A safer conversation: respiratory disease - Part II

Chronic obstructive pulmonary disease (COPD), asthma and silicosis are among the most prevalent respiratory diseases in the United Kingdom. Some of these diseases are caused or made worse by work activities, after workers breathe in hazardous substances such as dusts, fumes and gases, which damage the lungs. Around 13,000 people die every year as a result of them.

The cardiovascular system generally declines with age. This decline impacts significantly upon a worker’s uptake of oxygen. Age-related changes in the lungs include a decrease in peak airflow and gas exchange and decreases in lung function such as vital capacity (the maximum amount of air that can be breathed out following a maximum inhalation). For older employees in manual jobs, these changes in lung function can reduce their ability to do certain active tasks.

Do you think an organisation should do something to tackle the vulnerabilities of older workers. Do you think they are already doing it.

Kevin: Every person within a company should be evaluated individually regardless of age. The lung function testing can identify any persons who have become affected and are at risk. In many cases I am aware of, once issues have been identified following a lung function test, the employees will seek a solution to help prevent further exposure to the hazard, which may cause further damage.

There is certainly a case for organisations to evaluate older workers, but this is something I have personally not found substantial evidence of. Depending on the work rate in conjunction with their changes in lung function, negative pressure may further impair their breathing causing more discomfort. Power assisted RPE would reduce the breathing resistance, but depending on the task, these may be too cumbersome.

Alan: Safety practices must recognise vulnerable worker” and the issue of an ageing workforce has become increasingly topical as the 55-64 year- old age group is expected to comprise 16.2% of the total workforce between 2010 and 2030. Employers must be aware of this and be prepared to make  adjustments to their safety practices to ensure their workforces collectively remain healthy and safe.

Scott Safety recently wrote a whitepaper to help employers prepare for this change and to understand how and why older workers may need to be treated differently. Entitled Consideration of the effects of ageing in selection of PPE with a specific focus on RPE, this document highlights the health conditions that could be experienced by older workers, including loss of visual acuity, hearing impairment and reduced respiratory function. It reinforces the need to improve the current knowledge base and provides sound advice to employers to ensure older employees receive the respirators they need.

Mike: Currently, over 30% of people in employment in the UK are over the age of 50 and demographic and political changes will mean that the average age of the workforce is likely to continue to increase. This has a number of consequences for health and safety – including respiratory health. The first thing that employers need to do is to recognise that this is a potential problem and start to think about what actions they need to take. One of the fundamental principles of occupational hygiene and ergonomics is to ensure that work can be carried out without endangering health – adapting the work to the workforce, not the reverse as is too often the case.

So the key is to reduce the physical stress placed on the worker, for example by looking at measures such as automation, redesigning the task to minimise the stress and the introduction of mechanical aids. It’s also important to properly control exposure to dusts and other respiratory hazards that can further reduce lung function, making the workers even more vulnerable to physical stress.

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Around 86% of school buildings contain asbestos, according to a 2015 freedom of information survey conducted by the Asbestos in Schools Group. However, besides the basic knowledge of not disturbing asbestos during maintenance work, the message does not seem to have reached all levels, or the actions have not been that effective. And the cases of people dying as a result of past work in schools keep piling up.

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What else do you think can be done

Kevin: I believe this is again a question of education and training in relation to the specific hazard. It is important for all contractors in schools to be made aware of the hazards. The risk assessments and method statements must include how the work is to be carried out and contact with the hazard prevented. This should be reviewed by the stakeholders in the schools and monitored.

Much work in schools where contact with asbestos occurs can be fairly small, such as drilling walls and ceilings to hang up whiteboards or projectors. With the case of asbestos, this could be sufficient exposure to cause problems in later life.

Processes of damping down, tool extraction, isolation, etc. would help prevent the asbestos becoming airborne.

While disposable respirators may be used during the drilling, these are often removed almost immediately afterwards, while the fibres are still airborne and can be inhaled.

Alan: The Trade Union Congress (TUC) clearly recognises this issue and recently called for new UK legislation requiring all employers to complete a full asbestos survey no later than 2022, ensuring the removal of all asbestos by 2035. For schools, this should be done by 2028.  In this campaign, TUC also provide key actions to help eradicate the problem now, including ensuring asbestos are properly marked and managed and using a licensed contractor to negotiate the safe removal of asbestos by an agreed date.

Official guidance is that, unless asbestos is damaged, it should be safely managed in situ. It will be interesting to see the support TUC receives over the coming months and whether this will improve the current basic knowledge towards asbestos and subsequent figures in years to come.

Mike: Asbestos in schools is, understandably, an emotive issue. However, the principles of risk management are the same for schools as other types of premises. Unfortunately, nothing can be done about past exposures, therefore, the important point is to ensure that the current risks are properly managed. This means ensuring schools have properly identified any asbestos containing materials (ACMs) by having a survey completed by a competent person, compiling an asbestos register and then managing any identified ACMs, following HSE guidance on managing the materials, with removal by a competent contractor where necessary. Often, problems arise due to the poor management of contractors, who may come into the school to carry out minor maintenance tasks. They may not see the asbestos register, or may not read or understand it and then go on to unknowingly disturb an ACM, leading to problems of contamination. All work on a school site, as with any other premises, should be properly controlled. The responsibility lies with the management of the schools to ensure that there is someone on site with an understanding of the management of ACMs and that good practice is followed. Do that and the risk will be minimised.

Consideration of the effects of ageing in selection of PPE with a specific focus on RPE paper here

Asbestos eradication campaign: here

It’s important to properly control exposure to dusts and other respiratory hazards that can further reduce lung functions. Photograph: iStcok/ heidijpix

Nothing can be done about past exposures, therefore, the important point is to ensure that the current risks are properly managed. iStock/Mogala