In July 2019, the All-Party Parliamentary Group on Respiratory Health, in partnership with not-for-profit organisation B&CE, commenced an enquiry into the issue of silicosis in the construction industry. The report was published in April 2020. The fact that the report is entitled “Silica – the next asbestos?” probably tells you something about the level of perceived risk that was found to be present within the industry due to respirable crystalline silica (“RCS”) inhalation.

The report commented on academic research to suggest that up to 600,000 construction workers in the UK were exposed to silica dust on a daily basis and that silica posed the second highest health risk to construction workers behind asbestos. Knowledge within the industry of RCS, including its sources, risks and protective measures to alleviate those risks was found to be severely lacking and inadequate. The fact that since 2013 the development of silicosis has neither been reportable under RIDDOR nor a notifiable diseases under the Health Protection (Notification) Regulations 2010 has combined with this lack of industry knowledge to further compound the problems in surveying the extent to which exposure is occurring for workers within the sector. The present regulatory exposure limits were also deemed to be inadequate in the UK standing at 0.1 mg/m3, which is double the exposure limit in other countries and a limit which had been recommended in the UK since as long ago as 2003. Present exposure levels, however, were believed to be rarely adhered to in the UK and even rarer investigation or enforced by the HSE which is under-resourced to deal with the issues effectively.

“Respondents overwhelmingly told us that the true picture of silicosis in construction is unknown. It is not clear whether the number of cases is increasing over time, or whether it is better diagnosed. Several called for further clinical investigation into the true extent of the problem and a requirement to report newly diagnosed cases under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013, Surveillance of Work-related Diseases (SWORD) and The Health and Occupation Research network (THOR). iOH (formerly AOHNP) told us that there is a risk that many of the 2.2 million individuals working in construction in the UK could be exposed to the dangers of RCS. Some evidence suggests that their families could also be at risk but precise numbers affected by the silicosis problem are unclear. Contributors cite underreporting, the fragmented nature of the industry and poor diagnostic ability in the UK as factors which have limited the ability to pin down exactly how widespread the problem is.”

The report confirms the previously established facts that RCS remains a particular issue in the stone mason industry, but is also relevant for those engaging in stone-work (including bricks and tiles) where exposure risk is also enhanced due to the increased use of power-tools within the industry:

“RCS is most toxic when it is freshly ‘fractured’ through processes such as stonecutting, drilling and polishing. When broken down in this way, it is a fine enough dust to reach deep inside the lungs when inhaled. Silica dust particles are invisible to the naked eye in normal light, so high concentrations can be inhaled without the worker being aware of it.”

Presently, regulation for the control of RSC remains governed by COSHH which also sets the exposure limits already cited. In order to comply with COSHH, employers need to:

(1) carry out a risk assessment;
(2) keep a record of the assessment (if they employ more than five people);
(3) where practicable, consider substituting material with a lower RCS content;
(4) prevent or control exposure to RCS;
(5) explain the risks of RCS and how to avoid them; and
(6) provide the worker with respiratory protective equipment.

Health surveillance is also required under the Management of Health and Safety at Work Regulations 1999.

The recommendations from the collaboration can be summarised as follows:

(1) Make silicosis a reportable condition under the Reporting of Injuries, Diseases, and Dangerous Occurrences Regulations 2013 for those who are still at work and exposed, and make silicosis notifiable under the Health Protection (Notification) Regulations 2010 with the additional creation of a national silicosis register maintained by Public Health England.
(2) Commence a targeted industry awareness campaign for those at risk from RSC exposure.
(3) Allow for the share of occupational health records between workers and employers.
(4) Introduce occupational health services into GP surgeries to allow for occupational histories to be taken where work-related ill health is suspected.
(5) Introduce new health and safety regulations specifically relating to the control of respirable crystalline silica (RCS), to bring it into line with asbestos.
(6) Investigate the introduction, by the NHS, of an appropriate screening programme for those exposed to RCS.
(7) Increase access to occupational health services for those industries generating RCS exposure.
(8) Reduce the workplace exposure limit (WEL) for RCS in the UK from 0.1 mg/m3 to 0.05 mg/m3, and statutory monitoring requirements are introduced to ensure workers are not exposed above that limit.
(9) Introduce, via the HSE, compulsory requirements for the effective use of masks, dust extraction and water suppression, along with annual reporting of inspection and compliance levels.
(10) Increase HSE resources to raise the volume of on-site inspections of building contractors of all sizes.

(Full outlines of each recommendation are set out in the report along with reasoning for each.)

Plainly, some of the recommendations are ambitious. Others, however, are more nuanced and intended to make use of existing regulatory instruments to expand protection and curb risks. The most interesting feature is undoubtedly the recommendation to table a new regulatory instrument specific to silica inhalation in a similar guise to the Asbestos Regulations and thereby take regulation for silicosis outside the COSHH regime, within which it presently resides. With that, bespoke risk assessment, health surveillance and exposure limit guidance will undoubtedly emerge and plainly through the same, it is hoped that industry knowledge and extensive surveying will catch-up to form a better idea of the scale of the problem.

It is very much a case of ‘watch this space’.