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Heathrow's healthy o u tlook

HEALTH

At the Heathrow Terminal 5 construction site airport operator BAA has provided an occupational health service at no extra cost to contractors.

BAA's Mike Evans explains to Phil Bishop why this strategy is crucial for the retention of the workforce

AN ESTIMATED 37 million man-hours will be spent in the construction of BAA's £4 billion Terminal 5 at Heathrow Airport. At peak, there are 5,000 workers on site. Workplace safety was always going to be a key issue, but so too was the health and welfare of the workforce.

Right from the very start of planning, says Mike Evans, BAA's head of health and safety on the project, there were wide-ranging discussions about human resources. Over the course of the project as many as 60,000 people will have worked on the site. Attracting enough workers to this relatively awkward location was not easy.

'Occupational health was seen as part of the whole respect for people programme, designed to attract and retain the workforce, ' Mr Evans says.

Usually it is up to the contractors to provide welfare services but in this case BAA decided to provide occupational health services centrally and f ree of charge to the cont ractors.

For the on-site medical centre, nursing staff were selected that had both occupat ional health and accident and emergency experience. The medical team has a doctor on site two days a week, plus a local GP one day a week, and nine full-time nurses and two administrators.

Evans explains that there are two strands to occupational health. The first is the effect of health on work ? is the worker healthy enough to do the job? The second is the effect of the work on health ? does the job damage the health of the worker?

To address the first issue, pre-employment screenings are carried out. As of August, more than 22,500 workers had been screened at T5.

This involves filling in a medical history form.

Anything that alerts the nurses' attention may lead to a full medical. Workers in roles defined as safety-critical, which primarily includes plant operators (since if they collapsed on the job there could be safety consequences), are given full medicals before starting on site. To date, there have been more than 8,500 of these.

'I guess there was perhaps a little bit of cynicism at first, that screening was being used to exclude people, ' Mr Evans admits. 'But that's been totally dispersed.

We've used the information totally positively, to help people, to get treatment and employ them.' Medicals have shown that 30 per cent of safetycritical employees have potential health issues, 15 per cent of which were not previously diagnosed, since construction workers are not inclined to visit doctors regularly. The main problems were high blood pressure, poor vision and diabetes ? 'all things that can be addressed quite easily, ' Mr Evans adds.

'The nu rses have been amazed at the number of young guys with very h igh blood pressure, ' he says. 'That's the modern disease ? a high-salt diet and junk food.' The OH team also runs health promotion campaigns, ranging from construction-specific issues such as the risk of hand arm vibration syndrome, manual handling and cement dermatitis, to lifestyle issues such as cholesterol and smoking.

'Once a week a couple of the nurses will set up a stall in one of the canteens and, for example, offer free cholesterol checks there and then, ' Mr Evans says. The response has been very positive, he says. Around 50 per cent of the workforce has now had cholesterol checks, of which 4 per cent were referred to GPs for further investigation.

Certain workers are identified for regular surveillance if their work carries health risks. People working in cement gangs, for example, will be checked periodically for signs of cement dermatitis.

'Cement dermatitis is a horrible condition when you get it, but most people don't know what it looks like when you first get it, ' Mr Evans says. For this reason, all supervisors of concrete gangs have been t rained to recogn ise the first signs of it ? red blotches on the hands.

'For a long t ime we have recogn ised that safety is the responsibility of all site managers, and not just the safety officer. We are now bringing that approach to occupational health, ' he says.

As far as is practical, health hazards have been designed out, following discussions between the doctor and the designers. Mr Evans gives examples: 'We don't cut off the tops of piles with jack hammers ? we automate it. We have got rid of as much post d r illing as possible by cast ing sockets into the walls. You can't design everything out, but that's the direction we are moving in. I think the designers had never had anyone talk to them about occupational health before.' Recognising that there are limits to what can be designed out, the T5 occupational health team has also been working with tool manufacturers to reduce the incidence of hand-arm vibration syndrome. Many manufacturers offer tools that they claim to be low vibration, but manufacturers' data is notoriously unreliable, Mr Evans has found.

This is not because they are dishonest, but because the industry standard testing regime is based in laboratories and does not ref lect real site conditions.

Mr Evans says: 'So we have done our own field tests of vibrat ions of hund reds of different tools.

We've demanded real life data and some of the suppliers and manufacturers have co-operated fully.

'We've found there can be a huge difference between real-life data and manufacturers' theoretical data. In one example, we found that 30 minutes a day was the safe maximum usage time, but the manufacturer said you could use it for seven and a half hours a day.' From this work, BAA has produced a list of approved tools. In general, roughly half the tools tested were rejected on the basis of vibration. All tools such as percussive d r ills car ry BAA labels stating safe usage time and the culture on the project has changed sufficiently, says Mr Evans, for workers to take notice of such things. The health promotion campaigns have played a big part in this. 'It's about improving the culture so the guys themselves know the risks, ' he says.

Mr Evans sees a role for the Health & Safety Executive in promoting low vibration tools.

'My big plea, ' he says, 'would be for the HSE to exert pressure on the suppliers. Once the tool is on site, it's too late. The problem has got to be dealt with at source.' Three years into the project there have been surprisingly few incidents of hand-arm vibration syndrome at T5. Out of 1,194 people being tested for HAVS, 24 were diagnosed with related symptoms, although 2 per cent of those tested have had a long history of exposure.

Mr Evans says: 'My gut feeling is that HAVS is not as big a problem as the industry is making out ? that's compared to back injuries. I don't want to play down its seriousness ? it can end someone's career ? but it is quite rare. The industry has responded and there have been successes.' Such a comprehensive occupational health strategy may be outside the budget of smaller projects.

Indeed, the cost of the programme is difficult to isolate and identify, as some kind of medical facility would always be needed. But the cost is a very small percentage of the overall T5 project cost, and the benef its have outweighed the costs, BAA says.

Besides, it is not just about checking the health of workers ? it is an integral part of looking after the workforce.