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       Hazards, number 148, 2019
BITING THE DUST |  HSE defends a silica standard six times more deadly  
The Health and Safety Executive maintains its silica dust standard is just fine. Hazards editor Rory O’Neill spoke to former stonemason David Wood, who at 64 can’t work and struggles for breath. He, like hundreds of others who develop deadly silica-related diseases each year, are the undeniable proof HSE has got it dangerously wrong.

 

Silica dust may as well turn your lungs to stone. It’s a breathtaking reality UK workers have an extra reason to fear. Work in Canada and the maximum silica exposure is half that in the UK; in some provinces it is a quarter the UK limit of 0.1mg/m³. The US limit is half the UK ceiling. Australia is following the US lead, and some states are pushing for a 0.02mg/m³ standard, a fifth the UK limit.



BREATHLESS WEIGHT
  “When you work all your life, seven days a week, suddenly to be thrown on the scraphead is hard,” says Woody, whose lungs are choked with silica dust. “Sometimes I cry with it.”

Despite the tried and tested successful implementation of a more protective limit elsewhere, HSE insists it is not ‘technically feasible’ to introduce a safer silica standard. It concedes, however, that “significant risks still occur at and below” the UK’s current 0.1mg/m³ limit.

The lung cancer risk is 40 per cent higher, HSE admits. Then there’s COPD – the wheezy, breath-snatching conditions bronchitis and emphysema – and autoimmune and kidney diseases. But it is silicosis, which turns the lungs progressively into a stiff, inert, useless mass of scars, that many fear most.

David ‘Woody’ Wood has silicosis.  “I can’t do anything with it. Even talking I get out of breath,” he says.

Decades working as a stonemason in quarries and stone yards across West Yorkshire – he started in the trade aged 16 in 1971 and only retired after he was diagnosed with lung-scarring silicosis in 2014 – have left his lungs irreparably damaged by silica dust. At 59, he had to accept his working days were over. “I couldn’t do it anymore. They were working me to a frazzle,” he told Hazards.

Still, the diagnosis was a shock.  He’d always been a fit, strong, outdoors guy. At school he got certificates for cross country. He’d go fell walking in the Yorkshire Dales. He enjoyed fishing and mountain biking. None of that is possible anymore.

“I noticed I wasn’t as fit in about 2003. I started getting proper chest infections, but couldn’t have time of work,” he recalls. Over Christmas 2013 he developed a chest infection that wouldn’t go away. More breathing problems followed in May 2014, leading to a referral to chest specialist and his silicosis diagnosis.

KILLER SILICA Workplace silica exposure can cause potentially fatal cancers and lung and kidney diseases, and may lead to arthritis and other chronic health problems. In general, the more you are exposed, the greater the risk. more

“You can’t stop it. You can’t control it. It gets inside your lungs, your lungs are covered in black spots, they join up.” Now he struggles to walk a few yards up-hill. “I’ve got to think before I do anything. If it’s cold I can’t go out. You are frightened of getting wet if it rains. The wind takes your breath.”

He knows what is coming. While at his first job in the industry, at Pawson’s Brothers quarry in Morley near Leeds, Woody got his dad a start. After “10 to 12 years” at the firm his father was told “his lungs were fossilised.”

HSE has form on silica

The Health and Safety Executive (HSE), the UK safety regulator responsible for setting occupational exposures limits, has an unhealthy track record on silica (Hazards 127).



CUT THE DUST Unite is urging the Health and Safety Executive (HSE) to halve the workplace exposure limit for silica dust, a move it says could save 4,000 plus lives a year. The union says the move would dramatically reduce the incidence of silicosis, lung cancer, autoimmune diseases and other silica-related conditions. more

In 1992, when Woody was two decades into a stonemasonry career that had seen mechanisation increase silica dust levels “horrendously”, HSE caved to quarry industry pressure and increased the silica exposure limit by a factor of four, from 0.1mg/m³ to 0.4mg/m³. For many workers in the industry, exposure at this higher level amounted to a death sentence.

Around this time Woody moved jobs, to Bradley Natural Stone Products in Keighley. In his early days it had been bolsters, chisels and hammers. At Bradley’s it was all mechanised, and the main tools alongside the stone saws were pneumatic and grinders with diamond tipped blades. “Totally different, high speed all day, working flat out.”

Woody says the dust levels increased dramatically with mechanisation. “It was horrendous. We couldn’t see. It was like working in a fog.” Unlike the early days when “we’d pull our jumpers over our noses” to keep the dust out, workers at Bradley’s were provided dust masks, but they weren’t replaced or maintained regularly so workers blew dust out of the filter with an airline. The masks offered little protection. “I thought this is going to kill me,” he says. “I wish I’d got out when I had the chance.”

It wasn’t until 2006, a couple of years after he left Bradley’s, that the UK standard reverted to 0.1mg/m³, the current limit. Even at this level, HSE admits an estimated 30 in every 100 workers exposed over a working lifetime will, like Woody, develop silicosis. Halve the level to 0.05mg/m³ – a standard successfully enforced in many other jurisdictions in Europe, North America and beyond – and this drops to just five in a hundred, six times fewer victims.

  0.05mg/m3 silica standard                        0.1mg/m3 silica standard •  Current picture of health risks and exposure to respirable crystalline silica in Great Britain, HSE, December 2017.

We are talking big numbers at risk. An estimated 600,000 workers in the UK are still routinely exposed to the lung-wrecking dust. Extrapolating from European estimates in a July 2019 paper by Professor John Cherrie, a member of HSE’s Workplace Health Expert Committee, you reach a figure of over 150,000 UK workers who could be exposed above the current limit with a near 1-in-3 risk of life-sapping silicosis.

Silicosis is an ancient occupational disease that, while the dust remains, will not go away. And HSE knows it.

A 2019 Occupational and Environmental Medicine paper co-authored by researchers from HSE’s Centre for Workplace Health concluded: “Silicosis remains an important health problem in the UK affecting workers of all ages across a wide range of industries traditionally associated with silica exposure.”  It added “the majority of workers reported to have silicosis were still of working age.”

The authors noted: “Silicosis was reported in young workers across all industry groups, with around one in six of all silicosis cases affecting workers under the age of 46 years.”

It also means the disease is occurring in the current generation of workers for whom a substantial part – or in some cases all – of their exposures occurred in the period after the current silica exposure standard was introduced.

The victims, like Woody, are more often than not facing the prospect of their working lives as well as their life expectancy being cut short. “It might get to the stage where I’m not doing owt anymore,” he says. “It’s made me into an old man, it’s just cough, cough, cough.”

Despite HSE’s damning admission that a new generation is developing deadly silica-related diseases, the safety regulator is sticking resolutely with the more deadly 0.1mg/m³ standard. In a 3 September 2019 Freedom of Information Act response, HSE told Hazards its position is in line with a 2012 European Commission Advisory Committee on Safety and Health (ACSH) decision that the limit should be 0.1 mg/m³. 

What HSE didn’t say is this decision discounted the 2003 recommendation from the EU’s expert SCOEL exposure standards committee, which said the EU’s official exposure limit “should lie below 0.05mg/m³ for respirable silica dust.” Nor did the UK regulator acknowledge the 0.1 mg/m³ decision was reached because HSE backed the Employers’ Interest Group on ACSH and its demand for the weaker standard (Hazards 147).

The ACSH decision was based on the premise that “for the time being a concentration value of 0.05 mg/m³ does not yet seem to be technically feasible across all industries in Europe,” a claim that is undone by the many jurisdictions already at or below the 0.05mg/m³ limit. The ‘technical’ objection was transposed directly from the arguments put by the industry lobby to ACSH.

A 2013 paper to the European Commission from 18 European trade bodies with silica-exposed workforces, covering cement, glass fibre, ceramics, concrete, coal, gypsum, aggregates and minerals industries, concluded: “In terms of the combined socio-economic and health impact, as well as the technical feasibility, a European OEL for RCS should not be set below 0.1 mg/m³” (Hazards 126).

HSE’s defence of the 0.1mg/m³ standard also has industry’s fingerprints all over it.  In a 2014 statement, for example, HSE told Hazards: “Although under controlled conditions it is technically possible to measure below 0.1 mg/m³ results of work undertaken by the Health and Safety Laboratory [HSL] have shown that this is not currently practical within a workplace setting.”

The regulator, though, claims it has not retained any records relating to the ACSH silica decision. In HSE’s 3 September 2019 freedom of information response to Hazards’ request for the related “HSE notes/briefings/position papers/documents prepared for use by HSE at EC’s Advisory Committee on Safety and Health (ACSH), or submitted to the meetings, regarding occupational exposure limits for respirable crystalline silica, from 2003 to present”, HSE replied “the information you requested is not held by HSE.”

And it is not just UK workers that could suffer as a consequence of HSE’s complicity in a standards erosion. In an October 2019 move denounced by Spanish unions and the European Trade Union Confederation, the Spanish government announced it intended to weaken its silica standard from 0.05mg/m³ to match the less protective 0.1mg/m³ limit (more below).

Dying one day at a time

Woody survived over four decades working as stonemason. He stayed in the industry for a further 10 years after leaving Bradley’s, moving to M and M Yorkshire Stone Products in Bingley before crossing the border to take his final job in 2010 at Steptoes Yard in Altham, Lancashire.

The common themes throughout his employment were low pay and lots of dust. “We were so poorly paid, working for peanuts.

“Everywhere I worked it was bad. They just got greedier and greedier. You just had to work, work, work, speed all day to get the job done, then walk home. You didn’t have time to think about the dust, it was summat you just got used to.”

The available evidence suggests health risks were a shockingly low priority for the industry. HSE’s never again repeated 2009 Silica Baseline Study found almost half the stonemasonry workforce could be exposed above the current 0.1mg/m³ silica dust limit; in quarries overall the figure was 18 per cent.

For Woody and his co-workers, this meant working long hours in choking dust. “I’d come back from the toilet and think I can’t see the lads for the dust. Driving home at night, headlights would light up these sparkly bits filling the air inside the car. But it’s not the dust you see, it’s the dust you can’t that gives you silicosis.”



ACTION Don’t swallow HSE’s dust line. Send an e-postcard to HSE demanding it introduce a more protective UK silica exposure limit no higher than 0.05mg/m³ and with a phased move to 0.025mg/m³. www.hazards.org/HSEstopkillingus

Woody knows even though he is not exposed any more, the disease is progressive and his prospects are not good. His partner, Margaret, has said she’ll give up her job to look after him, if and when he needs it.

Six years on from his diagnosis, his natural optimism is near exhausted and the daily struggle with silicosis affects his moods. “I feel this black cloud over me. I can’t do anything with it. I’m short with our lass,” he admits. “Sometimes I cry with it. I have thought about doing myself in.”

He says he is lucky he has a good solicitor, Ian Toft of law firm Irwin Mitchell, who secured a “substantial settlement” including a provision allowing him to return to court if he goes on to develop silica-related lung cancer, tuberculosis, systemic sclerosis or increased disability.

For now it is a matter of making the best of it, but it is not easy. “You can’t get up every day and watch TV,” Woody says. “You have good days and you have bad days. You have to watch everything you do. Some days you can’t sleep flat, it’s like your lung are filling with water, a drowning sensation. It’s cough, cough, cough.” He fears the next infection could kill him. “If it is really bad, I think ‘what if it turns into pneumonia’.”

SEVERE UNDERESTIMATE  Severe and sometimes fatal cases of silica dust related diseases are being missed routinely by the authorities, a 2019 US study has concluded. more

And it can really hurt. “It feels like an arrow has been shot through my shoulder blades, it is painful to touch.”

He knows his health is deteriorating. “I keep it to myself. I don’t think I will live a right lot longer. I can’t breathe. The depression gets so bad some days, I think I’ve nowt to live for anymore.

“They think it is health and safety gone crazy,” he says. “I might have been a lot better off is health and safety had gone crazy then.”

HSE’s do or die decision

Another working generation could be spared Woody’s anguish. HSE could reduce the number of silica disease victims by a factor of six just by moving to and enforcing an occupational exposure standard of 0.05mg/m³ other countries believe is the minimum protection workers deserve.

If it continues to defend the 0.1mg/m³ exposure standard – which the regulator estimates also comes with a 40 per cent higher risk of lung cancer – we will know where HSE’s priorities lie.

The safety regulator would once again be demonstrating it is concerned more with placating the dirty end of industry than those suffering a slow, suffocating decline as a consequence of criminal neglect.

Woody fears for the future. “I don’t want a long, lingering death,” he says. “I don’t want to go like that.”

 

 

 


How does silica dust hurt you?

Workplace silica exposure can cause potentially fatal cancers and lung and kidney diseases, and may lead to arthritis and other chronic health problems. In general, the more you are exposed, the greater the risk.

Silicosis  A progressive disease in which accumulation of respirable crystalline silica particles causes an inflammatory reaction in the lung, leading to lung damage and scarring and, in some cases, progresses to complications resulting in disability and death. Silicosis is a UK government-recognised prescribed industrial disease. Silicosis can be complicated by bacterial infections including pulmonary tuberculosis (silicotuberculosis).

Lung and other cancers  HSE accepts silica exposure is responsible for several hundred lung cancer deaths in the UK each year. It estimates males exposed to silica at the UK standard of 0.1 mg/m³ have a lifetime risk of lung cancer, Britain’s biggest cancer killer, almost 40 per cent higher than for all males. Silica-related lung cancer is a UK government-recognised prescribed industrial disease.The International Agency for Research on Cancer (IARC)  notes: “Crystalline silica in the form of quartz or cristobalite dust is carcinogenic to humans (Group 1).” In the US, the safety regulator OSHA acknowledges the lung cancer association and says there is more limited evidence of associations with laryngeal, stomach and oesophageal cancers.

Other respiratory diseases  HSE and other regulatory agencies including OSHA accept silica exposure can cause chronic obstructive pulmonary disease (COPD) and impaired lung function, with affected workers frequently diagnosed with work-related emphysema or chronic bronchitis.

Renal and autoimmune diseases  HSE publications acknowledge the link between kidney disease and silica exposure. According to the US regulator OSHA: “There is also suggestive evidence that silica can increase the risk of rheumatoid arthritis and other autoimmune diseases. In fact, an autoimmune mechanism has been postulated for some silica-associated renal disease.” It adds: “OSHA preliminarily concludes that there is substantial evidence that silica exposure increases the risks of renal and autoimmune disease.” Renal disease caused by silica exposures can be deadly. Studies have linked silica exposure at work to sarcoidosis and scleroderma.

 

Selected references

1. Current picture of health risks and exposure to respirable crystalline silica in Great Britain, HSE, December 2017.
2. Silicosis and coal workers coal worker’s pneumoconiosis in Great Britain, 2018. HSE, 31 October 2018.
3. Silica baseline study, HSE, 2009.
4. C Barber, D Fishwick and others. Epidemiology of silicosis: reports from the SWORD scheme in the UK from 1996 to 2017, Occupational and Environmental Medicine volume 76, pages 17-21, 2019.
5. Opinion on the approach and content of an envisaged proposal by the Commission on the amendment of Directive 2004/37/EC on Carcinogens and Mutagens at the workplace, EC Advisory Committee on Safety and Health at Work Opinion, Doc. 2011/12, adopted 5 December 2012.
6. Recommendation from the Scientific Committee on Occupational Exposure Limits for silica, crystalline (respirable dust), SCOEL/SUM/94, SCOEL, November 2003.
7. Contribution to the impact study on the revision of the Carcinogens Directive (2004/37/EC) undertaken by European Commission DG EMPL Unit B3 [report by 18 industry groups], 30 August 2013.
8. BIPRO. A socio-economic impact study to an EU limit value for process generated respirable crystalline silica in the Chemical Agents at Work Directive compared to the Carcinogens and Mutagens at Work Directive, Final Report, 30 January 2014 [executive summary].
9. IARC Monograph Volume 100C. A Review of Human Carcinogens: Arsenic, Metals, Fibres, and Dusts, International Agency for Research on Cancer, Lyon, 2011.
10. Rose C, Heinzerling A, Patel K and others. Severe Silicosis in Engineered Stone Fabrication Workers — California, Colorado, Texas, and Washington, 2017–2019. Morbidity and Mortality Weekly Report (MMWR), volume 68, number 38, pages 813–818, 27 September 2019.



 



Unite calls for urgent cut to killer silica dust limit

Unite has given its strong backing to a campaign to force the Health and Safety Executive (HSE) to halve the workplace exposure limit for silica dust, a move it says will save 4,000 lives a year.

The union call came in response to a September 2019  ‘Choked’ report from Hazards magazine. This presents evidence for cutting the current legal limit of 0.1 mg/m³ for respirable crystalline silica to no more than 0.05 mg/m³, a move the report says would dramatically reduce the incidence of the lung scarring occupational disease silicosis, lung cancer, autoimmune diseases and other silica-related conditions.

Hazards reviewed the international scientific literature and internal HSE documents to calculate the annual excess silica-related death toll resulting from HSE’s repeat refusal to switch to and enforce the tighter standard, instead sticking with a level it admits comes with “significant risks”. It reveals that HSE’s own internal reports estimate the silicosis risk for workers is six times higher at the current HSE limit of 0.1 mg/m³, calculated at 30 cases per 100 workers exposed compared to just five per 100 at the tighter 0.05 mg/m³ standard.

The United States and a number of other jurisdictions already work to the safer standard. The Unite-backed campaign is asking supporters to send an online postcard to Sarah Albon, the new chief executive of the HSE.

Over 600,000 workers in the UK are regularly exposed to silica at work which is created when cutting, grinding drilling or polishing, natural substances such as rocks and sand and is a major constituent in bricks, tiles and concrete and materials. At least one-in-five workers in these jobs – and in some like stonemasonry and construction, possibly half – are exposed at or above the current deadly UK limit.

Unite national health and safety adviser Rob Miguel said: “It is time that the HSE took action on exposure to silica. The lives of thousands of workers can be saved if exposure levels are cut and the HSE starts to properly enforce exposure levels.” He added: “It is vital that everyone supports the Hazards campaign and puts pressure on the HSE to do the right thing and cut the maximum legal exposure level.”

At least one-in-five of those working routinely with silica – and in some industries like stonemasonry and construction, possibly half – are exposed at or above the current deadly UK limit.

HSE has a worrying track record on silica. On 1 January 1992, under pressure from the quarrying industry, HSE introduced a weaker permissible exposure standard for crystalline silica of 0.4mg/m³.

The UK only reverted to the 0.1mg/m³ standard in 2006, a level it admits comes with ‘significant risks’ but several times safer than the lung-shredding, suffocating extreme exposures it sanctioned for over a decade.

In August 2019, Unite launched an online silica register.

Unite  silica exposure register and silica dust hazards film.

 

 

Spain warned against dangerous silica shift

Europe’s top trade union body has condemned Spanish government proposals to reduce the protection for workers against lung scarring, cancer-causing silica. The European Trade Union Confederation (ETUC) is urging Spain’s government to abandon the plan to increase the exposure limits for crystalline silica, under the pretext of transposing the newly revised European Union (EU) directive on carcinogens or mutagens at work into national law.

For crystalline silica, the current Spanish occupational exposure limit value is 0.05mg/m³, in line with the US. However, the draft decree to transpose the EU directive allows for twice as much exposure, with the proposed new level set a 0.1mg/m³.

ETUC says the scientific literature shows that there is a significant mortality rate at this level, from silicosis, lung cancer and other health effects. Research has calculated the rate of potentially fatal silicosis is six times higher at the weaker 0.1mg/m³ standard.

 


Severe cases of silica disease are being missed

Even severe and sometimes fatal cases of silica dust related diseases are being missed by the authorities, a US study has concluded. Researchers examined reports of severe silicosis in engineered stone fabrication workers over the last two years in four US states – California, Colorado, Texas and Washington. Respirable crystalline silica exposure causes silicosis, a disabling and sometimes fatal lung disease.

Clusters of cases have been reported internationally among stone countertop fabrication workers, but only one US case in this industry had been reported previously. However, the US researchers discovered 18 cases of silicosis, including two fatalities, among stone fabrication workers in the four states. Several patients also had autoimmune disease and latent tuberculosis infection.

The authors note these figures are likely to be a substantial underestimate. “Given mounting evidence of silicosis risk among stone fabrication workers, the government of Queensland, Australia, initiated screening in 2018 for all at-risk employees. Ninety-eight cases of silicosis have been identified among 799 workers (12 per cent) examined.

These findings suggest that there might be many more US cases that have yet to be identified.” They add: “Silicosis is preventable; the cases reported here highlight the urgent need to identify stone fabrication workers at risk and prevent further excess exposure to silica dust.”

Noting the US exposure standard for silica dust was tightened to 0.05mg/m³ in 2016, they conclude: “Effective disease surveillance and regulatory enforcement are crucial to address the emerging silicosis threat in the stone fabrication industry.

Rose C, Heinzerling A, Patel K and others. Severe Silicosis in Engineered Stone Fabrication Workers — California, Colorado, Texas, and Washington, 2017–2019. Morbidity and Mortality Weekly Report (MMWR), volume 68, number 38, pages 813–818, 27 September 2019.

 

 

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Biting the dust

The Health and Safety Executive maintains its silica dust standard is just fine. Hazards editor Rory O’Neill spoke to former stonemason David Wood, who at 64 can’t work and struggles for breath. He, like hundreds of others who develop deadly silica-related diseases each year, are the undeniable proof HSE has got it dangerously wrong.


Contents
Introduction
HSE has form on silica
Dying one day at a time
HSE’s do or die decision
References

Other stories
How does silica dust hurt you?
Unite calls for urgent cut to killer silica dust limit
Spain warned against dangerous silica shift
Severe cases of silica disease are being missed

Hazards webpages
Dust
Cancer

    


SILICA ACTION!
Send an e-postcard to HSE demanding it introduce a more protective silica standard no higher than 0.05mg/m³ and with a phased move to 0.025mg/m³.


Read the evidence
Choked
The Health and Safety Executive (HSE) admits its silica dust limit is deadly, but claims there is no way to enforce a more protective exposure standard. HSE either made a fatal error or just plain lied – and may need to be forced to put things right. Hazards 147, July-September 2019.
A line in the sand
The Health and Safety Executive doesn't want a tighter exposure standard for crystalline silica, either in the UK or Europe. Hazards unpicks its flimsy – and dangerous – excuses. Hazards 127, July-September 2014
Dust to dust
Crystalline silica exposures kill over 1,000 workers a year in in the UK and leaves many more fighting for breath. But, unlike its US counterpart, the Health and Safety Executive (HSE) thinks our deadly silica exposure standard is just fine. Hazards 126, April-June 2014

Related story
Stone dead
Hundreds of stonemasons took to the streets of Pindwara in India on 1 May 2019, to protest at the deadly silica dust risks facing the workers building India’s temples.
Hazards 146, April-June 2019.