In edition 307 of BC Disease News (here), we examined the contents of a report on the dangers of respirable crystalline silica dust inhalation, which had been commissioned by the All-Party Parliamentary Group (APPG) on Respiratory Health.
‘Silica - the next asbestos?’ started a ‘long-overdue conversation’, between Government, Parliament, health bodies and the construction industry, about the currently unknown scale of silicosis in the UK, especially among its 2.2 million-strong construction workforce (1.4 million employed workers and 0.85 million self-employed workers), though risks also exists for kitchen worktop fitters, textile (denim) machine operators and other professionals – for more information, see the recent editorial in the CHEST journal.[i]
At the time of initial publication, the British Occupational Hygiene Society (BOHS) ‘welcomed’ and ‘applauded’ the report for its ‘strong recommendations’ calling for improvements to the provision of occupational health services.[ii] These were as follows:
- To make silicosis a reportable condition for those who are currently in work and exposed to RCS, under The Reporting of Injuries, Diseases, and Dangerous Occurrences Regulations (RIDDOR) 2013.
- To amend The Health Protection (Notification) Regulations 2010 to make silicosis notifiable through Public Health England, thereby creating a compulsory national silicosis register – in edition 283 (here), we reported that Unite and Thompsons Solicitors had created their own silica dust register.
- To develop and implement a targeted industry awareness campaign for those at risk of developing silicosis.
- To allow workers to hold their own occupational health records to encourage workers to make associations between symptoms and exposures.
- To merge occupational health services into GP surgeries to allow for occupational histories to be accounted for where work-related ill health is suspected.
- To introduce new Governmental health and safety regulations [outside of the Control of Substances Hazardous to Health Regulations 2002 (COSHH)] specifically relating to the control of respirable crystalline silica (RCS), so that it is afforded the same level of protection as asbestos.
- To investigate (through the NHS) a screening programme for those exposed to RCS.
- To provide access to occupational health services for RCS-generating industries.
- To halve the workplace exposure limit (WEL) for RCS in the UK from 0.1mg/m3 to 0.05mg/m3 (see the 4th edition of EH40/2005), in line with the 2003 recommended exposure standard from the Scientific Committee on Occupation Exposure Limits (SCOEL), and ensure that statutory monitoring requirements are in place to reduce over-exposure.
- To implement Health and Safety Executive (HSE) requirements, compelling compulsory use of masks, dust extraction and water suppression, along with annual reporting of inspection and compliance levels.
- To increase HSE resources to raise the volume of on-site inspections of building contractors of all sizes.
However, the Government is still yet to fully address the report.
In light of this, BOHS wrote a letter to ministerial members of the APPG in September, exhorting them to follow-up on recommendations made 6-months ago. Further, to take encouragement from counterparts in the Australian legislature, who most recently enriched their health surveillance practices by increasing mandatory chest X-ray capacity for miners and quarry workers – this was discussed in edition 312 (here).[iii]
Chief Executive, Kevin Bampton, agreed that MPs had ‘recognised the urgency of the issue’, but was now requesting that they ‘follow through’ on their pledges ‘immediately’, so that excess deaths and long-term illnesses may be prevented.
BOHS estimates that every year, there are approximately 500 UK construction workers deaths from silicosis and approximately 4,000 deaths from chronic obstructive pulmonary disease (COPD).
Kelvin Williams, President of the Society, believes that investing in preventative measures, such as those classified in the APPG Report, would be ‘undoubtedly cheaper, easier and better than trying to cure these illnesses’ associated with industrial exposures.
[i] Cohen RA and Go LHT, Artificial Stone Silicosis: Removal From Exposure Is Not Enough. Chest. 2020 Sep;158(3):862-863 <https://journal.chestnet.org/article/S0012-3692(19)34397-1/pdf> accessed 20 September 2020.
[ii] ‘BOHS welcomes an important new report on silica’ (BOHS) <https://www.bohs.org/bohs-welcomes-important-new-report-on-silica> accessed 20 September 2020.
[iii] ‘Exposure to Respirable Crystalline Silica How Kitchen Worktops and Stone-Washed Jeans are increasingly a matter of life and death’ (22 September BOHS) <https://www.bohs.org/exposure-to-respirable-crystalline-silica/> accessed 30 September 2020.