Health and and Safety Executive Occupational Disease: A UK Perspective Kären Clayton Director - Long Latency Health Risks Division Health and Safety Executive Kate Sweeney Chief Statistician - Statistics and Epidemiology Unit Health and Safety Executive
Occupational Disease in the UK Facts and Figures 13,000 deaths from lung disease and cancer due to past exposure to chemicals and dusts 80% of new conditions were MSDs/stress/ depression or anxiety 452,000 new cases of disease 1.1 million people (estimated) suffered from a work-related illness 22.7 million Working days lost Injuries and ill health (excluding cancer) costs an estimated 13.8 billion Other diseases: Skin / respiratory / hearing loss / vibration-related
Occupational Disease in the UK Facts and Figures - Cancer Over 5,000 cases per year from construction (estimated) 8,000 deaths and 13,500 new cases per year (estimated) Three times more men than women die from occupational cancer Most new cases: lung, breast or skin cancer Occupational Cancer Leading cause of death is exposure to asbestos Other causes: shift work, solar radiation, mineral oils, silica Most common cancers leading to death lung and mesothelioma
Where does the UK get its facts and figures from? LFS - Labour Force Survey THOR - The Health and Occupation Reporting network, includes: SWORD - Respiratory Surveillance Scheme EPIDERM - Skin Surveillance Scheme IIDB - Industrial Disablement Benefit DC - Death Certificates Bespoke Research e.g. Cancer Burden
LFS The Labour Force Survey (LFS) and The Health and Occupation Research network (THOR) Annual questions on work-related illness from 2003 to 2012 Provides estimates of self-reported work-related illness Large household survey (44k households) THOR Research & surveillance scheme(s) for occupational disease/work related ill-health run through the University of Manchester Work-relatedness decided by the physician Started in UK in 1989: SWORD respiratory specialists Ongoing schemes for skin specialists and General Practitioners Comparison of LFS and THOR-GP results LFS reports 25% higher rates Stress and MSD dominate both sources Very similar age and industry profile
Industrial Injuries Disablement Benefit Scheme (IIDB) The IIDB scheme compensates workers who have been disabled by a prescribed occupational disease. Diseases are prescribed where an occupational cause is well established, and where the terms of prescription can identify cases of genuine occupational origin. The list is updated from time to time. Diseases which are difficult to define clearly, e.g. some musculoskeletal disorders and work-related stress - are not currently covered by the scheme.
Occupational Disease Solutions: The UK approach The UK has a regulatory framework that works well and is effective e.g. The Control of Substances Hazardous to Health Regulations (COSHH) which implements CAD and C&M Directives BUT for difficult areas like long latency diseases such as Cancer a different approach needs to be taken to encourage and promote change and comply with the law The approach taken by the UK used an evidencebased business model
Occupational Disease Solutions: The Evidence-Based Business Model Clarify the Problem What is the problem? Who is affected? Is it solvable? Identify How to Address It How to reach the audience? Who best placed to reach them? What parts will HSE/others play? Identify How to Recognise Success Implementation Sustained Change Embedded behaviours Infrastructure in place to support best practice
Occupational Disease Solutions: The UK approach There are many solutions/approaches: Need to follow the evidence on what works Need to build on successes and learn lessons Need to be aware of: Changing industrial landscape but many of the old problems are still around too! The Economic climate
Occupational Disease Prevention: What has the UK focused on? Positioning the regulator where it can have best effect Promoting an active approach to communications on health, and enforcement on specific issues Forging partnerships and working with others Increasing focus on effective management of occupational health as well as safety Filling research gaps and maintaining statistical base to improve targeting of interventions
Asbestos - tradesmen Asbestos still around Tradesmen the group at risk 1000/year dying Unaware of risk Targeted campaign, partners promoting 8/10 tradesmen had seen PR, 71% said will take precautions
700 cancer deaths Silica Close to 1000 lung cancer registrations due to silica exposure Current exposed workforce ~ 30,000 Success so far: Roof tile cutting awareness sheets Kerb cutting - awareness, simple solutions, stakeholder led
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