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Hazards special online report, March 2013
Public peril: HSE’s risk menu only gives a taster of the true death toll
The Health and Safety Executive is downplaying dramatically the deadly harm caused by work, believes Roger Bibbings. The Royal Society for the Prevention of Accidents (RoSPA) expert says this undermines the safety watchdog’s rationale for exempting most workplaces from preventive inspections.

The plan to end Health and Safety Executive (HSE) inspections in ‘lower risk’ workplaces repeats changes already implemented under the Department for Work and Pensions’ March 2011 ‘Good health and safety, good for everyone’ strategy.

“Car and van drivers who cover 25,000 miles annually for work face the same risk of being killed in work as someone working on a trawler.”

Vince Cable’s plan includes a legally binding statutory code, to be introduced in April 2013, explicitly outlawing proactive inspections of all but ‘high risk areas’. This is under the guise of removing unnecessary red tape and putting “common sense back into areas like health and safety.”

I believe this latest move can be traced back to a hopelessly outdated misconception peddled in Lord Young’s review, which claimed that most modern work environments were ‘low risk’ and health and safety was really only about the ‘high risk’ workplaces associated with construction and traditional manufacturing industries.

But that is a far cry from reality.


Crude approach

HSE SKEWERED  RoSPA’s Roger Bibbings warns that HSE’s retreat from inspection is informed by ‘badly skewed’ intelligence.

HSE’s criteria for deciding what is ‘high risk’ are quite crude. For example, they do not take into account the number of deaths to members of the public. I believe HSE has always seen Section 3 of the Health and Safety at Work Act (the duty to protect non-employees) as a secondary part of its duties.

The HSE proposal to limit RIDDOR reporting of work-related injuries to members of the public in future to only deaths, as opposed to A&E attendances, may be symptomatic of its attitude to its role concerning protection of the general public from work-related risks.
According to latest HSE data, there were 90 members of the public fatally injured in accidents connected to work in 2011/12, excluding railways-related incidents. This is a significant addition to the 173 worker deaths featured in HSE’s headline figures. The actual figure could be much higher, considering RoSPA’s ‘Big book of accident prevention’ cites there are about 14,000 accidental deaths from all causes every year in the UK.

I believe there are many more non-worker work-related fatal injuries than appear in the current statistics. This is due to deaths often being misclassified in coroners’ reports. It ought to be possible to get a handle on this from these reports, particularly since there has been an increase in coroners recording narrative verdicts – with more than 3,000 narrative verdicts in 2009, compared with 111 in 2001.


Public priority

In an increasingly customer facing, service-based economy, protecting the public has become as important as the protection of workers. And good risk management to protect workers also helps protect the public.

The much more important consideration, however, is that work-related health damage kills at least 100 times as many people every year as workplace injuries. If you stick with mortality as the benchmark and include not only deaths of members of the public but fatal occupational disease and work-related road deaths, the picture looks very, very different.

FELL LUCKY? A chance sighting by a passing HSE inspector meant work on this potentially deadly Oldham scaffold was stopped, protecting workers and the shoppers passing below. In February 2013, Stretford Scaffolding Ltd received a 12-month conditional discharge and a costs order of £1,849 after admitting a criminal safety offence.

If you include long term morbidity this picture becomes even more challenging, especially when you take into account chronic work-related ill-health conditions, like stress and back pain, which affect millions of people at work.

The modern world of work continues to change, but if anything the risk menu is becoming even more challenging, particularly in relation to occupational health.

Lord Young, in his review ‘Common sense common safety’, was far too simplistic when he split employment sectors into alleged ‘low hazard’ workplaces, such as offices, shops and schools, as opposed to ‘major hazard’ sectors, such as construction and manufacturing. The risks to safety on building sites, in foundries and in heavy engineering are well known, but there are still very many serious health and safety issues to be tackled in what Lord Young termed ‘low risk settings’.

It was quite telling that Rory O’Neill’s research revealed that 53 per cent of the 258 deaths in HSE-enforced workplaces between April 2011 and October 2012 were in sectors exempt from proactive inspections - and that there were at least 37 ‘sectors without inspectors’, including agriculture, quarries, plastics, electricity generation and supply, and other industries, which are acknowledged by the HSE to be ‘higher risk’ (Hazards 120).

Even small, service-based firms, which might at first glance seem quite safe, will certainly have significant problems, such as fire and occupational road risk, not to mention issues with slips, trips and falls, stress and manual handling injury, as well as possibly threats and violence. Then there are likely to be facilities management issues, including safe access and egress, safe cleaning, safe storage, safe vehicle parking, lifts, gas and electrical safety, even possibly asbestos and Legionnaires’ problems [see: Hospital guilty after Legionnaires’ deaths].

It is also notable following the recent Legionnaires’ outbreaks in Edinburgh and Stoke that it took preventable deaths occurring outside traditional high hazard sectors to cause the government to shift inspection priorities.

The inescapable fact is that the distribution of Britain’s workforce has continued to change dramatically since the 1974 Health and Safety at Work Act was introduced. More people work in offices, call centres, shops and so on. There may be fewer fatal and major injuries in these settings, but troublesome minor injuries still occur and ill-health and well-being issues have now become much more important than accidents.

Across the whole economy, absence due to work-related ill-health is many times that due to accidental injury.


Bad language

A real problem is that people get ‘hazard’ and ‘risk’ mixed up. So what we have got to help get across to people, like Lord Young, is that it is the risk profile of jobs and not necessarily the hazard profile of work environments that is critical. Ragnar Löfstedt, in his review, hit the nail on the head when he said that we all needed to become more “risk literate”, calling on government to do more about it.

Low hazard can still mean high risk and vice versa. For example, if you work in an office but suddenly have to do a lot of work-related driving your risk profile increases dramatically. Car and van drivers who cover 25,000 miles annually for work face the same risk of being killed in work as someone working on a trawler.

If you are in a customer-facing role you are likely to face threats or even assault. If you work long hours in a call centre you are likely to face stress and ergonomic problems such as musculoskeletal disorders.

This is not just a question of a person’s proximity to the traditional forms of high kinetic or potential energies found in manufacturing, agricultural or construction environments. And many of the issues which cause accidents at work such as slips and trips – which account for 40 per cent of work-related injury causing people to have time off work - are in fact common to industrial and non-industrial settings.

I realise that HSE will always have to prioritise proactive inspection efforts (not that they have much resource left over for this after dealing with reactive work) but the present criteria for deciding what is a ‘high risk’ sector are extremely arbitrary.

Unless these criteria encompass the full risk menu, including areas like risks to the public, road risk and fatal occupational health risks, HSE’s approach is going to continue to be badly skewed.


Hospital guilty after Legionnaires’ deaths

A hospital has admitted failing to protect the public from deadly Legionnaires’ disease. The Health and Safety Executive (HSE) prosecuted Basildon University Hospital following a series of cases of the disease, two fatal. James Compton, 74, from Billericay, died in 2007, just after cost-cutting reductions in a water treatment programme came into effect.

Raymond Cackett, 54, died from Legionnaires’ in March 2010. Six further patients - Egbert Van Nuil, Lyn Kilshaw, Roy Leech, Joyce Limbert, Francis Nutt and Verona Hughes - were also infected. The hospital admitted at Chelmsford Magistrates' Court a criminal failure to protect patients and visitors between 28 February 2004 and 31 December 2010. The case was transferred by magistrates to Chelmsford Crown Court for sentencing, where the trust could be handed a six figure fine.

Clare Panniker, chief executive of Basildon and Thurrock University Hospitals NHS Trust, said the hospital had spent £3m and introduced a number of changes in the past decade in an attempt to control legionella.

Pascal Bates, from the HSE, said the hospital's procedures on legionella fell “markedly short”.  He added: “The problem went to board level. The hospital had numerous warnings from regulators and consultants which weren't followed.” In the financial year 2006/07 the hospital reduced its water treatment programme to save money, the court heard. “That was an inappropriate cost saving measure,” Mr Bates said.

The court was told that the hospital trust had been prosecuted before and fined £25,000 over the death in 2002 of 77-year-old George Bate from Legionnaires’ disease. Chairman of the bench Peter Rose said the case had been going on for “an extraordinarily long time, nearly seven years.”

A dramatic decline in HSE legionella inspections, which fell from 833 in 2009 to 464 in 2011, is to be reversed, HSE indicated in December 2012. This followed deadly outbreaks in Edinburgh and Stoke-on-Trent in 2012, in which over 120 people were affected and five died. HSE said it now wanted all cooling towers and evaporative condensers to be inspected in an 18 month programme.

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Public peril

The Health and Safety Executive is downplaying dramatically the deadly harm caused by work, believes Roger Bibbings. The Royal Society for the Prevention of Accidents (RoSPA) expert says this undermines the safety watchdog’s rationale for exempting most workplaces from preventive inspections.


Crude approach
Public priority
Bad language

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Hospital guilty after Legionnaires’ deaths


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