Occupational Health Risk Management in Construction: A Guide To The Key Issues of Occupational Health Provision
Occupational Health Risk Management in Construction: A Guide To The Key Issues of Occupational Health Provision
Occupational Health Risk Management in Construction: A Guide To The Key Issues of Occupational Health Provision
health risk
management
in construction
A guide to the key issues of occupational
health provision
Appendices 12
Glossary 15
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1. Defining occupational ill health 2. Occupational health risks in construction
Occupational ill health refers to all health problems in the work In construction, there are many dangers that can harm your
environment. The term covers health problems workers bring workers. By law, you must eliminate, prevent or control the
to the workplace, as well as health issues caused or made risks. Key risks include:
worse by work. It covers serious and fatal diseases, physical - exposure to asbestos, dusts including silica and lead,
effects on skin, breathing, hearing, mobility and functioning, chemicals, sunlight, diesel engine exhaust emissions
and psychological effects on mental wellbeing. Effects may be - frequent loud noise
immediate and visible, but are more often unseen and take a - frequent or excessive use of vibrating tools
long time to develop, so vigilance and monitoring can be key to - frequent or excessive manual handling of loads
identifying problems. Some effects can be cured if diagnosed - stress and fatigue.
early; many can only be prevented from getting worse. Of
course, some diseases are terminal. For more information, visit www.hse.gov.uk/construction/
healthrisks.
There‘s a lot of confusion as to what ‘occupational health’
means. So, when speaking with others, you need to be clear on
what they mean by the term.
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3. How to assess the risks to workers
Managing health risks is no different from managing safety - consider your workplace activities, processes and the
risks. Thinking about what you do, how the risks cause harm substances used that could harm employee health
and what you can do to prevent or control them are equally - ask your employees what they think the hazards are, as
appropriate when applied to health risks. they may notice things that are not obvious to you and
may have some good ideas on how to control the risks
This is known as risk assessment and it is something you - check manufacturers’ instructions or data sheets for
are required by law to carry out. Risk assessment is about chemicals and equipment, as they can be very helpful in
identifying and taking sensible and proportionate measures to spelling out the hazards
control the risks in your workplace, not about creating huge - some workers may have particular requirements, for
amounts of paperwork. You are probably already taking steps example new and young workers, migrant workers, people
to protect your employees, but your risk assessment will help with disabilities, temporary workers, subcontractors and
you decide whether you should be doing more. lone workers.
Implement and
record findings
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Having identified the hazards, you then have to decide how
likely it is that harm will occur. Risk is a part of everyday life In short...
and you are not expected to eliminate all risks. What you must
You should look at all the potential dangers around your
do is make sure you know about the main risks and the things
site and the work carried out, and then assess which
you need to do to manage them responsibly. Generally, you
workers are likely to be exposed to them. You should
need to do everything that is reasonably practicable to protect
consider the hazard, the length of time workers are
people from harm.
exposed and how much they’re exposed to. If you’re not
sure what to do about health risks, a good starting point
Make a record of your significant findings – the hazards,
may be to talk to your trade association. At some point, an
how people might be harmed by them and what you have
occupational health professional, occupational hygienist
in place to control the risks. Any record produced should
or ergonomist may help you assess the risks and identify
be simple and focused on controls. If you have fewer than
control measures.
five employees you do not have to write anything down.
But it is useful to do this so you can review it at a later date,
for example if something changes. If you have five or more
employees, you are required by law to write it down.
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4. What is occupational health risk management? 5. Worker involvement and consultation
Occupational health risk management is about putting in place a Workplaces where employees are involved in taking decisions
system to manage the risk of ill health caused by work activities. about their health are safer and healthier. Collaboration with
your employees helps you to manage health risks in a practical
At times you may employ occupational health service providers way by:
or others – such as occupational hygienists or other health - helping you spot workplace risks
and safety professionals – to give you advice and to help you - making sure health risk controls are practical
manage any residual health risks once control measures have - increasing the level of commitment to working in a safe and
been introduced to reduce risks. Managing occupational health healthy way.
service provision is crucial to ensure all parties involved work
together effectively to successfully manage risks to the health of You must consult all your employees, in good time, on health
your workers. risk matters. In workplaces where a trade union is recognised,
this will be through union health and safety representatives. In
Taking an integrated view of all the health checks for workers non-unionised workplaces, you can consult either directly or
can have benefits. For example: through other elected representatives.
- workers may feel more valued and, in turn, more motivated
to keep fit to carry out their jobs Consultation involves employers not only giving information
- encouraging workers to look after their health and to employees but also listening to them and taking account of
wellbeing to improve their quality of life and life expectancy what they say before making decisions on managing health
is likely to have an impact on their attitudes and behaviours risks.
towards workplace health risks
- speaking with workers about their general health and Issues you should consult employees on include:
wellbeing, or about their fitness to do their job, provides an - risks arising from their work
opportunity to coach and influence regarding workplace - proposals to manage or control these risks
risks. - the best ways of providing information and training.
You may provide other, more general, health checks for your For more information on your legal duties, see the HSE leaflet
workers. If so, you need to be clear about the distinction Consulting employees on health and safety: a brief guide to
between these checks and those that are required to satisfy the law (www.hse.gov.uk/pubns/indg232.htm). For more
your legal duties to safeguard the health of your workers. information on consulting with your employees, visit www.hse.
gov.uk/involvement.
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6. Hiring an occupational health service provider 7. What kind of occupational health provision?
If you decide you need help from an occupational health service A traffic light system is a useful way of considering the variety
provider, as with any other service you contract-out, you will of occupational health services available and can help you
want to make sure you get the right help. When recruiting their decide what is suitable and relevant for your workers and the
services, you should ensure they understand your workplace tasks they perform.
and workers. They should then be able to help you prioritise
what you must, should and possibly like to do. However, you 1. What must be done to ensure I comply with the law? – Red
should understand the different types of health check and be 2. What could the provider do so that I can ensure the workers
clear about what you want the provider to do. I have are fit, and remain so, to safely carry out the tasks
required of them? – Amber
3. What other health screening programmes would I like this
service provider to deliver to promote worker involvement in
reducing their risks of developing ill health? – Green
Red Legal requirements based on risk - Skin checks for dermatitis from cement exposure
You must fully consider all - Respiratory questionnaire for silica exposure
options to eliminate health risks - Lung function tests and x-rays for silica exposure
or control them to a minimum - Audiometry for noise exposure
- Hand–arm vibration (HAV) syndrome questionnaire and
Where health risk remains, Health surveillance tests for HAV exposure
health surveillance is appropriate - Biological monitoring for lead and mercury in blood,
to help identify what more must and cadmium in urine
be done to prevent harm and - Medical surveillance for asbestos and lead
protect employees
There are also other health - HGV medicals for Group 2 drivers (including drivers of
checks required by driving construction plant)
licence law - Health checks for night workers
Amber ‘Fitness for task’ health checks - Health monitoring for musculoskeletal problems
Industry accepted practice for safety-critical tasks
- Pre-placement health checks
- Forklift/car drivers’ health assessment
- Breathing apparatus user medicals
- Vision tests for identified roles
- Exit medicals
- Drug and alcohol testing
Table 1. Traffic light system ranking priority of health checks for workers
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8. Types of occupational health surveillance
There are general legal duties to provide health surveillance When setting up occupational health surveillance, you should
under overarching health and safety legislation (Management consider what to do if a worker becomes ill and is no longer fit
of Health and Safety at Work Regulations 1999). to perform their job, or if restrictions are put in place on what
they can do. Can alternative work arrangements be made? Can
Periodic health surveillance is also required under specific tasks be rotated to reduce exposure? Your occupational health
laws, such as the Control of Substances Hazardous to Health service provider should be able to assist you with these issues.
Regulations 2002 (Regulation 11) and Control of Noise at Work
Regulations 2005, which define what action needs to be taken Implementing occupational health surveillance is a part of
at various exposure levels. risk management. Where it is required, it is essential to get
results fed back to verify whether your controls are successfully
Under certain circumstances, by law you may need the managing the health risks on site. It is also useful to get workers
services of an ‘appointed doctor’ to conduct statutory medical and their representatives involved in a health surveillance
surveillance, eg for lead and asbestos. programme to feed back on how well they feel the risks are
being managed.
To make sure you get a service that’s fit for purpose, you
should:
- share your risk assessments with them and any other
relevant health and safety information
- allow them time to observe your workers and the work
they do.
08
Title Description Qualifications to look for
Appointed doctor Doctor approved by the HSE to undertake The HSE website holds a list of appointed doctors in
statutory health checks under certain your area – go to www.hse.gov.uk/doctors
regulations, eg for asbestos and lead
Occupational hygienist Professional trained to recognise, evaluate Certificate of Competence awarded by the British
and control risks associated with hazardous Occupational Hygiene Society
substances, such as asbestos, cement and silica
Occupational health Professional trained and qualified in specific Relevant certificates and diplomas for levels of
technician areas, such as spirometry and audiometry qualification/training
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11. What to expect from an occupational health
service provider ‘Fitness for task’ checks
This is the process whereby individuals are assessed against
Agree with your provider what feedback is appropriate. As a
a set of standards to ensure they are capable of safely
minimum, obtain regular anonymised feedback of the results
undertaking the tasks involved in their job role and are not
of health surveillance in a way that allows you to see if workers’
a risk to themselves or others. The focus of these checks is
health is being affected by work activities. This will help you
to enable workers to work safely and productively.
review your systems of work and controls as part of your risk
management duties.
Some fitness for task assessments are legal requirements
(eg HGV medical), industry requirements (eg personal
You must also receive information for each worker undergoing
trackside safety (PTS) when working in or around railways),
health surveillance regarding their ‘fitness’ for continued
or recommended practice (eg safety-critical workers).
exposure to particular hazards at work, as well as any
Where there are no specific legal or industry guidelines for
limitations or restrictions. You should receive certificates for
the fitness for task for a particular job role, the employer
those workers undergoing ‘fitness for task’ checks.
and the occupational health service provider should decide
on the content and scope of the assessment in line with
good practice and/or be evidence based, eg Constructing
12. What to do about restrictions on certain Better Health’s ‘Health assessment matrix’. In all cases,
workers’ exposures or tasks the checks should be carried out in consultation with the
Your occupational health service provider will use their workers and their representatives.
professional judgement to provide you with advice on future
restrictions on exposures at work and the fitness of individuals An important factor in fitness for task assessments is the
to continue working with certain exposures. You should already Equality Act 2010, which ensures that people classified as
have considered what you might do if this situation comes up. having a disability should not be discriminated against in
However, you can always talk it through with your occupational the workplace.
health service provider and consider the advice they give. There
are duties under the Equality Act 2010 which require you to
assess the need for appropriate adaptations to the work and
workplace, wherever it would be considered reasonable to do
Medical confidentiality
so. There are also rules under the Reporting of Injuries, Diseases
Your occupational health service provider must protect
and Dangerous Occurrences Regulations 2013 to report certain
confidential medical information contained in medical
diseases associated with particular tasks.
records. If medical details are disclosed to you following
written consent, you must retain the medical information
but separate it from the health record. This is because the
medical information is confidential to the employee and is
not to be disclosed to a third party.
10
13. Once I’m happy that I have a competent
provider, that’s my job done – right? Health records
The employer has a duty to keep health records for all
No. You should continue to manage the control of risks to
workers undergoing health surveillance.
health, including the occupational health service provision.
This involves monitoring and reviewing the performance of the
These are different to medical records, which contain
controls you have in place. Reviewing and analysing the results
confidential medical information, and are kept by the
of occupational health checks will assist in this.
occupational health service provider.
You should act on any advice given by your occupational
Workers’ health records contain general information such
health service provider. Meeting and talking at regular intervals
as name, date of birth, employee number, and also relevant
with your occupational health service provider, as well as
exposure information with the outcome of any health
any other professionals involved, will help ensure you’re
surveillance in relation to their fitness for task. An example
successfully managing health risks on site. You must also keep
of a health record is given in Appendix 3.
health records for all those undergoing occupational health
surveillance.
Health records should be kept for as long as the worker is
under health surveillance. For work relating to hazardous
substances and asbestos, records should be kept for 40
14. What if I have more than one occupational years. For work involving ionising radiation, it’s 50 years. It’s
health service provider? helpful to give workers their health records when they leave
This situation can be common and can make the management your employment to take to their next employer, although
of occupational health risks more difficult. Good channels of you should keep copies for future reference. They should
communication between you and all the providers, as well as not contain medically confidential information about an
between the providers, will ensure consistency and that relevant individual. Under the Data Protection Act 1998, you have to
information is shared. inform employees that you have a health record for them,
and that they have a right to access that information and
correct it.
15. What about other health and wellbeing and
fitness-for-work programmes – how do they
fit in?
General health and wellbeing services offer a two-fold benefit:
they can encourage the promotion of better health among
workers whose lifestyles make health a challenge; and workers
concentrating on better health for themselves will often be
more alert to the causes of ill health on site. However, any
wellbeing initiative should not be seen as a substitute for
managing the workplace risks themselves and will be most
effective if integrated with the risk management arrangements,
eg a smoking cessation programme alongside a targeted
initiative on reducing respiratory risk from silica exposure.
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Appendices
Appendix 1: Top tips for putting occupational health service arrangements in place
Prioritise your occupational health service needs (the ‘red, amber, green’ approach can simplify this) ✔
Agree this with your provider ✔
Check your provider has the organisational capability to carry out the tasks you require of them ✔
Agree roles, responsibilities and what communication you both need and expect ✔
Agree the format and frequency of tests and feedback of results, particularly from occupational health surveillance ✔
Agree the procedures and roles for referring workers with ill health for diagnosis or further treatment ✔
Agree and set up systems for maintaining appropriate records, particularly health records ✔
Consider options to deal with workers who are in ill health and who may no longer be fit for their current
position or need to have adjustments made ✔
Set up a system to act on the results you receive from health surveillance tests ✔
Agree a timescale for reviewing the occupational service and its performance in helping you manage the risks
of ill health at work ✔
At appropriate stages, consult your workers and their representatives on issues that will affect them, and
inform them of which health checks are required and why ✔
Make sure you don’t lose sight of the hazards to health you are exposing
workers to. However, having a workforce interested in looking after its
health is likely to bring benefits not only to the workers themselves but
also to the business through:
- workers being present at work, not off sick
- workers being fit and healthy to perform the work required of them
- increased productivity
- safer working practices and fewer accidents.
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Appendix 2: Useful links
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Appendix 3: Example of health record
Name of organisation:
Historical record of jobs in this employment involving exposure to identified substances requiring health surveillance
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Glossary
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About the CONIAC Health Risks Working Group
The Health and Safety Executive’s Construction Industry Advisory Committee includes a number of groups with specialist
remits. The Health Risks Working Group is made up of a wide range of construction industry representatives. The following
members of the Working Group have contributed to this guide:
Ian Strudley (Chair) – Health and Safety Executive Marianne Dyer – Consultant Occupational Physician
Jacquie Brown (Secretariat) – Health and Safety Executive Kevin Fear – Construction Industry Training Board
Clare Forshaw – Health and Safety Executive Melodie Gilbert – Park Health and Safety Partnership
David Ackerley – IOSH Construction Group Caroline Haslam – Home Builders Federation
Michelle Aldous – Constructing Better Health Kevin Minton – Construction Plant Hire Association
Paul Bussey – Royal Institute of British Architects Susan Murray – Unite
Denis Doody – Union of Construction, Allied Trades and Gren Tipper - Construction Clients Group
Technicians Andy Turrell – UK Contractors Group
The Group acknowledges the support of IOSH in publishing and hosting this guide to occupational health in construction.
The document joins IOSH’s range of authoritative, free guidance, available at www.iosh.co.uk/techguide.
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