2007 and it is considered 'the most ambitious legislation on chemicals in the world', aims at ensuring a high level of protection for both the health of people and the environment. It was integrated by the ruling n. 1272/2008 (CLP). This regulation introduces a system of classification and labelling (GHS) which was developed by the UN. The classification is based on the inner dangerousness of the substances without any threshold levels.
In the hospitals the identification of the chemical risk, its assessment and the choice of the handling measures to be taken it is heavily influenced by the CLP regulation and by the information on the dangers of chemical substances; the assessment must primarily identify and classify the chemical agents which can be risky for the workers taking into consideration the properties that each chemical substance carries and what inevitably changes when they are mixed together in each step of the working activity: usage, storage, transportation.
The CLP regulation precisely indicates the hazard class for hazardous chemical agents. This regulation classifies the hazardous chemical agents by making the following distinction: chemical agents dangerous for safety, chemical agents dangerous for their own chemical and physical properties, chemical agents dangerous for the health of human people because of their short, medium or long term toxicity. For each chemical substance which is present in a work environment it is necessary to disclose its chemical composition, its chemical and physical characteristics and what it is necessary to know to use them safely to handle and storage them (vapor pressure, flammability limits, incompatibility with other products). All this information is available on the Safety Data Sheet.
To sum up it is safe to say that according to the current laws on safety and health at work, the chemical risk for the workers' safety is related to all the toxicological properties of the chemical agents, while the risk for the safety of workers is related to the chemical and physical properties of the substances and to the acute toxicological property. In other words, the chemical risk for the health is related to the possibility of a work–related disease, while the chemical risk is related to the possibility that and injury may take place.
In case there was a classificatory uncertainty, the workers must always be protected as far as possible according to the PRECAUTIONARY PRINCIPLE as established by the European Regulation on chemical substances regardless the proper application of national and European models to evaluate chemical risks or the proper ways to measure the exposure to chemical agents in the workplace.
The chemical products which are used in the healthcare industry and can be hazardous can be divided in two wide categories: the chemical products that stem from the activities carried out in a specific department such as chemical deriving from disinfectants or cleansers and those that stem from the many activities carried out in the laboratories. For some products though, such as medicines, medical devices, medical devices which are particularly invasive, cosmetics which are a mixture of different chemical substances or human use, the REACH agreement doesn't apply.
Generally the evaluation of the risk is linked to how dangerous the substance is, the information on health and safety on the safety data sheet the kind of exposure in the workplace and the limits to be respected, the prevention measures and the data stemming from the sanitary surveillance. It is therefore important to consider all the above mentioned factors in a comprehensive system that takes into account these following principles: elimination, substitution, reduction. This concept is explained in the following chart below:

Once the sources for the risk and evaluation test have been identified, it will be necessary to set up a series of strategies to control and contain the risk. In other words, it will be necessary to manage the risk by applying the technical, organizational and procedural measures to the reduce the exposure for healthcare professionals.