Controlling exposures to prevent occupational lung disease in industry

Interview with Tracey Boyle,
President of the British Occupational Hygiene Society (BOHS) -  ahead of her Breathe Freely talk at BOHS’ Worker Health Protection Conference in Abu Dhabi this September.


What are the latest developments of the BOHS Breathe Freely Campaign?

The Breathe Freely initiative is now in its second year, having been launched by BOHS, the Chartered Society for Worker Health Protection, in April 2015 in order to the tackle the enormous challenge of occupational lung disease in the construction industry.

In the UK, people are often surprised to discover that construction workers in the UK are at least 100 times more likely to die from an occupational disease than from an accident at work. What’s equally shocking is that the vast majority of these deaths are due to cases of work-related lung disease or cancer, largely caused by workers having breathed in dangerous chemicals and dusts at work in the past.

Globally, work-related diseases claim an estimated 2 million lives each year and so we have little reason to hope that these challenges are less daunting elsewhere in the world.

The Breathe Freely website (at has been developed to offer a wide range of useful, practical and free resources, to protect workers’ health.

The latest of these resources is our Health in Industry (HI) Management Standard. This self-assessment tool is designed to set out exactly what “good” looks like in managing workplace health risks, with the latest edition now offering a unique level of support for managers and their organisations.

In addition, a construction managers’ toolkit, sponsored by Arco, offers checklists, visual standards and presentation material to assist managers in delivering talks to protect workers’ lungs. These toolbox talks introduce basic occupational hygiene controls, such as fitting a simple ventilation system or water supply to tools, which make a massive difference in the exposures of workers to the hazards that cause lung disease.


How has the Breathe Freely initiative impacted the health and safety of workers in the UK construction industry so far?

We at BOHS have been delighted with the unprecedented levels of support the Breathe Freely initiative has attracted in its first two years. We have now signed up over 120 supporters from across the construction industry, including our founder members  – the Health and Safety Executive (HSE), Land Securities, Mace and Constructing Better Health – and now many other employers, trade unions and influential people and organisations.

We hope that the increased support and take-up of our guidance means that employers are becoming more aware of what the hazards are and how they can control these – and that they are putting these safeguards in place.

The challenge we face is that work-related lung hazards such as asbestos and silica dust are invisible and silent. Moreover, the effects of these hazards have a long latency. Unlike a workplace accident where the tragic consequences are immediately clear for all to see, the effects, for example,  of breathing in silica dust during abrasive blasting work will take many years to become apparent.

These complexities make it difficult to measure the progress of the Breathe Freely initiative, since we will only have proof of our success in years to come when we see the illness and mortality figures declining, which of course is what we greatly hope for.

However, right now, our Breathe Freely campaign is based on the simple premise that we can protect workers’ health and actually prevent deaths caused by lung cancer and other respiratory diseases through good occupational hygiene practice. To put it simply, by recognising the hazards, evaluating the risks, and controlling exposures today, we can make a huge difference to worker health in years to come.


How can the Middle East construction industry also benefit from the Breathe Freely initiative?

On the Breathe Freely website we have a wealth of free resources available for the construction industry in the Middle East to access and share.

The same hazards will be present on a construction site regardless of whether that site is in London or Dubai. Therefore, the advice and guidance, which is based on cost-effective and proven methods of control, can be applied as successfully in the Middle East as elsewhere.

We are adding to the available resources all the time, with the emphasis on highly practical materials such as case study examples of good practice which can be shared.

We also know that effective controls do not have to be expensive. Simple changes – such as procuring silica-free materials and using plastic instead of concrete kerb stones – can have very large financial pay-offs.

With the business case for prevention so strong, why not sign up?


What would the next steps be to implement such an imitative in this region?

At the 3rd Annual BOHS Worker Health Protection Conference (WHPC) in Abu Dhabi, we will urge organisations to access our Breathe Freely resources, to sign up to be a supporter and to adopt the HI standard.

As a Society, we took a long time in planning the Breathe Freely initiative. At first, we spent months engaging and consulting stakeholders in order to decide how we best target our energies to really make a difference to the disease burden in the UK.

We then embarked on the Breathe Freely campaign, having found that by honing in on the specific issue of lung disease, in the key sector of the construction industry, we could achieve maximum results.

We’re not doing this alone – we’ve brought in top notch partners and supporters and now we are seeing the Breathe Freely campaign truly gaining in traction in the UK.

However, it’s also important to note that our vision at BOHS, with around 1700 members in 57 countries, is a truly global one. Many construction companies operating in the Middle East are multinationals with an international outlook. We want our Breathe Freely initiative to offer a coherent, joined up, approach for the global construction sector, and we believe this is a far better prospect than individual campaigns around the world, all started from scratch.


Do you feel the Middle East construction industry does enough to protect its workforce from respiratory and lung diseases?

Without access to the specific industry statistics, it is difficult to comment on this aspect. However, from a UK perspective, about 13,000 people die each year from diseases which were caused by the work that they do, or used to do.  Last year, in comparison, precisely 142 people died from accidents at work.  In other words, 99% of deaths caused by work can be attributed to ill-health, and 1% to poor safety. Furthermore, the majority of these deaths are due to cases of work-related lung disease and cancers, largely caused by breathing in dangerous chemicals and dusts, many years previously whilst at work.

It is ironic therefore, that despite this statistical disparity between fatal accidents and deaths due to diseases, for a long time the focus has largely been on safety issues, with work-related health hazards all too often overlooked.

Now we are trying to help employers to understand what more they can do to get better at health – specifically in managing workplace health risks. What we’re saying is that it’s time to start treating health like safety in our UK workplaces, and that safety first should never mean that we neglect risks to worker health.


What more can they do?

Construction companies in the Middle East can take immediate action on the issue of worker health protection by signing up to our HI Management Standard. The UK’s leading occupational hygienists have worked on the HI Management Standard with the latest version of this self-assessment tool offering a unique level of user-friendly detail, including sample questions and evidence points, to truly guide managers through the process of achieving the HI Standard.

Using the HI Standard’s solid framework of good practice, construction managers will be guided to focus on the prevention of work-related ill health, for example putting controls in place and ensuring compliance with exposure limits rather than simply relying on respiratory protective equipment (RPE).

We also urge construction companies to take advantage of the toolbox talks on the Breathe Freely website which will form a concise summary of the health hazards arising from the construction industry and how to address them. Again the approach with these training talks is extremely practical, for example emphasising that respirators need to be of an appropriate standard and face fitted, in order to be useful.


Can you please provide more detail about your presentation at the BOHS Worker Health Protection Conference?

I’m looking forward to the opportunity to explain the Breathe Freely journey so far and then focus specifically on the free HI standard self-assessment tool, because this is such a useful tool which can be applied in the real world, to really help employers better manage workplace health risks.

I also want to share our message that work-related ill health and deaths can be prevented.  In the UK for example, research has indicated that almost all work-related cancers can be eliminated through better recognition of the risks within occupations and appropriate focused efforts - yet there is a sense that too many stakeholders shy away from the occupational cancer question because it just seems too complex.

As occupational hygienists, we at BOHS have at our disposal the knowledge and practical means to achieve success in preventing occupational cancer and other work-related diseases.

Indeed, the potential benefits of getting worker health protection right are huge, ranging from the financial to the social, not to mention the potential impacts on improving employee relations and safeguarding the company’s reputation.


Finally, how important is it for you to speak at the 3rd BOHS Worker Health Protection Conference?

Since its beginnings in 2014, the event has become the most eminent annual gathering of renowned occupational health, hygiene and HSE experts in the region

During a packed two days of the main conference, as well as three days of certified professional development courses and an innovative exhibition, we can anticipate critical debate and practical solutions to tackle the region’s most important challenges in occupational ill health and disease.

As BOHS’s President, I am delighted to attend and present at the 3rd Annual BOHS Worker Health Protection Conference, in support of the ultimate goal of effective worker health protection and the many benefits this will bring to the Middle East region.


BOHS Worker Health Protection Middle East takes place in Abu Dhabi from 25 – 28 September 2016. For more information visit


For more information about Breathe Freely or to request a speaker, email



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