Occupational cancer - preventative action

Preventive action and early identification

The Health and Safety at Work etc Act 1974 requires employers to secure the health (including mental health), safety and welfare of employees at work. This includes providing a safe place of work, safe systems of work, and information and training.

The Management of Health and Safety at Work Regulations 1999 (as amended) require suitable and sufficient assessments of health and safety risks at work to be carried out - this includes the risk of stress-related ill health.

The Equality Act 2010 consolidates, harmonises and expands on existing discrimination law. It gives rights to people who have or have had a disability which makes it difficult for them to carry out day-to-day activities. The disability could be physical, sensory or mental. Find out more by visiting the Macmillan Cancer Support website.

More relevant legislation

The Carcinogens Directive (90/394/EEC) requires employers to replace a carcinogen with a substance which is less harmful. Where replacement proves technically impossible, the employer must make sure that workers’ exposure is reduced to as low a level as possible. This directive also provides for occupational exposure limit values to be established.

The purpose of the Chemicals (Hazard Information and Packaging for Supply) Regulations 2009 is to protect people and the environment from the effects of dangerous chemicals by requiring suppliers to provide information about the risks and to package them safely.

The Classification, Labelling and Packaging Regulations (CLP), EC No 1272/2008 were introduced to implement the globally harmonised system on the classification and labelling of chemicals throughout Europe. These regulations will be enforced alongside CHIP regulations in the UK, eventually replacing them completely in 2015.

EC 1907/2006 - Registration, Evaluation, Authorisation and restriction of Chemicals (REACH) aims to protect human health and the environment from the use of chemicals. It makes manufacturers and importers responsible for understanding and managing the risks associated with chemicals and enhances innovation in the chemicals industry, making workplace substances safer.

The Control of Substances Hazardous to Health (COSHH) Regulations 2002 (as amended) require employers to assess the risk posed to their employees by substances hazardous to health, and to prevent or adequately control those risks using a hierarchy of control measures. The regulations also require health surveillance in some circumstances under medical supervision. Health surveillance records might need to be retained for 50 years, even after the employee leaves, as the ill health effect might not emerge until long after exposure. There is also a requirement to ensure employees receive information, instruction, training and supervision for substances they might use.

The Workplace (Health, Safety and Welfare) Regulations 1992 aim to make sure workplaces meet the health, safety and welfare needs of each member of the workforce, which may include people with disabilities.

The Personal Protective Equipment at Work Regulations 1992 seek to ensure that where the risk can’t be controlled by other means, personal protective equipment (PPE) is supplied. The regulations also require that PPE should be suitable for the task, adequately maintained and correctly worn. PPE means all equipment (including clothing that protects against weather) which is intended to be worn or held by a person at work and which protects against one or more risks to health or safety, and any addition or accessory designed to meet that objective.

The Ionising Radiations Regulations 1999 apply to a wide range of workplaces where radioactive substances and electrical equipment emitting ionising radiation are used. They also apply to work with natural radiation, including work in which people are exposed to naturally occurring radon gas and its decay products. The regulations require employers to keep exposure as low as reasonably practicable. Exposures must not exceed specified limits and should be restricted first using engineering control and design features. Where this is not reasonably practicable employers should introduce safe systems of work and only rely on the provision of PPE as a last resort.

The Control of Asbestos Regulations 2012 prohibit the importation, supply and use of all forms of asbestos. They also continue to ban the second-hand use of asbestos products such as asbestos cement sheets and asbestos boards and tiles. If existing asbestos-containing materials are in good condition they may be left in place but must be monitored and managed to ensure they are not disturbed. The regulations require mandatory training for anyone liable to be exposed to asbestos fibres at work. This includes maintenance workers and others who may come into contact with or who may disturb asbestos (eg cable installers) as well as those involved in asbestos removal work. Most asbestos removal work must be undertaken by a licensed contractor but you should check the regulations to find out what actions are required.

The Employment Rights Act 1996 and Employment Act 2002 set out many of the statutory rights that most employees can get when they work, including unfair dismissal, reasonable notice before dismissal, time-off rights for parenting, redundancy and the right to request flexible working time.

You can get more information on these pieces of legislation on the Office of Public Sector Information and HSE websites. The European Agency for Safety and Health at Work outlines a variety of European Directives which have become law in the UK.

Identifying the cause of the problem

Occupational cancers are a leading cause of work-related death and despite their devastating effects, cancer-causing agents are still used in the workplace. Developed nations are adopting innovative working practices and introducing stringent laws to control exposure to those substances or use less harmful ones. However, the same cannot be said for all of the developing nations.

Control measures

Thousands of people die each year from cancer due to occupational causes. According to the World Health Organization (WHO), 20-30 per cent of males and 5-20 per cent of females in the working-age population could have been exposed to an occupational lung cancer risk during their working lives. Therefore, it’s important to correctly identify carcinogens used in the workplace and put adequate control measure in place to reduce the risk of exposure and harm. This can be achieved by:

  • identifying any possible carcinogenic substances being used in the workplace (look at the labelling material data sheets or other information such as the schedules in the COSHH regulations)
  • identifying the likely level of exposure and possible emissions or spread of carcinogenic substances determining whether a less harmful substance could be used or produced looking into engineering controls to completely enclose the process of using or handling of the carcinogenic substance if it can’t be substituted
  • looking at engineering controls to reduce exposure such as partial enclosure and local exhaust ventilation if total enclosure isn’t possible
  • developing a process or system of work to reduce exposure using PPE - this is an important part of the control programme, but it must not be the sole element and must be used in combination with other controls
  • keeping stocks in closed and clearly labelled containers in secure areas
  • ensuring any waste or emissions are correctly controlled.

Risk management programme

Control of carcinogens should sit with your risk management process. There are several ways of conduction risk assessments, but it's essential that the process you use identifies the risks and those who might be harmed and that control measures are put in place to reduce the risk of harm.

The HSE provides a template model in its five steps to risk assessment:

  • identify the hazards
  • decide who might be harmed and how
  • evaluate the risks and decide on precautions
  • record your findings and implement them
  • review your assessment and update if necessary.

The HSE’s COSHH essentials website provides advice on controlling the use of chemicals and was developed to help firms comply with the COSHH regulations. Users are asked for information about the process, tasks and use of chemicals before being offered advice.

It’s important to follow the requirements in the regulations and associated guidance documents relating to the particular carcinogen you are using. The Approved Code of Practice for COSHH contains a lot of useful guidance on how to comply with the regulations.

Health surveillance under the supervision of a medical practitioner might be required for employees who are, or who are likely to be, exposed to substances that are hazardous to health. Health surveillance helps employers and employees detect any signs of ill health at an early stage and reduce exposure to substances if there’s a problem. It also allows the employer to determine whether the controls put in place are working.

The HSE’s Understanding health surveillance at work offers brief guidance for employers, which is further expanded in Health surveillance at work.

The TUC’s workSMART site also provides information on health surveillance for employees.

If PPE is used as one element of the risk control programme (it must not be the sole measure used to reduce exposure), it must be:

  • suitable for the substance used and work activity
  • fit properly (which would mean face fit testing for respiratory protective equipment)
  • disposed of properly or cleaned
  • stored properly
  • maintained if it is non-disposable.

Under the various regulations regarding carcinogens, employers have a duty to provide employees who may be exposed to a hazardous substance with information, instruction and training on the possible risks to health, and the precautions and control measures they should take. This should cover specific signs and symptoms to be aware of. Employees should be advised to report any problems and taught how to conduct self examinations for symptoms linked to the carcinogen they are using.

The effect of some carcinogens can be increased by other factors such as smoking or drinking, so it could be beneficial to provide information on healthy lifestyles, such as giving up smoking, eating healthily and being more active.