Working together to manage occupational lung disease

The Health and Safety Executive’s ongoing “Dustbuster” campaign is aiming to crack down on occupational lung disease, especially that caused by construction dust and other hazardous substances. Mary Cameron outlines how occupational hygienists and occupational health can collaborate to help workplaces stay complaint.

The Health and Safety Executive’s (HSE) “Dustbuster” campaign periodically descends on construction sites around the UK to ensure workers are not being exposed to silica dust and other hazardous airborne substances, such as asbestos and wood dust, with (at time of writing) the most recent inspection “blitz” taking place in January.

As most occupational health professionals will undoubtedly be well aware, silica inhalation is a big risk to construction workers, along with asbestos and wood dust. Repeated and prolonged exposure to silica dust can cause lung cancer and other serious respiratory diseases such as silicosis.

In fact the HSE has estimated that in 2005 there were 500-silica related deaths in the construction industry. More recent statistics have shown that deaths from Chronic Obstructive Pulmonary Diseases (COPD) as a result of dust inhalation (such as silica) are on the rise.

Approximately 4000 deaths are estimated annually from COPD due to past workplace exposures, with construction workers being a significant “at risk” group. High risk activities include: cutting, drilling, or grinding of common construction materials such as bricks, tiles, concrete, and mortar. These activities can create fine silica dust clouds which can be easily inhaled and penetrate deep into the lungs.

Preventing lung disease

The Dustbuster inspection programme is designed to assess compliance with workplace health regulations, and the control measures in place to protect workers’ health, with a focus on preventing lung disease.

HSE inspections can be carried out in different forms including: general inspections of the workplace or inspections of particular dangerous activities, processes or areas that may involve sampling.

“Incident inspections” can also be carried out after a reported accident resulting in an injury or a case of ill health. The frequency of inspections will depend on the nature of the work, if an inspection has been carried out within the previous three months, if there have been any significant changes to the workplace, or if the HSE has published any new information.

While businesses are normally notified of upcoming inspections, inspectors can access and assess at any time. Inspectors will look at the workplace’s activities, occupational health management programmes, and legislation compliance.

After the inspection, if the health and safety representative has drawn attention to an area of concern then the site manager must consider the issue and decide on the most appropriate follow-up actions to take. Improvement notices may be served if a breach to health and safety law has been found, although this is case dependent, and more information can be found in the HSE’s Enforcement Policy Statement.

How to prepare for an inspection

To be prepared and ensure the inspection runs smoothly, the employer should:

• work closely with the inspector to plan a programme of inspections in advance
• carry out the inspections together to help build the relationship
• consult specialists such as occupational hygienists and other occupational health professionals for advice, and for large workplaces
• break down the tasks so that inspections can be carried out over multiple sessions if needed.

The purpose of HSE inspections, naturally, is to prevent occupational ill health, injury or death.

The inspectors work to identify areas of high risk and support the employer in resolving the issue. Should the employer not demonstrate that corrective actions were taken, this may result in prosecutions and fines.

The employer must ensure the site’s health and safety is risk assessed and that complies with corresponding legislation, with the goal being exposure prevention and risk reduction. Managing these health risks in the workplace may require advice from various occupational health professionals.

How occupational hygienists can help

Passing an HSE inspection starts with ensuring health and safety compliance all year round, a duty is placed on employers to ensure they are doing what is reasonably practicable to ensure health and safety.

Often working alongside occupational health, occupational hygienists can help employers create an occupational health compliance strategy proportionate to the size of the business.

This may include building a risk assessment, carrying out workplace exposure monitoring, and control measure testing. A risk assessment involves identifying existing or potential workplace hazards, the likelihood of harm caused by these hazards, subsequent adverse health effects upon exposure, how exposure may occur and to whom, and whether or not current exposure prevention or control measures are in place.

Regular risk assessments must be carried out should the workplace environment be variable with new or changing hazards and levels of risk; such is the case with many construction sites.

An occupational hygienist can also aid the employer in complying with regulations by assessing the personal exposure to hazardous substances and examining the control measures in place (such as local exhaust ventilation testing) to assess its performance.

Occupational hygienists anticipate and identify hazardous agents (physical, chemical, and biological) in the workplace that can cause occupational disease or discomfort. The aim is to evaluate the extent of the risk due to exposure and recommend the best controls to prevent ill-health.

At SOCOTEC, for example, our occupational hygienists often attend construction sites to undertake workplace monitoring and control measure evaluations. We can also help employers in their COSHH compliance programme by assessing the worker’s exposure to hazardous substances and by undertaking examination of control measures in place to ensure continued performance or recommend improvements.

References
‘Become a #DustBuster and show your support for our health campaign’, HSE, January 2019, http://press.hse.gov.uk/2019/01/21/become-a-dustbuster-and-show-your-support-for-our-health-campaign-2/

Cancer and construction: Silica, HSE guidance, http://www.hse.gov.uk/construction/healthrisks/cancer-and-construction/silica-dust.htm

Chronic Obstructive Pulmonary Disease, NHS, https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/

Enforcement Policy Statement, HSE, http://www.hse.gov.uk/pubns/hse41.pdf