Risks 550 - 7 April 2012

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Asbestos - the hidden killer
Hazards magazine
Hazards at Work

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Editor: Rory O'Neill of Hazards magazine. Comments to the TUC at [email protected]

Union News

Safety reps do the business

Union safety reps have saved 'countless lives', a new TUC briefing has revealed. The message comes in the latest bulletin from TUC ahead of its national 28 April Day of Action to defend health and safety. It spells out how this 'union effect' not only prevents between 8,000 and 13,000 workplace accidents and between 3,000 and 8,000 work-related illnesses each year, it could deliver a cost saving to society of over half a billion pounds annually - and that's take from government figures. According to the TUC briefing, part of a package of resources for reps ahead of international Workers' Memorial Day on 28 April, 'health and safety representatives know the workplace far better than management as they are aware of what really goes on. They also act as a channel for individual workers to raise their concerns.' It is a role the Health and Safety Executive (HSE) has acknowledged is 'invaluable.' It's also preventive. From asbestos to vinyl chloride, stress to strain injuries, unions exposed the problem and demanded preventive action long before official agencies caught on. The briefing notes: 'Even today it is unions and groups of safety representatives that are highlighting the potential risks within the semi-conductor industry, or from nanotechnology.' TUC concludes that with safety facing an unprecedented attack from the government, the 28 April Day of Action will 'make it clear that we want clear commitments and action from those who should be protecting us. Join any events in your area on that day and demonstrate that we will not give up our right to a safe workplace.'

Government makes jobs less secure

Increasing the time before workers are protected from unfair dismissal from one year to two years could leave 2.7 million people at increased risk of losing their jobs, the TUC has warned. The TUC says the government-imposed changes (Risks 550), which took effect on 6 April, will increase job insecurity, discriminate against younger workers, part-time women workers and employees from black and ethnic (BME) communities, and encourage more of a 'hire and fire' culture in the UK. TUC says the reforms have been pushed through by the government despite having little support from business. TUC general secretary Brendan Barber said: 'The government's proposals to weaken unfair dismissal rights risk generating a 'hire and fire' culture in the UK and will lead to the creation of insecure employment which is here today and gone tomorrow. Cutting back on protection against unfair dismissal will do nothing to boost the economy. If people are constantly in fear of losing their jobs it will lead to even less consumer spending, and losing your job is one of the worst things that can happen to anyone, especially when unemployment is so high.' He added: 'Businesses have told the government that above all they need the economy to be growing and the banks to get lending again. The government appears to be reacting to pressure from backbench Conservative MPs rather than actual business concerns.' Job insecurity has been linked to higher rates of injuries at work and of work-related suicides (Risks 528), sickness and ill-health (Risks 526). It has also been shown to drive down productivity.

Unite acts on safety problems in fuel industry

A 'turn and burn' culture is forcing fuel drivers to deliver faster for less, raising fears about public safety, Unite's Len McCluskey has warned. And he added this is why the union has been forced to consider industrial action. In a comment piece last week in The Guardian he explained why tanker drivers voted overwhelmingly for strike action. 'All they want are sensible, responsible minimum standards on terms and conditions, and health and safety. But you would have thought drivers were asking companies to sign over the rights to their oil fields, such was the dodge and weave of big business.' The union general secretary writes: 'The 'turn and burn' culture pressurises drivers responsible for 38,000 tonnes of volatile fuel to deliver ever faster. Drivers' fears for public safety deepen when corners are cut on essential health and safety measures. It used to be the case that the oil companies directly employed the drivers, but in the dash for pure profits they pulled out. Workers, it seemed, were a cost and responsibility they could do without, so they jettisoned them to contractors. And as the supply chain was stretched, so were standards, including safety practices.' The union leader warned this cost-cutting 'has consequences for us all. In 2005, a fire at the Buncefield refinery caused explosions that could be heard 200 miles away [Risks 466]. The report that followed concluded that safety practices were at risk of compromise with so many contractors in the industry. Mercifully, nobody was injured - yet still the contract culture wants more from workers, for less. Little wonder drivers' patience has now snapped.'

Government criticised for petrol panic

Panic-buying of fuel and mixed messages over the safe storage of petrol have exposed the irrational decision to close the government agency that specialised in public information, the union PCS has said. And firefighters' union FBU has warned a minister's advice that householders should keep jerry cans of petrol in the garage is 'wrong' and 'massively dangerous.' The comments from civil service union PCS came as the government's Central Office of Information closes its doors last week. The cabinet minister responsible for the decision to shut it down, Francis Maude, was the same minister who gave the controversial advice on storing petrol at home. Commenting last week, PCS said: 'Mixed messages from government ministers, and their politically-motivated attempts to blame the Unite union for the tanker driver dispute, have led to panic-buying at petrol stations. This could easily have been avoided if the government had planned properly and professionally how to communicate the serious issues at stake.' FBU on 30 March called on the government to make an urgent public safety announcement highlighting the dangers of petrol in the home. It says the call echoes the safety concerns of North Yorkshire fire and rescue service after Diane Hill, 46, was critically injured, suffering 40 per cent burns, when petrol she was decanting in her kitchen ignited. The union called for advice to be issued by government warning the public of the dangers of petrol handling and storage. Matt Wrack, FBU general secretary said: 'Government needs to issue urgent professionally-based advice to warn the public before we have another incident, perhaps with far worse consequences. It is important we're taking every step to ensure there are no other incidents of this kind.'

The shocking reality of sickness absence

Nearly half of public sector workers in Scotland believe sickness absence policies encourage staff to turn up ill or injured at work, a UNISON Scotland survey has found. A quarter of workers (25 per cent) said they had worked in the previous month when too ill to do so, while almost two thirds (60 per cent) said they had worked when ill during the past year. UNISON says its survey looked at the reality of sickness absence policies in Scotland and provides further evidence to dispel the myth that public sector workers are prone to taking sick leave. One in seven (14 per cent) of those polled said the sickness absence policy at their work is 'unfair' and more than a quarter (26 per cent) said the policy is badly implemented by management. Almost two thirds (60 per cent) reported that the stress policy in their workplace was not effective, while 28 per cent said there was no stress policy at all. Scott Donohoe, chair of UNISON's Scottish health and safety committee, said: 'Given the sort of jobs UNISON members do we should all be concerned that nurses, care workers, school staff and others are going to work when they are too ill to do so. Of even more concern is the evidence of poor sickness absence policies and little effective action on stress.' He added: 'From this survey, it appears that many public service employers in Scotland see managing sickness absence as forcing employees back to work as soon as possible, or disciplining those who are off work more regularly than others.' A new survey by the Dutch health care union Abvakabo FNV found six out of ten workers in the health care sector are afraid they won't be able to work until retirement age as are result of the increasing pressure of their jobs.

Offshore union wants wider exclusion zone

Offshore union Unite has called for the exclusion zone around the crippled Elgin platform in the North Sea to be extended. The union said the three-mile zone should be increased to five miles. It said this would require a further 200 workers being withdrawn from neighbouring installations. Commenting on 29 March, the union also expressed 'deep concern' about crews still being deployed within the current three-mile zone imposed after the 25 March leak (Risks 549). The union contacted Total and the Health and Safety Executive (HSE) about the deployment of a small team to the Franklin platform, a satellite rig three miles from the Elgin platform. Unite regional officer Willie Wallace said: 'Families of our members offshore are getting in touch asking for clarity on the situation. We estimate that there could be anything between 100-200 people currently working on rigs in and around five miles of the Elgin. In the case of the Franklin - normally an unmanned platform - we must question the urgency of putting a crew out there at this time, given its close proximity to the Elgin.' He added 'the oil companies must put people before profit and we are now calling for them to bring forward plans for an immediate evacuation of the impacted area.' HSE said it was 'in close and regular contact with Total to monitor the options they are developing.' A statement said a Government Interest Group, comprising HSE, DECC, MCA, CAA and Marine Scotland, has been established 'to ensure good coordination between the government agencies involved with the incident.'

Usdaw fights for violent crime compensation

Retail union Usdaw is fighting government cost-cutting plans which would deny thousands of workers compensation after violent attacks at work. An estimated 17,000 workers will miss out on payouts under the changes (Risks 543). Usdaw, whose members are in the service sector frontline for violence at work, has initiated a petition opposing the changes to the Criminal Injuries Compensation Scheme (CICA). The petition to the House of Commons 'declares that innocent victims of violent crime should continue to be compensated through the Criminal Injuries Compensation Scheme for all level of injuries and in accordance with the Scheme currently in operation. Proposed changes to the Scheme will result in taking 30,000 innocent victims of criminal assault out of the CICA scheme altogether, or significantly reduce their right to compensation.' It adds: 'Many Usdaw members have first-hand experience of what it is like to be a victim of violence and compensation awarded through the Criminal Injuries Compensation Scheme was a lifeline to them and their families after going through a very difficult period financially and emotionally.' The petition urges MPs to oppose the changes.

CWU fury over broken danger dogs promise

Postal union CWU has reacted angrily after the government broke its promise 'yet again' to strengthen the law on dangerous dogs. The government had said an announcement would be made before the Easter recess but parliament broke up on 27 March and nothing had been debated. CWU general secretary Billy Hayes said: 'This is extremely disappointing - and I'm afraid, very typical. Animal welfare minister Jim Pace has repeatedly said he will address this urgent issue, but then done absolutely nothing.' He added: 'More than 23,000 of our members have been attacked over the last four years and 11 people have been killed in dog attacks since 2006 - six of them children. How many more tragedies will it take for the government to stop the irresponsible shilly-shallying that's gone on in the two years since David Cameron gave us an assurance in 2010 that he would act? His words have proven to be empty.' CWU wants the law to be changed to cover attacks on private land, where it says 70 per cent of attacks on postal workers occur but irresponsible owners are immune from prosecution. It is also seeking increased police and dog warden powers; compulsory microchipping; the introduction of Dog Control Notices; better enforcement and stiffer court penalties.

Unions welcome improved asbestos rights

Unions have reiterated their 'delight' at last week's Supreme Court ruling which will allow many more asbestos victims to receive compensation for related cancers (Risks 549). The Joint Union Asbestos Committee (JUAC), which includes the six main education unions, said the 'landmark' decision 'means that thousands of families will be able to seek compensation for the loss of loved ones. The fact that judges in the country's highest court agreed that the insurers of an employer at the time of the exposure to asbestos should pay compensation means that liability for causing this fatal disease can no longer be shirked by them.' Chair of JUAC, Julie Winn, commented: 'We are delighted that the Supreme Court has rejected the arguments put forward by the insurance companies, who for too long have denied compensation to victims of this terrible disease.' In an unrelated move, a new asbestos at work law took effect on 6 April. The changes to the Control of Asbestos at Work Regulations extends the law's protection to a wider group of workers, after European Commission lawmakers indicated the UK's law was too restrictive to meet minimum Europe-wide requirements (Risks 504). Additional types of work now have to be notified to the Health and Safety Executive.

  • JUAC news release [pdf] and website. The Guardian.
  • Unite alert on changes to the Control of Asbestos at Work Regulations [pdf].

Other news

Docs warned on high work asthma rates

Doctors are being advised to explore the potential job-related causes of asthma when diagnosing patients. The Royal College of Physicians (RCP) says an estimated one in six cases of asthma in people of working age is either caused or aggravated by work-related factors. New RCP guidance advises hospital doctors to question patients with respiratory problems about their job, the materials they work with and whether their symptoms improve when they are away from work. Dr Paul Nicholson, lead author of the guidance, said: 'Highlighting the prevalence of occupational asthma is absolutely key, as too often work-related factors are overlooked leading to unnecessary delays in proper investigation and management. When a patient displays signs of asthma, doctors should be enquiring about the patient's job, the materials they work with, and whether their symptoms improve regularly when away from work.' The guidance, published in the Journal of Clinical Medicine, recommends that doctors seek consent from sufferers to communicate with the employer and advise them of the diagnosis and of the need to protect the patient from further exposure. The medical profession is belatedly catching up with unions, which long ago recognised the real extent of occupational asthma. 'Asthma at work', a 1995 report from the TUC, concluded 1 in 5 adult asthma cases were work-related and called for urgent preventive action. At the time, this was dramatically higher than official estimates. Since then, however, reports have indicated the TUC figure was the most accurate around (Risks 507).

Heart disease risk for asbestos workers

Workers exposed to asbestos as part of their job are at a significantly greater risk of heart disease and stroke than the general population, with women more likely to be affected than men, according to new research. The study was conducted by researchers at the Health and Safety Executive's research arm, HSL, and was published online in the journal Occupational and Environmental Medicine. HSL analysed cause of death among just under 100,000 asbestos workers taking part in regular voluntary health monitoring and answering questions on levels of exposure for the Asbestos Workers Survey. Most of the men taking part in the survey worked in asbestos removal while most of the women worked in manufacturing. The research team, led by HSL's Anne-Helen Harding, compared the number of deaths from stroke and heart attacks among these workers between 1971 and 2005 against the number that would be expected to occur in the general population. They found asbestos workers were significantly more likely to die of cardiovascular disease than the general population, even after taking account of smoking. Male asbestos workers were 63 per cent more likely to die of a stroke and 39 per cent more likely to die of heart disease. The corresponding figures for women were, respectively, 100 per cent and 89 per cent. There was some evidence that the longer the duration of exposure to asbestos, the greater was the likelihood of dying from heart disease. Hazards magazine warned last year that cardiovascular disease is a common but frequently overlooked consequence of exposure to dust at work.

Dad's asbestos-ridden clothes killed daughter

A mother-of-two died of cancer because she used to welcome her shipyard worker father home from work each night with a hug, an inquest heard last week. Annette Bhatti, who was just 49, also helped her ill mother to scrub her father's asbestos contaminated work uniform by hand more than 40 years ago. Mrs Bhatti, a housing officer, was diagnosed with mesothelioma in June 2010. She married her long-term partner Bal Bhatti a month later. Just 18 months later, in December 2011, she died from the asbestos cancer. Mrs Bhatti's father Lawrence Ramplee, now a pensioner, was exposed to asbestos while employed by Hills Construction in Eastleigh, Hampshire. He was later further exposed to asbestos during shifts at ship repairers Harland and Wolff when Annette was just a toddler. Mr Ramplee's jobs involved cutting up 10ft corrugated asbestos sheets by hand, coroner Keith Wiseman heard. Mrs Bhatti helped to wash her dad's clothes because her mother was ill with lung disease. Mr Wiseman said: 'The clothing worn during the week was taken home to be cleaned at home. Somewhat tragically, Mr Ramplee recalls occasions giving his daughter a hug when he got home before he changed. In later childhood Annette was often doing the laundry herself because her mother was not always entirely well. The washing was done by hand so she was exposed to dust fibres in the air. This was from a very young age.' He added: 'One doesn't have to be working oneself in industry to die in this way. Annette's exposure to the industrial disease occurred very much indirectly, when her father Mr Ramplee was employed from the mid-50s.' Recording a verdict of death due to an industrial disease, Mr Wiseman said: 'The way in which events happened in this case is not in my experience uncommon, but perhaps it is uncommon for someone quite so young.'

Mental health chief quits welfare panel

The head of a mental health charity has left a government panel implementing changes to the welfare system, describing the system as 'deeply flawed.' Chief executive of Mind Paul Farmer said he quit the government's review panel for the Work Capability Assessment (WCA) because ministers refused to listen to his criticism of the fitness-to-work test. But employment minister Chris Grayling said Mr Farmer was asked to leave after Mind began legal action over the WCA tests. The tests determine if people are eligible for Employment Support Allowance (ESA), the successor to incapacity benefit. Mind's Paul Farmer told the BBC the government's claim that 37 per cent figure of those assessed were fit for work was 'likely to be overstated'. He said he had resigned because his concerns, as part of the four-person advisory panel, were not being 'appropriately listened to'. He added: 'The test itself is not fit for purpose. It's extremely crude.' Some 50 per cent of people deemed fit to work have appealed the decision and 50 per cent of those have been successful, Mr Farmer said. Last week the TUC said the tests were being used to kick people off benefits, not help them (Risks 549).

Action call over capital's travel violence fears

Transport union RMT has called for urgent action on transport safety and staffing after a survey found more than a quarter of women do not feel safe using London public transport, even in the day. The End Violence Against Women coalition's YouGov survey found 28 per cent of women and 15 per cent of men do not feel safe travelling on London transport at any time of the day and night. RMT general secretary Bob Crow said: 'It is shocking and deplorable that so many of London's passengers do not feel safe, and it is clear from this survey that lack of staff is the key reason. RMT calls on Transport for London (TfL) and London Underground to commit to making no further staff cuts, and to reverse the cuts it has already made.' Women survey respondents identified staffing as the main area where they wanted to see action. Janine Booth, who represents London Transport workers on RMT's national executive, said: 'TfL's policy of stripping staffing levels to the bare minimum has left many women, and some men, afraid to travel. We have millions of jobless people looking for work, and important work that needs to be done making our transport safe and accessible. TfL and London Underground should create jobs and increase staffing.' End Violence Against Women Coalition co-chair Marai Larasi said the survey results were 'truly disturbing.' Some 1,047 Londoners took part in the survey, 523 of them women.

Lift firm fined after Heathrow death

Lift manufacturer Schindler Ltd has been fined £300,000 for criminal safety failings after an employee was crushed to death while installing a passenger lift at Heathrow Airport. Lift engineer Kevin Dawson, 45, was helping with the construction of Terminal 5A at London Heathrow when the incident occurred on 27 October 2007. Isleworth Crown Court heard that Mr Dawson was working from a ladder within the pit of a lift shaft, into which he and other Schindler employees were installing three new lift cars. As a colleague used one of the cars to fetch equipment from a higher level, a counterweight descended, crushing Mr Dawson and causing fatal injuries. An investigation by the Health and Safety Executive (HSE) revealed the unfinished passenger lift was used to carry workers, tools and materials despite missing key safety critical components. HSE also found the company's radio and telephone arrangements were ineffective, and workers routinely communicated by shouting up and down the lift shaft. This was potentially confusing when others were working in adjacent shafts. And there was no evidence that Schindler had identified the risk of impact or crushing from moving lift parts, and so failed to plan, organise or supervise activity to control and prevent this risk. Schindler Ltd pleaded guilty three criminal breaches of safety law and was fined £300,000 and ordered to pay £169,970 in costs.

Cleaning firm fined over porter's death

A national cleaning company has been fined £175,000 after a hospital porter was killed by an industrial waste compactor in Bolton. Peter Bonomy's neck was broken when the lid on the large metal container slammed down on him at the Royal Bolton Hospital in Farnworth in 2006. Manchester Crown Court heard the 58-year-old ISS Mediclean Ltd employee had been collecting waste cardboard from around the hospital on Sunday 8 October 2006. He was found by a colleague with his head and arms under the lid of one of the compactors. A Health and Safety Executive (HSE) investigation concluded that the most likely explanation for Mr Bonomy's death was that he leaned against a lever while leaning over the waste compactor, causing the lid to snap down. The manufacturer's recommendations for the compactor stated that it should be loaded from the front, away from the controls, but the court was told it was standard practice for porters to load it from the side. ISS Mediclean Ltd, part of the ISS group which employs more than 43,500 people around the world, pleaded guilty to a criminal breach of safety law and was fined £175,000 and ordered to pay £42,000 in prosecution costs. Speaking after the hearing, HSE inspector Rose Leese-Weller, said: 'Peter Bonomy's employer, ISS Mediclean, should have done more to make sure he and his colleagues were using the waste compactors safely. The lids snapped down instantly when the levers were operated so he had no chance of getting out of the way.'

Health screening firm left workers at risk

A health screening company has been fined after using unqualified staff to assess the health of workers from dozens of firms across the UK. Audio Medical Services Ltd (AMS) carried out tests for 59 companies over a period of at least four years. But the company failed to provide employers with information to prevent workers' health deteriorating and did not refer employees to occupational health professionals when required. Bodmin Magistrates Court heard that staff employed by AMS to carry out the tests on vibration-exposed workers did not have occupational health training and had not received the relevant training to perform screening for Hand Arm Vibration Syndrome (HAVS). The issue came to light after a company identified anomalies with the screening performed by AMS. The Health and Safety Executive (HSE) then contacted shipbuilding, quarrying, civil engineering and rail companies using AMS screening services. The investigation found 'numerous' affected employees at these companies had not been referred to an occupational health provider and so continued to be exposed to vibration at work. This put individuals at risk of further deterioration and permanent damage to their health. HSE inspector, Georgina Speake, said: 'The failures of AMS were totally unacceptable. Companies using AMS thought they were doing the right thing by providing screening for their employees. AMS's negligent behaviour meant a significant number of workers have been put at risk of worsening their conditions by continuing with their normal work practices when they should have stopped.' Audio Medical Services Ltd pleaded guilty to a criminal breach of safety law and was fined £3,200 and ordered to pay costs of £5,000. Nick Nickson, the managing director of AMS, pleaded guilty to the same offence and was fined £700. The firm's website - which displays both the ISO 9001 and UKAS quality management logos - says AMS undertakes a range of other workplace tests, including hearing and vision checks, lung and cardiac function tests and drug and alcohol screening.

International News

Global: Apple hit by China Foxconn factory report

An independent investigation has found 'significant issues' including concerns about safety, excessive hours and low pay at Chinese plants making Apple iPhones and iPads. The independent report, however, has been criticised by campaigners for going easy on Apple and ducking issues like subcontractor Foxconn's notoriously 'militaristic' management style. The US Fair Labor Association (FLA) was asked by Apple to investigate working conditions at Foxconn after reports of long hours and poor safety. The FLA says it has now secured agreements to reduce hours, protect pay, and improve staff representation. Apple said it 'fully accepted' the report's recommendations. 'We share the FLA's goal of improving lives and raising the bar for manufacturing companies everywhere,' it said in a statement. The investigation - one of the largest ever conducted of a US company's operations abroad - found employees often worked more than 60 hours a week and sometimes for seven days running without the required day off. Other violations included unpaid overtime and health and safety risks. The FLA said Foxconn had agreed to comply with the association's standards on working hours by July 2013, bringing them in line with a legal limit in China of 49 hours per week. The company will hire thousands more workers in order to compensate for the move. But campaign group Students and Scholars Against Corporate Misbehaviour (SACOM) said 'the problem of harsh management and work pressure has been tactfully omitted in the report'. And Ted Smith of the International Campaign for Responsible Technology (ICRT), referencing Apple's iconic 'Think Different' PR campaign, commented: 'Apple could insist that Foxconn open its doors to outside NGOs and experts to help develop safer and more transparent production methods. A small fraction of Apple's cash reserves could provide a huge step toward developing sustainable production benchmarks that would be a beacon for the industry. That kind of leadership would truly be a way to 'think different.'' In a San Jose Mercury opinion piece after the cash-rich company said it was going to pay a shareholder dividend, he adds: 'If Apple's current leaders really want to 'think different' and provide 21st century leadership, a small fraction of their 'excess cash' would go a long way. They could recapture the mantle of the company that cares. Now that would truly be different.'

Russia: Migrant workers die in blaze

At least 17 migrant workers have been killed by a fire that swept through a market warehouse in southern Moscow. The victims are believed to be market traders from former Soviet states, city officials have indicated. The two storey building was being used as living quarters for the market vendors. The market fire broke out in the early hours of 3 April and was extinguished some three hours later, RIA Novosti said, citing officials. It is thought the people who died may have come from the central Asian nation of Tajikistan. They were staying in a metal storage warehouse at a construction materials market which 'was not meant for people to live in,' Sergei Gorbunov of the fire department told RIA. Emergency workers described squalid, cramped living conditions where people slept on hard cots stacked on top of each other. The living quarters had no direct access to the street, and emergency workers had to cut their way into the building. The Itar-Tass news agency reported that an investigator suggested the fire could have been caused by an electric heater left on overnight. Last month, at least 11 migrant workers died when tents used as accommodation on a Turkish construction site burned, with the blaze again attributed to a heater used to stave off the extreme cold (Risks 547).

USA: Bad work is more costly than you think

A study that revealed the annual 'economic burden' of occupational injury and illness in the US is at least $250 billion (Risks 540) underestimates the true costs, government workplace health researchers have revealed. The National Institute of Occupational Safety and Health (NIOSH) experts, writing on the agency's blog, describe the study by University of California Davis professor J Paul Leigh as a 'landmark paper' and 'the most comprehensive analysis of the burden of occupational illness and injury in the US ever conducted'. But they add 'the estimates, due to methodologic issues inherent in the data, still do not capture the full economic burden.' As Leigh indicated, the cost estimates did not include: employer costs for labour turnover, retraining and hiring; dementia, depression, diseases of the nervous system and osteoarthritis; the impact on productivity of 'presenteeism'; and the costs of pain and suffering. According to the NIOSH commentary: 'Although these exclusions were justifiable for methodological reasons, the study finding of a $250 billion [£160bn] economic burden is an underestimate of the true burden of occupational illness and injury. Additionally, the Leigh study does not include the costs resulting from the interaction of occupational and personal risk factors that lead to many diseases of public health importance.' It adds: 'Leigh observes that the cost of job-related injuries and illnesses are greater than generally assumed. However, the national investment in addressing occupational illness and injuries is far less than for many other diseases with lower economic burden even though occupational illnesses and injuries are eminently preventable.'

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