Guidance: what you need to know
In the first of two articles on respiratory protection,
Connect looks at what respiratory illnesses are and what we should
be doing to protect our workforce.
Respiratory protection
Headlines
- In 2006/07, 142,000
people in the UK had breathing or lung problems caused, or made
worse, by work
- There were over 2,000 deaths due to mesothelioma and 4,000
deaths from asbestos-related cancer in 2006. Asbestosis,
pneumoconiosis and silicosis accounted for a further 278
deaths
- Every year, 4,000 deaths are caused by chronic obstructive
pulmonary disease as a result of airborne contaminants at
work.
The problem
Airborne contaminants can include solids (dust, powder and
fibres), gases and vapours (usually resulting from a chemical
process), mists and aerosols (finely dispersed liquids) and fumes.
Some contaminants can trigger an allergic reaction in the
respiratory system.
Asbestos fibres cause illness by becoming embedded in the lungs.
The fibres cause scarring of lung tissue, and can reduce the
effectiveness of the lungs. In some cases, this can result in
cancer.
Most current deaths, particularly those related to asbestos, are
due to past exposure. However, surveys carried out by the HSE
found that over a fifth of respondents believe they are still
exposed to airborne contaminants at work, and over a fifth of
employers admitted that their workers were at risk of breathing
problems from airborne contaminants.
What are respiratory illnesses?
Respiratory illnesses may be chronic, with long-term discomfort.
The effects are made worse by repeated and prolonged exposure over
a working life. Chronic respiratory illnesses include:
- asthma
- chronic obstructive pulmonary disease (COPD)
- pneumoconiosis (coal dust)
- silicosis (quarry work, foundries or potteries)
- allergic alveolitis (‘farmer’s lung’)
- allergic rhinitis (hayfever)
- byssinosis (cotton dust)
The main asbestos-related diseases are:
- asbestosis
- mesothelioma
- asbestos-related lung cancer
- diffuse pleural thickening
Respiratory failure can be acute, where workers die within a
short time of being exposed to a respiratory irritant or poison.
This
case provides an example of a worker who died after only two
exposures to isocyanates at work.
What should we be doing?
Prevention of both chronic and acute respiratory illnesses
starts with the same question: how can contaminants be eliminated
or reduced? The hierarchy of controls is:
- elimination and substitution
- isolation and ventilation
- provision, use and maintenance of respiratory protective
equipment (RPE)
- training and information
- monitoring and health surveillance.
Elimination and substitution
Identify which substances are being used that can result in
respiratory illnesses. Safety data sheets should warn you if a
substance is a respiratory sensitiser. Be aware that common
substances such as sawdust, hay and flour can create problems.
Factsheet
39 from the European Agency for Safety and Health at Work
provides useful advice on where natural and chemical sensitisers
may be found.
Having identified hazardous substances, can you stop using, or
producing, the substances that cause problems? For example, if
sawdust is created as a by-product of sawing timber, can you simply
buy timber already sawn to size? Are there safer alternatives to
the substances used? If so, substitute the safer substance for the
more hazardous one. Can you use less of the substance?
Isolation and ventilation
If a significant risk remains, consider how the substance can be
isolated. Enclosing a process which produces a respiratory
sensitiser is a more effective safeguard than expecting every
person who walks through an area to wear respiratory protection.
Contaminants from the enclosed area must be safely ventilated and
dealt with, for example with a filter to catch solid
particles.
Where the work area cannot be completely enclosed, can you
reduce the number of people exposed and the amount of time they’re
exposed for? Where some workers are still exposed, ventilation
needs to be provided. The HSE has advice on local exhaust ventilation (LEV) at
and through its free leaflet ‘Clearing the air: a
simple guide to buying and using local exhaust
ventilation’. You can also download HSG 258
‘Controlling airborne contaminants at work’ for free. Connect
also carried an
article about guidance on LEV.
Enclosures and ventilation systems must be maintained and
checked to make sure they’re working effectively. Care should also
be taken in developing cleaning procedures so that cleaners aren’t
exposed to respiratory sensitisers more than necessary. Wet
cleaning or vacuum cleaners, for example, should be used in
preference to sweeping.
Provision, use and maintenance of RPE
Only when everything has been done to eliminate or reduce the
hazard through substitution, isolation and ventilation should RPE
be considered. Two main types of RPE exist: respirators (which use
filters to remove contaminants from the air before the user
breathes it) and breathing apparatus which supplies high-quality
air to the wearer.
Selection of RPE should take account of:
Individual factors such as:
- Facial hair, glasses or contact lenses, medical conditions such
as existing respiratory illnesses, high blood pressure,
claustrophobia, heart disease, difficulties with hearing, and skin
conditions such as eczema. Pregnancy and day-to-day coughs and
colds may also influence the choice of RPE or whether it’s
appropriate for an individual to wear RPE at all.
Task factors such as:
- Duration, temperature, humidity, work rate (sedentary, moderate
or heavy work), tools being used, other personal protective
equipment (PPE) needed, requirements to see fine detail, to move
around or to communicate, congestion in the work area.
Hazard factors such as:
- Risk phrase (R-phrase) from the safety data sheet, amount of
substance used, dustiness (of solids such as pellets, grains or
powder) or volatility of liquids.
Guidance to selecting RPE is provided in HSG 53 ‘Respiratory
protective equipment at work: a practical guide’ which can now be
downloaded free from the HSE website. The
COSHH Essentials
R series provides advice for RPE with different levels of
protection.
RPE for dealing with asbestos is described in EM6 ‘Asbestos
essentials: PPE’.
Training and information
Where processes creating airborne contaminants have been
isolated, staff need to know to keep away – for example, not using
an area as a short cut where respiratory hazards may be present.
Staff who need to enter the area should know what RPE is required,
how to make pre-use checks, and how to wear it correctly. All
workers should understand the procedure for reporting any
respiratory problems which may be work-related, whether or not
they’ve been identified as working in a hazardous area.
Monitoring and health surveillance
Air quality should be monitored to make sure levels of
contaminants in the air stay below an acceptable level. Individuals
can wear monitors or workplaces can be monitored directly. See
COSHH Essentials
G409 ‘Exposure measurement’ for more details.
Health monitoring should involve an assessment of a worker’s
respiratory health before they start a potentially hazardous job. A
suitably qualified health professional can help you decide how
often the worker should be re-assessed. Records should be kept of
all assessments, along with a description of the work
undertaken.
If health problems are identified through regular checks, or if
workers report symptoms between tests, action may be needed to
remove the worker from the job until a further assessment is
made.
COSHH Essentials
publications in the ‘G4’ series describe health surveillance
and monitoring.
The law
The main law concerning respiratory protection is COSHH (Control
of Substances Hazardous to Health Regulations, 2002). Other
regulations may be relevant depending on the work environment:
- The Control of Asbestos Regulations 2006
- The Control of Lead at Work Regulations 2002
- The Ionising Radiations Regulations 1999
- The Confined Spaces Regulations 1997
Requirements for health surveillance are set out in the
Management of Health and Safety at Work Regulations 1999.
Summary
Elimination, substitution and engineering controls, such as
isolation and ventilation, should be applied before resorting to
RPE. All controls should be backed up with training, monitoring and
health surveillance.
Links
HSE COSHH area
HSE
statistics on respiratory illnesses and asbestos
related diseases
COSHH Essentials
website
Health and Safety
Laboratory training courses
BOHS occupational hygiene modules, in particular M103