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Illness should not be an occupational risk


Occupational health schemes are the new 'must haves' in health and safety strategy.

But just how effective are they?

In the next two features Phil Bishop looks at a pilot scheme aimed at small companies and the health strategy on the UK's biggest building site

THE CONSTRUCTION indust ry has made huge progress in site safety over the 31 years since the introduction of the Health & Safety at Work Act.

The number of site fatalities per year is a quarter of what it was. Occupat ional health, however, 'has hardly been on the agenda', says Lawrence Waterman, president of the Institute of Occupational Safety & Health. While accidents can be dramatic and attract headlines, occupational health is actually a far bigger issue for the construction industry, he says.

According to the Institute for Employment Studies, there are on average 4,500 construction workers absent from work every day because of injuries caused by accidents. But there are on average 11,000 construction workers off sick at any one time with a work-related illness.

Mr Waterman is project director of the Constructing Better Health initiative, a national scheme now nearly half-way through a two-year pilot in Leicestershire. The project team is offering a free occupational health service to construction companies and workers across the county.

The project grew out of the Health & Safety Execut ive's Secu r ing Health Together in it iat ive, which launched a national debate about general occupational health. The construction industry argued that it had special circumstances that meant it should be treated differently in any programmes, Mr Waterman says. It has an itinerant workforce and a lot of very small companies. The idea of annual check-ups that a large factory could undertake would not work in construction, it was argued.

Sypol, a health and safety consultancy with experience in the construction industry, and chaired by Mr Waterman, was selected as the contractor for the Leicestershire pilot study to see how an occupational health service aimed specifically at construction could be implemented. Mr Waterman says Leicestershire was chosen because of the urban renewal projects going on in Leicester and the amount of house building across the county.

The £1.1 million trial, which began in October 2004, is funded by the HSE, the Department for Work & Pensions, the Department of Trade & Industry and the B&CE. Sypol's client is the board of Constructing Health Together, and independent verification of the data is being provided by the Institute for Employment Studies.

The first task for Mr Waterman's team was to persuade people he was offering a worthwhile service and conquer widespread ignorance of the issues. 'We are offering a free mousetrap, but if people think they haven't got mice, they won't pick up a free mousetrap, ' he says.

The response to an initial mailshot offering free occupation health consultancy was generally poor. It was followed up with phone calls and more visible outreach activities, taking stalls at public events, builders' merchants' open days and the like, to get face to face meetings.

'A lot of the work we have been doing has been overcoming suspicions ? what's this going to cost us?' says Mr Waterman. Most compan ies believed they did not have any health problems. 'With site safety, problems are visible. With health it can take years before the problems become evident.' The project team comprises a site team of four people focusing on reducing exposu re to r isks and a health team of two people giving health checks to workers and talking to them about personal health issues. Mr Waterman says they are currently seeing approximately 10 new companies every week and carrying out more than 100 health checks a month on construction workers in Leicestershire.

The f ive health issues the team is focusing on are:

n Musculo-skeletal disorders ? the most widespread problem in the industry, says Mr Waterman.

n Chemicals ? skin problems from handling physical irritants, including dermatitis from cement. 'Ten per cent of trained bricklayers are leaving the industry early because of skin trouble from handling cement, ' he says.

n Airborne particulates such as dust and fumes.

n Noise and noise-induced hearing loss.

n Hand-arm vibration syndrome caused by overexposure to the vibrations of hand-held tools.

'Once people accept the service, they f ind it very useful, ' says Mr Waterman. 'But there have been huge problems get t ing people to accept that the health of workers in const ruct ion is being adversely affected by something that is relatively easy to put right. Once we begin to get people engaged, they find it is really helpful and not difficult.' The k ind of simple advice that he and the team are giving includes:

n Washing hands after handling hazardous substances.

n Wearing gloves in cold weather when handling a breaker.

n Covering up in sunny weather.

They also offer advice on reducing manual handling on site ? not necessarily by suggesting expensive mechanical plant, but more often by suggesting practical improvements to logistics such as stor ing mater ial nearer the point of use.

A lot of the workers being targeted hardly ever see doctors, if at all, says Mr Waterman, partly because of their itinerant lifestyle. 'One of the benefits of an outreach project like this is that you reach people who are not plugged into the health service, ' he says. Non-work related health problems can be picked up early, such as high blood pressu re caused by poor diets, before they become too serious.

'We are confident this pilot will show it is worth reaching out, particularly to small firms, with occupational health support, ' says Mr Waterman.

Come October 2006 and the conclusion of the pilot, two possible ways forward are open. One is to introduce Constructing Better Health on a national basis. The other is for a national occupational health service to have a construction centre of excellence to enable the general service to meet the needs of the construction industry. Both options have merits, says Mr Waterman, and it is a debating point among health and safety professionals. 'The ju ry is st ill out on that.'