The health monitor: occupational health

22 June 2015

The long-term health of offshore workers is often under-reported, but affects far more people than headline-grabbing accidents. Mark Brierley speaks to HSE’s Dr Ahsan Saleem to find out how occupational health in the oil and gas industry is monitored and maintained.

The Health and Safety Executive (HSE) has been monitoring workers in the North Sea for decades, allowing long-term health trends to form and be remedied. Work of this kind could prove pivotal for emerging oil and gas-producing regions, where the future effects of employment offshore may not yet be understood fully. Dr Ahsan Saleem, HSE's team leader for the offshore occupational health team, energy division, discusses the impact that a life at sea can have on an individual's well-being.

Mark Brierley: How is occupational health monitored offshore?

Dr Ahsan Saleem: Workers in the offshore industry are exposed to a range of occupational health risks, the consequences of which can be devastating for the individuals and their families - there is often a long-term impact on quality of life and financial security. Occupational health is about protecting the physical and mental health of workers, and ensuring their welfare in the workplace. This includes a wide range of activities, but the key is to prevent occupational diseases arising out of conditions at work by identifying, assessing and controlling health risks.

Health issues in the workplace are harder to tackle/monitor than safety issues because cause and effect are often not immediate. Many serious occupational diseases have a long period of latency; some up to 30 years between exposure and development of ill health, making the links even more difficult to establish.

However, causal links have been established for most occupational diseases, and a range of sources are available to look at the incidence of occupational diseases offshore. These include:

  • HSE annual statistics (RIDDOR, Labour Force Survey or SWORD)
  • HSE operational intelligence (offshore inspections/investigations or health-surveillance data from offshore duty holders)
  • health surveillance data from other offshore regulators (Norwegian Petroleum Directorate, for example).

What are the most common causes of ill health among offshore workers?

Many more people become ill as a result of their work than are killed in industrial accidents. Most diseases caused by work do not kill, but they can involve years of pain and suffering for those affected. All of the health hazards common to onshore industry are also present offshore. The most common health risks offshore are as follows:

  1. Musculosketal disorders (MSD) are a significant contributor to the incidence of occupational disease offshore, accounting for over 20% of the injuries reported to the HSE (30-50 incidents a year) from the offshore industry. As most back injuries go unreported, these represent only a portion of the problem. The hazards include heavy loads, repetitive work, and environments resulting in poor posture during lifting. In particular, the inadequate management and execution of manual handling operations is responsible for many incidents of accidental injury and working days lost due to MSD.
  2. Noise-induced hearing loss (NIHL) is insidious. You don't realise you are being affected until it is too late, and the damage to hearing is irreversible and can have a serious impact on an individual's quality of life. Noise can also impact on communications (ability to hear alarms/instructions) and quality of sleep (fatigue and increased incidence of human error). So noise can be a health and safety issue. Taking the UK as an example, NIHL is the second-highest cause of claims under the Industrial Injuries Benefits scheme, and an estimated 18,000 people currently have NIHL that was caused or made worse by work (according to the Labour Force Survey 2013/14). Offshore-specific data is not available, but the industry routinely exposes workers to high noise levels. Typically, 30-40% of the workforce is potentially exposed to above the upper exposure action level of 85dB. Health-surveillance data from the Norwegian offshore sector shows significant numbers of workers being identified with NIHL (200-250 cases a year). Engineering solutions can be costly and so there is heavy reliance on the use of hearing protection to control exposures to noise. The major sources of exposure include helideck, diesel/gas turbine power generation, process plant (gas compression, water injection), use of power tools and drilling (drill floor, shale shakers and mud pumps).
  3. Past asbestos exposure still accounts for around 5,000 deaths a year in the UK, for example. However, asbestos is not just a problem of the past. Many of the offshore installations are of a vintage when asbestos was commonly in use and therefore contain asbestos-containing materials (ACMs) in their structure. The types will range from the 'higher'-risk materials such as insulation/coatings and asbestos insulating board through to lower-risk materials such as gaskets. Increased fabric maintenance of the aging offshore infrastructure has the potential to expose a number of trades and significant numbers of people to asbestos. There is a reasonable level of abatement activity offshore, but there is a lot of ACM also left in place, which needs to be managed. Some of these ACMs - Durasteel and Galbestos panelling - will have been exposed to the harsh external environment and subject to deterioration/damage. The identification and management of asbestos offshore is therefore essential.
  4. Exposure to hazardous substances is a daily occurrence for many workers in the offshore industry. The health consequences will be dependent on the concentration and duration of exposure. Single-figure cases of dermatitis and uncontrolled releases of hazardous substances are reported under RIDDOR but not chronic conditions, which take a long time to develop following exposure.

RIDDOR is therefore not a reliable source, but some of the common operational issues relating to hazardous substances offshore include:

  • hydrogen sulphide, which is a very toxic gas found in oil and natural gas deposits - it can cause respiratory irritation, and can lead to respiratory failure and death at high concentrations
  • diesel exhaust from engines, which contains a mixture of gases and particulate matter that may be coated with aromatic hydrocarbons - inhalation exposure can cause short-term respiratory irritation, and long-term effects may include respiratory disease
  • drilling, which presents the potential for exposure to a range of substances that are contained in drilling muds - health effects include dermatitis from skin contact with drilling muds and respiratory effects from exposure to vapours/mists from drilling muds
  • fabric maintenance activities, which present the potential for exposure to a range of surface coatings being removed (lead/chromium-based paints) and applied (epoxy/isocyante paints).

Are the common causes of ill health changing as the average age of the offshore worker rises?

It would be logical to assume that there would be an increase in the reporting of chronic long-latency conditions as the workforce ages, but there is no strong evidence to support this. One explanation for this may be that the offshore workforce is a survivor population and that people with chronic conditions may leave the industry or be deselected by the offshore medical. It is also important to note that the offshore sector (regulator and industry) has traditionally been well resourced for managing occupational health risks, thereby reducing the risk of acute and chronic ill health.

Do you think aging infrastructure and increasing decommissioning activity will present new occupational health challenges?

The aging fields and infrastructure will present new and increased occupational health challenges. Older fields will present challenges in relation to control of exposure to hydrogen sulphide, mercury and naturally occurring radioactive materials (NORM). Increased fabric maintenance and decommissioning/dismantling will result in a range of health risks, which will need to be assessed and controlled - disturbance of ACMs, use of power tools resulting in exposure to noise and vibration, exposure to cutting/welding fumes.

What role does HSE play in promoting occupational health best practice for offshore workers?

The aim of HSE's offshore occupational health team is to protect workers' health by promoting and supporting the principles and practice of good occupational health offshore. It does this by:

  • prioritising work and developing interventions to raise awareness, and by creating behaviour to reduce exposures and prevent ill health
  • providing specialist inspector resource for assessment of safety case, inspections and investigations
  • producing guidance and other publications
  • playing an active role in appropriate committees, working groups and professional bodies - Energy Institute, Oil and Gas UK/Step Change, British Occupational Health Society.

There are examples of recent/current initiatives:

  • There is a long-term strategy in place to tackle occupational disease.
  • The current focus is on noise and vibration. An inspection delivery guide has been published and a programme of targeted inspections is ongoing.
  • Guidance on good control practice for the control of hazardous substances ('Offshore COSHH Essentials') has been published by a joint HSE/industry/Unions Working Group.
  • Licensed asbestos removal work offshore is monitored by the offshore occupational health team and targeted inspections of notifications carried out.
  • An industry/HSE working group has been set up to develop and publish guidance on manual-handling good practice.

The myriad health issues related to offshore working might shock you.

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