Occupational health continues to climb up the industry’s agenda. A panel of health, safety and environment experts came together to define the problem, the barriers to progress and how it could address other key issues such as productivity.
Jennie Armstrong, Tideway | Kaveh Asanati, Society of Occupational Medicine | Alan Cheung, Costain | Henrietta Frater, The Crown Estate | Margaret Grahamslaw, B&CE | Fiona King, HS2 | Gregg McClymont B&CE | Keith Prince, Laing O’Rourke | Patricia Sloneczny, AR Demolition | Lawrence Waterman, Park H&S Partnership | Samantha Wilding, B&CE
Between health and safety, it has historically been the latter on which the industry has focused. Lately, however, this has begun to change.
With safety standards having shot up in recent decades, industry leaders are now waking up to the fact that occupational health is an area desperately in need of similar improvement. Last month, an expert panel gathered in a Soho hotel for a discussion entitled Occupational health in 2025: improving compliance and co-ordinated approaches in construction.
Kicking off the debate – hosted by Construction News in association with not-for-profit financial services company B&CE – former politician and B&CE director Gregg McClymont set out the situation: “It is clear that there is a challenge in construction around occupational health,” he said.
“There is a challenge around enabling employers to comply with the current regulations. It’s clear coming in from the outside that employers want to comply, but the question is how one complies when there might not be the skills or the resources.”
Mr McClymont added that the broader issue around both health and safety and occupational health had been made clear to him as he was preparing for the debate: “I was working from home and the lady who cleans our flat was half hanging off our balcony 40 ft above the ground cleaning the window.
“In that moment, the importance of getting this right was brought home to me. It’s the right thing to do, but it also brings efficiencies.”
Where to start? With the employer
Lawrence Waterman, managing partner at consultancy Park Health and Safety Partnership, suggested that driving improvements in occupational health started at the top.
“First, there is the responsibility of the employer to manage work in a way that reduces exposure to health risks and, where they do arise, to mitigate the potential effects and monitor [how well measures to mitigate are working],” he said. “That’s where I start: with an employer.”
The point, Mr Waterman explained, was employers had to face up to their responsibilities for their employees’ wellbeing.
“Construction is the sector in which traditional hazards are still there. We don’t see it in other industries”
Kaveh Asanati, Imperial College London
He drew a parallel with comments made by health secretary Matt Hancock, who had declared the previous day that people must take more responsibility for managing their own health. “It could be a bit like a minister telling people they are individually responsible for health in the UK while doing absolutely nothing about air pollution.”
Mr Waterman added that individual circumstances and issues did need to be addressed by employers, and that employees could be supported towards making better choices.
“Once you’ve started managing the risks, you realise that people come with their own health conditions that need to be managed with support,” he said. “Then there is the fact that there is a lot of personal effort that can be put into self-maintenance, and that whole wellbeing piece is about helping people to develop the knowledge to manage that.”
Kaveh Asanati from Imperial College London agreed: “Anything that involves the effect of work on health is occupational medicine,” he said.
“It’s a huge range of activities. Construction is the sector in which traditional hazards are still there. We don’t see it in other industries. Construction would benefit the most from occupational health input. Academic papers have managed to show that if one organisation has a better health and safety system and better occupational health, its share price is higher.”
BCE occupational health roundtable 8
Costain group HSE operations and behavioural management director Alan Cheung was keen to point out that changes in terms of reducing stress and promoting wellbeing needed to come from senior levels.
Management had to acknowledge that they were in a position of power, Mr Cheung said, and that even seemingly innocuous actions could have serious consequences for their employees: something as simple as sending emails in the evening can have negative effects.
“There is a behavioural aspect to this that is often overlooked,” he said. “A simple example that we’re looking at is the impact that leaders have on their teams. Sending emails at 8pm… people think they need to get things done and that’s fine – just don’t hit send.
“What is the last thing people do at night? Look at their phone. If you’ve got an email from your boss, it can mess up your sleep and so on. I think that’s a piece that we don’t really consider enough.”
Mr Cheung added: “Some large fines have been handed out recently [for safety breaches], so the danger is that is where the focus goes. Does our focus go on the here and the now, or does it go on the longer-term stuff? Our stats have [improved consistently] on safety, but the next stage is to tackle wellbeing, because when incidents do happen it’s because somebody has just switched off.”
B&CE head of occupational health Margaret Grahamslaw agreed, but added that change would be hard to come by: “Things like emails at 8pm… it’s difficult to admit that you’re doing that to people,” she said.
“Fruity Fridays and checking people’s blood pressure are things that people are looking at, not whether people are working a reasonable shift pattern or if they are being looked after properly. Everyone is responsible for their health, whereas how an employer affects your wellbeing is not being addressed.”
Focus on more than fresh fruit
However, Laing O’Rourke HS&E leader Keith Prince said he worried that softer aspects of wellbeing, such as providing fresh fruit in canteens, were distracting people from confronting more serious occupational health concerns. Even concentrating on mental health, which he agreed was a significant issue, could lead to employers failing to focus on other risks to employees’ long-term health.
“As safety professionals, we were pushing occupational health, but then all of a sudden the mental health juggernaut went past us,” he said.
“I feel that we’ve slightly put some things in the too-difficult box, such as how do we stop people from dying of cancer? Mental health isn’t easy, but it is easy to engage with. Wellbeing is easy to engage with. But stopping people breathing in harmful substances is much harder to tackle. We desperately need to put the spotlight back onto that.”
“The highest proportion of HSE activity is still safety. If I don’t have a handrail, I’m going to get prosecuted. If I have a guy without a dust mask on, I’m not”
Keith Prince, Laing O’Rourke
HS2 senior occupational health manager Fiona King agreed. The problem, she said, was that conditions that develop as a result of exposure to harmful substances could take many years to become apparent and the systems simply were not in place to ensure they were measured properly.
“Outcomes still aren’t well-defined,” Ms King added. “We haven’t got enough research that looks at the latency and the control measures and the hygiene.”
Part of the problem, according to Mr Prince, was that employers were generally motivated to act by the prospect of working conditions having direct consequences. Long-term health risks represented a good example.
“The highest proportion of HSE activity around occupational health is still safety,” he said. “If I don’t have a handrail, I’m going to get prosecuted. If I have a guy without a dust mask on, I’m not. It’s changing, but there is still a disconnect. It’s tipping but it needs to tip a lot further.”
BCE occupational health roundtable 1
Henrietta Frater, HSE and wellbeing manager at The Crown Estate, added: “I think people are more conscious of it. People are collating much more information about what’s causing impacts and that is prompting people to think more about enforcement activity. People are more aware of occupational health. I don’t think they’re there yet, but people are more conscious of it.”
For Mr Waterman, it would be politically expedient for the regulators to concentrate more on highlighting long-term risks and the improvements that are required. Efforts made to combat immediate safety concerns have yielded substantial results, he said, but there was a danger that political support for improving occupational health in the construction industry would be lost if efforts were not refocused.
“I think there is an opportunity to turn the regulator’s focus onto health because they need to justify their existence”
Lawrence Waterman, Park H&S Partnership
“There are so few deaths from accidents now, but the numbers for health are frighteningly large,” Mr Waterman said.
“I think part of it is enlightened self-interest on the part of regulators recognising that political support for HSE is not going to be there if all they are saying is that we’ve had 150 deaths this year and we’re going to make it 149 next year and 148 the year after.”
He added: “But if they say that we’ve got thousands of people dying from work-related cancer and we think we can make a difference, I think there is an opportunity to turn the regulator’s focus onto health because they need to justify their existence.”
Part of the issue, according to Ms Grahamslaw, was that long-term health issues by their very nature took time to become apparent.
“Whatever we do today to fix things in terms of health, we won’t reap the benefits for 10 or 20 years,” she said. “You can reduce the number of accidents year on year, but with reducing the number of ill-health cases you’re working in the dark.”
BCE occupational health roundtable 4
Referring back to Mr Waterman’s earlier point about the government saying people should be taking responsibility for their own long-term health outcomes, B&CE communications and public affairs manager Samantha Wilding argued that occupational health in construction should receive government support.
“This is a government that has just produced a green paper on prevention and is producing lots of words around prevention and taking the pressure off the NHS,” she said. “Surely they have got to be waking up to this.”
A productive solution
Aside from being the right thing to do, monitoring and improving employees’ health and wellbeing was also important in terms of productivity, the panel agreed.
After all, the UK is often lambasted for having the lowest productivity in Europe, something panellists said had to be addressed for the sake of UK plc – especially in the face of the Brexit.
“It’s at a bit of a tipping point because there are a lot of seniors now talking about doing more by doing less”
Alan Cheung, Costain
“We always get whipped for not being productive enough as a country,” Mr Prince said. “We work longer hours than anywhere else in Europe. [Laing O’Rourke boss] Ray O’Rourke recently came out and said we should have a 35-hour week via a smarter way of working and people said he was crackers, but he has a point. Why do we work the hardest yet have the lowest productivity?”
This issue, according to Mr Cheung, was already being taken very seriously by many leaders in the construction industry.
Poor productivity, he said, consumed a lot of management thinking, with occupational health a key consideration. “It’s at a bit of a tipping point because there are a lot of seniors now talking about doing more by doing less,” he said.
“That’s why our chief finance officer is driving our wellbeing agenda. There is that recognition now that we just need to be smarter.”
The role of technology
Part of the solution, suggested AR Demolition development director Patricia Sloneczny, had to be technological innovation.
“What we’ve found is that technology has really helped,” she said. “Years ago, people would have to get out of their machine to change an attachment. It was hugely dangerous. That can all be done now from the cab – it’s all automatic. It has a massive knock-on effect. They’re not getting out of the cab and it’s making the job more productive.”
BCE occupational health roundtable 11
Jennie Armstrong, head of occupational health and wellbeing at the Tideway Tunnel project, agreed. “We’ve got some fantastic people on the project and they’re making some massive changes in the way they design things, but they don’t even realise that they’ve designed out some of the health risks that come with it,” she said.
So, the panel agreed that protecting workers, both in the short and long-term, is a moral imperative for employers; so too is helping them to make better decisions about their health.
However, the need to do so is not just altruistic. Rather, supporting, enabling and protecting a workforce can also lead to better outcomes for a business and for the economy as a whole.