Health risk management A practical guide for managers in small and medium-sized enterprises

This is a free-to-download, web-friendly version of HSG137 (first edition, published 1995). This version has been adapted for online use from HSE’s current printed version.

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ISBN 978 0 7176 0905 5 Price £6.50

This booklet has been prepared to help the owners and managers of small and medium sized enterprises to control health risks arising from work. It is based on information and experience gained by the Health and Safety Executive, and actual case studies are used to illustrate particular points. Management needs to be competent to deal effectively with occupational health risks.

As a manager you will be concerned if your employees’ health is affected by their work. Management skills can be applied to preventing ill health as part of running a business. The link between the workplace cause and later ill health is not always obvious. This booklet provides a framework and some examples to help you to improve the control of health risks in your workplace.

HSE Books Page 1 of 31

© Crown copyright 1995

First published 1995

ISBN 978 0 7176 0905 5

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means (electronic, mechanical, photocopying, recording or otherwise) without the prior written permission of the copyright owner.

Applications for reproduction should be made in writing to: The Office of Public Sector Information, Information Policy Team, Kew, Richmond, Surrey TW9 4DU or e-mail: licensing@opsi.gov.uk

This guidance is issued by the Health and Safety Executive. Following the guidance is not compulsory and you are free to take other action. But if you do follow the guidance you will normally be doing enough to comply with the law. Health and safety inspectors seek to secure compliance with the law and may refer to this guidance as illustrating good practice.

Foreword The Health and Safety Commission and Executive are convinced that good health and safety management is the key to achieving real improvements in all aspects of health and safety at work, and that this should lead to greater efficiency and cost savings. Improving health and safety management continues to be one of our priority tasks. I believe that this guide will help small and medium sized employers in particular to recognise that managing work-related health risks need not be difficult, and that they can do it successfully. The results will benefit both individual employees and the company as a whole.

Frank J Davies CBE, OStJ Chairman, Health and Safety Commission

Contents Introduction 5

Stage 1 Finding out if you have a problem 9

Stage 2 Deciding what to do 12

Stage 3 Taking action 17

Stage 4 Checking what you have done 20

Where to go for help 22

Final checklist 24

Further reading 25

HSE regional offices 30

Introduction 1 This booklet has been prepared to help the owners and managers of small and medium sized enterprises to control health risks arising from work. It is based on information and experience gained by HSE, and actual case studies are used to illustrate particular points. Management needs to be competent to deal effectively with occupational health risks.

2 Each year more people become ill as a result of their work than are killed or injured in industrial accidents (Box 1). While most diseases caused by work do not kill, they can involve years of pain, suffering and discomfort for those affected. This might include musculo-skeletal problems, respiratory disease, dermatitis and noise induced hearing loss.

Box 1

Approximately 1 million people suffer a workplace injury each year. 2 million people suffer ill health caused or made worse by work. Altogether 30 million working days a year are lost due to workplace injuries and ill health.

3 As a manager you will be concerned if your employees’ health is affected by their work. Management skills can be applied to preventing ill health as part of running a business. The link between the workplace cause and later ill health is not always obvious. This booklet provides a framework and some examples to help you to improve the control of health risks in your workplace.

Table 1 Hazards to health

Hazardous chemicals – if inhaled can cause asthma, bronchitis or cancer; if swallowed can cause poisoning; if spilt onto the skin or splashed into the eyes can cause dermatitis or severe irritation.

Sprains, strains and pains – can be caused by manual lifting of heavy loads. Upper limb disorders (ULDs), so called repetitive strain injury (RSI), can happen if the workstation is poorly designed so that people have to adopt awkward body positions. ULDs can also occur as a result of repetitive or fast movements, poor posture and high forces.

Noise – noise levels which are too high (eg having to shout to be heard) can lead to deafness or conditions such as tinnitus (ringing in the ears).

Vibration – too much vibration, eg from continual use of powered hand tools, can lead to debilitating diseases such as vibration white finger.

Ionising radiation – eg exposure to X-rays, can cause burns, sickness and cancer. Non-ionising radiation such as infra-red and ultra-violet radiation and lasers can all damage the eyes and skin. Microwaves can cause excessive heating of exposed parts of the body.

Extremes of temperature, pressure and humidity – can affect people’s ability to work safely and can cause harmful changes within their bodies, such as heat stress and ‘the bends’ (pressure).

Hazardous micro-organisms – eg bacteria, if inhaled, swallowed, accidentally injected into the skin, splashed into the eyes or allowed to contaminate skin cuts can cause disease, allergy or toxic effects. While the majority of micro-organisms are harmless some can lead to potentially fatal conditions such as legionnaires’ disease and Weil’s disease.

Stress – can affect all employees, not just managers. It is often behind a lot of sickness absences. It can contribute to coronary heart disease and illness caused by high blood pressure.

4 Many employers wait for a health problem to arise before doing something about it, but this can result in:

n employees being made ill or even killed, n lost time; n unplanned changes to the work; n retraining; n bad publicity; n investigation by health and safety inspectors; n employees taking early retirement, employees with a reduced quality of life; n court fines and legal fees; n compensation claims; n increased insurance premiums.

What the law requires

5 There are legal duties on employers to prevent ill health which can be caused by work. The two main pieces of law are the Health and Safety at Work etc Act 1974 (HSW Act) and the Management of Health and Safety at Work Regulations 1999 (MHSW Regulations) as amended.

6 Under the HSW Act, employers have to ensure so far as is reasonably practicable the health and safety of employees and others who may be affected by their work. The Act applies to all work activities and premises. Employers are required to provide suitable plant and systems of work, to train, instruct, inform and supervise employees so that their health at work is not affected. Employees have responsibilities under the HSW Act not to endanger themselves or others.

7 The MHSW Regulations build on the HSW Act and include duties to assess risks and make arrangements for health and safety by effective:

n planning; n organisation; n control; n monitoring and review.

HSC’s Approved Code of Practice on the MHSW Regulations gives guidance on what is meant by these terms. This guide gives more detail, particularly in relation to health risks.

8 The MHSW Regulations also contain duties for health surveillance which is about looking for early signs of ill health caused by hazards at work. In addition all employers are required to appoint a competent person to assist in complying with health and safety legal requirements and in the design and use of protective measures. The person appointed to assist could be one of your managers who has been properly trained to do this, although if the risks are complicated, or their management involves special knowledge, you may need to involve people from outside your business (see Table 2, p 23).

9 In addition there are several laws (Box 2) that relate to specific risks to health at work, such as lead, asbestos, chemicals and noise, and some that relate to particular industries (Box 3). Look at them to find out what you must do.

Box 2

Examples of health and safety legal requirements for specific health risks at work

Control of Substances Hazardous to Health (COSHH) Regulations 2002 Control of Lead at Work Regulations 2002 Ionising Radiations Regulations 1985 Control of Asbestos at Work Regulations 2002 Noise at Work Regulations 1989 The Manual Handling Operations Regulations 1992 The Health and Safety (Display Screen Equipment) Regulations 1992

Box 3

A company employing 250 people in the manufacture of bathroom fittings described the health and safety legislation relating to their industry as providing ‘a framework for action’. The legislation pointed to those risks they should give priority to and how to take steps to manage the risks.

Being a traditional industry they were able to draw on a range of existing specific guidance and established industry practice.

What is health risk management?

10 Health risk management is about identifying and controlling health risks before they can cause problems and lead to the losses described in paragraph 4. To do this you need to:

n find out if you have a problem; n decide what to do based on what you have found out; n act and put the decisions into practice; n check that the action has made the intended improvements.

This is what good health risk management is all about.

11 For this approach to work there needs to be commitment at the top of your organisation to achieving better health risk management. This should be expressed in a clear policy for health and safety which influences all your activities in a practical way. It should be clear about who is responsible for what, and the arrangements for identifying hazards, assessing risks and controlling them. Managers need to demonstrate their commitment to other members of the workforce and be the driving force behind making improvements. If you are not motivated neither will be the rest of the workforce. As a manager you are the key to what does or doesn’t happen to improve health at work.

Box 4

‘In a survey carried out of small companies who had a good control of health risks the one common factor identified was the commitment shown by top management.’ Quote from HSE inspector.

12 Good health risk management is also about teamwork. Talk to the workforce and involve them in sorting out problems and encourage early reporting. Use the knowledge and skills within your company; ask employees, their representatives, and members of the health and safety committee for their views and ideas. Tell the workforce about any changes in face to face talks, via posters and company leaflets. Remember that employees may need to be retrained following any changes, and safety representatives either appointed under the Safety Representatives and Safety Committees Regulations 1977 or the Health and Safety (Consultation with Employees) Regulations 1996 will need to be consulted in advance.

Stage 1 Finding out if you have a problem Look for the hazards. ‘Hazard’ is anything that can cause harm (see Table 1).

13 The starting point in managing health risks is finding the hazards in your workplace, and there may be a wide range. Some hazards to health are not as immediately obvious as others. For example some substances give off invisible vapours and dusts, large quantities of which may be produced during handling activities.

To pinpoint hazards:

n walk around the workplace – take a fresh look at the way employees work, look at what they work with, look at what is already done to protect their health (Box 6 gives an example of how to do this); n talk to employees – ask them if their work affects their health; n get advice from suppliers of equipment, chemicals and other materials used at work (Box 5); n read safety data sheets, manufacturers’ and suppliers’ guidance.

Remember, radiation and micro-organisms cannot be detected just by looking.

Box 5

Suppliers of hazardous substances are required to provide information to users which includes:

n safety data sheets; n proper labelling designed to make hazards and necessary controls clear.

Some suppliers may also provide:

n training in the use of their products; n workplace surveys on exposure to health hazards.

A fee may be charged for training and surveys, so ask your suppliers what help they can give you. For further information about this see Chemicals (Hazard Information and Packaging for Supply) (Amendment) Regulations 1997 known as CHIP.

Suppliers fo work equipment are also required to provide users with hazard data including:

n noise and vibration emissions; n advice on safe use.

Box 6 Manual handling

As you walk around the workplace, look out for the following activities:

n strenuous pulling or pushing; n whether more than one person is required for the task; n over-reaching; n repetitive handling; n reaching above shoulder height; n getting into awkward postures; n lifting heavy or awkward loads; n carrying for long distances; n lifting in awkward places.

Looking for these activities will help you decide if you have manual handling problems in the workplace.

Provision of a simple manual handling aid can eliminate the need to carry loads

14 Changes to the law or new guidance can be a spur to tackling long standing problems (Box 7).

Box 7

Managers at a hospice were alerted to new legislation on manual handling and ways of tackling problems through their professional literature. They identified that the nurses had not been properly trained in how to lift patients safely, and as a first step designed and introduced a thorough training programme.

15 If, for example, you handle a lot of chemicals, do not assume that your hazards to health will be associated only with chemicals. Find out whether there are other health hazards at your workplace such as noise from the process and manual handling problems in moving bulk chemical materials. At the back of this booklet is a list of other HSE guidance to help you tackle particular risks.

Lifestyle and work

16 Some health problems can be caused both at work and at home. Handling chemicals in the workplace can cause dermatitis, as can washing powder used at home. Lifting heavy loads at work can cause back injury, as can, for example, moving furniture at home and leisure activities. Some existing health conditions can be made worse by work; a heavy smoker is more likely to suffer breathing problems following exposure to chemicals at work.

17 Be aware of the overlaps between work and non-work health risks. Legally, as an employer you need to tackle only work-related risks but many companies do not distinguish between the two. They deal with health risks at work and also promote the need for employees to look after their health by, for example, giving advice on smoking and drinking, diet, and exercise. This is one company’s reason: ‘If someone does not turn up for work because of a bad back caused by work here or in their garden, the result for us is the same – no work’.

Checklist Hazards Have you looked at how work is carried out in your workplace?

Have you found which hazards exist?

Have you looked at available information, eg labels, suppliers’ safety data sheets?

Have you found out what your employees and their safety representatives think about the effect of work on their health?

Have you considered who can help you?

Stage 2 Deciding what to do 18 Having found out what health hazards are present in your workplace you need now to decide what needs to be done so that your employees’ health is not harmed. It may be that what you already do is enough but you cannot decide this properly until you have gone through the following steps.

Who might be harmed?

19 First, you need to identify who may be at risk. Think about those workers, for example, who handle chemicals, operate noisy machines or who have to lift heavy or awkward loads manually. Don’t forget the risks to cleaners, maintenance and part-time workers. Could other people be harmed by what goes on in your place of work, for instance sales representatives, suppliers, customers and members of the public?

How big are the risks?

20 The next step is to decide how big are the risks to health in your workplace. ‘Risk’ is the chance or likelihood of someone being harmed by a hazard. For example, paints containing isocyanates are a hazard to health. Breathing in isocyanates can cause asthma. The health risk is the chance that someone’s lungs will be damaged. Whether this happens will depend upon:

n the amount of isocyanate in the air; n how often the job is done. Is it all day every day or once or twice a year? n the work method – how the paint is used, eg if it is sprayed the risk will be greater than if brushed on; n the number of people that could be affected – is just one person working with the paint or many? Could their work affect others? n what could go wrong? n are the precautions (exhaust ventilation, personal protective equipment) already taken sufficient? How do they compare with good practice and HSE or ‘trade’ guidance?

21 Answering these sorts of question is what is meant by risk assessment. Further guidance can be found in the free HSE leaflet Five Steps to Risk Assessment. It is useful to write down the results of risk assessments as you may need to look