Your good health

In the nine months to December last year 92 workers died on site. Over 5000 others suffered some form of major injury, and a further 100 000 were absent for at least three consecutive days due to work-related accidents.

These shocking statistics were highlighted at a recent seminar part-funded by the European Commission and aimed at small to medium-sized enterprises: Health and safety in the construction industry. Perhaps more shocking is that despite legislation and the increased awareness of health and safety issues, the annual number of fatalities has been steadily rising since 1998/99, having been in gradual decline in the preceding nine years. "More people are killed today than ten years ago...but the rates would be far higher if the legislation was not in place," Phil James, group safety, health and environment manager at EC Harris told the audience.

Construction workers are said to be six times more likely to have an accident at work than those in other UK industries.

The causes
Falls were by far the biggest killer of construction workers in the five years to April 2000: 47·5% of fatalities were due to high falls, with other falls accounting for a further 4·2% (figure 1). Electricity was responsible for 5·8% of fatal accidents in the construction sector over this period – killing 23 people.

Of the major accidents, where workers suffered a serious injury, falls remained the biggest problem at 39%. However in this category falls from lower heights exceeded those from higher levels (20·2% compared to 18.8%). Emma Davies from the HSE's construction sector confirmed that "most falls are from heights of 2 m or below".

Other principal areas of major accidents were trips (18·8%), handling (7·9%) and being struck by objects (17·4%). Electricity remains a cause of major accidents (2%), and minor incidents that cause at least a three-day absence from work (1%). But it is not only accidents that are affecting the workforce, as Peter Buckley, the head of the HSE's construction sector, reported: "Despite the appalling toll of people who die each year from accidents, six times that number die from asbestos-related diseases."

In total, the HSE recorded 122 000 cases of ill health in its 1995 survey of the industry. This survey is carried out at five-yearly intervals and shows up any health problems that may not otherwise be accounted for. It is sent to the homes of construction workers and they must report on the work they have carried out over the preceding period.

Of the total, 96 000 cases were musculoskeletal disorders, 15 000 cases were respiratory diseases, 6000 cases were skin diseases and 5000 were noise-induced hearing loss.

The financial implications
"Accidents are a hidden cost," said Phil James. "Some proactive companies realise that health and safety is a cost but can save money in the long run."

"Daytime television," he suggested "could have the biggest impact on health and safety. One in five adverts during the day are now for claims companies and the UK is becoming more like the USA in terms of suing."

As well as the costs of injuries and accidents and the possibility of losing work, additional dangers are coming to the fore for those who ignore the risks. "Proposals on corporate manslaughter legislation and stiffer penalties are raising health and safety up the corporate agenda," said James, adding that there is a "real possibility that a director of a company will serve a custodial sentence as a result of a serious accident at work." As well as the legal costs this needed to fight a case in court, the company could then be faced with the need to replace this person if found guilty. The publicity that would arise from such an event would also be sure to be detrimental to winning future work.

Andrew Staniforth, account director with contractor Pearce, agreed: "The positive financial implications far outweight the negatives."

Typical costs to ensure health and safety standards stem from training, administration and the use of consultants, as well as enforcing legislation on site. The benefits include improved industry status, a better track record, higher scores on client audits, increased site production and more easily managed sites as well as the more obvious reduction in accidents and personal ill health.

Controlling the risks
The first step to controlling risks is identification. "Greater consideration is needed at the design stage," stressed the HSE's Emma Davies. "Designers must consider the health and safety risks during construction and maintenance. It's easier to make changes on a piece of paper than on site."

It is essential that the dangers are considered at this point. Phil James agreed: "Some clients and designers see health and safety as the contractor's problem." This can cause its own problems: "A client can understand the dangers, but on seeing a design they like, the health and safety considerations may not be accounted for. Clients must accept that they have a role to play in assisting the main contractor."

There are methods to prevent accidents; some are legislative, but many are just common sense. The highest numbers of fatal falls are from roofs, followed by falls from scaffolds. But, stated Davies: "The reality is that most of these could have been prevented if the right equipment had been provided and used."

Planning is another key factor of safe working, said Davies. There is a hierarchy of safety that should be applied when using a working platform, for example, and these steps must be planned and considered before going on site.

Transport injuries can also be reduced dramatically by preplanning before a project starts on site. By looking at the infrastructure and designating access and loading points, pedestrian walkways and traffic routes on a site at the design stage, the risks of contact between workers and vehicles can be reduced.

Everyone who enters a construction site is in danger of being struck by a vehicle if inadequate segregation of pedestrians is used. "Drivers need as much help as possible," said Davies, "as visibility from some vehicles can be restrictive." By having defined routes for walking and driving on site, safety is increased but routes must also be usable – if they are longer than necessary or are too narrow they may not be used at all.

Preplanning can be used to reduce physical dangers on sites, but how can health problems be tackled? Identification and prevention are the key factors.

"You have a legal duty to control the health risks you create," the HSE's Nichola Elvy reminded delegates. Currently 2000-3000 people die every year from asbestos-related cancers in the UK alone, according to the HSE. Another big area of concern is skin cancer. "The most common place to get skin cancer is on the forearms," said Elvy. Employers can help reduce the risks with training, but more stringent preventative measures can be enforced: "Make it a site rule that workers must wear long-sleeved tops," suggested Elvy, "and create summer rest zones in shady areas." Employers should also encourage workers to check their skin regularly.

The risk of musculo-skeletal disorders can be reduced by careful planning at the design phase of a project. "One-third of all construction industry accidents reported to the HSE involve manual handling," Elvy told the audience. Best practice working methods and preplanning can help by arranging the construction so that manual handling can be avoided or minimised. Materials being delivered directly to the place where they are actually needed removes the need for carrying loads across sites, and the designer or contractor could specify smaller or lighter materials.

On a financial note, Phil James advised: "Adequate resources need to be ring-fenced in the tender by the client for the contractor to manage health and safety effectively." The client can also use its power in other ways: "The client can state to the main contractor who they do and don't want to work on their site." This effectively would ensure control over the working methods and procedures applied on a site are complied with.

As seminar chair Robert McNally so aptly said: "Responsibility lies not only with government but with everyone on site. We all need to adopt a safety first culture." Your life depends on it.