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Contents

RIDDOR (The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995)

RIDDOR places a legal duty on employers and other specified duty holders to report certain workplace incidents to the relevant enforcing authority, namely HSE, local authorities (LAs) and the Office of Rail Regulation (ORR). These Regulations came into effect on 1 April 1996. Since 1 April 2006, enforcement of health and safety on railways has been the responsibility of ORR, and since that date they have provided relevant figures that fall within the scope of RIDDOR. More information on railway safety can be found on the ORR website.

Incidents falling within scope of RIDDOR are specified fatal and non-fatal injuries; occupational diseases; dangerous occurrences; and certain gas incidents. Aggregated statistics based on these reported incidents are provided in these 'statistics' web pages, and a brief description is given below.

From September 2011 reporting arrangements changed, although RIDDOR itself did not. From April 2012 the legal reporting threshold of over-3-day injuries changed to over-7-days. The main effects of both these changes on published RIDDOR statistics is summarised at Summary of the effects on 2011/12 statistics

For details on current reporting methods, please visit the RIDDOR website

Deaths of all employed people and members of the public arising from work activity are reportable to the relevant enforcing authority. There are three categories of reportable injury to workers defined under the Regulations: fatal, major and over-3-day (over-7-day from April 2012) injury. Examples of major injuries include: fractures (except to fingers, thumbs or toes), amputations, dislocations (of shoulder, hip, knee, spine) and other injuries leading to resuscitation or 24 hour admittance to hospital. Over-7-day injuries include other injuries to workers that lead to their absence from work, or inability to do their usual job, for over seven days. A non-fatal injury to a member of the public is reportable if it results in the injured person being taken from the site of the incident to hospital. Reporting requirements generally exclude incidents that occur to persons travelling in a vehicle, as part of their work, whilst on a public on a highway.

From 1 October 2013, following a change in legislation, RIDDOR was further updated. However, these changes will not impact on the statistics until the 2013/14 figures are released in autumn 2014. More detail on this reporting change is available on the RIDDOR website.

Injuries which are not reportable under RIDDOR 95 are: road traffic accidents involving people travelling in the course of their work, which are covered by road traffic legislation; accidents reportable under separate merchant shipping, civil aviation and air navigation legislation; and accidents to members of the armed forces. In response to a requirement placed on us by the UK statistics authority in May 2010, a feasibility study was undertaken to assess whether it was feasible to produce estimates of the total number of workers killed or injured at work. The results can be found in the report below.

Although fatal injuries to the self-employed, arising out of accidents at premises which the deceased person either owned or occupied, are technically not reportable under RIDDOR, any such incidents are presented in the published figures.

While the enforcing authorities are informed about almost all relevant fatal workplace injuries, it is known that non-fatal injuries are substantially under-reported. Currently, it is estimated that around half of all such injuries to employees are actually reported, with the self-employed reporting a much smaller proportion. These results are achieved by comparing reported non-fatal injuries (major as well as over-3-day), with results from the Labour Force Survey- Injuries. However, work is ongoing to clarify the effects on reporting levels, following the recent change to over-7-day reporting. Tables of estimated reporting levels to 2011/12 are available in the index of tables.

Under-reporting is the major limitation on the use of RIDDOR data for statistical purposes, especially where reporting is uneven (eg some industries have higher or lower reporting levels than the average of 50%). Other notable limitations include the lack of actual days off work as a result of an injury (separate from the generic over-7-day category).

Summary of RIDDOR main strengths and weaknesses

Strengths

Weaknesses

On first publication, RIDDOR data is classified as provisional and marked with a 'p' suffix. The following year data are finalised. Typically, the finalised figures for non-fatal injuries are approximately 1% higher than the provisional figures due to the inclusion of late reports. Fatal injuries are much smaller in number, and can go down as well as up, by up to +/-3% on finalisation. Late reports are less relevant for fatal injuries, however the change from provisional to final usually reflects more up-to-date information following the detailed investigations of these incidents.

Selected incidents that have a high potential to cause death or serious injury are reportable under RIDDOR as dangerous occurrences. A dangerous occurrence is reportable whether or not someone is injured, and if so an injury report should also be made.

RIDDOR Regulation 6(1) places a duty on certain conveyors of gas (including LPG), to notify HSE of an incident involving a fatal or major injury that has occurred as a result of the distribution or supply of flammable gas. Regulation 6(2) requires specified gas installation businesses to notify HSE of gas appliances or fittings they consider to be dangerous. RIDDOR also places a requirement on employers to report prescribed occupational diseases, although such reports are small in number. More details can be found on the RIDDOR website.

Readily available RIDDOR data tables can be found within the index of tables.

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Electricity Safety, Quality and Continuity Regulations 2002 (as amended) (ESQCR)

Regulation 31 of ESQCR places a duty on those working on, or owning power network apparatus such as generators, distributors, meter operators and others to report injuries, near misses or fires or explosions which have occurred as a result of work on or near to electrical systems by others, or incidents arising from leisure and other non-work activities in proximity to electrical plant, or from equipment failure.

Prior to October 2006, such safety-related incidents were reported to the Engineering Inspectorate of the former Department for Trade and Industry, and HSE since. The annual basis for reporting is the planning year 1 April to 31 March.

From October 2013 reporting arrangements changed. More information is available at Electricity Safety, Quality and Continuity Regulations (ESQCR)

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Labour Force Survey

The Labour Force Survey (LFS) is a large nationally representative survey of households living at private addresses in the UK currently consisting of around 44 000 responding households each quarter. It provides a rich source of information about the labour market, and is designed, developed and managed by the Office for National Statistics (ONS) in Great Britain and by the Department of Finance and Personnel in Northern Ireland on behalf of the Department of Enterprise, Trade and Investment (DETINI).

The HSE commissions questions in the LFS, to gain a view of work-related illness and workplace injury based on individual's perceptions. The HSE questions are included in two survey modules - 'The Workplace Injury survey' module and the 'Self-reported Work-related Illness (SWI) survey' module.

The workplace injury survey module was first included in the LFS in 1990, with a limited question set included annually since 1993/94. The LFS gives annual estimates of the levels of workplace injury by a range of demographic and employment-related variables, and complements the flow of non-fatal injury reports made by employers and others under RIDDOR.

The SWI survey module has been included in the LFS annually from 2003/04 to 2011/12, and periodically prior to then (earliest results are from 1990, although results prior to 2001/02 are not directly comparable with later time periods). From 2011/12, the frequency moved to a biennial data collection i.e. work-related ill health data was not collected in 2012/13. This survey module provides an indication of the annual prevalence (including long standing as well as new cases) and incidence (new cases) of work-related illness and its distribution by major disease groups and a range of demographic and employment-related variables. It captures the most widely based definition of work-related ill health. Because individuals are asked to self-report any work-related illness they believe to have suffered over the previous 12 months, responses obviously depend on lay-peoples perceptions of medical matters. Whilst such perceptions are of interest and importance in their own right, they cannot be taken as a precise measure of the "true" extent of work-related illness. Peoples beliefs may be mistaken: they may ascribe the cause of illness to work when there is no such link; and may fail to recognise a link with working conditions when there is one e.g. because of the possible multifactorial nature of ill health or the delay between exposure and ill health (several decades in the case of cancer). Even with these discrepancies, individuals are uniquely well-placed to assess the role that work factors play in their illness. They are in a position to follow in detail how particular aspects of work have impacted them and to observe their body's response to this.

Research undertaken in 1995 and 2010 indicates a reasonable degree of reliability in self reports of work-related ill health in the LFS, and when sensibly interpreted, such surveys provide valid and relevant information not available from other sources.

Both the workplace injury and the SWI survey modules have between 2003/04 and 2011/12 (and periodically prior to then) also provided information about the number of working days lost due to workplace injury and work-related ill health. From 2011/12, ill health moved to a biennial data collection i.e. no working days lost information was collected for ill health in 2012/13. Estimates of working days lost for both workplace injuries and work-related ill health are expressed as full-day equivalent days to take account of the variation in daily hours worked (for example part-timers who work a short day or people who work particularly long hours). This information is available by a range of demographic and employment-related variables.

Due to a routing error in the 2007/08 and 2008/09 surveys, coverage of the SWI survey module was restricted to people working in the last 12 months rather than people ever employed (as in earlier surveys from 2001/02). Hence, all published estimates are restricted to people working in the last 12 months for comparison purposes.

In November 2011, results (from 2001/02) were published using the Standard Industrial Classification (SIC2007). A full explanation of the impacts and reasons for this change can be found at SIC2007.

In October 2012, results (from 2001/02) were published based on the new Standard Occupational Classification, SOC2010. More details about SOC2010 are available on the ONS website.

ONS periodically revise the LFS weights (estimates for the population). Any subsequent revisions made to the work-related illness and workplace injury published estimates are noted in the revision log.

Since estimates derived from the LFS are based on a sample (rather than the full population), they are subject to a margin of error. The main factor which determines the width of an estimates margin is the number of sample cases an estimate is based on. In published reports and tables, the sampling errors are often expressed as 95% confidence intervals. Each of these represents a range of values which has a 95% chance of containing the true value in the absence of bias. Confidence intervals should be quoted in preference to the prevalence or incidence central estimate or rate whenever there are less than 30 sample cases. In order to reflect some of the variability in the days lost estimates (measure from person to person) as well as the sample numbers involved, confidence intervals should be quoted for days lost estimates and rates based on fewer than 40 cases taking time off. Estimates based on fewer than 20 sample cases are deemed unreliable and not published.

More detailed information about the survey design and methods used are given in a technical note. Workplace injury and work-related illness survey modules of the Labour Force Survey: Background and methods. Published reports for SWI surveys from 1995 onwards can be accessed via the publications/release schedule.

Summary of the LFS's main strengths and weaknesses

Strengths

Weaknesses

User defined tables based on the Labour Force Survey data can also be created using the online HSE statistics data tool "HandS-On", and a number of readily available tables can be accessed through the HSE statistics index of tables.

NOTE: The Office for National Statistics (ONS) is the provider of the LFS data, but the analysis and interpretation of these data published on the HSE web site are the sole responsibility of HSE.

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Voluntary reporting of occupational diseases by General Practitioners (THOR GP)

THOR GP is a surveillance scheme in which general practitioners (GPs) are asked to report new cases of work-related ill health. It was initiated in 2005. Participating GPs report anonymised information about newly diagnosed cases to a multidisciplinary team at the Centre for Occupational and Environmental Health (COEH), Manchester University.

The pool of voluntary reporters currently participating in this project consists of around 270 GPs already trained at a postgraduate level in Occupational Medicine by the University of Manchester. The specific course is offered by distance learning and COEH is one of only a very few sites in the UK that offers this type of specialist GP training. Consequently volunteer GPs reporters practice in areas widely distributed across the UK. The GPs reporters are instructed to make their decisions as to whether a new case should be identified as being attributable to work on the balance of probabilities (i.e. whether it is more likely than not). Reports are collected via web forms each month. When reporting a case the GPs are asked to classify it into a broad disease category and to provide information on age, gender, job, industry, type of exposure, and absence from work.

An audit of the accuracy of the recording of sickness absence within the surveillance scheme revealed that there was a considerable level of underreporting. This was primarily because some reporters tended to forget to arrange for updating of the database on occasions when they signed off patients for further sickness absence after the initial period of sickness absence. The published estimates are adjusted to correct for this under recording.

Since the scheme only covers a small fraction (roughly one percent) of the total number of GPs, some check on the representativeness of the population under surveillance is needed. This has been done by comparing demographic information about the patient make-up in the practices of the participating GPs with the national distributions. This shows a good degree of representativeness by industry, age and sex, and area type. This implies that a simple grossing of the reported case numbers should give a valid estimate of the national picture. The details of the current grossing method are given in "Methods and caveats relating to the calculation of incidence rates from THOR-GP data".

At the start of THOR-GP data collection, all participating GPs reported incident cases every month (these GPs are termed core reporters), thus permitting the rapid collection of relatively large incident data sets for analysis and interpretation. As the scheme progressed, in common with other THOR schemes, an increasing proportion of GPs were asked to report incident data during only one randomly selected month of the year (these GPs are termed sample reporters). This helped to contain costs and also to reduce the potential of GPs to 'fatigue' in their reporting.

In line with the practice in the specialist THOR schemes, estimates for the number of cases seen by the reporting group as a whole were calculated by multiplying the case numbers reported by sample reporters by 12. However, it became apparent when applying this approach to the data for 2010, that the reporting rate per reporting month was much higher for sample reporters than for core reporters.

Previously published work in relation to occupational physicians' reporting (McNamee et al. 2010. Epidemiology. 21: 376-8) showed incidence rates based on sample reporting modestly (25%) higher than those based on core reporting, to a degree that was plausibly ascribable to lower levels of under-reporting in sample reporters.

By contrast, the difference between reporting rates for sample and core GP reporters was a factor approaching 3. The reasons for this difference are unclear, but may be related to multiple consultations at GP level and the fact that these may be dealt with by different practice members. Work is in hand to clarify the reasons for this difference, but in the mean time the summary 'incidence' rates for sample reporters have been reduced by the overall sample: core reporting ratio to align them with the incidence based on core reporters. To allow readers to assess the impact of this adjustment, separate data for the core and sample reporters for this table are shown on the next sheet.

As well as work quantify and explain the difference in core: sample reporting rates amongst GPs, the THOR team are undertaking work to refine denominator estimates, with the long-term aim of improving the accuracy and reliability of incidence estimates.

The main step currently being explored to refine denominator estimates involves collecting anonymous individual level postcode data from participating general practitioners. These data are then transformed by the Office of National Statistics (ONS) into THOR-GP specific estimates of the working population denominator. However individual level denominator data are only available for about half of THOR-GPs. Therefore a consistently applicable denominator estimation method is still being tested and validated.

Summary of THOR GP strengths and weaknesses

Strengths

Weaknesses

Tables for THOR and THOR-GP can be found within the index of tables.

For more information on THOR GP, please visit the University of Manchester website - THOR GP.

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Voluntary reporting of work-related ill health by specialist doctors (THOR)

The Health and Occupation Reporting network (THOR) is a voluntary surveillance scheme for work-related ill health. Under this network specialist doctors undertake to systematically report all new cases that they see in their clinics. These reports are collated and analysed by a multidisciplinary team at the Centre for Occupational and Environmental Health, Manchester University. The THOR network currently consists of 2 specialist reporting schemes and one for general practitioners (see below). These are SWORD (based on reports from hospital consultants specialising in respiratory disease) and EPIDERM (based on reports from consultant dermatologists). A third scheme, OPRA (based on reports from occupational physicians), operated until the end of 2010. Until the end of 2009 two additional schemes were in operation - SOSMI (based on reports from consultant psychiatrists) and MOSS (based on reports from consultant rheumatologists). The databases for several of these schemes now extend back for more than ten years and thus provide a powerful resource for investigating the increased risks of particular types of ill health in relation to occupations, industries and causal agents or work activities.

In all of the THOR schemes, there is a sampling process whereby most participating doctors are asked to send in reports for one month in each year, and the numbers of cases that they report are multiplied by 12 in arriving at the estimated annual totals. To avoid any systematic seasonal biases the sampled doctors are randomly allocated their reporting month, and this allocation changes from year to year. Not all reporting doctors are sampled; some are so called 'core' reporters, who report cases every month throughout the year. Cases reported by them are included in the estimated annual totals without any scaling up. The estimated annual totals are generally based on smaller (often considerably smaller) numbers of actual reported cases, and are subject to random variation due to sampling error. Decisions as to whether particular cases of ill health are work-related are a matter for the professional judgement of the reporters, who are asked to decide on the balance of probabilities.

The THOR schemes only cover a subset of the total cases of work-related disease. This is because quite a proportion of cases will either never come to the attention of a doctor or will be dealt with by a general practitioner. Moreover, many workers will not have access to an occupational physician at their place of work. Therefore, the subset of cases that are recorded within the THOR schemes will largely consist of either the serious or difficult-to-resolve cases that are referred to specialists by general practitioners or the more general cases from industrial sectors that are well covered by occupational physicians. Given this, the numbers of cases recorded in the THOR schemes clearly underestimate the total burden of work-related ill health. Nevertheless the subset of cases that are recorded should be identified by reasonably consistent process each year thereby making it possible to assess trends over time.

Figures published by HSE relate to Great Britain only, although the THOR schemes do collect reports from doctors throughout the UK.

The incidence rates for THOR cases, per 100 000 workers in each occupation or industry, are calculated using denominators from Annual Population Survey (APS). The analyses by occupation use the Standard Occupational Classification (SOC) 2000.

Any analysis of the raw THOR data currently presented on the HSE website in order to identify trends over time should be undertaken with caution. Those wishing to draw inferences regarding apparent changes in reported numbers of cases should be aware that there can be several potential explanations for differences between one year and the next. For example, participation by specialist doctors in the schemes is voluntary and so the number of reporters may vary with time. In addition, there is evidence that some reporters may be less inclined to report as time goes on.

A more sophisticated longer term statistical analysis is being undertaken to take account of the kinds of factors identified above which complicate the measurement of trends. This has involved the use of a multi-level statistical model (see report on Trends in ill health data from THOR). Within this model data is analysed in a process which effectively calculates the trends over time in the level of reporting by individual reporters and then summates these individual trends as part of the process of calculating the overall trend. This modelling approach takes full account of changes in the number of reporters over time. It also enables some allowance to be made for the fact that individual reporters may vary in factors such as the density of cases they see and the stringency of the criteria which they apply when deciding whether particular cases are work-related.

Summary of THOR strengths and weaknesses

Strengths

Weaknesses

Tables for THOR and THOR-GP can be found within the index of tables.

For more information on THOR, please visit the University of Manchester website .

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Industrial Injuries Disablement Benefit Scheme (IIDB)

The Industrial Injuries Disablement Benefit (IIDB) scheme, administered by the Department for Work and Pensions (DWP), compensates employed earners who have been disabled by a prescribed occupational disease (PD). Diseases are prescribed where an occupational cause is well established, and where the terms of prescription can be framed to identify cases of genuine occupational origin. For diseases in which the clinical features do not in themselves allow attribution to occupation, and which may have common non-occupational as well as occupational causes, the terms of prescription are usually defined based on epidemiological evidence of occupational circumstances in which the risk is at least doubled, since this implies that a majority of cases arising from such circumstances will be occupational.

Diseases which are difficult to define clearly - such as some musculoskeletal disorders and work-related stress - are not currently covered by the scheme. Neither are diseases that may be associated with work but where it isn't possible to define circumstances where the risks are as much as doubled. The scheme can thus be used to give an indication of the scale of annual incidence of those diseases for which the evidence about occupational causation is strongest.

For diseases that are prescribed on the basis of a doubling of risk the IIDB figures potentially overestimate the annual incidence by a factor of up to two: if certain occupational circumstances confer at least a doubling of risk then at most one half of disease cases arising from those circumstances will be caused by non-occupational factors (if the risk is exactly two the occupational proportion will be exactly one half). In reality, however, assessed IIDB cases will usually understate the scale of disease incidence because cases may arise from circumstances other than those covered by the terms of the prescription, individuals may be unaware of the possible occupational origin of their disease or the availability of compensation, and because the scheme does not cover the self employed.

For most diseases, benefit is payable if the extent of disability (from a single PD or from a number of PDs together) is assessed at 14% or more. However, figures are available for all newly assessed cases including those assessed at 1-13% disability. This so called '14% rule' was introduced for all claims lodged after 1 October 1986, for all diseases except pneumoconiosis, mesothelioma, and byssinosis (where benefit is still payable for lesser degrees of disability) and deafness (where the benefit threshold is 20% disability). For pneumoconiosis, byssinosis and mesothelioma, benefit continues to be paid and statistics are collected for all cases assessed at 1% or more disability. For deafness the available figures do not identify those assessed at less than 20% disability, who do not qualify for benefit.

In April 2002 a new method of collecting statistical information on claims and assessments was introduced by DWP, making the data more accurate. The apparent increase in some figures is believed to be largely due to this rather than reflecting a true rise in claims and assessments. It will also reflect the fact that, as of April 2002, the data include cases where the assessment results in "0%" disability being recorded, i.e. where the condition is accepted but where there is no loss of faculty. This category also includes cases where the percentage disability is missing (not coded at the time of publication) due to the provisional nature of the data.

Care should be taken in interpreting the annual totals for all prescribed diseases and their trend. Prescribed diseases do not represent the full spectrum of work-related illness. Figures for individual diseases making up the total are liable to be strongly affected by any changes in prescription criteria and factors affecting the take-up of claims (e.g. the contraction of traditional industries where the availability of compensation is well known, and the shift in employment to newer industries where it may be less well known). Much of the total is accounted for by lung diseases, vibration white finger, and deafness, and many such cases are a legacy of past working conditions which would be judged inadequate or in some cases illegal by today's standards.

Summary of IIDB strengths and weaknesses

Strengths

  1. A large number (more than 20,000) of clinically validated individual disease cases are recorded each year in the scheme.
  2. The scheme permits an assessment of the incidence of rare diseases and time trends (with caution); it is HSE's only data source for certain conditions.
  3. The scheme gives a lower bound estimate of the total incidence of diseases which are most clearly occupational in origin rather than the wider category of work-related diseases.
  4. The scheme has been running since the late 1940s and for many diseases there are several decades of information; HSE holds electronic data since the mid 1980s. The method of data collection has been unchanged since April 2002.

Weaknesses

  1. Coverage is limited to diseases which can be attributed to occupation either based on clinical features or where there is epidemiological evidence to allow attribution in certain circumstances on the balance of probabilities.
  2. For those disease that are included, annual incidence will tend to be underestimated due to:
    • cases arising from circumstances other than those covered by the terms of the prescription;
    • individuals being unaware of the possible occupational origin of their disease;
    • a lack of knowledge regarding the availability of compensation;
    • the scheme not including self-employed workers which is a particular issue in occupations with a high proportion of self-employed.
  3. Large increases in claims can coincide with media campaigns, as well as with newly prescribed diseases where an initial backlog of cases may have been assessed rather than a steady stream of incident cases. Any analysis of trends must take this into account.
  4. Many of the diseases reflect occupational conditions in the past rather than current working conditions.

Tables of data for IIDB can be found within the index of tables.

The current set of data have been rounded to the nearest 5 cases, or to "-" if less than 5 cases. This has been done to maintain the anonymity of DWP customers.

For more information on the IIDB, please visit the website of the Industrial Injuries Advisory Council.

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Death certificates as a source of deaths from asbestos-related and other occupational lung diseases

Mesothelioma and asbestosis mortality statistics for Great Britain are derived mesothelioma and asbestosis registers maintained by HSE.

The mesothelioma register comprises deaths where the description of the cause of death on the death certificate mentioned the word 'mesothelioma'. For a substantial proportion of cases, it also contains information about whether the site of the mesothelioma was pleural (affecting the external lining of the lungs), peritoneal (affecting the external lining of the lower digestive tract) or both.

The asbestosis register comprises deaths where the cause of death on the death certificate mentioned the word 'asbestosis'. The information on the registers from the death records includes date of birth, date of death, sex, last occupation and postcode of residence at death.

Mesothelioma and asbestosis death records are supplied to HSE electronically by the Office for National Statistics (ONS) - for deaths in England and Wales - and the National Records of Scotland (NRS) - for Scottish deaths. Records are currently selected by ONS and NRS from their data collection systems via the mesothelioma cause of death code. ONS also search for strings 'meso', 'mesa' and 'asb' within the cause of death text descriptions. This combined approach helps to ensure that any deaths in England and Wales that may have been miscoded are identified. In addition, processing within HSE of asbestosis deaths is carried out before the mesotheliomas to identify any additional mesotheliomas where mesothelioma was spelt incorrectly on the death certificate.

Some death certificates mention both asbestosis and mesothelioma. Such deaths are included on both registers in order to keep track of cases where both diseases were present. However, on some death certificates - particularly those that also mention mesothelioma - the term asbestosis appears to be used incorrectly to indicate role of asbestos exposure in the death rather than to describe the disease that led to death. Thus separate figures are provided for deaths certificates that mention asbestosis together with other asbestos related diseases. The best indication of the number of deaths where the disease asbestosis contributed as a cause of death is to exclude those deaths that also mention mesothelioma.

The mesothelioma and asbestosis mortality statistics are updated annually to include figures for the year two years behind the current year. The delay is a result of the substantial time periods that can be involved in the death certification process. When we publish a figure for the latest available year it will include deaths for that year, which are registered up to 15 months after the year end. This means that the data will be approximately complete when first published. However, there may eventually be a small number of further registrations after this 15-month period, in which case figures are updated during subsequent annual updates.

A series of validation checks includes checking for important missing information, such as date of birth or death, and checking for duplicates are carried out each year and queries are followed up with ONS and NRS. Coding of mesothelioma site is also carried out at this stage along with categorisation of asbestosis deaths according to the other diseases also mentioned on the death certificate.

As a further check on the completeness of the mesothelioma register, HSE has periodically carried out checks of mesothelioma deaths against details of cancer registrations in Great Britain with morphology codes associated with mesothelioma. In recent years this process has yielded very few additional deaths.

Before 1993, if there was insufficient information on a death certificate to accurately classify the death, the ONS sent a 'medical enquiry' to the certifying doctor for further information. This procedure was discontinued for deaths registered from 1993 onwards, but ONS hope to reintroduce it sometime in the future. This discontinuation has affected the site coding of mesothelioma deaths: the proportion coded as 'site not specified' was typically around 10-20% before 1993 and over 45% thereafter.

Summary of strengths and weaknesses

Strengths

  1. The registers provide a long term series of data collected on a consistent basis for over 4 decades.
  2. The data includes all deaths where mesothelioma and asbestosis contributed as a cause of death - not just those where these diseases were recorded as the underlying cause of death.

Weaknesses

  1. The completeness of the registers depends on those certifying deaths recognising and recording that mesothelioma or asbestosis was a cause of death. Under ascertainment would have been more likely in the past than in recent years.
  2. The asbestosis register may include some deaths where the disease asbestosis was not present if the term was used incorrectly to indicate that asbestos exposure took place.

Tables on asbestos-related and other occupational lung diseases can be found within the index of tables

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Surveillance of workers exposed to lead

Under the Control of Lead at Work Regulations (CLAW) 2002 and the former 1980 and 1998 Regulations, all workers with significant exposure to lead are required to be under medical surveillance by an appointed doctor or one of HSEs medical inspectors. Exposure to lead is described as significant if one or more of the following conditions are met (i) the workers exposure is liable to exceed half the occupational exposure limit for lead in the atmosphere; 0.15 mg/m3 for lead other than lead alkyls and 0.10 mg/m3 for lead alkyls, (ii) the worker has a recorded blood-lead concentration that equals or exceeds 20µg/100ml for women of reproductive capacity or 35µg/100ml for all other employees, or (iii) an appointed doctor certifies that the worker should be under medical surveillance as there is substantial risk of ingestion or dermal absorption of lead. The surveillance includes the measurement of each worker's 'blood-lead level'; the amount of lead in samples of their blood, expressed in micrograms per 100 millilitres (µg/100ml). Annual returns give summary statistics for each workplace based on the maximum blood-lead level recorded for each worker under surveillance.

The Approved Code of Practice issued with the Regulations lays down levels of blood-lead concentration above which the appointed doctor is required to decide whether to certify that the worker should no longer be exposed to lead. If a worker's blood lead level reaches or exceeds this 'suspension level' a repeat measurement must be made, and if this is still at or over the level the worker should be suspended from working with lead. At the doctors discretion employees can be removed from working with lead even if the blood lead concentration is below the suspension limit. The number of such workers suspended is also recorded annually and analysed in the statistics. Under the 1980 Regulations the suspension levels were 70µg/100ml for males (80µg/100ml up to 1986) and 40µg/100ml for females of reproductive capacity (to protect the health of any developing foetus). The suspension levels were lowered in the 1998 Regulations (and remain unchanged in the 2002 Regulations) to 60 and 30 µg/100ml respectively, with new 'action levels' of 50 and 25 µg/100ml. The 1998 Regulations also introduced suspension and action levels for young persons aged under 18 years of 50 and 40 µg/100ml respectively. In most cases, female employees under 18 years of age will also be women of reproductive capacity and the lower action and suspension levels apply. If an individual's blood-lead level reaches the action level the employer should investigate the circumstances leading to the heightened level and so far as reasonably practicable, give effect to measures designed to reduce the blood-lead concentration to a level below the appropriate action level. This could include issue of personal protective equipment or suspension from working with lead for a period.

Statistics for blood lead levels are subject to a number of limitations. Firstly, the coverage of the statistics is defined by the extent of medical surveillance that occurs in practice and this may not be completely aligned with what should take place under the CLAW regulations. The basic decision as to whether surveillance is required rests with each employer. Over-coverage can occur if exposure in a lead-using workplace has fallen to levels which are no longer "significant" by the criteria set out in the Approved Code of Practice. The application of these criteria have some flexibility, and in any case employers where blood lead surveillance has been established, may decide to continue it on a precautionary basis even when not strictly required by the regulation. If any such measurements are included this will result in the implied estimate of the numbers of workers with potentially significant exposure being overestimated, though the statistics will also correctly reflect the fact that these workers have consistently low levels of lead in their blood. Conversely, measurements not included because employers have not adequately assessed the potential for lead exposure in their workforce (or are unaware of their duty to do so) will lead to an underestimate of the number with potentially significant exposure. HSE inspectors may identify such workplaces from time to time, and they will then be included. The nature of the data collection and processing are also subject to potential human error, in particular, whether the HSE appointed doctors fill out their annual blood lead returns accurately. Finally, comparison of recent data with that for earlier years may be affected by changes to the measurement categories over time.

Summary of strengths and weaknesses

Strengths

  1. The blood lead data constitutes a long-term data series that provides annual estimates of size of the population with the highest occupational exposures to lead.
  2. The data series is based on a relatively large number of blood lead measurements in all workers undergoing medical surveillance, rather than a sample survey approach. This permits a detailed view of the distribution of lead exposure in each of the main industry sectors with the highest potential for ongoing exposure.

Weaknesses

  1. Coverage is dependent on the extent of compliance with the CLAW regulations - potentially including workers that need not be under surveillance because exposures are not significant, as well as not including those that should be under surveillance.
  2. The completeness and accuracy of the data is subject to human error and dependent on whether reporting doctors fill out their annual blood lead returns accurately.
  3. The current data collection arrangements do not permit the tracking of consecutive blood lead levels for particular individuals.
  4. The data provides limited information about the number of people exposed to lead at lower levels who would not be required to undergo medical surveillance under the CLAW regulations.

More Information on working with lead can be found at:

Tables of data on lead exposure can be found within the index of tables

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Enforcement

Enforcement notices cover improvement (requiring employers to put right a contravention of health and safety legislation within a specified time limit); prohibition (stopping work activity that gives, or will give, rise to a risk of serious personal injury); and deferred (stopping a work activity within a specified time) prohibition notices, as issued by all enforcing authorities, namely HSE, local authorities (LAs) and the Office of Rail Regulation (ORR). Offences prosecuted refer to individual breaches of health and safety legislation; a prosecution case may include more than one offence.

Where enforcement statistics are allocated against a particular year, for notices this refers to the date the notice was issued; for prosecutions this relates to the date of the final hearing and where an outcome is known. Prosecution figures exclude offences where the hearing result is classified as 'not finished', as these offences will be counted in the statistics for the following year.

In Scotland HSE and local authorities investigate potential offences but cannot institute legal proceedings. HSE and local authorities send a report to the Crown Office and Procurator Fiscal Service (COPFS). COPFS makes the final decision whether to institute legal proceedings and which offences are taken. For more information, please read the explanatory note HSE and the prosecutions process in Scotland .

Summary of main strengths and weaknesses

Strengths

Weaknesses

Tables of data on enforcement can be found within the index of tables. For more information about enforcement data see the Enforcement Data Quality Statement.

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Employment

In November 2011, HSE moved to a single data source for compiling employment related statistics - the Annual Population Survey (APS). The APS is a self-completion sample survey that was launched in 2004. It is published on a quarterly basis (with a 6 month lag) and provides detailed information on a range of employment structures that allows HSE to highlight population subgroups with highest risk of occupational injury and ill health.

Summary of strengths and weaknesses

Strengths

Weaknesses

The move to the APS as the sole employment data source may result in a one off jump or drop in RIDDOR injury rates, particularly within industry sectors, compared to that previously published - however, this will be a one-off change, and a back-series of data to 2004 is being provided to allow for time-series trend analysis where appropriate.

The Office for National Statistics (ONS) is the provider of the APS data. The analysis and interpretation of these data are the sole responsibility of HSE.

For further information on the APS, please visit the Office for National Statistics (ONS) website .

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Working Condition Surveys

HSE have run a number of surveys which measure aspects of working conditions and potential precursors of adverse health and safety events.

Workplace Health and Safety surveys (WHASS)

The Workplace Health and Safety surveys included separate cross sectional worker and employer surveys. These surveys included a broad range of questions, on risk control, health and safety management and other precursors of health and safety outcome. They drew probability samples that were representative of all British workers, for the worker survey, and workplaces, for the employer survey.

The 2005 WHASS employer survey, used a random probability sample of workplaces drawn from the Inter Departmental Business register. From selected workplaces just under one thousand employers with responsibility for health and safety management at this workplace completed the survey. This represented a response rate of 63%.

The 2005 WHASS worker survey, was based on responses from 10 016 British workers, a response rate of 26%. The survey was administered by telephone, with households selected by random digit dialing and a respondent selected randomly from household members who worked at some time in the last 12 months prior to interview.

Fit3 (Fit for work, fit for life, fit for tomorrow) surveys

A series of three annual employer and employee surveys, commissioned to support progress monitoring of HSE's FIT3 strategic delivery programme. These Fit3 surveys measured outcome precursors, risk control and other aspects that this strategic programme hoped to influence.

The employer survey was a cross-sectional quota telephone survey of those responsible for health and safety management at approx. 3000 British workplaces. These surveys ran from 2005 to 2007. All broad industry sectors were sampled, with sample numbers boosted for specific industries within sectors where monitoring of Fit3 activity was required. The survey questionnaire had a modular design with a random sample of eligible respondents selected for each module of questions.

The employee survey was a face to face panel survey; starting with a panel of around 9000 workers in 2006. These surveys ran from 2006 to 2008. The panel was selected from a random probability sample of working householders. The survey questionnaire had a modular design with a random sample of eligible respondents selected for each module of questions.

Psychosocial Working Conditions Survey

This ongoing annual series of surveys provides data on selected psychosocial working conditions from face to face interviews with a random probability sample of British working households. The series, beginning in 2004, has been delivered through modules in the ONS Omnibus survey series. Response rates for the surveys are around 60-70%, and the number of eligible workers interviewed per month ranged between 500 and 900. The survey is designed to monitor key working conditions on the areas underpinning HSE's Management Standards for Work-Related Stress, namely demand, control, support, role, relationships and change.

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European data sources

Eurostat

Fatal Injuries

Despite issues with comparability, Eurostat publishes data on fatal accidents at work in as standardised a form as possible. Fatalities cover 8 common industry groupings, are standardised to take account of the different structure of working populations across member states, and fatalities due to road traffic accidents are removed to account for GB and Ireland who do not record work related road traffic accidents.

For further details on the scope and coverage of the fatalities data please see the metadata provided by Eurostat.

To download European data on fatal accidents please visit the Eurostat database.

Non-fatal Injuries

Unlike fatal injuries, where reporting is thought to be relatively complete, non-fatal injuries may be subject to under-reporting in some countries. The differences arise in countries such as GB, Ireland and Denmark where employers report accidents to a national labour inspectorate (such as HSE). In other countries such as Germany, Spain or Italy, reports are made through insurance systems with a relatively low level of under-claiming. This difference, and the inclusion of road traffic accidents in statistics from countries other than GB and Ireland, means that HSE do not draw direct comparisons from this data and instead use the self-reported accident data gathered in the European Union Labour Force Survey (EU LFS).

Europe-Wide Surveys

Labour Force Survey (LFS)

The European Union Labour Force Survey (EU LFS) is a large household survey carried out in the 27 Member States of the European Union, 3 candidate countries and 3 countries of the European Free Trade Association (EFTA). In 2007 the EU-LFS included an ad hoc module asking about accidents at work, work-related health problems, and exposure to factors that can adversely affect mental well-being or physical health in the previous 12 months.

Eurostat tries to ensure comparability with a common questionnaire, although national statistical institutes in each country run the surveys so differences may still arise in sample selection and conducting the interviews.

Data is available in Eurostat's online database.

For further information and publications see also the European Labour Force Survey website.

European Working Conditions Surveys (EWCS)

Eurofound (the European Foundation for the Improvement of Living and Working Conditions) is a European Union body set up to contribute to the planning and design of better living and working conditions in Europe. Every five years the foundation conducts a survey to study working conditions in Europe. For more details on the background to the European Working Conditions Survey please visit the EWCS homepage on the Eurofound website

To view the latest data, use the mapping tool

European Survey of New and Emerging Risks (ESENER)

The European Survey of New and Emerging Risks (ESENER) ran in 2009 and surveyed businesses with more than 10 employees in all sectors apart from agriculture. EU-OSHA undertook telephone interviews with nearly 30,000 managers and over 7000 worker representatives across 31 countries; 27 Member States, 2 candidate countries, 2 EFTA countries. Key areas of focus were psychosocial risks such as stress, violence and harassment. For more background on the survey, and to view the results visit the mapping tool on the website of the European Agency for Safety and Health at Work

Data tables on European comparisons can be found within the index of tables.

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HSE Cost model

Model description: developed to estimate the costs of injury and common ill health complaints arising from current working conditions. It uses the number of annual fatalities reported under RIDDOR and the estimated annual number of people reporting a non-fatal workplace injury or work-related illness in the LFS (the latter are restricted to self-reports of newly occurring illness to best capture costs arising from current working conditions). The cost model explicitly allows for those people who permanently leave the labour market as a result of their workplace injury or illness, again estimated from the LFS.

To increase the robustness of the estimated number of cases derived from the LFS, and particularly the detailed breakdown of these cases for costing purposes, annual estimates are based on the average of three successive years' data. For example the estimated number of cases of illness and injury in 2010/11 are based on the average annual number for 2009/10, 2010/11 and 2011/12. Therefore, costs for successive years are based on overlapping samples. Whilst this gives an indication of the direction in which costs are moving, to get a more definitive picture of changes in cost over time, cost estimates for independent time periods should be compared (e.g. 2006/07 compared with 2010/11).

Those people whose illness or injury results in their permanent withdrawal from the labour market are an important subset of cases, because of their high associated costs. However, it is difficult to estimate the numbers who permanently withdraw from the labour market both now and in the future as a result of a workplace illness or injury arising from current working conditions. The LFS currently provides the best basis for estimating the magnitude of this group, though it is recognised to be an imperfect measure of the absolute number. For this reason, the number of these 'never returns' is held constant in the model across years.

The model estimates both the financial costs (actual monetary costs) and non-financial costs (monetary values given to individuals' 'pain, grief and suffering') of these cases of injury and illness.

Financial costs include loss of income, compensation, production disturbance, health and rehabilitation and administrative and legal costs. Information on financial costs needed to quantify the different cost categories come from a wide range of sources including ONS surveys on earnings, NHS data on treatment costs and DWP figures on benefit rates. Some cost elements are limited by availability of robust data to quantify the financial impact. For example, non-injury accidents may cause damage to machinery or equipment and thus incur cost, whilst 'presenteeism', whereby a worker's health impairment results in their reduced productivity, also incurs cost. However, the lack of robust data for such cost elements means that we cannot quantify their costs with any degree of accuracy at this point in time and so they are currently omitted from the cost model.

Non-financial costs are based on the value that individuals would be willing to pay to have reduced risk of death or avoid reductions in quality of life which result from injury or illness.

The cost estimates only include first-order effects; any second-order effects such as employers or Government passing on the costs of workplace injury and ill health in the form of higher prices or taxation have not been considered. The cost model approach uses similar methods to other Government Departments.

The costs of workplace injuries and ill health are apportioned between three distinct groups: the individuals directly affected; their employers; and the government. In some cases, a cost to one group is an equal and opposite benefit for another group. For example sick pay represents a cost to the employer but is an equal and opposite benefit to the individual who receives it. Total costs to society, estimated by summing across the three groups, are net of transfers between one group and another.

The cost estimates are subject to uncertainty, due to both sampling error in the estimated number of annual illness, injury and 'never return to work' cases and the underpinning assumptions used to assign costs. The cost model accounts for the former uncertainty and estimates are often expressed as 95% confidence intervals - the range of values which has a 95% chance of containing the true cost. When comparing costs over time, it is important that any judgement on change in costs is based on a consideration of the confidence interval, rather than the central estimate itself.

Further work is underway to estimate costs of work-related illness conditions caused by previous working conditions such as cancer. The LFS is limited in terms of measuring rarer long latency conditions such as occupational cancers or chronic obstructive pulmonary disease. This is because the LFS estimates are based on an individual's self assessment of the link between their newly occurring ill health and their work (which for long-latency disease will include work from many years ago). Using research by Imperial College on the portion of cancer registrations that can be attributed to occupational exposures1, HSE is developing a model to estimate the costs associated with cases of occupational cancer. Because the estimates of the cost of occupational cancer will reflect historical exposures, while the existing model's aim is to reflect illness and injury arising from current working conditions, it is unlikely that the Costs to Britain estimate and any future cost of occupational cancer estimate will be directly combined. It is planned that a separate estimate of the cost of occupational cancer will be published after the remaining work on it has been completed.

Summary of the model's main strengths and weaknesses

Strengths

Weaknesses

Data tables on Costs to Britain can be found within the index of tables.

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  1. See Rushton et al (2012) The Burden of Occupational Cancer in Great Britain HSE Research Report RR931
Updated 2013-10-28