A measure of success

It will be scant comfort to the families tragically affected. But latest statistics from the Health and Safety Executive (HSE) show that the number of fatal injuries to workers fell by 7% last year – from 236 to 220.

Before getting too self-congratulatory about the progress made, it is worth looking a little more closely at the figures. Two industries stand out like a sore thumb when it comes to their record on health and safety and occupational health: agriculture and construction.

Of the 220 deaths recorded by the HSE in 2004-05, 42 were in agriculture, forestry and fishing, and 71 were in construction. Together, these two industries accounted for more than half of the total.

Agriculture – where people often work in isolation – is particularly difficult to police when it comes to health and safety. But by rights, construction ought to be a different matter.

With some two million workers, construction is the UK’s biggest industry and, while there are many small operators, there should be enough big players to set the standard and lead by example. Yet, even without the damning fatality rate, the industry has a woefully poor record. About 115,000 people are estimated to be absent with a work-related illness every day.

Areas for concern

It is not just trips and falls from height that are an issue (although they are two of the most prevalent problems, with falls from height accounting for 28 of the fatalities in construction). Occupational asthma among carpenters and occupational dermatitis caused by mixing concrete, and the use of solvents and degreasers among builders and bricklayers are also common afflictions.

Other common areas for potential hazards involve work on fragile roofs, use of vehicles on site, lifting on site and exposure to asbestos.
In the areas of musculoskeletal disorders (MSDs), noise, hand-arm vibration syndrome (HAVS), asbestos-related disease and cement dermatitis, construction still has a long way to go, argues the HSE.

Latest figures from the Office for National Statistics’ Self-reported Work-Related Injury Survey for 2003-04 estimate that 96,000 people whose current or most recent job was in construction suffered from an illness that was caused or made worse by the job, with a prevalence rate of 4,400 per 100,000 workers at a cost of 180m – as HSE spokeswoman Denise Lewisohn points out.

MSDs are estimated to affect about 5% of the construction workforce (about 90,000 people), while the prevalence of HAVS is about six times higher than the all-industry average, and noise-induced hearing loss is double the all-industry average. Around 10% of the bricklaying industry is estimated to leave their profession because of contact dermatitis from wet cement. And a culture of tight deadlines, bad environmental conditions and under-resourcing can also lead to stress.

The construction workforce is predominantly mature – a factor often overlooked. In some parts of the country, the average age is as high as 47. It is also commonly relatively transient and casual, and may often be multicultural, which may create language challenges when it comes to communicating health and safety and OH messages.

It is for these reasons – plus the fact that, despite a spate of initiatives in recent years, improvement has been slow and stubborn – that the HSE, for one, is so concerned about the industry.

Looking forward, the prospect of the 2012 Olympics in London is just as worrying. Skills body ConstructionSkills estimates that the Olympics will create 33,500 additional jobs in the sector over the next seven years, particularly in areas such as civil engineering – which is good for the industry, of course. But if the pressures on construction firms are anything like they were for the last games in Athens (where 14 construction workers were killed and 180 injured), safety at work is going to become an even more pressing issue.

Taking action

There is a lot of activity taking place. Tackling the construction industry is a key plank of the government’s 10-year ‘Revitalising Health and Safety Strategy’. A ‘construction summit’ is held each February to gauge progress being made on improving health and safety and areas where action needs to be stepped up.

Over the past few years, HSE inspectors have been carrying out a targeted ‘blitz’ on construction sites as part of its ‘Fit Out’ and ‘Working Well Together’ campaigns. It has focused in particular on targeting working at height and getting sites in good order.

Then there has been the development of an OH management model by the HSE. It is designed to provide advice to construction companies on how to manage issues such as manual handling, HAVS, noise-induced hearing loss and dermatitis. This is currently at the pilot stage and the latest development has been a call for volunteers among small and medium-sized enterprises (SMEs) to take part.

The model aims to give the industry a clear guide on minimum standards of OH management that are simple enough for small organisations to use, but detailed enough for large ones.

Key areas being covered include entry health checks for new recruits, risk control, ongoing health checks and back to work assessments.
The pilots, which last six months each, began taking place last April. They are being rolled out until Christmas, and are expected to be completed by 23 June 2006.

Running alongside this in Leicestershire is an innovative government-backed and funded pilot project called ‘Constructing Better Health’. It offers free OH and health and safety advice and support to construction projects in the area until September next year.

Services include free site visits from health and safety professionals, on-site training for managers and workers demonstrating how to minimise the effects of work-related ill health, free confidential on-site health checks, health surveillance, and advice on legislation and how to draw up action plans.

In fact, barely a month goes by without some sort of construction-based health or safety initiative being unveiled. In the past two months alone, the HSE called for SME volunteers for its OH management model pilot project, published guidance on ladder safety as well as injury and fatality statistics for the construction industry, ran a ‘Ladders Week’, and issued a warning to the industry about the possible dangers of using a mobile plant, such as mobile working platforms.

Going further back, in July, new regulations on HAVS were brought in. And new guidance on noise at work was also introduced in light of the new regulations which come into force in April 2006.

The question is whether any of this is making a difference. According to Lewisohn of the HSE, one problem is that health and welfare in still not a priority for construction workers on the ground.

“Most workers rely on the site foreman to inform them of what they need to know about health and safety,” she says. “Companies that engage, communicate with and train their workforces have fewer accidents and ill-health matters to deal with. The HSE wants to see more companies managing the risks, not the symptoms. A healthy workforce is good for business,” she adds.

The industry has been making attempts to improve its record. But it is a slow process, and there is still a long way to go, says Jenny Mason, senior OH adviser for healthcare service Bupa Health and Wellbeing.

“At the moment, they are only really touching the surface,” she says. “There are some companies that are doing a lot and others are not, and most small companies simply do not come into the equation.”

Room for improvement

Most of the big players in the industry are now aware of the need for, and business benefits of good occupational health and health and safety information. “But a lot of the time, it is how companies interpret what is meant by ‘occupational health’ that leaves a lot to be desired,” Mason says.

“Are they, for instance, assessing things such as occupational asthma, dermatitis, MSDs, back injuries and so on, or is it just a nurse on site – perhaps with no formal training or experience – in the first-aid room, putting on plasters?

“The construction industry is like the final frontier when it comes to addressing the health needs of workers,” she adds.

Factors such as pre-employment baseline assessments and regular monitoring of workers are rare in the industry. Tackling areas such as noise on a construction site can also be challenging for the OH practitioner, as noise levels vary according to where staff are using the noise equipment. “You may have someone picking up a grinder and working with it somewhere for five minutes, and then walking off to another part of the site,” says Mason.

In an ideal world, good OH would be a requirement of the contract, she says, but this is often not included in the contract agreement.

Contractors could also make much more use of simple ‘toolbox talks’ to workers, she adds. “On one contract I was working on, the health and safety manager would work with me and tell me what they were doing that week. I would then do a 10 to 20-minute toolbox talk on whatever the issue was – protecting their skin while pouring concrete, for example. I probably did about three talks a week,” says Mason.

But a proactive approach such as this will only happen when both the client and contractor recognise it needs to happen, as she readily admits.
Some big construction firms are recognising how good OH can help. Taylor Woodrow, for instance, has had an outsourced service in place through Bupa since 2003. It offers pre-employment health assessments, health surveillance, counselling and overseas assessments. It also collects data on injury statistics, and has a communication network in place for health and safety issues.

Sickness absence levels at Taylor Woodrow were 3.2 days per employee in 2002-03, and 2.8 in 2003-04 – significantly lower than the average figure of 6.6 days per person identified for the sector by the Chartered Institute of Personnel and Development, it points out.

Looking ahead

The construction industry is starting to place more emphasis on the ‘health’ part of health and safety. But Alan Ritchie, general secretary of the Union of Construction, Allied Trades and Technicians (Ucatt), says there is still not enough being done to prevent many workers from developing OH problems.

Initiatives such as the ‘Constructing Better Health’ pilot – an OH toolkit developed by the Civil Engineering Contractors Association – and the OH facilities now being provided on the very big projects, are all a start, he says.

“But many construction workers are still suspicious of these initiatives, fearing that their employer is looking for an excuse to deprive them of their livelihood,” he warns, adding that trade union safety representatives can play an important role here.

“Until there is a national OH scheme covering all construction workers, we will continue to lose skilled staff because of avoidable health issues,” he says. “Ucatt will continue to press government for such a scheme to be set up.”

One area the industry could look to for guidance is the offshore oil and gas sector, says Mason.

Although similar in many ways, the industry, from necessity, has a much better health and safety and OH record than the construction industry.
Operators have to follow stringent UK Offshore Operators Association guidelines to ensure staff are fit to fly and able to cope with ditching at sea.
Workers have a thorough health assessment and there is effective ongoing health surveillance while offshore. The fact that ill or injured workers have to be flown home – an expensive business – has helped to focus minds on this area.

“I’d like to see more and more contractors taking a more proactive approach,” says Mason.

Go to www.hse.gov.uk for more information on Constructing Better Health

Recent construction health and safety court cases

October 2005: 



  • A worker was crushed to death while unloading a two-tonne beam from his truck at a construction site in Leith.
  • Cambridge construction firm MB Mills General Contractors was fined 3,000 after employees were allowed to use an unsecured ladder and strip a roof without a risk assessment, scaffolding or roof ladders.

August 2005



  • A construction worker was killed and another seriously injured while working on the new Terminal 5 site at Heathrow airport. The two employees were helping to build a car park when a bolt failed on a cantilever slab.

June 2005



  • Three Northern Irish construction firms were fined a total of 22,500 after the death of an employee while working on a shopping centre, fines branded “ridiculous” by union Ucatt.

April 2005



  • A Grimsby construction firm, JMPI, and a Southampton firm, TSL Hygienic, were fined a total of 13,000, plus 10,000 for the death of a worker in 2001. The panel installer fell from a scaffold platform while trying to climb a ladder.



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