Life/Health Consulting Medical Officer, London
World Asthma Day (1 May)
is an annual event organised by the Global Initiative for Asthma to improve
asthma awareness and care around the world.
The
risks to the lungs from inhaling foreign substances while at work have been
known since the Romans recognised baker’s asthma. Today the range of recognised
occupational lung disease is far more extensive and growing. Some problems,
such as asthma, develop soon after exposure. Other conditions only develop
years later - for example, mesothelioma from exposure to asbestos - and can be
life threatening and shortening.
The
UK’s Health and Safety Executive (HSE) estimates that occupational lung
disease is responsible for 12,000 deaths each year and approximately
18,000 new cases that cause 400,000 lost working days.1 These
numbers have remained roughly stable over the past 10 years.
More
recently, the blog on Keeping Workers Safe From Cancer raised
important questions on the impact and effectiveness of proposed EU regulations
in this regard. For the UK, preparing to exit from the EU leaves regulations
like these hanging in the balance. Despite the uncertainty of Brexit, the HSE
Workplace Healthy Lungs Summit 2017 helped keep the issue on the radar.2
The
Summit celebrated the success in reducing respiratory risk achieved in large
organisations where hazards - such as flour dust, welding fumes and crystalline
silica exposure - are all being increasingly controlled by new and effective
technological solutions.
Despite
these gains, two major concerns remain. The first concern regards small and
medium-sized companies where awareness and understanding of the risks, and
potential fixes, is not so well developed. Businesses like these are
particularly difficult to engage as hazard exposure may be intermittent rather
than fundamental to particular job roles.
Secondly,
rapid technological developments bring with them exposure to new substances:
for example, powdered metal for additive manufacturing or in 3D printing.3,4 Their
effects are not well characterised and have the potential to be harmful. Less
familiar risks are presented by working with new materials, such as the carbon
nanotubes used in aerospace, electronics, biotechnology and biomedicine.5,6 Nanotubes
are made up of tough fibres similar in size, shape and inert nature to
asbestos, which may be a risk when inhaled and are known to cause cancer in
rodents.
The
response to new occupational risks like these can depend on how importantly
they are regarded by workers themselves, or even how visible any contaminants
are when in the air. The interventions required to address these perceptions is
a focus of research and debate. Behavioural initiatives are important but so is
the legislative framework to ensure the enforcement of safe exposure levels.
Ensuring control by law is as important as ensuring that health and safety
inspectors do not have a mindset that normalises a degree of risk.7
The
health problems associated with diesel emissions are well known, but the
exposure of workers most at risk (e.g., drivers or warehouse operatives) is
rarely adequately monitored.8 It’s in conventional industries -
such as stone working, construction, baking, steel work and welding, roadworks
and quarrying - that occupational lung diseases have traditionally been
concentrated, and it’s also where most risk reduction effort has been made.
Achieving
some progress means that short and long-term health risks have been reduced,
and this is positive for insurers seeking to provide cover for those actively
at work. To fully understand the occupational risk to which some applicants are
exposed, insurers will need to be aware of new work sectors and job roles that
have emerging exposure to health harms. The potential for claims many years
after exposure is a reality wherever in the world these technologies develop.
Endnotes
3. Ibid.
6. https://www.ed.ac.uk/inflammation-research/news-events/2017/carbon-nanotubes-may-pose-cancer-risk
7. Op. cit. see note 4.
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