Construction card scheme aims to sort the fit from the ailing

News | HSW
12.08.2007

Construction workers will be asked to carry smart cards stating whether they are fit for safety-critical work under a new occupational health (OH) scheme due to launch this year.

Major construction employers will be expected to pay for periodic health screening for site workers, who would then be classed as "safety critical" or "increased risk" if any medical conditions raise the level of risk to themselves or their co-workers.

The checks would be backed by a set of 21 occupational health standards for the industry setting out the legal and best-practice requirements for employers on issues such as alcohol and drug dependence, dermatitis, musculoskeletal problems, stress and respiratory disease.

Occupational health specialists would be contracted by employers
to assess workers against the standards and to class them in one of four categories: fit to work; fit with certain restrictions; temporarily unfit; or permanently unfit.

The new definition of safety-critical workers (those such as mobile-plant operators where a condition liable to result in sudden loss of consciousness or impaired coordination would make them a danger to colleagues) is adapted from the rail industry.

The lower "increased risk" category would apply to workers with medical conditions that might make  some conditions - lone working or wearing breathing apparatus, for example - unsafe for them.

Corporate venture

The scheme, set to be launched nationally this year, has been
developed by Constructing Better Health, a not-for-profit company which grew out of a recent 18-month pilot project in Leicestershire, funded by employers, insurers, government and construction unions.

Michelle Aldous, who heads the company and coordinated the new standards' development, told HSW they were designed to be as relevant as possible to the sector.

"Too many employers put occupational health in the 'too difficult' box," she said. "So they outsource it to an occupational health provider who doesn't always understand the sector-specific hazards and risks."

The standards are intended to create consistent measures for occupational health screening and surveillance across the industry, she explained. The basic information on individual workers' fitness to work will be included on a smart card, probably in conjunction with the existing Construction Skills Certification Scheme.

Employers will pay for the screening and surveillance and Aldous said she hopes that principal contractors will encourage smaller firms to adopt the standards, at least in part. "We have to be realistic and accept that while the larger companies will buy into this and take it on board initially, at the small end of the industry it will take some time," she admitted. "I don't know if we will ever hit all of them."

Constructing Better Health will be funded by a small levy on each registration with the national database that provides information for the smart cards. Aldous said she expects OH providers to pass this cost onto construction employers.

She said any fear that extensive screening would reveal large numbers of workers with medical conditions that made them unfit for work was misplaced, as the 1700 health checks in the Leicestershire pilot had only found a few cases where employees were permanently unfit.

"Most things can be dealt with," she said. "It might just mean taking them out for a few days while they get more controls in position."

A consultation exercise on the draft standards (available at www.fitbuilder.com/Final%20draft%20version%20OH%20Standards%20CBH%20_2_.pdf) ended on 30 June and produced only suggestions for minor changes to the proposed scheme.

Aldous said the employers and construction bodies which responded were "very positive". The scheme already has the support of the Major Contractors Group, which represents the largest construction employers.

Starting point

The £1 million pilot involved more than 360 construction employers. Occupational health staff provided around 1700 free health checks,
and some 2600 workers attended  toolbox talks on work health topics.

More than one-third of the workers tested were referred for further advice, either for general health conditions such as raised blood pressure or undiagnosed diabetes, or for work-related issues such as hand-arm vibration or hearing loss.

A study of the pilot by the Institute of Employment Studies (IES) - available at www.hse.gov.uk/research/rrpdf/rr565.pdf - found  there was little resistance among construction workers to health screening and information.

Claire Tyers, who led the IES evaluation of the scheme, said: "When the pilot was trying to get onto construction sites, one of the main objections from managers was that the 'lads aren't going to be interested'." But when the van turned up to offer free checks on larger sites, it was soon full.

The study found the real blockage was among the managers themselves, who mainly failed to use the case management or health surveillance services, and there was only limited take-up of document reviews and site risk assessments.