Occupational Health & Hygiene Essay

Occupational Health & Hygiene Essay

Table of Contents

1. Introduction
2. The Origins of the Disease/Condition
3. Possible Mechanisms for Disease/Condition Development
4. Silicosis
5. Lung Cancer
6. COPD (Chronic Obstructive Pulmonary Disease)
7. Activities within the stonemasonry industry where respiratory disease/condition is likely to occur
8. The burden of disease/condition in the UK
9. Any Appropriate Occupational Exposure Limits and Methods of Assessing Exposure
10. A Strategy for the Measurement of Exposure to the ‘Trigger’ Substance(s)
11. A Strategy for the Prevention and Management of Respiratory Disease with Reference to Good Practice Guidance, including Health Surveillance
12. Conclusion
13. References

Occupational Health & Hygiene

Respiratory Disease in Stonemasonry

Introduction

The rate of respiratory disease in stonemasonry in the UK over the last few years has continued to escalate despite valuable regulations and legislation being implemented effectively. Shockingly, numerous authoritative research findings showed that nearly one in five stonemasons worldwide were diagnosed with a killer respiratory disease associated with stonemasonry in what has been regarded as the workers’ worst crisis since asbestos. These cases have continued to double annually, according to new credible figures. This report will be addressed to an industry advisory committee on respiratory disease in stonemasonry and will cover various aspects, including the origins of the disease/condition and possible mechanisms for disease/condition development. It will also discuss activities within the stonemasonry industry where disease/condition is likely to occur, the burden of disease/condition in the UK, appropriate occupational exposure limits, and methods of assessing exposure. Additionally, it will address a strategy for measuring exposure to the ‘trigger’ substances and a strategy for preventing and managing disease/condition with reference to good practice guidance, including health surveillance.

The Origins of the Disease/Condition

Stonemasons can contract various respiratory diseases associated with stonemasonry, including COPD (chronic obstructive pulmonary disease), lung cancer, and silicosis. Respiratory disease in stonemasonry also affects employees working within the stone working industry, including safety and health consultants, machinery suppliers, safety representatives, and other workers. Employees responsible for processing stone are at higher risks of developing occupational lung diseases resulting from their exposure to dangerous stone dust, especially RCS (respirable crystalline silica)-containing dust. These occupational lung diseases include COPD, lung cancer, and silicosis. Silicosis can worsen even after exposure has stopped and can lead to severe breathlessness, early death, and permanent disability. It has also been associated with an increased risk of lung cancer.

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Possible Mechanisms for Disease/Condition Development

Employees in stonemasonry can suffer respiratory diseases from inhaling stone dust containing RCS or silica dust. The mechanisms for disease/condition development depend on factors such as the amount and duration of exposure, type of stone worked on, respiratory protective equipment, and tools used. Inhalable dust and respirable dust play significant roles in these mechanisms. Respirable dust, which contains fine particles that can penetrate deep into the lungs, is particularly hazardous. Various health effects, including musculoskeletal disorders, hand-arm vibration syndrome, hearing damage, and dermatitis, are linked to stone working in addition to respiratory diseases.

Silicosis

Silicosis is an incurable, progressive lung disease caused by exposure to silica dust, primarily from quartz in materials like granite, sandstone, and concrete. Different types of silicosis exist, with varying severity and risks. Acute silicosis develops within 6 months to 2 years of intense silica dust exposure and leads to shortness of breath, weight loss, and an increased risk of TB. Accelerated silicosis appears after 5 to 10 years of exposure, with similar symptoms and added autoimmune disorders. Complicated silicosis arises after 10 to 15 years of exposure and is associated with TB risk. Chronic silicosis develops after 15 years or more of exposure but causes only mild lung functioning impairment. Chronic silicosis can progress into more advanced types, which are life-threatening.

Lung Cancer

Repeated, long-term silica dust exposure can cause lung cancer, and smoking can exacerbate the risk among employees in stonemasonry. Lung cancer symptoms include persistent breathlessness, coughing up blood, and persistent cough.

COPD (Chronic Obstructive Pulmonary Disease)

COPD, including emphysema and chronic bronchitis, is associated with RCS exposure. Continuous RCS exposure can lead to advanced COPD, resulting in chest infections, persistent coughs, and severe breathlessness.

Activities within the stonemasonry industry where respiratory disease/condition is likely to occur

Activities leading to respiratory disease/condition in the stonemasonry industry include working with materials containing RCS, such as concrete, tiles, bricks, and natural and engineered stone. Employees can be exposed to RCS when these materials are polished, ground, carved, sanded, chiseled, or cut. The type of stone and various mineral-based materials used also affects RCS exposure levels.

The burden of disease/condition in the UK

Respiratory diseases associated with stonemasonry pose a substantial burden in the UK. The cost of respiratory disease in the UK is estimated at £11 billion annually, affecting the economy, patients, and the NHS. It is the fourth costliest disease in the country, with COPD alone costing £1.9 billion annually. Respiratory diseases contribute significantly to premature death and morbidity in the UK.

Any Appropriate Occupational Exposure Limits and Methods of Assessing Exposure

Employers in the stonemasonry industry must comply with appropriate occupational exposure limits set by regulations like COSHH (Control of Substances Hazardous to Health Regulations 2002). The workplace exposure limit (WEL) for RCS in the UK is 0.1 mg/m3 as an 8-hour time-weighted average. Employers must implement controls and measures to ensure exposure does not exceed these limits.

A Strategy for the Measurement of Exposure to the ‘Trigger’ Substance(s)

A strategy for measuring exposure to RCS involves implementing the Hierarchy of Control strategy, which includes eliminating exposure, using engineering controls, segregating tasks, implementing organizational controls, providing personal protective equipment (PPE), and maintaining controls such as local exhaust ventilation (LEV) systems. This strategy aligns with COSHH guidelines.

A Strategy for the Prevention and Management of Respiratory Disease with Reference to Good Practice Guidance, including Health Surveillance

Preventing and managing respiratory disease in stonemasonry includes controlling dust and fumes effectively through process changes, high-quality respiratory protection equipment, LEV systems, and water suppression during work. Employers should follow guidance from organizations like IOSH, BOHS, NEPSI, and EU SLIC.

Conclusion

In conclusion, respiratory disease in stonemasonry is a serious issue with severe health and economic implications. Understanding its origins, mechanisms of development, and appropriate control measures is crucial for safeguarding the health of workers in the stonemasonry industry and reducing the burden of disease in the UK.

10. References

Baldwin, P. E., Yates, T., Beattie, H., & Keen, C. (2019). Exposure to Respirable Crystalline Silica in the GB Brick Manufacturing and Stone Working Industries. Annals of Work Experiences and Health 63(2):1-13. DOI:10.1093/annweh/wxy103. https://www.researchgate.net/publication/331037161_Exposure_to_Respirable_Crystalline_Silica_in_the_GB_Brick_Manufacturing_and_Stone_Working_Industries

Barber, C. M., Fishwick, D., Carder, M., & Tongeren, M. (2018). Epidemiology of Silicosis: Reports from the SWORD scheme in the UK from 1996 to 2017. Occupational and Environmental Medicine 76(1). http://dx.doi.org/10.1136/oemed-2018-105337 Occupational Health & Hygiene Essay. https://www.researchgate.net/publication/328863437_Epidemiology_of_silicosis_Reports_from_the_SWORD_scheme_in_the_UK_from_1996_to_2017

Barber, C. M., Fishwick, D., Seed, M. J., & Carder, M. (2018a). Artificial Stone-Associated Silicosis in the UK. Occupational and Environmental Medicine 75(7). DOI:10.1136/oemed-2018-105028. https://www.researchgate.net/publication/323198277_Artificial_stone-associated_silicosis_in_the_UK

Bloch, K. E., Brack, T., & Ulrich, S. (2022). Self-Assessment in Respiratory Medicine. London: European Respiratory Medicine.

Breathe Freely Organisation. (2021). Stonemason. https://breathe-freely-staging.wabbajack.co.uk/wp-content/uploads/2021/07/stonemason_fact_sheet.pdf

British Lung Foundation. (2017). Estimating the Economic Burden of Respiratory Illness in the UK. http://allcatsrgrey.org.uk/wp/download/respiratory_diseases/PC-1601_-_Economic_burden_report_FINAL_8cdaba2a-589a-4a49-bd14-f45d66167795.pdf

Donaldson, K., Wallace, W., Henry, C., & Seaton, A. (2017). Death in the New Town: Edinburgh’s hidden story of stonemason’s silicosis. Journal of the Royal College of Physicians of Edinburgh. https://www.rcpe.ac.uk/sites/default/files/jrcpe_47_4_donaldson.pdf

Feary, J., Suojalehto, H., & Cullinan, P. (2020). Occupational and Environmental Lung Disease. London: European Respiratory Society. Occupational Health & Hygiene Essay

Koh, D. S. Q. & Gan, W. H. (2022). Textbook of Occupational Medicine Practice (Fifth Edition). Cambridge: World Scientific.

McCleery, A. (2020). The Great Tradie Shame: One in Five Stonemasons have been diagnosed with a killer disease in the worst crisis for workers since asbestos. https://www.dailymail.co.uk/news/article-7904725/One-five-stonemasons-diagnosed-killer-disease-worst-worker-crisis-asbestos.html

Rosental, P. (2017). Silicosis: A World History. New York: JHU Press.

Salciccioli, J. D., Marshall, D. C., Shalhoub, J., Maruthappu, M., Carlo, G., & Chung, K. F. (2018). Respiratory disease mortality in the United Kingdom compared with EU15+ countries in 1985-2015: observational study. NIH National Library of Medicine. Doi: 10.1136/bmj.k4680. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6259045/

Segelov Taylor Lawyers. (2020). Silicosis and Stonemasons. https://www.segelovtaylor.com.au/silicosis-and-stonemasons/

The Asthma and Lung UK Company. The Battle for Breath – The Economic Burden of Lung Disease. https://www.blf.org.uk/policy/economic-burden

The HSE. (2022). Controlling Exposure to Stone Dust. https://www.hse.gov.uk/pubns/priced/hsg201.pdf

The HSE. (2022a). Stoneworker. https://www.hse.gov.uk/lung-disease/stonemasonry.htm#:~:text=How%20to%20control,water%20suppression%20and%20process%20changes.

The HSE. (2022b). Silicosis. https://www.hse.gov.uk/lung-disease/silicosis.htm

The HSE. (2022c). Silica Dust. https://www.hse.gov.uk/stonemasonry/silica-dust.htm

The NHS Lothian. (2022). Stonemason Medicals. https://services.nhslothian.scot/occupationalhealthcommercial/Services/Pages/StonemasonMedicals.aspx

The NHS. (2022). Respiratory Disease. https://www.england.nhs.uk/ourwork/clinical-policy/respiratory-disease/

The State of Queensland. (2019). Code of Practice 2019. https://www.worksafe.qld.gov.au/__data/assets/pdf_file/0013/32413/managing-respirable-crystalline-silica-dust-exposure-in-the-stone-benchtop-industry-code-of-practice-2019.pdf

The WHO. (2022). Chronic Obstructive Pulmonary Disease (COPD). https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd) Occupational Health & Hygiene Essay