Lung disease in the construction industry

– the role of occupational hygiene in prevention.

By Chris Keen, Policy and Technical Committee, BOHS

The burden of respiratory disease in construction

Exposure to airborne dust is often considered to be an unavoidable part of working in the construction industry, and historically there has been a view in some parts of the industry that ‘it’s just dust’ and doesn’t represent a serious health risk. In reality, the facts are very different. Construction dusts contain a mixture of individual contaminants, and often these have the potential to do serious, irreversible harm if exposures are not properly controlled. And because of the long latency of most lung diseases associated with these exposures, the true impact is often not fully appreciated. This is compounded by the transient exposure patterns typically found in construction. The provision of long term health surveillance is notoriously difficult in this industry, and many cases of ill health go un-reported and remain hidden. The true burden of respiratory disease in construction workers isn’t accurately known, but estimates are that several hundred people die each year as a result of historic exposures to respirable crystalline silica. The issue is so big as to be the subject of a recent public inquiry, co-ordinated by the All-Party Parliamentary Group (APPG) on Respiratory Health.

The role of Occupational Hygiene and the Breathe Freely Campaign

As these facts have become more apparent, the construction industry have responded and much has been done in the past few years to drive improvements in the industry. Key to providing solutions is the implementation of good practice to prevent, or at least control, the exposures which cause respiratory disease. The recognition, evaluation and control of harmful workplace exposures is the bedrock of the occupational hygiene profession.In 2015 the British Occupational Hygiene Society (BOHS), the chartered society for worker health protection, launched theBreathe Freely in Construction campaign. Historically, interaction between the occupational hygiene profession and the construction industry has not been commonplace, which may go some way to explaining the disease burden associated with construction. The Breathe Freely campaign aimed clearly to address this, and to provide the construction industry with effective support to drive down the dust exposures which are at the root of occupational lung disease.

The basis of occupational hygiene is the hierarchy of control. This recognises that all risk control measures are not equal, and that some are far more reliable than others. Clearly, the elimination of a hazard entirely, or if that is not possible, the control of emissions at source, provides a far more robust control approach than a reliance on personal protective equipment. But we still see, all too often, dust masks being used as the only control against dusts which are known to cause cancer and other life changing diseases. Through Breathe Freely, we have worked with stakeholders including the Health in Construction Leadership Group, the Construction Dust Partnership, the Healthy Lungs Partnership and more to produce a suite of materials providing guidance on effective dust control across a wide range of construction tasks. We have created training materials which allow the upskilling of site supervisors to allow a better understanding of respiratory risks and the associated need to control exposures.  And through a series of roadshows, we have reached well over a thousand construction industry stakeholders directly, to spread our messages. 117 high profile business operating in the UK construction sector have signed up as campaign supporters.

There is no doubt that the Breathe Freely campaign is part of a sea change in controlling respiratory disease risks in construction. Major construction clients, and large principal contractors are now giving this topic much more attention. The application of exposure controls, other than the ubiquitous dust mask, is now the norm on larger construction projects. Dust exposures are reducing and the future burden of lung disease should follow on from this as a natural progression.

However, there is still much to do. The overriding number of businesses operating in the construction industry are SMEs. The level of risk awareness, and the accompanying standards of exposure control, still have a long way to go within this sector of the industry. As our campaign moves forward, we will provide a greater focus on reaching these businesses, with specific targeting on the construction trades known to be at highest risk of dust exposures.  We are always looking for new campaign supporters, and we would especially welcome interest from stakeholders operating in, or interacting with, construction SMEs. You can find out more by visiting our website.