State of the nation01 March 2008

Health and safety in the workplace is not only about PUWER (Provision and Use of Work Equipment Regulations) and LOLER (Lifting Operations and Lifting Equipment Regulations), important though both are. It's also not just about precautions around working at height, or in confined spaces (page 18), or slips, trips and falls. Clearly, working safely, particularly with plant and equipment, is paramount, but occupational health is increasingly being seen as at least as important.

As Martyn Grant, former REME officer and now head of health and safety at Thames Valley Police, says: 'We've tended to focus on workplace safety, and that's reduced work-related accidents and fatalities, but now people are realising the relevance of occupational health. Some work does make people ill - not just manual handling leading to MSD [musculoskeletal disorders], but where there's exposure to certain substances, or noise and vibration, or where stress is involved. So, yes, risk management still needs to address accidents, but it's also important to prevent people getting sick.'

Unhealthy numbers
Just how important is revealed by RoSPA (the Royal Society for the Prevention of Accidents), which notes that, while 29 million days are lost annually in the UK due to health and safety problems, either caused or made worse by work, only 6 million of those are the result of accidents. Says Roger Bibbings, RoSPA occupational safety adviser: 'Health-related problems in, or associated with, the workplace are twice as prevalent as work-related injuries, so the challenge is to get managers to look at the broader health issues in their health and safety audits.'

Engineering managers are going to have to do this. As professor Sayeed Khan, chief medical adviser at the EEF (the manufacturers' organisation), says: 'The pressure is now on legislatively. The European Commission has published guidance on, for example, noise and vibration, and those exposed to health issues at work do now need to be assessed, in terms of health, their work patterns and environment - and equipment adjusted as necessary. Ignorance of the law is no excuse.'

Best practice is to start by getting advice from an occupational health adviser, who may well recommend a surveillance programme, the objective being to start understanding potential health problems just as well as you already understand safety issues. Says Khan: 'Engineering managers and those that work for them will be exposed to all the common stuff - the biggies being MSD, noise, vibration and asbestos. In terms of diseases, we're talking about everything from noise-induced hearing loss, to HAV [hand arm vibration] syndrome, dermatitis, occupational asthma and mesothelioma. These can be entirely work-related, but there are others that, although not caused by work, can be made worse.'

He gives the example of maintenance engineers climbing around equipment in difficult, cramped, often hot and humid conditions. 'Machine manufacturers in the past haven't given much thought to maintenance, so it's not uncommon to find engineers scrabbling around in nooks and crannies, trying to lubricate, adjust or dismantle something they can only just reach with their fingertips. Ergonomically, it's terrible.' And he points to increasing work-related stress, due to lack of investment in plant and machinery, yet with the pressure piled on to get that ageing plant up and running fast, so that, for example, production can resume.

'That's why health surveillance is so important. If engineers are exposed to certain coolants, noise, vibration or asbestos, you should have surveillance anyway. But all industrial organisations should be doing it. It's all about trying to pick up potential disease before it impacts people's functioning - partly by ensuring that employees don't get more exposure than they should and partly by providing health tests. So, for example, if engineers are exposed to dusts or powders, then they should be getting breathing tests annually. And those must be done by an occupational health professional.'

Cost of compensation
Khan emphasises that this is not just about ethics: there can be hard economic benefits, but also penalties. 'Looking after equipment, in terms of ensuring against losses, is clearly part of a plant engineer's role. But management also has an important part to play in protecting those plant engineers from over-exposure to any liabilities. If managers say they can't afford a recommended plant improvement - suppose it's a £10,000 booth to protect against noise - they need to remember that you only need three people claiming compensation for work-induced hearing loss and you're up to that cost already.'

Attitudes will change: the Institute of Directors and the HSC, for instance, have recently published new guidance on the importance of improving management leadership in the health end of health and safety, spurred on by the Corporate Manslaughter Act, which comes into force on 6 April. Says RoSPA's Bibbings: 'Health and safety need to be seen as a key business performance indicator, not just a regulatory compliance issue. The challenge for directors is to ensure that they have got systematic capacity to manage it as something integral to planning, with delivery, monitoring and review throughout the organisation.'

What does he mean by that? Bibbings says it's basic stuff, such as plant safety tours and inspections and chairing safety committees, so they can understand the issues and see for themselves what good and bad look like. 'Managers need to ensure that people are properly trained, in line with their health and safety policy statement, and that has to be constantly reviewed in light of experience, ideally with performance appraisals.'

None of this is rocket science. 'Workforce involvement just needs a reboot,' says Bibbings. 'It's very important that training is lead by supervisors - those responsible for the work - so that everyone at the sharp end has a practical understanding. And there need to be team briefings, suggestion schemes, rapid reporting arrangements, behavioural safety programmes - that sort of thing. We're not talking about prescriptive rules, but underpinning judgement and avoiding under-hitting the mark, so leaving people exposed, or overkill and restrictive practices.'

New asbestos guidelines
The Control of Asbestos Regulations came into force in October 2006, building on the Control of Asbestos at Work Regulations 2002. It's an important piece of legislation, not particularly for the changes to how asbestos should be handled, but for its insistence on adequate training and materials wherever asbestos is encountered - and because it recognises that asbestosis is still the greatest single work-related cause of death from ill-health.

HSE reckons that around 1.8 million workers in the UK alone could be at risk from asbestos exposure - that's maintenance engineers, fitters, electricians, heating and ventilating engineers, construction workers, demolition workers etc. Hence its ongoing mesothelioma campaign. Marc Smith, group health and safety director at asbestos handling firm Silverdell, warns: 'Although asbestos has been banned for a long time, it's still commonplace in the fabric of all sorts of buildings coming up for refurbishment and routine maintenance. Plant engineers, like everyone else, need to know there's a legal requirement that employers must ensure adequate protection and training for them before they can work with the material. That includes understanding the properties, effects on health, materials likely to contain asbestos, operations that could expose them and the importance of safe measures.' ARCA (the Asbestos Removal Contractors Association) has published a new ?Guidance note for Asbestos Removal in Confined Spaces'. The note has been provided to give guidance to both clients and contractors on the procedures of working safely in confined spaces and to provide adequate practical guidance for those undertaking asbestos removal. Go to: www.arca.org.uk

For further information, go to: www.hse.gov.uk/asbestos/repsguide.pdf

Practical resources
IOSH (the Institution of Occupational Safety and Health) is offering a free occupational health toolkit, bringing together guidance, factsheets, case studies, training materials and presentations - and covering everything from background information to identifying and dealing with early symptoms and getting people back to work. Key aspects covered include stress, MSD and skin and inhalation disorders. Go to: www.ohtoolkit.co.uk

EEF (the manufacturers' organisation) has also launched a ?Managing sickness absence' toolkit, which it describes as providing a systematic guide to culture change. EEF chief medical adviser professor Sayeed Khan (right) says that it's designed to show companies how they can change their work culture by managing sickness absence in a professional way.

The award-winning toolkit, produced in association with AXA, is a multi-disciplinary resource that covers employment law, human relations, occupational health and general medical practice - right through to issues of people suffering from anxiety, stress and depression. It provides checklists, model policies and route maps for creating what EEF calls 'a high attendance ethos among employees'.

Price is £65.00 for EEF members and £95.00 for non-members.
Go to: www.eef.org.uk to order a copy.

Points
- Health-related problems associated with work are twice as prevalent as work-related injuries
- While workplace safety needs to remain key, a new emphasis is needed on occupational health
- Watch out for coolants, noise and vibration and stress-inducing problems
- The Control of Asbestos Regulations came into force in October 2006, requiring adequate training for all
- Good ergonomics are key for fitters and maintenance engineers on plant
- Practical guidance is now available, with legal, medical and procedural advice

Good order on site

Slips and trips remain the biggest single cause of reported injuries in the construction industry, but HSE is also currently emphasising the importance of segregating people from traffic movements on all sites, wherever there is mobile plant.

Implementing the requirement isn't difficult, but does require rigour, as Phil Waghorn, safety officer at Southampton Container Terminals, points out. SCT, which is jointly owned by DP World and Associated British Ports, is the second largest container port in the UK and its list of mobile plant is impressive - including 10 gantry cranes (with two more huge Liebherr cranes arriving this summer) and more than 100 container straddle carriers, as well as a fleet of forklifts and reach stackers with telescopic booms.

'Our main risk is the pedestrian and mobile plant issue, so everything is very strictly controlled: wherever machines are operating on site is a no-go area for pedestrians - end of story,' says Waghorn. 'If we do have to get people, such as maintenance engineers, into the main container stacking area, then there are strict procedures. We shut the machines down and isolate the area of work. Once the people are in the safe area, we start up the machines again.'

Making such straightforward control measures work on a site like this sounds simple, but needs care, given the visibility issues with big plant and stacks of containers. 'All areas of the site are grid referenced and all movements are monitored by a computer system. All mobile plant, apart from the big quay cranes, has a computer in the cab for the drivers' work instructions, and we can send instructions to the driver via that to stop work. We also have satellite positioning, so we can see if they're moving and get in radio contact.

'Then, within the computer system, we can mark areas as being out of bounds to the straddle carriers - normally, that would be the work area, plus two container rows either side - so that the computer won't send machines into that area. We also put physical barriers on the area.' Common sense, plus belt and braces.

For more information on good site order, go to: www.safetyservices.co.uk/news.asp?ID=64

SOE

Related Websites
www.safetyservices.co.uk/news.asp?ID=64

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