Different Types of Health Risk

The principles of control for health risks are the same as those for safety. However, the nature of health risks can link work activities and employee ill health less obvious than in the case of injury from an accident. The COSHH Amendment Regulations 2004 set out the principles of good practice for controlling exposure.

Unlike safety risks, which can lead to immediate injury, the result of daily exposure to health risks may not manifest itself for months, years, and, in some cases, decades. Irreversible health damage may occur before any symptoms are apparent. It is, therefore, essential to develop a preventive strategy to identify and control risks before anyone is exposed to them. 

Risks to health from work activities include:

• skin contact with irritant substances, leading to dermatitis, etc.; 
• inhalation of respiratory sensitizers, triggering immune responses such as asthma; 
• badly designed workstations requiring awkward body postures or repetitive movements, resulting in upper limb disorders, repetitive strain injury, and other musculoskeletal conditions; 
•  noise levels that are too high, causing deafness and conditions such as tinnitus; 
• too much vibration, for example, from hand-held tools leads to hand-arm vibration syndrome and circulatory problems; 
• exposure to ionizing and non-ionizing radiation hazards, including ultraviolet in the sun’s rays, causing burns, sickness, and skin cancer; 
• infections ranging from the minor sickness to life-threatening conditions caused by inhaling or being contaminated with microbiological organisms; 
• Stress causes mental and physical disorders. 

Some illnesses or conditions, such as asthma and back pain, have occupational and non-occupational causes. It may be difficult to establish a causal link with a person’s work activity or exposure to particular agents or substances. But, if evidence shows the illness or condition is prevalent among the type of workers to which the person belongs or among workers exposed to similar agents or substances, their work and exposure have likely contributed somehow. 

Assessing exposure and health surveillance 

Some aspects of health exposure will need input from specialists or professional advisers, such as occupational health hygienists, nurses, and doctors. However, considerable progress can be made by taking straightforward measures such as:

• consulting the workforce on the design of workplaces; 
• talking to manufacturers and suppliers of substances and work equipment about minimizing exposure; 
• enclosing machinery to cut down dust, fumes, and noise; 
• researching the use of less hazardous substances; 
• Ensuring that employees are given appropriate information and are trained in the safe handling of all the substances and materials they may be exposed to. 

To assess health risks and to make sure that control measures are working properly, it may be necessary, for example, to measure the concentration of substances in the air to make sure that exposures remain within the assigned WELs. Sometimes health surveillance of workers who may be exposed will be needed. This will enable data to be collected to check control measures and for early detection of any adverse health changes. Health surveillance procedures include biological monitoring for bodily uptake of substances, examination for symptoms, and medical surveillance – which may entail clinical examinations and physiological or psychological measurements by occupationally qualified registered medical practitioners. The procedure chosen should be suitable for the case concerned. Sometimes a surveillance method is specified for a particular substance, for example, in the COSHH ACOP. A health record has to be kept for the person concerned whenever surveillance is undertaken. 

Health surveillance should be supervised by a registered medical practitioner or, where appropriate, a suitably qualified person should do it (e.g., an occupational nurse). In the case of inspections for easily detectable symptoms like chrome ulceration or early signs of dermatitis, health surveillance should be done by a suitably trained, responsible person. If workers could be exposed to substances listed in Schedule 6 of the COSHH Regulations, medical surveillance under the supervision of an HSE employment medical adviser or a doctor appointed by HSE is required. 

Principles of good practice for the control of exposure to substances hazardous to health 

Design and operate processes and activities to minimize the emission, release, and spread of substances hazardous to health. 

• When developing control measures, take into account all relevant routes of exposure – inhalation, skin absorption, and ingestion. 
• Control exposure by measures that are proportionate to the health risk. 
• Choose the most effective and reliable control options which minimize the escape and spread of substances hazardous to health. 
• Where adequate control of exposure cannot be achieved by other means, provide suitable PPE in combination with other control measures. 
• Check and review regularly all elements of control measures for their continuing effectiveness. 
• Inform and train all employees on the hazards and risks of the substances they work with and the use of control measures developed to minimize the risks. 
• Ensure that the introduction of control measures does not increase the overall risk to health and safety.