8.2. Explain the requirements of COSHH in relation to infection prevention and control

This. guide will help you answer 8.2. Explain the requirements of COSHH in relation to infection prevention and control.

COSHH stands for the Control of Substances Hazardous to Health Regulations 2002. It is UK legislation that provides a legal framework for controlling risks from hazardous substances. These substances might harm people’s health if not handled properly. In health and social care settings, COSHH is directly connected to infection prevention and control because many hazardous substances include infectious materials, cleaning chemicals, disinfectants, and biological agents like bacteria or viruses.

Following COSHH requirements in the workplace helps to reduce the spread of infection. It aims to protect workers, service users, visitors, and others who might be exposed to harmful substances. Good COSHH practice is a key part of having safe systems in place for managing infection risks.

What COSHH Covers in Relation to Infection Prevention and Control

Infection prevention and control focus on stopping or reducing the spread of pathogens. COSHH supports this by:

• Identifying substances that may cause infections or worsen them
• Reducing or controlling exposure to those substances
• Putting in place safe systems of work
• Providing information and training for staff
• Monitoring and reviewing control measures

Examples of relevant hazardous substances include:

• Clinical waste
• Blood and other body fluids
• Infectious materials from patients and service users
• Used needles and sharps
• Cleaning chemicals, sanitisers, and disinfectants
• Aerosols and droplets from coughing or sneezing

Identifying Hazardous Substances

Under COSHH, employers must identify all substances that may present a risk to health. In terms of infection prevention and control, this includes identifying biological agents that cause infections.

This means:

• Keeping an up-to-date inventory of hazardous substances used or produced in the workplace
• Recording information about where and how these substances are used or stored
• Recognising that even naturally occurring biological agents can be hazardous in healthcare situations

For example, if a patient has a wound infected with MRSA, the bacteria present in dressings and bandages are considered hazardous substances. Handling them requires COSHH controls.

Carrying Out Risk Assessments

COSHH requires a thorough risk assessment for hazardous substances. For infection prevention and control, this means assessing:

• The type of harm the biological or chemical substance could cause
• How it could spread or contact the body (for example, inhalation, ingestion, skin contact)
• Who might be exposed, including staff, patients, visitors, and contractors
• The likelihood and severity of harm occurring
• Current control measures and whether they are adequate
• Additional actions needed to control the risk

Risk assessments must be written down, regularly reviewed, and updated when work processes change or when there is new information about the hazard.

Controlling Exposure to Hazardous Substances

COSHH sets out a clear requirement: prevent exposure to hazardous substances where possible. If prevention is not realistic, exposure should be controlled as much as possible.

In infection prevention and control, this could mean:

• Using safer alternatives to a hazardous chemical disinfectant where available
• Isolating infectious patients to reduce spread
• Using engineering controls like ventilation systems to reduce airborne hazards
• Establishing safe systems for disposing of clinical waste
• Wearing appropriate personal protective equipment (PPE) such as gloves, masks, eye protection, aprons
• Training staff to follow hand hygiene protocols
• Developing cleaning schedules for high-touch surfaces

Control measures should always be practical and linked to the actual risks identified in the assessment.

Safe Storage and Labelling

COSHH requires safe storage of hazardous substances. This is important to infection prevention and control because improper storage can lead to accidental release or contamination.

Safe storage principles include:

• Clearly labelling all hazardous substances according to regulations
• Keeping biological hazards in secure, designated areas
• Storing chemicals away from food preparation or medication areas
• Using locked cabinets or designated clinical waste bins
• Making sure sharps bins are used for needles and scalpel blades, and never overfilled

Labelling should be easy to read, use hazard symbols where appropriate, and be placed so it is visible without handling the container.

Safe Handling Procedures

Handling hazardous substances must be done in a way that minimises exposure and prevents infection risks. COSHH supports the use of written procedures that all staff can follow.

Examples include:

• Wearing PPE before touching clinical waste or contaminated laundry
• Using tools or designated containers for transferring infectious materials
• Never recapping needles to avoid sharps injuries
• Cleaning up spills promptly using the correct disinfectant for the pathogen
• Following a colour-coded cleaning equipment system to stop cross-contamination
• Decontaminating surfaces and equipment after use

These procedures should be trained into all staff and reinforced through supervision.

Personal Protective Equipment (PPE)

PPE is a legal requirement where the risk assessment shows it is necessary. COSHH supports PPE use as a last line of defence after other controls.

Examples of PPE for infection prevention include:

• Disposable gloves to prevent skin contact with infectious materials
• Fluid-repellent gowns or aprons to protect clothing
• Fluid-resistant surgical masks or respirators to prevent inhalation of infectious droplets or aerosols
• Eye protection to stop splashes from reaching the eyes
• Shoe covers in high-risk areas, such as operating theatres

PPE must be:

• Correct for the hazard
• Available in a range of sizes and types to suit staff needs
• Stored correctly so it does not become contaminated
• Disposed of safely after use, following infection control protocols
• Accompanied by training on correct use, removal, and disposal

Training and Information for Staff

COSHH requires that staff receive the right information, instruction, and training to work safely.

For infection prevention and control, this training should cover:

• How infections spread and how to break the chain of infection
• Specific risks from identified hazardous substances
• Correct use of PPE
• Decontamination and cleaning processes
• Waste segregation and disposal rules
• Emergency procedures for exposure (for example, needlestick injury)
• The location of COSHH risk assessments and safety data sheets

Training should be provided when staff start the role, when new substances or equipment are introduced, and refreshed regularly.

Incident Reporting and Emergency Procedures

Accidents still happen even with control measures in place. COSHH supports the need for early reporting and response.

In infection prevention and control, emergency procedures may involve:

• Reporting exposure incidents immediately to a supervisor
• Following needlestick injury protocols, including medical review and possible post-exposure prophylaxis
• Isolating and cleaning spillages of infectious substances using the correct method for the pathogen type
• Safely managing clinical waste if containers are damaged or leaking
• Recording incidents in the organisation’s reporting system to monitor patterns and improve controls

A quick, structured response reduces the chance of infection spreading further and supports worker safety.

Monitoring and Health Surveillance

Some hazardous substances require ongoing monitoring of exposure levels or health surveillance for workers. This is especially relevant if staff are regularly exposed to certain biological agents.

In a healthcare setting, this could mean:

• Monitoring staff immunisation status, such as hepatitis B for those at risk of blood contact
• Offering regular health checks if work involves exposure to respiratory infections
• Recording and reviewing incidents involving hazardous substances
• Checking cleaning procedures and PPE use periodically
• Sampling and testing environmental surfaces where infection risk is high, such as operating theatres or intensive care units

Health surveillance must be confidential and comply with data protection rules.

Record Keeping

Under COSHH, records must be maintained as part of the compliance process. For infection prevention, records help demonstrate that control measures are active and effective.

Records may include:

• Risk assessments and their reviews
• Training attendance records
• Inventory of hazardous substances with safety data sheets
• Incident reports and outcomes
• Equipment maintenance schedules
• Waste management logs

Good records are useful in inspections, audits, and investigations.

Links Between COSHH and Wider Infection Control Policies

COSHH is not a stand-alone system. It links closely to other policies such as:

• Infection control policy
• Health and safety at work policy
• Waste management policy
• Cleaning schedules and hygiene standards
• Sharps disposal policy

In practice, following COSHH requirements helps to make infection control policies stronger and more reliable. It creates a framework that can be checked and upheld.

Final Thoughts

COSHH plays a major role in keeping people safe from infectious risks in health and social care work. By identifying, assessing, and controlling exposure to hazardous substances, it supports effective infection prevention and control systems. It gives legal weight to safe working practices and ensures that workers know exactly what to do to reduce risks.

For you as a health and social care worker, understanding COSHH is not just about chemical hazards. It is equally about recognising how infectious materials are hazardous substances that must be managed carefully every time they appear in your work. By following COSHH procedures, wearing PPE correctly, reporting concerns quickly, and keeping up to date with training, you protect yourself, your colleagues, and the people you care for. This is a shared responsibility, and it is one of the foundations of safe, quality care.