Part 10: Health Hazards on Site

1
Part 10 Health Hazards on Site

• Construction Health Safety Management
• Simon Smith (University of Edinburgh)
• Philip Matyear (Balfour Beatty)

2
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
3
General
We 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.
4
Health Legislation
Contrary to popular belief there is a substantial
amount of legislation surrounding employee health
and health management.

• 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.

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
5
HSE view
Revitalising Health and Safety in
Construction Construction 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.
6
What are the main health hazards ?
Respiratory Problems Asthma
Asbestosis
Noise Induced Hearing Loss
Vibration White Finger
Skin Dermatitis Cancer
Musculoskeletal Injuries
7
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.
8
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
9
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 Sunburn Blisteri
ng Skin ageing and in the long term can
lead to skin cancer.
A tan is a sign that the skin has been damaged
10
Health

• Skin - Cancer
• The HSE has produced a sixpoint 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
bleeding
An operative uses a makeshift Sun Shade on his
hard hat
11
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 Mists Gases Vapours
Fumes Micro-organisms
There are an estimated 1,500 to 3,000 new cases
of occupational asthma each year
12
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.
13
(No Transcript)
14
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.
15
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.
16
Health
4. Respiratory Problems - Asbestosis
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)
Asbestos fibres under a electron microscope
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 !
17
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.
18
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)

L141
L140
19
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
20
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.
21
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 Swimming Golf
• Washing the car Gardening
• Fastening buttons or sorting out coins.

22
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
23
Health
Hand - Arm Vibration Syndrome
There must be a better way !
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.
24
Health
6. Noise Induced hearing loss Noise induced
hearing loss is one of the most common causes of
ill health in industryabout 1.3 million workers
are thought to be exposed to noise levels that
could damage their hearing. Damage caused by
noise is permanent and incurableit 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 difficulties in construction workers are
roughly twice the national rate
25
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.

26
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

27
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.

28
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

29
Health

• Weils Disease
• Prevention -
• Get rid of the source of the problem
• Dont 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

Remember ! If you feel unwell with similar
symptoms always consult your doctor.
A rat caught in the lights of pipe camera on an
underground pipe survey
30
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.
31
Further Reading
Available from HSE Books
For more information on health issues please
contact your local safety adviser