Respiratory disease

What you need to do

The law says employers must reduce the exposure of workers to substances that can cause respiratory disease or breathing difficulty if inhaled.

This can be done by eliminating the hazard where possible or controlling the substance by means other than personal protective equipment (PPE), e.g. by water suppression or extraction of the dust.

As a last resort, PPE may be needed along with clear information, instruction and training for those exposed to the risk.

In the construction industry the most prevalent of these respiratory diseases are:

• Chronic obstructive pulmonary disease
• Occupational asthma and
• Silicosis

It is vital that you are managing the risk.

What you need to know

Work-related respiratory disease covers a range of illnesses that are caused or made worse by breathing hazardous substances that damage the lungs.

A number of construction activities can cause respiratory disease. These include:

• cutting kerbstones, stonemasonry, scabbling and surface grinding, tunnelling, crushing and screening demolition material, clearing and removing rubble, chasing out mortar before repointing, laying epoxy floors and carpentry.

Chronic obstructive pulmonary disease

COPD is an obstruction of the airway that is not fully reversible. The condition is usually progressive and is associated with inflammatory responses of the lungs to hazardous substances.

• Causes – the main cause of COPD is cigarette smoking, but exposure to harmful dust, fume and gases at work can contribute to the development of the disease.
• Symptoms – include a chronic cough, sputum production, and shortness of breath.

Construction workers have higher levels of this disease than the general population.

Occupational asthma

Occupational asthma is an allergic reaction some people experience when they are exposed to substances in the workplace, e.g. wood dust.

These substances are called ‘respiratory sensitisers’, or asthmagens. They can cause a ‘hypersensitive state’ in the airways of those affected.

Not everyone who becomes sensitised goes on to develop asthma, but once the lungs become hypersensitive, further exposure to the substance, even at quite low levels, may trigger an attack.

Work-related asthma can be triggered by exposure to substances in the workplace. People with asthma are more likely to be sensitive to these respiratory sensitisers.

Silicosis

Silicosis is an irreversible lung disease that can take years to develop.

• Causes – fine particles of respirable crystalline silica (RCS) cause damage and inflammation in the lungs. Over time, this leads to the formation of scar tissue (fibrosis), which shows up on chest X-rays.
• Symptoms are breathing difficulties and a chronic cough which may not appear before retirement. Silicosis can be extremely disabling and lead to early death.

Construction workers have an increased risk of developing silicosis because of exposure to high levels of silica dust during certain tasks.

If high-speed cutting tools are used on high-silica-content materials without suitable controls, RCS exposures can be very high. Exposures to freshly cut surfaces of RCS occur in many construction tasks such as cutting, blasting, drilling and grinding.

The RCS hazard is present whether the parent material is granite, sandstone, slate, or a manufactured product such as brick or concrete.

Managing the risk

The HSE five-stage plan for construction health risks shows how to manage the risk from substances that can cause respiratory disease:

• Stage 1: Arrangement
• Stage 2: Assess health risks
• Stage 3: Eliminate risk
• Stage 4: Control risk
• Stage 5: Manage remaining risk