What was the problem?
There are a number of roles in the UK construction where workers are likely to be exposed to silica at levels which exceed occupational exposure limits: tunnel construction workers, rig operators, concrete finishers and bricklayers. we employ people in these roles and, like most of the industry, did not have sufficient data relating to their levels of silica exposure. Our occupational health team undertook a review of our health surveillance protocols which led to a different approach to surveillance for RCS and/or sensitisers.
There were two main issues:
- Like many construction companies, Skanska does not have an in-house occupational hygienist. Nor did we have data relating to exposure to respirable silica dusts in our operations. We knew some of our operations were dusty, but not what the component parts of the dust were. This meant we were reliant on engineering, PPE and health surveillance controls to mitigate the risk.
- While Skanska’s health surveillance protocol met with HSE requirements, we were concerned that it represented a ‘one size fits all’ approach to irritants and sensitisers. We were also concerned that when we referred employees to a GP or occupational respiratory specialist, we did not receive an opinion back on whether the condition was work related. The consequence of this was we had to ‘stand people down’ which affected employee confidence and business productivity.
What did we do?
- Carried out a major exercise to categorise all employees based on their exposure to health risks. This enabled us to identify our ‘at risk’ population.
- Revised our operational procedures to focus on workplace hazards.
- Consulted with an expert in occupational and environmental respiratory disease, Professor Cullinan, to review and provide advice on our health surveillance protocol. Professor Cullinan suggested that, in the absence of data for the UK construction industry with regard to RCS, we should undertake some environmental and personal monitoring of our construction workers. It was thought that there was more risk from drilling and tunnelling than general demolition/construction work. This data would provide a basis to identify the population that were most at risk and required increased frequency of surveillance.
- Appointed an occupational hygienist to undertake environmental testing in our piling and foundation operations, which include many of the roles cited as being at most risk to the exposure to RCS above workplace exposure limits (WEL).
- Presented at the Workplace Respiratory Surveillance Study Day at the National Heart and Lung Institute, Imperial College Hospital, London to share our experience, challenges and approach in the construction industry.
What was the outcome?
- Raised awareness across our piling and foundation business regarding RCS.
- Revised our health surveillance questionnaire, protocol and markers for onward escalation for NHS specialist occupational respiratory assessment.
- A focus on appropriately referring employees with deteriorating lung function whilst putting people back to work more confidently.
- Funding gained for further sampling focussed on tunnelling and drilling operations.
- Building a data and knowledge bank for Skanska and the wider industry regarding RSC which could help inform the policy and guidance from the Regulator.
- A defined question set for different respiratory risks so that it is able to identify earlier respiratory health issues.