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Early intervention and immediate corrective action

 

Helping an employee with respiratory problems 

The HSE recommends early intervention for all work-related ill health as a key aspect of ensuring the best outcome for the employee and the employer. It’s important to protect an individual who has a suspected occupational respiratory problem from further exposure while the cause or causes of the symptoms are identified and investigated. Once an employee has developed respiratory symptoms, exposure must be controlled to prevent further problems, and the employee should avoid being exposed to the substance. As a last resort, the employer and/or employee may have to consider if the employee should be given a new role.
 
Not all respiratory problems are due to occupational factors, and employers need to consider whether an employee’s condition has been made worse by work, or whether the condition could make work difficult. For example, a person with asthma or COPD may find it difficult to carry out heavy physical work or wear respiratory protection.

 

Immediate medical advice 

When an employee develops a respiratory problem, they should be put in touch with the employer’s occupational health service (occupational physician or occupational nurse). If the employer doesn’t have an occupational health service, the employee should be advised to consult their GP. It’s important that the employee provides information about their work and the materials they’re exposed to so that the health practitioner can make an informed judgment about the likely cause and prescribe appropriate treatment.

 

Employees can get advice from the NHS Direct website, or by calling 0845 4647. With serious respiratory problems, expert medical advice should be sought as soon as possible.

 

Information about specific conditions 

The HSE provides brief descriptions of asthma and COPD.
 
Asthma UK has extensive information about asthma and asthma at work. It also has information on hayfever and rhinitis.
 
The National Institute for Health and Clinical Excellence offers guidance on:

The British Lung Foundation has comprehensive information on lung conditions and diseases, including occupational lung disease, asthma, allergy, COPD, extrinsic allergic alveolitis, asbestos, lung cancer and mesothelioma.

 

The website of the Canadian Centre for Occupational Health and Safety has comprehensive factsheets on asthma, COPD, farmer’s lung and extrinsic allergic alveolitis. It also has information on infections, including anthrax, avian influenza, Legionnaires’ disease and psittacosis. This site focuses on these diseases from an occupational point of view. As well as providing information on causes, symptoms, diagnosis and treatment, the website also offers information on occupations at risk, associated substances that can cause a problem, and outlines preventive measures.

 

You can also get information on respiratory diseases here.

 

Advice for employers 

It’s important that you investigate respiratory problems thoroughly to identify the causes and prevent further exposure. Occupational physicians and respiratory or chest physicians can help to identify and manage respiratory problems. They may use skin prick tests, measure Immunoglobulin E (IgE) levels in serum, or carry out ‘bronchial challenge tests’ to identify whether a particular substance is causing rhinitis or asthma. Occupational hygienists can also help you identify and control risks.
 
The free Health for Work Adviceline for Small Business helps you to quickly and effectively address the issue of employee ill health, minimise the impact of staff illness, and provide essential support to staff with physical or mental health issues.
 

If a doctor confirms that an employee is suffering from an occupational lung disease, you must report it to the HSE under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 1995.

  

Advice for employees 

If you have a breathing problem, you should tell your manager and/or safety representative immediately. You should also speak to your manager and/or safety representative if controls aren't effective. This includes respirators that aren’t working properly. It’s important that you have a lung function test and attend health surveillance sessions if your employer asks you.

 

Reviewing the management protection programme 

If you detect respiratory problems in the workplace, you should review your protection programme, or develop one if you don’t have one already. The programme should cover:
  • risk assessment
  • control measures
  • monitoring of exposure
  • health surveillance
  • education and training
These aspects are discussed further in Preventive action and early intervention.  Avoiding long-term incapacity for work: Developing an early intervention in primary care is a Peninsula Medical School literature review which provides an evidence base for early intervention in sickness absence.