Preparing for the industrial diseases of tomorrow

21 March 2018

If the construction industry wants to prepare for the industrial diseases of the future, it needs to look to the past.

The construction sector has a long and painful history of occupational illnesses.

Each year 80,000 suffer work-related ill health, according to the most recent Labour Force Survey – a figure including both new and long-standing cases.

Each week an estimated 100 workers die as a result, according to the Institution of Occupational Safety and Health (IOSH).

That compares with 30 construction industry fatalities in the most recent year from injuries such as falls.

And, while injuries are at a record low, the record for industrial diseases is not improving, says Keith Hole, the Vice-Chair of the IOSH Construction Group.

According to IOSH, the number of deaths is pretty consistent.

The costs are substantial, both human and financial; the HSE estimates new cases of work- related illnesses in construction cost £500 million a year in the UK alone, a similar figure to that caused by construction workplace injuries.

There is, therefore, a strong incentive to identify emerging risks before they become the next epidemic.

IOSH’s current priorities for construction include tackling risks from diesel particulates, silica particles and solar radiation exposure.

Traditional risks in construction

Nevertheless, construction firms would do well not to ignore more traditional risks.

That’s not least because they remain the key causes of work-related deaths and ill health.

Asbestos is still the single biggest work-related killer in the UK, for instance, and is largely associated with construction workers.

The HSE forecasts deaths from mesothelioma alone will peak next year at over 2,500.

However, Philip Dodd, Partner for Construction Claims at JLT Specialty, says: “We’ve been told for years that these are due to peak and then diminish, but the date always seems to keep drifting back.”

Likewise, noise induced hearing loss and vibration- related cases continue to be significant sources of claims, he says, despite the number of new cases of the conditions falling since the start of the decade.

In the past ten years, there have been almost 11,000 new cases of hand-arm vibration reported across sectors in the UK, according to the HSE.

And these claims can often be expensive where affected employees are unable to return to their normal work operating vibratory tools.

“Asbestos is a big worry because of the high cost per individual claim, but conditions like noise- induced hearing loss and Hand Arm Vibration syndrome give rise to really large claims volumes,” says Dodd.

Small particles, big problems

Another reason not to ignore historic claims, though, is that these claims offer clues as to where cases will come from in the future.

Claims have a way of developing, says Tanya Cross, a Partner at insurance and risk law specialist BLM Law. “Claimants’ solicitors often try to expand upon established cases. So, we started off with white finger cases and then we saw carpal tunnel claims.

“Now we’re looking at claims being brought for Dupuytren’s contracture and whole- body vibration.”

And it’s not just the claims, but potentially the causes of existing industrial diseases that may tell us where new risks could emerge.

Asbestos is a case in point, says Jon Fitzsimons, Principal Consultant at Fitz & Co Claims Consultants.

“While the chemical properties of asbestos fibres can have a profound impact on the development of an asbestos-related condition, the size and shape of the particles is equally if not more important,” he says.

So how might this signpost future claims types? “Well, as a common theme in respiratory illness relates to the size of the particles, if we’re starting to crystal ball gaze we need to look at where people may be exposed to similar particles in the future, both at the micron and sub-micron level.

That should prompt us to look at other potential sources – from the established problems of diesel and silica particulates to nanotechnology,” he says.

That nanoparticles are apparently already being used safely for things such as coatings on self- cleaning windows and in plastics offers only limited reassurance as, again, experience with asbestos should tell us it is principally when structures containing asbestos are demolished or damaged that the problems occur, remarks Hole.

Historical claims for work-related illnesses

Finally, whatever they may tell us about where new claims could originate, past cases certainly offer a good guide as to what will be needed to defend them.

In particular, they show records are crucial. Unfortunately, the long lead-time for many industrial claims means that there are often “massive gaps” in employers’ documentation, says Cross.

It’s not just risk assessments and policies that get lost, destroyed or, sometimes, never existed, but documents such as pre- employment medical questionnaires that could show responsibility lies elsewhere.

It is often the documentation – as much as the employer’s practice – that determines whether the employer can mount a defence.

“It really is a case of getting the documents in order and keeping hold of them. Don’t destroy them seven years after a contract has ended, because it might be 30 years down the line that you need them for a case,” says Cross.

As ever, the lesson is that those who don’t know their history may find themselves doomed to repeat it. 

The problem of prediction

Almost by definition, the big industrial diseases of tomorrow will be those that aren’t predicted. Those anticipated are prevented.

From nanotechnologies to 3D printing (again, a potential source of ultrafine particles), there is no shortage of potential sources of issues in the future.

Predicting which will be behind claims in the decades ahead is complicated by a number of factors, however.

First, as the examples mentioned illustrate, is the pace of technological change.

As the HSE’s 2016 Foresight Report noted, even technology used to make work safer, such as robotics, augmented reality and wearable health and safety technology, could lead to new risks, such as musculoskeletal conditions or increased stress.

More prosaically, changes in processes can create new risks from old materials.

Silica, for instance, has long been found in materials such as kerb stones (and is now often found in plastic composites, too) but, in past decades, tools such as block breakers were used to work with it.

Only with the move to cut-off saws operating at high speeds did they become a source of the huge clouds of dust that can lead to respiratory conditions.

“As technology changes and we use different construction methods and tools, the risks change,” says Hole.

The changing nature of claims

And it’s not just the technology and processes that evolve, either. Legal practice and lawyers’ ‘claims farming’ has a large role in determining the cases firms face in the courts.

“Higher recoverable legal costs by claimant solicitors was a key factor in the explosion in noise and vibration claims in the last few years, even though a high proportion of these were spurious and successfully defended,” says Fitzsimons.

Finally, society itself doesn’t stand still. As the workforce ages and people live longer, the nature of claims also changes, as well as the likelihood.

Employees that might have died earlier of other conditions may now live long enough to develop work-related diseases.

“Because people are getting older, these diseases have more time to materialise, and they’re also better recognised and diagnosed,” says Hole.

That’s good news, of course, but it does means we’re unlikely to see the number of cases – and claims – for industrial illnesses diminish any time soon.

For more information please contact Philip Dodd, Partner for Construction Claims on +44 (0)20 7528 4681 or email