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       Hazards, number 147, 2019
CHOKED |  End killer silica exposures at work  |  Tell HSE to clear the air
The Health and Safety Executive (HSE) admits its silica dust limit is deadly, but told Hazards there was no way to enforce a more protective exposure standard. Then the US acted. Then Australia. Hazards editor Rory O’Neill says HSE either made a fatal error or just plain lied – and says HSE may need to be forced to put things right.


What should you do when a regulator created to protect workers’ health goes rogue? When behind closed doors it lobbies successfully for a less protective workplace standard that will leave workers, by its own admission, at significant risk (1) from suffocating, lung-shredding silica dust?



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. more

It is not as though the Health and Safety Executive (HSE) can pretend there is no evidence. Despite being a shadow of its former self – the HSE’s budget is barely half where it was a decade ago – the inspection-shy regulator is still finding shocking evidence of the harm caused by the lung-wrecking dust to which an estimated 600,000 workers in the UK are still routinely exposed.

“Since April 2013 HSE has brought 16 prosecutions, issued 409 prohibition notices and 1,210 improvement notices for health and safety offences related to respirable crystalline silica,” a spokesperson for the workplace safety enforcer told Hazards.

These are just the firms caught in the last five years exposing their workers to limit-busting levels of a dust accepted to cause cancer, lung-destroying silicosis, breath-stealing chronic obstructive pulmonary diseases (COPD), and kidney and autoimmune diseases.

Breathtaking impact

It is a silica victims’ disability dossier that HSE accepts now claims over a thousand lives in the UK each year. While HSE knows this, only a tiny proportion of the victims find out what robbed years of their health and life. Official records show just 10 to 20 people each year have silicosis listed as their cause of death (2). Family doctors rarely spot a case and by the time someone succumbs from a slow suffocation over decades, it may be other complicating but often related health issues listed as cause of death.





GO DEADLY GO Stonemasonry Limited has been fined £8,000 and ordered to pay costs of £10,000 after an employee developed the disabling lung-scarring disease silicosis. An investigation by the Health and Safety Executive (HSE) found the firm had been cutting and working with stone without any suitable dust extraction or effective respiratory protective equipment (RPE). [more]

“It is likely from the typical pattern of disease development and progression prior to the development of symptoms that substantial numbers of people develop some degree of silicosis and either die of unrelated causes or from causes which were indirectly related to having silicosis, whether or not this had been previously diagnosed,” HSE’s spokesperson told Hazards.

It is not as some assume an old man’s disease. “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,” found a 2019 study of UK silicosis cases reported since 1996.

The authors, writing in the journal Occupational and Environmental Medicine (3) and including Chris Barber and David Fishwick 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.” They added “the majority of workers reported to have silicosis were still of working age.”

The paper 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.”

Substandard watchdog

The ‘accelerated’ or rapid onset of some severe cases in the UK and the proportion of younger workers affected is telling.

It means the disease is occurring in workers for whom a substantial part – or in some cases all – of their exposures occurred in the period after the current silica exposure standard of 0.1mg/m³ was introduced in 2006.

HSE estimates that at the current exposure limit of 0.1mg/m³, 30 in every 100 workers exposed over a working lifetime would develop silicosis. Halve the level to 0.05mg/m³ and that drops to just 5 in a hundred, six times more protective.

  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.

The cancer estimates give a better insight into the real extent of the harm caused by silica dust.  HSE’s 2010 report, The burden of occupational cancer in Great Britain, estimated that 2.4 per cent of lung cancer is attributed to past exposures to silica, equivalent to approximately 800 deaths and 900 cancer registrations per year.



RHINESTONE COWBOYS Work in dusty Chinese factories making rhinestones, the artificial gems often found on high street fashion, jewellery and decorative items, is causing silicosis. Researchers found the rhinestone workers developing the disabling disease were on average first exposed to silica dust at age 22 and were diagnosed at 33-years-old. Most of the affected workers were drilling holes into rhinestones. In 2018 DSI London, the company that produces the costumes for BBC’s Strictly Come Dancing, said that around 3.5 million rhinestones are added to costumes during each series. More

HSE acknowledged these cancer figures imply that the incidence of silicosis is likely to be “substantially higher” than the official statistics show “since many such lung cancers would be expected to develop from among highly exposed workers who were also developing silicosis.”

HSE estimates males exposed to silica have a lifetime risk of lung cancer almost 40 per cent higher than for all males. (1)

When it comes to other conditions caused by an overdose of silica dust, no-one is counting the bodies. “Statistics on autoimmune disease due to silica exposures, or the extent to which silica contributes to Chronic Obstructive Pulmonary Disease (COPD), are not currently available,” HSE admitted.

What HSE knows and admits it doesn’t know, suggests an annual death toll that could be in the thousands. It is not just that workers are being exposed to a deadly dust. It is that at the 0.1mg/m³ legal exposure limit for respirable crystalline silica in the workplace, by HSE’s own admission, “significant risks still occur.”(1)

The regulator’s 2009 Silica Baseline Study (4) provided worrying confirmation that HSE had long under-estimated the extent of workplace exposures and had over-estimated levels of compliance by employers in all four industrial silica hotspots investigated – stonemasonry, quarries, construction and brickworks and tile manufacture. It found almost half the stonemasonry workforce could be exposed above the current 0.1mg/m³ silica dust ceiling. In brickmaking the figure was 29 per cent;  in quarries, 18 per cent. In construction it was around 50 per cent, with HSE admitting it “found that in many cases exposure control has not been treated as a priority.”

But HSE didn’t ask again . Ten years after the original shocking results, HSE told Hazards: “The 2009 Silica Baseline Survey has not been updated.” There is, though, evidence little has improved.

A 2015 HSE inspection initiative found over half of stonemasonry firms visited were still not controlling exposures. Since April 2013, HSE‘s pared back inspection programme, which means the chances of most errant firms receiving a visit is vanishingly small, has still discovered over 1,600 instances of UK companies exposing their workforce to criminal levels of silica dust.

A July 2019 paper by John Cherrie of Edinburgh’s Heriot Watt University indicated the numbers at risk were substantial. Citing the 0.1 mg/m³ limit as an example of an “outrageously high” standard, Professor Cherrie, a member of HSE’s Workplace Health Expert Committee, noted: “We estimated that around 26 per cent of workers in Europe were exposed to respirable crystalline silica >0.1 mg/m³ and almost half were exposed >0.05 mg/m³. We estimated that – with no intervention – 440,000 Europeans would die from lung cancer caused by occupational silica exposure between 2010 and 2069.”(5)

In the UK, that would translate to over 150,000 workers exposed above the current limit.

Unlimited harm

It’s a standard that it acknowledges is dangerous, but it is one HSE has defended consistently.  In 2014, HSE told Hazards that even measuring dust levels to a more protective standard than 0.1mg/m³ was “not currently practical within a workplace setting.”

HSE was wrong. The proof was in the public domain and it is hard to believe HSE was unaware of it. US regulators had examined the issue through a protracted federal standard-setting process involving years of evidence from experts, unions, industry and academia.



REGISTER CONCERN  UK union Unite has launched an online register to allow workers who have been exposed to dangerous silica dust to record their exposure. The union says this will assist with potential future legal cases if they experience long term health problems, including cancer. Unite says industries where workers are potentially exposed to respirable crystalline silica include mining, quarrying, foundries, potteries, ceramics, glass manufacturing, stonemasonry, construction and industries using silica flour. More

Hazards covered the slow approvals process throughout. It was a major news story. It was discussed in peer reviewed scientific journals. (6) It was talked about all the way from the workplace to the White House.

The objections to a safer standard raised by HSE also came up at the US hearings and were examined forensically and dismissed as plain wrong. The US went on to reduce its silica exposure standard to 0.05mg/m³, half the current UK limit. (7)

“There is compelling evidence that US OSHA's previous occupational exposure limit of 0.1mg/m³ silica was inadequately protective,” said David Michaels, who was head of the US government safety regulator OSHA and President Obama’s Assistant Secretary of Labor when the new standard was passed.

He told Hazards the health and technical arguments had been thoroughly tested before the standard was approved. “Through a process in which we evaluated studies and testimony from hundreds of experts and held days of public hearings, we determined that reducing the limit to the 0.05mg/m³ silica standard would prevent hundreds of cases of silicosis and cancer each year, and could be met by employers without major pain or disruption. Opponents of the standard took OSHA to court, claiming the evidence did not support the standard and a US Court of Appeals panel unanimously upheld the rule.”

Australia, where a surge in silicosis cases crippling and killing young workers (8) has become a national scandal, is following suit, and is in the process of introducing a 0.05mg/m³ standard. Unions in Australian states including Victoria and Western Australia, as well as the state government in Victoria, are arguing this proposed shift isn’t protective enough and are pressing for a nationwide 0.02mg/m³ standard, five times more protective than the UK limit.

Breathtaking complacency

HSE though has no intention of lowering the UK limit. In 2014, HSE told Hazards it was neither practical nor necessary to tighten the respirable crystalline silica (RCS) occupational exposure limit (Hazards 127). 



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. www.hazards.org/HSEstopkillingus

Today, HSE is still standing by the 0.1mg/m³ standard. “There is a robust regulatory framework in place to protect workers from the health risks associated with exposure to RCS,” an HSE spokesperson told Hazards.

“Under the Control of Substances Hazardous to Health Regulations 2002 employers have a duty prevent or control employee exposure to hazardous substances. Employers are required to put in place measures to control exposures that are appropriate to the activity and the risk to health from RCS, as well as meeting the Workplace Exposure Level (WEL) of 0.1mg/m³.”

HSE added: “The RCS occupational exposure limit value has recently been reviewed at EU level and, as a result, a binding limit of 0.1mg/m³ has been added to the Carcinogens and Mutagens Directive (CMD). This is identical to the WEL already in place in Great Britain.

“The classification of RCS as a carcinogen means dutyholders must not only ensure that the WEL is not exceeded, but also that exposure to RCS is controlled proportionate to the health risk of its classification as a carcinogen.”



TIDY JOB  Proper ventilation equipment and work organisation made sure this job inside Amsterdam’s Schiphol airport minimised silica dust levels. Like several other European Union countries, the Netherlands already has a silica dust standard more protective than the UK’s.

However, the standard agreed at EU level after over a decade of discussion, wasn’t the outcome of a process centring on evaluating and reducing health risks.

The European Commission’s expert Scientific Committee on Occupational Exposure Limits (SCOEL) (9) in 2003 had recommended the EU’s official exposure standard “should lie below 0.05 mg/m³ of respirable silica dust.” It noted that even this standard would reduce but not remove the risk of silicosis.

Hazards has established that HSE argued behind closed doors at the EC’s Advisory Committee on Safety and Health (ACSH) for an EU limit matching the current UK standard of 0.1 mg/m³, and for any new Binding Occupational Exposure Limit (BOEL) to be under the more general chemical agents directive (CAD) rather than the more prescriptive carcinogens directive (CMD). 

It was a position at odds with other national regulators and unions, but wholly consistent with that put by the Employers’ Interest Group on ACSH. This objective was spelled out in 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. The industry paper 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.” (10)

The fact the new EU silica standard is covered by the carcinogens directive was against the express wishes of the industry (11) and HSE. It was one minor victory for health over vested interest. But the ceiling itself – and this limit is the reference point most employers will use when devising workplace controls – will be still stuck at the
0.1 mg/m³ level defended by HSE and which it admits comes with “significant risks.”

EU countries including Finland, Italy, Portugal, Bulgaria, Ireland and the Netherlands already have more protective standards. So has the US, and some Canadian provinces.  Australia is getting flak for proposing a 0.05 mg/m³ standard because unions, experts and at least one state government believe it is nowhere near protective enough.

HSE asserts that while the numbers won’t move, the new style EU “binding” occupational exposure limit will create a more effective, protective 0.1mg/m³ standard.

But Heriot Watt University’s John Cherrie, an expert adviser to the European Commission involved in the development of the EU standard – and one of HSE’s own hand-picked workplace health expert advisers – said binding standards “are neither good nor bad, but rather they are a necessary part of ensuring a safe workplace. However, on their own they are not sufficient to achieve the kind of progress we would like to see. We really need to consider legislation and a health and safety system that promotes a culture of continuous improvement of workplace conditions.” (5)

Commenting on potential beneficiaries of a shift to a tighter 0.05mg/m³ standard for silica, he noted: “The real benefit of low limits is for young workers who will potentially have a large part of their working life in much better conditions than their predecessors.”

In the UK, in a display of breathtaking complacency, the Health and Safety Executive (HSE) is sticking to its guns – a strategy set to choke the life out of another generation of workers.

 

Stop it, you’re killing us

Inside or outside the EU, the UK government can introduce a better standard. It could match the US standard. It could aim high, and introduce like many nations a tighter, more protective standard still.

But HSE, the UK government’s safety regulator, has been a bad actor in Europe. It has been a cheerleader for the dirty rump of industry, undermining those governments wanting to reduce the silica-related disease burden. HSE is guilty of a craven capitulation to a UK government long wedded to the notion of a regulatory light touch, even if that results in a heavy dust burden clouding the lungs of tens of thousands of workers each year. It is time to clear the air.

It is time to tell the Health and Safety Executive (HSE) it has to stand up for decent working conditions that don’t by design come with “significant risks”.

It is time HSE did its job. Make sure it gets this message.

>>> 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. www.hazards.org/HSEstopkillingus

 


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. Silica-related lung cancer is a UK government-recognised prescribed industrial disease. The International Agency for Research on Cancer (IARC) (12) 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.

 

Dusty work gave worker a deadly lung disease

A stone masonry company has been fined after a criminal failure to control silica dust resulted in an employee developing the disabling lung-scarring disease silicosis. Burnley Magistrates’ Court heard how prior to 2017, employees of GO Stonemasonry Limited in Accrington carried out work that resulted in exposure to respirable silica dust.

An investigation by the Health and Safety Executive (HSE) found the firm had been cutting and working with stone for several years without any suitable dust extraction. The company had also failed to ensure that respiratory protective equipment (RPE) was adequately controlling exposure to respiratory silica dust.

The company did not have appropriate work processes, systems or control measures in place and had no health surveillance to identify early effects on workers’ health.
GO Stonemasonry Limited pleaded guilty to a criminal breach of safety regulations and was fined £8,000 and ordered to pay costs of £10,000. HSE inspector Sharon Butler commented: “Exposure to this dust can cause silicosis, leading to impaired lung function, breathing problems and is life-threatening. Simple steps to stop workers breathing in the dust must be taken and companies should know HSE will not hesitate to take action against those failing to protect their workers’ health."

HSE’s silica baseline study, (4) published in 2009, found in the stonemasonry industry approaching half the workforce could be exposed above the 0.1mg/m³ ceiling, and about one in five was potentially exposed to 0.3mg/m³ or more. 

The regulator has no way to know if the industry’s performance has improved. Ten years after the original and shocking results, HSE told Hazards: “The 2009 Silica Baseline Survey has not been updated.”

 

All that glitters is not good

The surging popularity of ballroom dancing could have a deadly consequence. The fake jewels adorning the glittering outfits in their millions are causing deadly lung diseases in those making them. Workers making the rhinestones, the artificial gems often found on high street jewellery, fashion and decorative items, are developing the deadly lung disease silicosis, according to a new study.

Researchers diagnosed 98 cases of silicosis between the years 2006-2012 in a single crystal rhinestone factory in Guangdong province, China. Crystal rhinestones are imitation gemstones with quartz sand the main raw material. Workers in the rhinestone manufacturing industry are exposed to crystalline silica dust when cutting, grinding, polishing and buffing the artificial crystals. Inhaling crystalline silica dust can lead to the deadly lung-scarring disease silicosis, lung cancer and autoimmune conditions.

The authors, publishing their findings in the journal Occupational Medicine, (13) note that the rhinestone workers developing silicosis were on average first exposed to silica dust at age 22 and were diagnosed at 33 years old. Most of the workers who developed the disease were drilling holes into rhinestones.

Lead author Dr Cuiju Wen called for health screening for the workers, adding: “The rhinestones manufacturing industry is labour intensive, most of the activities within the factory involved in this study involve manual work.

“The first step in protecting these workers is to change the manufacturing processes to automatic methods, this will decrease the time that workers are exposed to silica dust. Appropriate ventilation should be installed, workers would benefit from using wet methods and they should be provided with personal respiratory protective equipment.”
In 2018 DSI London, the company that produces the costumes for Strictly Come Dancing, said that around 3.5 million rhinestones are added to costumes during each series.

C Wen and others. Silicosis in rhinestone-manufacturing workers in South China, Occupational Medicine, kqz107, published first online 22 August 2019.

Unite launches silica exposure register

UK union Unite has launched an online register to allow workers who have been exposed to dangerous silica dust to record their exposure. The union says this will assist with potential future legal cases if they experience long term health problems, including cancer.

Unite says industries where workers are potentially exposed to respirable crystalline silica include mining, quarrying, foundries, potteries, ceramics, glass manufacturing, stonemasonry, construction and industries using silica flour.

Unite national health and safety adviser Bud Hudspith said: “Unfortunately many employers remain willing to play fast and loose with the health of their workers. Unite’s primary aim is to ensure employers prevent silicosis and lung cancer through the removal or strict control of silica dust.”

The silica exposure register was developed in Unite’s south east region, where members of the union employed at cable producer Prysmian Cables in Hampshire raised concerns about the long-term welfare of workers.

Michael Hobbs, Unite’s senior steward at Prysmian Cables, said: “The silica register is long overdue; the threat of exposure is a millstone round the necks of workers in many different sectors. Educating and warning workers about the dangers of airborne dust will undoubtedly save lives, so credit should be given to everyone behind launching this much needed campaign.”

 



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. 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.
4. Silica baseline study, HSE, 2009.
5. JW Cherrie. Letter to the editor: Binding occupational exposure limits for carcinogens in the EU – necessary but not sufficient to reduce risk, Scandinavian Journal of Work Environment and Health, volume 45, number 4, pages 423-424, 2019.
G Johanson and Tinnerberg. Editorial: Binding occupational exposure limits for carcinogens in the EU – necessary but not sufficient to reduce risk, Scandinavian Journal of Work Environment and Health, volume 45, number 3, pages 213-414, 2019.
6. Full disclosure: Regulatory agencies must demand conflict-of-interest statements for the research they use. Editorial, Nature, volume 507, issue 7490, page 8, 6 March 2014. Dust regulations trigger backlash, Nature, volume 507, issue 7490, page 18, 6 March 2014.
7. Enforcement Launch for the Respirable Crystalline Silica Standard in General Industry and Maritime, 29 CFR § 1910.1053, OSHA memoranda to regional directors, 7 June 2018.
8. Ryan Hoy, Timothy Baird, Gary Hammerschlag and others. Artificial stone-associated silicosis: a rapidly emerging occupational lung disease, Occupational and Environmental Medicine, volume 75, pages 3-5, 2018.
9. Recommendation from the Scientific Committee on Occupational Exposure Limits for silica, crystalline (respirable dust), SCOEL/SUM/94, SCOEL, November 2003.
10. 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.
11. 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].
12. IARC Monograph Volume 100C. A Review of Human Carcinogens: Arsenic, Metals, Fibres, and Dusts, International Agency for Research on Cancer, Lyon, 2011.
13. C Wen and others. Silicosis in rhinestone-manufacturing workers in South China, Occupational Medicine, kqz107, published first online 22 August 2019. https://doi.org/10.1093/occmed/kqz107.

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Choked

The Health and Safety Executive (HSE) admits its silica dust limit is deadly, but told Hazards there was no way to enforce a more protective exposure standard. Then the US acted. Then Australia. Hazards editor Rory O’Neill says HSE either made a fatal error or just plain lied – and says HSE may need to be forced to put things right.

Contents
Introduction
Breathtaking impact
Substandard watchdog
Unlimited harm
Breathtaking complacency
ACTION - Stop it, you’re killing us
References

Related stories
How does silica dust hurt you?
Dusty work gave worker a deadly lung disease
All that glitters is not good
Unite launches silica exposure register

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 on
silica’s deadly record
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