CPD: A health policy that’s fit for purpose

Continuing Professional Development: Occupational health

•  The benefits of health surveillance

•  What the law says

•  How to write an occupational health policy statement

The CIOB requires members to assess and fulfil their own CPD needs. Members can therefore choose to study the CPD articles published in CM as a valid part of their personal record of CPD activity. 

To complete the questionnaire, members should click on the link to the online questionnaire below. Select your answers, fill in your contact details then click “submit”. If all five questions are answered correctly, you will be invited to download and print a PDF document confirming your successful completion of the questionnaire. If one or more questions is answered incorrectly, please reread the article and try again, pressing “submit” to resend the amended form.

Click here to be taken to the online CPD questionnaire for the June 2011 issue

We are no longer offering the facility to send questionnaires by fax or post. Please email any questions regarding this CPD service to cmcpd@atompublishing.co.uk.

Health has often been overshadowed by safety issues, but it’s time to redress the balance, says Michelle Aldous, ceo at Constructing Better Health

The health and well-being of the UK workforce has shot up the policy agenda in the past decade. As awareness of work-related health issues increases, the UK’s first and only organisation dedicated to managing worker health issues in the construction industry, Constructing Better Health (CBH), has emerged.

CBH provides solutions for sound occupational health practice in the workplace by creating an infrastructure of standards and information. This article provides an overview of the health risks faced by workers, the legal considerations, and how risks can be mitigated.

Health issues in construction

Due to its operating structure and the nature of the work involved, the UK construction sector suffers from disproportionately high levels of occupational health issues. Construction workers face a number of occupational risks, including hand-arm vibration (HAVS), noise or hearing impairment, respiratory illness, and musculoskeletal disorders.

Many workers who have spent time in the sector may already typically suffer a range of common occupational health disorders around these key areas of physical risk. Safety risks on site also increase if a worker’s health jeopardises their fitness to carry out a task.

With the construction sector’s current focus on safety rather than health, the existing strategies for addressing such occupational health issues and developing strategies are failing. Although regulations have been in place for some time, they are not always enforced. It is leaving the construction sector open to crippling health liabilities that will drive skills out of the sector and potentially force construction and infrastructure companies into unnecessary recruitment, training and litigation costs.

Managing workplace health can be seen as a complex matter. Often there is confusion about what should be provided to protect and enhance health and by whom. The Health and Safety Executive says that good occupational health services are central to the effective management of workplace health and can:

• protect and promote the health and well-being of the working population;

• enhance a company’s image and reputation as a good employer;

• provide early advice to help prevent workers being absent for health reasons;

• improve opportunities for people to recover from illness while at work;

• provide critical support to the process of effective absence management and increase the number of staff returning to work earlier;

• fulfil the statutory requirement to have access to “competent” occupational health advice as part of the organisational arrangements to ensure that the health of staff and others is not adversely affected by their work.

Health and the law

The Health and Safety at Work etc Act 1974 requires employers, the self-employed and those in control of work to ensure the health and safety of their employees and others who may be affected by their work activities (such as others working on the site or members of the public). Where the health of a worker could affect their ability to do the job safely, the employer or person in control of the work needs to take action to ensure that this risk is controlled.

The Management of Health and Safety at Work Regulations 1999 require a risk assessment to be carried out to identify the level and nature of risks associated with a particular work activity. Appropriate precautions need to be taken to eliminate or control this risk and regulation 5 requires the provision of appropriate health surveillance.

Other, more specific regulations also outline legislative requirements for the prevention and control of occupational health issues:

• Control of Substances Hazardous to Health (Amendment) Regulations 2004 (COSHH)

• Control of Asbestos at Work Regulations 2002

• Control of Lead at Work Regulations

• Control of Vibration at Work Regulations 2005

• Control of Noise at Work Regulations 2005

The health of a worker can impair their ability to do their job safely, or the job can damage the workers health. This raises the following questions:

• Are workers doing a safety critical job where an existing health condition may affect their ability to do the job safely? For example, a dumper driver with uncorrected poor eyesight puts himself and others at risk.

• Are they doing a job that could affect their health? For example, a road breaker will be at risk from noise and vibration.

• Can the exposure be prevented? If not, there may be a requirement to undertake health surveillance on those workers who continue to be exposed to the hazard.

What is health surveillance?

Health surveillance is the application of systematic, regular and appropriate procedures to detect early signs of work-related ill health in workers who are exposed to certain health risks and acting on the results.

It provides information that can help detect harmful health effects at an early stage and checks that control measures are working, highlighting where and what further action might be needed. It also provides an opportunity to train and instruct workers and gives them the opportunity to raise any concerns.

At its simplest, health surveillance involves the completion of self-assessment questionnaires by the workforce that are then reviewed to see if any further action is necessary. This is often known as “health screening”.

As well as providing information to detect harmful health effects at an early stage, health surveillance can also check that control measures are working by giving feedback on risk assessments, suggesting where further action might be needed and what it might be. In addition, it can provide data, by means of the health records, to detect and evaluate risks; provide an opportunity to train and instruct workers further in safe and health working practices; and give workers the chance to raise any concerns about the effect of their work on their health.

Health surveillance is required if: it is prescribed by legislation; the work is known to damage health in any particular way; or it is reasonably likely that damage to health may occur under the particular conditions at work.

Health surveillance is only worthwhile where it can reliably show that damage to health is starting to happen or becoming likely. A technique is only useful if it provides accurate results, is safe and practicable. The surveillance must also be shown to benefit the employee.

When assessing the need for health surveillance, be aware that it is not a substitute for preventing or controlling harmful exposure to hazards, but another means of protecting workers’ health. Using the right technique, correctly and at the right time is vital as getting it wrong can be expensive. Whichever technique is used, health surveillance should be carried out systematically and regularly. Simply executing health surveillance procedures is not enough, it is essential that action is taken on the results.

Record keeping

Completed pre-placement questionnaires and/or correspondence with occupational health professionals regarding individual workers should be kept in a secure place with restricted access.

It is essential to keep records to demonstrate that individuals have been assessed and that advice about work suitability has been given. This entry health check information will be fitness data only, not confidential medical information (medical information should be kept by the occupational health professionals).

These records will also assist with decisions made in the risk assessments to see if the controls identified and put in to place to control the risks are working.

Health surveillance records should be kept for 40 years from the date of the last entry, while records of examination and testing of control equipment and repairs carried out as a result should be kept for five years.

The Data Protection Act 1999 places a requirement on employers holding information on surveillance records. As a minimum, those holding such records must take steps to tell those on whom records are held that a record is being kept, the purpose for which it is being held and that they have the right of access to information and the right to correct it.

What steps is the industry taking?

For the first time, the UK has a co-ordinated, consistent and pragmatic approach to the management of the occupational health of the construction workforce, through Constructing Better Health.

The scheme requires individual workers to carry a “workplace health fitness for task” card, demonstrating that they are fit for the task they have been assigned. The national scheme satisfies the challenge presented to principal contractors needing to demonstrate to clients and other key stakeholders their supply chain complies with legislative workplace health requirements. In addition, it shows they have completed the steps necessary to reduce or avoid the risk of future litigation.

While the safety element of health and safety has received much deserved attention in the past decade, health remains the poor relation. As an industry we need to keep key skills in the construction sector and reduce the cost of health liabilities and risk of future litigation. We know that “healthy” companies perform much better, and their corporate profiles and reputations also improve. As our awareness increases on work-related health issues, so will economic prosperity if we take action now.

Constructing Better Health (CBH) is a not-for-profit organisation delivering the first national workplace health scheme on behalf of the construction industry. www.cbhscheme.com

Writing an occupational health policy statement

Each firm should write its own occupational health policy according to its particular needs. It should contain a general commitment to ensure the work which you do does not affect the health of people working for you, or anyone else, contractors or members of the public, for example. It should also contain a commitment to ensure that those who are working for you do not have any health conditions which, because of the nature of their work, could put others at risk.

The “organisation” section deals mainly with the allocation of responsibilities to people. It may include details of:

• the director or partner who has ultimate responsibility for occupational health;

• how duties and responsibilities for occupational health are allocated in a clear and logical way, with everyone knowing who and what they are responsible for;

• who will be responsible for giving expert advice if needed, particularly when medical advice, health surveillance or return to work advice is needed;

• how workers’ views on occupational health matters will be taken into account;

• who is responsible for the delivery of training, including site inductions;

• who is responsible for monitoring compliance with the policy.

The “arrangements” section deals mainly with how the responsibilities under the organisation section will be carried out, in relation to health issues. It may include details of:

• the procedures for identifying, eliminating or controlling health risks which may arise from the company’s work;

• arrangements for helping those workers whose health may have been affected by their work;

• arrangements for obtaining expert occupational health advice, including details of the company’s occupational health provider where relevant;

• arrangements for identifying training needs and for training delivery;

• arrangements for consultation with health and safety representatives and involvement with safety committees;

• arrangements for the provision and use of personal protective equipment, including its storage, maintenance and cleaning;

• arrangements for accident and ill health recording, including investigation procedures when something goes wrong;

• Procedures for checking the effectiveness of these arrangements and revising them when necessary.

CPD test paper

Occupational health

To access and complete the June 2011 CPD online questionnaire, click on the link below. Select your answers, fill in your contact details then click “submit”. If all five questions are answered correctly, you will be invited to download and print a PDF document confirming your successful completion of the questionnaire. If one or more questions is answered incorrectly, please reread the article and try again, pressing “submit” to resend the amended form.

www.construction-manager.co.uk/construction-professional/cpd-questionnaire/16/

We are no longer offering the facility to send questionnaires by fax or post. Please email any questions regarding this CPD service to cmcpd@atompublishing.co.uk.