Night-Shift Work – a link to breast cancer in women?
It is well established that there can be undesirable consequences for those working shifts outside standard daytime hours, particularly those covering the night or with early morning starts. Over the past few years, evidence has been emerging that suggests that night shifts are bad for you. Typical symptoms include: fatigue, disturbed sleep, digestive problems and a greater risk of accidents at work. Some studies also show a higher risk of breast cancer in women who sleep for fewer hours at night.
Danish Government pays out for breast cancer in shift workers
In March 2009, the Danish government paid compensation to around forty women who had developed breast cancer after long spells of shift work involving working at night. This decision followed a ruling by Agency for Research on Cancer (IARC, which is part of the United Nations World Health Organisation) that night shifts probably increase the risk of developing cancer. Part of the function of the IARC is to study and rank cancer risks. Category One risks are known carcinogens, including asbestos, but night-working has been categorised as only one level below that, i.e. a probable cause of cancer. The IARC reached this conclusion after looking at a wide number of studies in humans and in animals. A report published in the Journal of the National Cancer Institute reported a 36% greater risk of breast cancer for women who had worked night shifts for more than 30 years, compared with women who had never worked nights.
A hormonal mechanism for breast cancer
When faced with a diagnosis of cancer, people want be able to identify a single factor in their history that they can identify as the single cause of the disease. Cancer, however, is a complicated disease and rather than thinking in terms of a single cause, its best considered as being the result of a combination of many factors, which all have a small, but significant, contribution. In the case of breast cancer these factors would include: the woman’s genes, her age, her weight, her race, how much she drinks, when she started (and stopped) her periods, how many children she has had, whether (and for how long) she took birth control pills or hormone replacement therapy, and how long she breast-fed.
In 2001, several epidemiological studies providing evidence linking breast cancer in women with prolonged periods of working at night were reported. Within these studies, a biologically plausible mechanism related to the suppression of melatonin was suggested as a potential explanation for these findings. According to this theory, this association arises from reductions in serum levels of melatonin that follow from nocturnal exposure to light. Melatonin is known to suppress tumour growth in experimental animal models, and reduced melatonin levels may increase ovarian oestrogen release. In the normal pattern of life, our eyes sense the reduction of natural light levels. This triggers the pineal gland to begin the secretion of the hormone melatonin and as the melatonin levels rise in our bodies we tend to get sleepy. In women, as the melatonin levels rise, the production of the female sex hormone oestrogen decreases. It is believed that the production of oestrogen stimulates the growth of breast tissue including some breast cancers. It may be considered that more light results in less melatonin and in more oestrogen, which means a greater risk of cancer.
Information from studies
Nurse study - In 1988, nearly 80,000 nurses who had no history of breast cancer were questioned about previous overnight shift work. The study participants were then followed for ten years. The resulting analysis was then adjusted for potential confounding factors and it was found that women who had worked rotating night shifts for 30 years or longer had significantly increased risk for developing breast cancer compared with those who had never worked night shifts (a relative risk of 1.36). Among nurses with less than 30 years of shift work, risk was slightly elevated but fell just short of significance (a relative risk of 1.08).
Second study - In a separate study, 813 women with breast cancer were compared with 793 age-matched controls. A history of overnight shift work during the previous 10 years was associated with significantly increased risk for breast cancer (an “odds ratio” of 1.6, after adjustment for other risk factors). Breast cancer risk was also found to be increased significantly among women who frequently did not sleep during the middle of the night for any reason (there was an “odds ratio” of 1.7 for the group with at least 2.6 nights per week of interrupted sleep).
Danish Study - In a population-based case-control study, the breast cancer risk among Danish women aged between 30 and 54 who worked predominantly at night was investigated. Individual employment histories were reconstructed back as far as 1964 for each of 7035 women with breast cancer along with individually matched controls from the records of a nationwide pension scheme with compulsory membership. The “odds ratio” for breast cancer among women who worked at night at least half of a year was 1.5 and there was a tendency to increasing odds ratio by increasing duration of night time employment.
Practical steps to reduce the risks of breast cancer - for shift workers
Shift workers can reduce their personal risk by eliminating some lifestyle risk factors, by:
• stopping the use of tobacco
• keeping alcohol intake moderate
• exercising regularly
• maintaining a healthy weight
• getting enough sleep on a regular basis
• make sure that their bedroom is completely dark when they sleep (both at night and during daytime, to make sure that melatonin secretion is not affected)
“Be Breast Aware” – there is a free leaflet available from the NHS in a range of languages. Breast aware encourages women to:
• Take care of your own well-being
• Know what is normal for you
• Know what to look and feel for
• Report any changes without delay
• Attend for breast screening if aged 50 for over
Practical steps to reduce the risks of breast cancer - for the employer
• Train and educate shift workers on what constitutes a healthy lifestyle and how to achieve it and maintain good quality sleep
• Design shift schedules to allow sufficient rest and provide the opportunity to obtain adequate sleep.
• Keep overtime at a healthy level
• Introduce health surveillance for night shift workers
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Sunday 28 February 2010
Spray Painting - Health & Safety considerations
The nature of spray painting operations means that they create the potential for employees (and others) to be exposed to substances that are hazardous to health. These substances include: solvents (often refer to as or thinners); simple paint systems (which may contain lead) and two pack paint systems. Two pack paint systems will usually be either epoxy systems or polyurethane systems. Polyurethane systems involve the use of isocyanates (in the hardener) which are respiratory sensitizers and are associated with occupational asthma. Further to this, preparation of surfaces for painting may involve exposure to dusts generated from rubbing down and to filling materials, such as epoxy resins.
This article does not deal with the fire and explosion risks associated with solvents or with the paint spraying operation.
COSHH
When considering exposure to hazardous substances,
The prime piece of legislation applicable when considering the [potential for exposure to hazardous substances is the Control of Substances Hazardous to Health Regulations 2002 (COSHH). If lead based materials are being used, then consideration must be given to the provisions of the Control of Lead at Work Regulations 2002 (CLAW).
Under COSHH, the employer is charged with the duty of preventing exposure to hazardous substances (where this is reasonably practicable) and for controlling exposure to prevent harm to employees (and others). The employer must:
• assess the health risk arising from the work done and decide what precautions are needed
• implement appropriate measures to prevent or control the risk
• ensure that control measures are used and the equipment is properly maintained and procedures observed
• where appropriate, monitor exposure to hazardous substances and carry out appropriate health surveillance
• inform, instruct and train employees as to the risks and of the precautions to be taken
• make suitable arrangements for dealing with accidents, incidents and emergencies
There is an explicit duty on the employer to avoid the use of a hazardous substance by replacing it with another substance or process that either eliminates or reduces the risk to employees, so far as is reasonably practicable. The Approved Code of Practice for the COSHH Regulations makes it clear that it is an employer’s overriding duty and first priority to consider how to prevent employees being exposed to substances hazardous to health. Failure to tackle this duty is a failure to comply with a fundamental principle of the Regulations. To achieve this, employers should consider:
• changes to the method of work such that the operation giving rise to the exposure is no longer required (such as using a water based system in place of a solvent based system); or
• modifications to the processes to eliminate the generation of a hazardous by-product or waste material; or
• substitution of a hazardous substance with a non-hazardous substance that presents no risk to health
Where use of a hazardous substance cannot be eliminated, the employer must consider routes to reduce exposure to hazardous substances. These should include:
• using an alternative, safer substance (such as moving to a one pack isocyanate free system in place of a two pack polyurethane); or
• using a different form of the same substances; or
• using a different process
It should be noted that such changes may create new or different risks. These risks should be considered as part of the risk assessment processes required under COSHH, the Management of Health and Safety at Work Regulations 1999 and the Dangerous Substances and Explosive Atmosphere Regulations 2002 or any other piece of relevant legislation. It may not be appropriate to change to a slightly safer substance, health wise, if the fire risks are increased disproportionately.
Health hazards
Solvents/Thinners
Direct skin contact with organic solvents can cause defatting, irritation and even lead to dermatitis. Commonly used solvents include xylene, acetone and methylethylketone (MEK). These solvents may be absorbed through unbroken skin and are also harmful by inhalation. Once absorbed into the body they may cause systemic effects.
Paints
The hazards associated with paints vary enormously and are often associated with the solvent, the hardener (such as isocyanates) or with the pigment system (such as lead), etc.
Lead
Lead can be absorbed into the body by inhalation and ingestion. Typical symptoms of lead poisoning include headaches, tiredness, stomach pains, constipation and loss of weight. Continued exposure may cause more serious problems such as nerve and brain damage. In the case of pregnant workers, the developing foetus is especially vulnerable to the effects of lead, which may lead to impaired mental development.
Dusts
Prolonged exposure to dust can cause respiratory disorders and any dust of a substantial concentration is regarded as hazardous under COSHH, whether or not the substance of the dust is hazardous. Some dusts will be more hazardous than the so called nuisance dusts above. For example: if paint work if rubbed down as part of the preparation process, then if the original paint contained lead, the dust will also contain lead, but it will be present in a form that is more easily inhaled.
Isocyanates
Vapours containing isocyanates are highly irritating to the eyes and to the respiratory tract and may cause asthma. Asthmatic attacks may occur immediately or may be delayed for up to 12 hours after exposure. Symptoms of over exposure include: sore eyes; running nose; sore throat; coughing; wheezing; tight chest fever and breathlessness. In many cases, complaints will (at first) clear up at weekends or during other breaks from work, but are likely to return on resumption of work. Some people may become sensitised and even minute concentrations of isocyanates can lead to severe asthmatic attacks. There are an estimated 1,500 to 3,000 new cases of occupational asthma each year and this rises to 7,000 cases a year if you include asthma made worse by work (work-related asthma). There are thought to be at least 150 new cases of occupational asthma associated with paint spraying operations, although the figure may be higher and paint sprayers are considered to be 80 times more likely to develop work related asthma than the rest of the working population.
Control measures - to protect employees and other from harm
The best control measures are those that avoid exposure to hazardous substances, while others limit the amount of contact or attempt to mitigate the effects.
Elimination
If hazardous substances are not used, then employees cannot be exposed to them and so avoidance is the best solution. Inferior to this is to user safer, rather than safe, substances. If is essential that alternatives are sought to paint systems that contain or that utilise isocyanates. Increasingly, lead free paints are now available and new water based paint systems have been developed.
Ventilation, extraction systems and spray booths
Ensure that hazardous substances are not used in confined spaces or areas of poor ventilation. Where possible, use them in areas of good natural ventilation, such as outdoors. If natural or general ventilation is inadequate, then local exhaust ventilation may be required to remove hazardous fumes and vapours from the workplace.
Most spray painting operations take place inside a booth. The booth needs to be designed to deal with the operations to be undertaken: it needs to be the right size and have suitable extraction for the materials being sprayed. It must be designed such that the solvents and the overspray are captured and then ducted away and exhausted into a safe area. There have been cases of “home made” booths being used that were inadequate for the tasks (and so did not protect the sprayer) or which exhausted fumes into the workplace, causing ill health (from exposure to solvents and to isocyanates) to develop in others, including the receptionist in one case.
All local exhaust ventilation systems must be tested and inspected, by a competent person, at least once in every fourteen month period. They must also be maintained in working condition and should be checked, routinely, by the operatives.
Personal Protective Equipment
Despite the fact that personal protective equipment (PPE) is to be considered as the last resort, it will often have a role to play in protecting spray painting operatives. Different types of PPE are available: skin protection (overalls, gloves, gauntlets); eye protection (glasses, goggles, face masks, etc) and respiratory protection (dust masks through to air fed respirators). It is important that the appropriate PPE is provided and that risk assessments have been carried out to show that the PPE provided is appropriate and that it provides the right level of protection.
Welfare facilities
Decent washing facilities are necessary to remove hazardous substances from the skin. These should include both hot and cold running water as well as suitable skin cleansers. Suitable hand drying facilities should also be provided, such as paper towels. The use of suitable conditioning creams after washing can help to counter the degreasing effects of the oil on the skin. Skin must never be cleaned with solvents, etc. So called “barrier creams” must not be relied on to protect the skin from exposure to solvents. They can, however, be a useful extra protection and can make it easier to wash oils off of the skin after exposure.
Smoking, eating and drinking
Smoking is now prohibited in all workplaces. Suitable welfare arrangements should be made so that there is no eating or drinking in areas where hazardous substances are present. Employees should be discouraged from consuming food or from drinking in the work area as any contamination on their hands may easily be ingested.
Health surveillance
Heath surveillance will not protect employees from exposure to hazardous substance. However, appropriate health surveillance will often allow for early identification of symptoms so that additional preventive measures can be taken at an early stage. Where workers are exposed to solvents, the employer should carry out routine skin inspections as a precautionary measure. Where workers are exposed to isocyanates, the employer should arrange for lung function testing to be carried out regularly. The results of health surveillance must be recorded and records must be retained for 40 years.
Information, instruction and training
Employees must be made aware of the hazards associated with the substances to which they may be exposed and of the control measures to be used to protect their health. Awareness can also be raised by obtaining and distributing suitable notices and leaflets, many of which are available from the HSE.
Spillages
Spillages should be cleaned up immediately, using suitable absorbent granules. A suitable spillage response kit should be kept available on site. Employees should be trained in the safe use of this spillage response kit and the disposal of the materials.
Active Monitoring
The use of control measures should be actively monitored by the employer. It is not sufficient to put systems in place: they must be monitored and their effectiveness and use checked by managers and/or supervisors.
Summary
Occupational ill health may result from uncontrolled or inadequately controlled exposure to hazardous substances associated with paint spraying. Isocyanates are one of the most hazardous substances used in paint spraying, leading to over 150 new cases of work related asthma each year. A key to avoiding ill health is to avoid or control exposure to hazardous substances, including solvents, lead and isocyanates. This may involve extraction and ventilation systems (such as spray booths), PPE, personal hygiene regimes, training and health surveillance.
Please visit our website
This article does not deal with the fire and explosion risks associated with solvents or with the paint spraying operation.
COSHH
When considering exposure to hazardous substances,
The prime piece of legislation applicable when considering the [potential for exposure to hazardous substances is the Control of Substances Hazardous to Health Regulations 2002 (COSHH). If lead based materials are being used, then consideration must be given to the provisions of the Control of Lead at Work Regulations 2002 (CLAW).
Under COSHH, the employer is charged with the duty of preventing exposure to hazardous substances (where this is reasonably practicable) and for controlling exposure to prevent harm to employees (and others). The employer must:
• assess the health risk arising from the work done and decide what precautions are needed
• implement appropriate measures to prevent or control the risk
• ensure that control measures are used and the equipment is properly maintained and procedures observed
• where appropriate, monitor exposure to hazardous substances and carry out appropriate health surveillance
• inform, instruct and train employees as to the risks and of the precautions to be taken
• make suitable arrangements for dealing with accidents, incidents and emergencies
There is an explicit duty on the employer to avoid the use of a hazardous substance by replacing it with another substance or process that either eliminates or reduces the risk to employees, so far as is reasonably practicable. The Approved Code of Practice for the COSHH Regulations makes it clear that it is an employer’s overriding duty and first priority to consider how to prevent employees being exposed to substances hazardous to health. Failure to tackle this duty is a failure to comply with a fundamental principle of the Regulations. To achieve this, employers should consider:
• changes to the method of work such that the operation giving rise to the exposure is no longer required (such as using a water based system in place of a solvent based system); or
• modifications to the processes to eliminate the generation of a hazardous by-product or waste material; or
• substitution of a hazardous substance with a non-hazardous substance that presents no risk to health
Where use of a hazardous substance cannot be eliminated, the employer must consider routes to reduce exposure to hazardous substances. These should include:
• using an alternative, safer substance (such as moving to a one pack isocyanate free system in place of a two pack polyurethane); or
• using a different form of the same substances; or
• using a different process
It should be noted that such changes may create new or different risks. These risks should be considered as part of the risk assessment processes required under COSHH, the Management of Health and Safety at Work Regulations 1999 and the Dangerous Substances and Explosive Atmosphere Regulations 2002 or any other piece of relevant legislation. It may not be appropriate to change to a slightly safer substance, health wise, if the fire risks are increased disproportionately.
Health hazards
Solvents/Thinners
Direct skin contact with organic solvents can cause defatting, irritation and even lead to dermatitis. Commonly used solvents include xylene, acetone and methylethylketone (MEK). These solvents may be absorbed through unbroken skin and are also harmful by inhalation. Once absorbed into the body they may cause systemic effects.
Paints
The hazards associated with paints vary enormously and are often associated with the solvent, the hardener (such as isocyanates) or with the pigment system (such as lead), etc.
Lead
Lead can be absorbed into the body by inhalation and ingestion. Typical symptoms of lead poisoning include headaches, tiredness, stomach pains, constipation and loss of weight. Continued exposure may cause more serious problems such as nerve and brain damage. In the case of pregnant workers, the developing foetus is especially vulnerable to the effects of lead, which may lead to impaired mental development.
Dusts
Prolonged exposure to dust can cause respiratory disorders and any dust of a substantial concentration is regarded as hazardous under COSHH, whether or not the substance of the dust is hazardous. Some dusts will be more hazardous than the so called nuisance dusts above. For example: if paint work if rubbed down as part of the preparation process, then if the original paint contained lead, the dust will also contain lead, but it will be present in a form that is more easily inhaled.
Isocyanates
Vapours containing isocyanates are highly irritating to the eyes and to the respiratory tract and may cause asthma. Asthmatic attacks may occur immediately or may be delayed for up to 12 hours after exposure. Symptoms of over exposure include: sore eyes; running nose; sore throat; coughing; wheezing; tight chest fever and breathlessness. In many cases, complaints will (at first) clear up at weekends or during other breaks from work, but are likely to return on resumption of work. Some people may become sensitised and even minute concentrations of isocyanates can lead to severe asthmatic attacks. There are an estimated 1,500 to 3,000 new cases of occupational asthma each year and this rises to 7,000 cases a year if you include asthma made worse by work (work-related asthma). There are thought to be at least 150 new cases of occupational asthma associated with paint spraying operations, although the figure may be higher and paint sprayers are considered to be 80 times more likely to develop work related asthma than the rest of the working population.
Control measures - to protect employees and other from harm
The best control measures are those that avoid exposure to hazardous substances, while others limit the amount of contact or attempt to mitigate the effects.
Elimination
If hazardous substances are not used, then employees cannot be exposed to them and so avoidance is the best solution. Inferior to this is to user safer, rather than safe, substances. If is essential that alternatives are sought to paint systems that contain or that utilise isocyanates. Increasingly, lead free paints are now available and new water based paint systems have been developed.
Ventilation, extraction systems and spray booths
Ensure that hazardous substances are not used in confined spaces or areas of poor ventilation. Where possible, use them in areas of good natural ventilation, such as outdoors. If natural or general ventilation is inadequate, then local exhaust ventilation may be required to remove hazardous fumes and vapours from the workplace.
Most spray painting operations take place inside a booth. The booth needs to be designed to deal with the operations to be undertaken: it needs to be the right size and have suitable extraction for the materials being sprayed. It must be designed such that the solvents and the overspray are captured and then ducted away and exhausted into a safe area. There have been cases of “home made” booths being used that were inadequate for the tasks (and so did not protect the sprayer) or which exhausted fumes into the workplace, causing ill health (from exposure to solvents and to isocyanates) to develop in others, including the receptionist in one case.
All local exhaust ventilation systems must be tested and inspected, by a competent person, at least once in every fourteen month period. They must also be maintained in working condition and should be checked, routinely, by the operatives.
Personal Protective Equipment
Despite the fact that personal protective equipment (PPE) is to be considered as the last resort, it will often have a role to play in protecting spray painting operatives. Different types of PPE are available: skin protection (overalls, gloves, gauntlets); eye protection (glasses, goggles, face masks, etc) and respiratory protection (dust masks through to air fed respirators). It is important that the appropriate PPE is provided and that risk assessments have been carried out to show that the PPE provided is appropriate and that it provides the right level of protection.
Welfare facilities
Decent washing facilities are necessary to remove hazardous substances from the skin. These should include both hot and cold running water as well as suitable skin cleansers. Suitable hand drying facilities should also be provided, such as paper towels. The use of suitable conditioning creams after washing can help to counter the degreasing effects of the oil on the skin. Skin must never be cleaned with solvents, etc. So called “barrier creams” must not be relied on to protect the skin from exposure to solvents. They can, however, be a useful extra protection and can make it easier to wash oils off of the skin after exposure.
Smoking, eating and drinking
Smoking is now prohibited in all workplaces. Suitable welfare arrangements should be made so that there is no eating or drinking in areas where hazardous substances are present. Employees should be discouraged from consuming food or from drinking in the work area as any contamination on their hands may easily be ingested.
Health surveillance
Heath surveillance will not protect employees from exposure to hazardous substance. However, appropriate health surveillance will often allow for early identification of symptoms so that additional preventive measures can be taken at an early stage. Where workers are exposed to solvents, the employer should carry out routine skin inspections as a precautionary measure. Where workers are exposed to isocyanates, the employer should arrange for lung function testing to be carried out regularly. The results of health surveillance must be recorded and records must be retained for 40 years.
Information, instruction and training
Employees must be made aware of the hazards associated with the substances to which they may be exposed and of the control measures to be used to protect their health. Awareness can also be raised by obtaining and distributing suitable notices and leaflets, many of which are available from the HSE.
Spillages
Spillages should be cleaned up immediately, using suitable absorbent granules. A suitable spillage response kit should be kept available on site. Employees should be trained in the safe use of this spillage response kit and the disposal of the materials.
Active Monitoring
The use of control measures should be actively monitored by the employer. It is not sufficient to put systems in place: they must be monitored and their effectiveness and use checked by managers and/or supervisors.
Summary
Occupational ill health may result from uncontrolled or inadequately controlled exposure to hazardous substances associated with paint spraying. Isocyanates are one of the most hazardous substances used in paint spraying, leading to over 150 new cases of work related asthma each year. A key to avoiding ill health is to avoid or control exposure to hazardous substances, including solvents, lead and isocyanates. This may involve extraction and ventilation systems (such as spray booths), PPE, personal hygiene regimes, training and health surveillance.
Please visit our website
Friday 26 February 2010
New Tower Cranes Regulations
The Notification of Conventional Tower Cranes Regulations 2010
As expected, the new Notification of Conventional Tower Cranes Regulations 2010 have been issued and will come into force in April this year. To see the Regulations, click here
These new regulations apply to an employer who provides for use, or whose employee uses, a conventional tower crane at work on a construction site. They also apply to self-employed persons, in respect of a conventional tower crane used at work, and a person who has control to any extent of the management, supervision and use of a conventional tower crane, subject to the extent of that control.
Employers are required to notify the HSE of the information relating to the conventional tower crane set in the Schedule to the regulations within 14 days of the completion of the thorough examination of the crane, before it is put into service, as required by the Lifting Operations and Lifting Equipment Regulations 1998.
Where no thorough examination of the conventional tower crane has been carried out within 14 days of its installation, the HSE must be notifoed of the details of the crane as soon as reasonably practicable and of any subsequent thorough examination under LOLER, within 14 days of that information becoming available.
If you require assistance with matters relating to Health & Safety, please contact me through my website.
As expected, the new Notification of Conventional Tower Cranes Regulations 2010 have been issued and will come into force in April this year. To see the Regulations, click here
These new regulations apply to an employer who provides for use, or whose employee uses, a conventional tower crane at work on a construction site. They also apply to self-employed persons, in respect of a conventional tower crane used at work, and a person who has control to any extent of the management, supervision and use of a conventional tower crane, subject to the extent of that control.
Employers are required to notify the HSE of the information relating to the conventional tower crane set in the Schedule to the regulations within 14 days of the completion of the thorough examination of the crane, before it is put into service, as required by the Lifting Operations and Lifting Equipment Regulations 1998.
Where no thorough examination of the conventional tower crane has been carried out within 14 days of its installation, the HSE must be notifoed of the details of the crane as soon as reasonably practicable and of any subsequent thorough examination under LOLER, within 14 days of that information becoming available.
If you require assistance with matters relating to Health & Safety, please contact me through my website.
Wednesday 17 February 2010
A returning client - British Library
I'm about to start work on another interesting project for the British Library!
Their operations are more diverse than you might think - several interesting and challenging areas of health and safety to look at with them.
COSHH, Risk Assessment, Fire Safety, Training ... all good stuff
Please let us provide your health and safety needs - visit our website
Their operations are more diverse than you might think - several interesting and challenging areas of health and safety to look at with them.
COSHH, Risk Assessment, Fire Safety, Training ... all good stuff
Please let us provide your health and safety needs - visit our website
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