Construction Health and Safety Management

By Dr Simon Smith – licensed under the Creative Commons Attribution – Non-Commercial – Share Alike License

http://creativecommons.org/licenses/by-nc-sa/2.5/

Part 10: Health Hazards on Site

Construction Health & Safety Management

Simon Smith (University of Edinburgh)

& Philip Matyear (Balfour Beatty)

Overview

General

Legislation

HSE view

Other - Weils Disease

Summary

Further reading / Information

What are the main hazards ?

1. Skin - Dermatitis

2. Skin Cancer

3. Respiratory Problems - Occupational Asthma

4. Respiratory Problems - Asbestosis

5. Hand - arm vibration syndrome

6. Noise induced hearing loss

7. Musculo-skeletal injury's

GeneralWe all take our health for granted, but

every day on site we are exposed to numerous health hazards from every day things we use or have become accustomed to within our daily routine.

In this presentation we take a brief look at some of the typical hazards on a construction site, what it does to our health and what we can do to help minimise the risks.

Our health not only affects our ability to work but can also have a significant impact on our social life.

Health Legislation Health and Safety at Work Act etc 1974

Requires employers and self employed workers to:

• Ensure they provide and maintain safe methods in the use , handling, storage and transport of articles and substances.

• Employees to take care of their own and others health and safety.

Management of Health and Safety at Work Regs 1999

Regulation 6. Health Surveillance

• Provide appropriate health surveillance with regard to risks identified in risk assessment.

Construction, Design and management Regs 1994

Applies to all stages of a construction project and places duties upon clients, designers and contractors. The regulations aim to ensure:

• Reduction of risk at the planning and design stages - design out health hazards by specifying less hazardous materials. e.g Solvent free adhesives.

Control of Substances Hazardous to Health Regs 2002

Regulation 11. Health Surveillance

• Where employee's are exposed to substances listed in schedule 6 of the Regulations or where it is reasonably foreseeable that a disease or health condition may arise from exposure to a substance, health surveillance shall be provided.

Contrary to popular belief there is a substantial amount of legislation surrounding employee health and health management.

Other regulations requiring health surveillance include;

The Control of Asbestos at Work Regulations 1987(3rd Edition)

The Work in Compressed Air Regulations 1996

Control of lead at Work Regulations 1998

Ionsings Radiation Regulations 1999

HSE viewRevitalising Health and Safety in ConstructionConstruction has a reputation for being a particularly unhealthy industry to work in because its rate of work-related illness is one of the highest of all occupational groups.

Health problems within the industry are prevalent because of the number of high-risk work activities involved and the transient nature of the work force.

Health issues have always been on the HSE agenda but in the last three years the management of health on site has come under much closer scrutiny.

We can now expect visiting HSE inspectors to ask questions about hand arm vibration management, dermatitis caused by cement and noise control.

What are the main health hazards ?

Skin Dermatitis Cancer

Noise Induced

Hearing Loss

Vibration White Finger

Respiratory Problems

Asthma

Asbestosis

Musculoskeletal Injuries

Health 1. Skin - Dermatitis

Few people realise what a serious and debilitating disease dermatitis can be until it happens to them. It is one of the most widespread causes of ill health affecting many people in different industry sectors.

It is caused by the skin coming into contact with certain substances.

Symptoms of the condition can be;

•Redness,

•Itching

•Scaling and blistering of the skin.

In extreme cases the skin can crack and bleed and can spread to other parts of the body.

It can be extremely painful — bad enough to keep people off work and in some cases serious enough to force them to change jobs.

Every year an

estimated 66,000 people

across all industries suffer

from skin diseases caused or

made worse by

their work.

Health Skin - Dermatitis

Some people are more prone to dermatitis than others, different substances and chemicals affect people differently.

How quickly you contract it depends on a number of things -

•the substance

•the strength or potency and

•how long it is in contact with the skin

In our industry the most common substances that can cause dermatitis are;

•Cement products

•Fuel & oils

•Resins and cleaning products

The best way of preventing dermatitis is to use a product that doesn't irritate the skin, where this cannot be achieved, the skin and hands must be covered to prevent risk of contact.

(Note; sometimes the protection we wear, e.g. latex gloves can sometimes cause dermatitis).

About 10% of

bricklayers leave the industry

after developing

allergic dermatitis

from chromate's in cement

Health

2. Skin - Cancer

Skin cancer is the most common form of cancer in the UK, with over 40,000 new cases diagnosed each year.

People with pale skin are most at risk of skin damage, especially those with fair or red hair, with a lot of freckles or with a history of skin cancer.

Exposure to ultraviolet rays (UV) radiation from the sun can cause skin damage including;

SunburnBlistering

Skin ageingand in the long term can lead to skin cancer.

A tan is a sign that the skin has been damaged

Health Skin - Cancer

The HSE has produced a six—point code for sun protection.•Keep your top on, clothes form a barrier to the suns harmful rays.

•Wear a hat with a brim or a flap that covers the ears and the back of the neck.

•Stay in the shade if possible, during breaks and especially at lunch time.

•Use a high factor sun screen of at least SPF15 on any exposed skin.

•Drink plenty of water to avoid dehydration.•Check your skin regularly for any unusual moles or spots.

See a doctor promptly if you

find anything that is changing in

shape, size,

colour, itching or

bleedingAn operative uses a makeshift Sun Shade on his hard hat

Health

3. Respiratory Problems - Occupational Asthma

Work related (occupational) asthma is an extremely distressing and potentially life threatening disease.

Most cases occur as a result of employees being exposed to substances in the workplace that can be broadly classified as;

Dusts Fibres MistsGases Vapours

FumesMicro-organisms

There are an

estimated 1,500 to

3,000 new cases of occupatio

nal asthma

each year

Health

Occupational Asthma

Asthma is a disease that causes narrowing of the airways and constricts breathing.

The most common symptoms of asthma include:

Wheezing

Shortness of breath

Tightness in the chest

Very often the symptoms do not show themselves straight away and may take months or years to become noticeable.

Health

Occupational Asthma

The best way to prevent occupational asthma is to substitute known allergenic materials with those less likely to cause an allergy.

Where this can not be achieved other measures such as good ventilation and local exhaust ventilation schemes can help reduce material concentrations in the air to an acceptable level.

The final control is Respiratory Protective Equipment, this has to be selected very carefully as different types can give widely varying degrees of protection.

Selection of RPE

Respiratory Protective Equipment, may be used to provide protection against a variety of substances with varying degrees of protection.

You need to be aware that NO form of PPE provides complete protection. There is always some actual or potential leakage into the breathing zone.

The Selection of RPE will consider:

1. Type of RPE.2. Personal and work related factors.3. Training.4. Use of RPE.5. Maintenance of RPE.6. Storage of RPE.7. Relative costs of RPE.

Minimum Protection Factor = concentration outside face piece(MPF) max allowable concentration

inside

Compare MPF value with the assigned protection factor (APF) to identify the range of equipment required.

Health

Asbestos is a naturally occurring mineral fibre that has been used in more than 3,000 different construction materials and manufactured products.

It is commonly found in heating system insulation, wall and ceiling panels, roofing materials, floor tiles and a variety of other additional materials.

Around 4000 people a year

in United Kingdom die

from diseases caused by past

exposure to asbestos

(HSE, www.hse.gov.uk)

4. Respiratory Problems - Asbestosis

All asbestos-containing materials were banned from 1999

All types of asbestos tend to break into very tiny fibres. These individual fibres are so small that many must be identified using a microscope. In fact, some individual fibres may be up to 700 times smaller than a human hair.

Because asbestos fibres are so small, once released into the air, they may stay suspended there for hours or even days !

Asbestos fibres under a electron microscope

Health

Asbestosis

Asbestos fibres can have serious effects on your health if inhaled.

The odds of getting cancer increase with the level and duration of exposure.

Asbestos fibres can cause asbestosis, a scarring of the lungs that leads to breathing problems and heart failure. Workers who used to be involved with the manufacture or use asbestos products and have been exposed to high levels are often affected with asbestosis.

The amount of time between exposure to asbestos and the first signs of disease can be as much as 30 years. It is known that smokers exposed to asbestos have a much greater chance of developing lung cancer than just from smoking alone.

Inhalation of asbestos can also cause lung cancer and mesothelioma, a rare cancer of the lining of the chest and abdomen lining. It may be linked to cancer of the stomach and intestines, as well.

The Control Of Vibration At Work Regulations 2005

• Came into force on 6 July 2005

• Covers:– Hand Arm

Vibration Syndrome (HAVS)

– Whole-body Vibration (WBV)

L140

L141

Health

5. Hand - Arm Vibration Syndrome

Hand Arm Vibration Syndrome (HAV's) is a disease linked to prolonged and regular use of hand held power tools, the most common condition is known as vibration white finger (VWF). Regular exposure to vibration can cause a range of permanent injuries to your hands and arms.

The injuries you could suffer include damage to your:

Blood circulatory system (white finger)

Sensory nerves

Muscles

Bones

Joints (Similar to arthritis)

About half a million

construction

workers are at risk of

vibration white finger from using

vibrating tools

Health

Hand - Arm Vibration Syndrome

Early signs of the condition are a tingling sensation or pins and needles in the fingers accompanied by numbness.

Ignoring these early warning signs may lead to further attacks when your fingers become white (See photos).

In more severe forms the attacks are more frequent in the cold weather and may last up to an hour, causing considerable pain and loss of manual dexterity.

Health Hand - Arm Vibration Syndrome

HAVs could limit your ability to work. For example you may not be able to:

Continue working with vibrating equipment (which would make symptoms worse).

Work in cold or wet conditions (which could trigger painful attacks).

Carry out work requiring a high degree of manual dexterity (e.g. handling screws and nails)

The symptoms may also affect your family and leisure activities for the same reasons, for example:

Fishing SwimmingGolf

Washing the car Gardening

Fastening buttons or sorting out coins.

Health

Hand - Arm Vibration Syndrome

Risks to individuals can be reduced by reviewing the task concerned by considering the hierarchy of control.

•Can the operation be designed out ?

•Is there an engineering solution ? – perform

task mechanically.

•Use low vibration equipment.

•Use the correct tool for the job (maintained in

good condition).

•Isolation of workers – Job rotation.

•Use of Personnel Protective Equipment.

Remote controlled demolition pick

Low Vibration Jack Hammer

Health

Hand - Arm Vibration Syndrome

An operative preparing a concrete joint using a single headed scabbler. When this photo was taken the operative had already been scabbling for two hours.

There

must be a better

way !

Health 6. Noise Induced hearing loss

Noise induced hearing loss is one of the most common causes of ill health in industry—about 1.3 million workers are thought to be exposed to noise levels that could damage their hearing.

Damage caused by noise is permanent and incurable—it can range from sounds appearing muffled to total deafness.

People can also suffer from ‘tinnitus’ a constant ringing in the ears that can cause endless suffering.

Other effects may include increased stress, reduced efficiency and disturbed sleep.

Hearing difficulti

es in construc

tion workers

are roughly

twice the national

rate

The Control Of Noise at Work Regulations 2005

Control Measures :

• Hearing protection made available at 80 dB(A) and 112 Pa

• Hearing protection must be worn at 85 dB (A) and 140 Pa

• Define areas, put up signs and control access at 85 dB(A) and 140 Pa where technically feasible.

Health 7. Musculo-skeletal injury's

Musculo-skeletal disorders account for more cases of work related ill health in Great Britain than any other health hazard.

It is estimated that around 1.2 million individuals suffer from Musculo-skeletal disorders caused by their work.

Musculo-skeletal disorders describe a variety of;

•Strains and Sprains

•Over use problems affecting body muscles and joints

Areas most prone injury are;

•Back

•Neck

•Shoulders and upper limbs

Health 7. Musculo-skeletal injury's

Problems include a variety of aliments;

• Herniated discs

• Back ache

• Pains

• Swelling

• Numbness

• Repetitive Strain Injury ( R S I )

• Loss of strength in arms and hands

• Upper Limb Disorders ( U L D )

All of conditions may be caused or made worse by work, leisure or home activities or a combination of both.

Health

Other - Weils Disease

This is a serious and sometimes fatal infection that is transmitted to humans by contact with with urine from infected rats.

Symptoms start with a flu like illness with persistent and severe headaches.

Construction workers, farmers and people that work on canals and rivers are most at risk from contact and infection.

Bacteria suspended in the rats urine and contaminated water such as in sewers, ditches , ponds and slow flowing rivers can get into your body through;

•Cuts and scratches

•Lining of mouth, throat and eyes

Health Weils Disease

Prevention -

•Get rid of the source of the problem

•Don’t touch them with unprotected hands

•Cover all cuts, scratches and broken skin with a waterproof plaster before and during work

•Wear protective clothing - gloves, overalls etc

•Always wash your hands, before eating, drinking and smoking

A rat caught in the lights of pipe camera on an underground pipe survey

Remember !

If you feel unwell with similar symptoms

always consult your doctor.

Summary

For many years employee health has been on the back burner in construction - safety and safe management systems have been the main focus of attention.

In recent times health and the management of health issues have come into the spotlight.

On today's sites we must not only ensure the work is carried out in a safe manner but a healthy one for all concerned.

Further Reading

Available from HSE Books

For more information on health issues please contact your local safety adviser