1. Health and Safety Executive Health and Safety Executive Cancer: An occupational health challenge for the profession …..in construction Ian Strudley Head of Health Risk Management Unit HSE Construction Sector

2. What I’ll do….. What’s the problem ?.......... What priorities are HSE ( and IOSH !) taking forward…. What’s next ????

3. Background HSE’s former Chief Inspector Heather Bryant : “ We recognise the construction sector’s progress in reducing the number of people killed and injured by its activities. But it is clear from these figures why there is an unacceptable toll of ill-health and fatal disease in the industry. We will make sure the construction industry thinks health, as well as safety. “

4. Together, we can make a difference

9. THE biggest risk to construction workers Occupational Cancer:

10. Burden of occupational cancer Lesley Rushton et al Imperial College London: http://www.nature.com/ bjc/journal/v107/n1s/index.html

11. What’s the problem … ? Occupational cancers = 5.3% of total –2005 deaths 8010 –2004 registrations 13598 –56% registrations in construction

12. Top 10 causes of cancer registrations attributable to occupational carcinogens (Rushton/HSE) RankAgent/activityNumber of Registrations/year 1Asbestos4216 2Shiftwork1957 3Mineral oils1730 4Solar radiation1541 5Silica907 6Diesel engine exhaust801 7Coal tars and pitches545 8Painters359 9Tertachlorodibenzodioxin316 10Tobacco284

13. Where’s the problem…?

14. What’s causing the problem ?

15. Where’s the problem ? – in construction Asbestos Solar radiation Silica Painters Diesel engine exhaust emissions PAHs – Coal tars / pitches

16. What’s HSE been doing….. HSE Inspection initiatives: ‘Health initiative’ Refurbishment initiative –What are we looking at….. –What aren’t we looking at…..

17. Health initiative –2 week focus on health interventions –500 inspections –Operational guidance detailing enforcement expectations to be issued on leading health risk issues

18. Health initiative Focus on : –Respiratory risks from silica / dusts –(other) Hazardous substances –Manual handling –Noise –Vibration Whilst maintaining push on : –Asbestos risks –Welfare

19. HSE plan of work Thereafter, have been focusing a consolidated effort on :

20. HSE plan of work Silica

21. HSE plan of work Other hazardous substances

22. HSE plan of work Manual handling

23. HSE plan of work Noise and vibration

24. HSE plan of work Welfare

25. HSE plan of work Asbestos

26. Is there still a problem ? 2014 Health initiative ??: 570 site visits 13 Prohibition Notices 108 Improvement Notices 267 Notices of Contravention

27. 2014 Health initiative

28. Is there still a problem ? 2014 refurbishment initiative: Commonest health issues : –Dust – 12% –Welfare – 12% –Asbestos – 10% Health related enforcement action carried out: –46 PNs were served out of a total of 314 –92 INs were served out of a total of 221

29. 2014 (Health in ) Refurbishment Inspection Initiative - Enforcement Asbestos : PNs 24, INs 24 Dust : PNs 21, INs 31 Manual handling : PN 1 Welfare : 33 Ins Vibration : 3 Ins Noise : 1 IN

30. 2014 Health Initiative 13 Prohibition Notices; 108 Improvement Notices 267 Notices of Contravention issued at 146 sites

31. 2014 Refurbishment Initiative Health and Safety Inspection of smaller refurb sites: –537 Notices (including 2 ELCI) –314 PNs (including 46 on health) –221 INs (including 92 on health)

32. 2014 Health Inspection Initiatives - Conclusions : dusts Most significant enforcement area but still an improving picture: Contractors starting to look more at removing risk or improving available controls. Risk awareness amongst larger contractors is generally high but let down by application.

33. 2014 Health Inspection Initiatives - Conclusions : dusts Focus has moved on from silica to include other dusts. Much greater appreciation / use of extraction systems but not always to the correct standard and dry sweeping remains an issue. Reliance on RPE

34. What to do.….? Occupational Risks v Lifestyle Issues

35. What to do …..? Surveillance/Monitoring? Risk Control?

36. What to do …..? ‘Control the risk not the symptoms’ –Monitoring and health surveillance are not enough on their own. The first priority is to stop people being harmed ‘Manage risk, not lifestyle’ –Helping workers tackle lifestyle issues may be beneficial but is not a substitute for preventing work- related ill health.

37. http://www.hse.gov.uk/construction/healthrisks/index.htm HSE website guidance : How healthy is your business?

38. IOSH : campaign on occupational cancer

39. IOSH - No time to lose …. 50+ work-related carcinogens – focusing on : –Diesel engine exhaust –Solar radiation –Silica –Shiftwork –Asbestos

40. IOSH - No time to lose …. www.notimetolose.org.ukwww.notimetolose.org.uk

41. What’s next ? Think Health! –Greater focus on health, not just by HSE…

42. Thank you for listening any questions ? Ian Strudley HM Principal Inspector Head of Health Risk Management Unit Construction Division HSE 01256 404085 ian.strudley@hse.gsi.gov.uk