Gordon Walters (above) worked on Elgin Cathedral in the 1980s. The stonemason was employed by a Scottish government precursor of Historic Scotland on the renovation and maintenance of the building. The PCS member was not given a mask while carrying out renovation and maintenance works. The work was dusty.

In the mid-1990s, he was forced to give up his career after being diagnosed with Systemic Lupus Erythematosus, an autoimmune disease linked to exposure to silica dust and which can cause symptoms include fatigue, rashes, fever and pain and swelling in the joints. Gordon was later diagnosed with silicosis, a life-limiting lung-scarring disease. The condition is progressive; despite having no exposure to silica for decades, the scarring on his lungs gets worse every year.

Gordon, 59, is being slowly suffocated. He says his body has been ‘ravaged’ by silica-related diseases.

To many, the 0.1mg/m³ silica exposure limit allowable when Geoff worked on the cathedral sounds absurdly complacent today, with countries including the USA, Australia, Canada and several across the EU now at a much more protective level half of that or lower.

But not here.

Significantly deadly

Gordon’s plight is not unusual. Other silicosis cases have been reported in stonemasons who worked on Elgin Cathedral. And inadequate working conditions for silica-exposed workers in Britain remain commonplace.

Just as Gordon wasn’t provided the necessary breathing protection over 30 years ago, a February 2023 HSE report on the initial findings of its ongoing silica inspection initiative “indicate poor management of Respiratory Protective Equipment (RPE) in those industries.”

DEADLY FAILURE Silica is poorly managed in Britain’s workplaces, HSE admits, with hundreds of thousands of workers facing potentially lethal exposures. But the regulator is refusing to follow other countries and introduce a more protective exposure standard.

HSE told Hazards the UK standard for respirable crystalline silica (RCS) will remain at 0.1mg/m³, the limit in place when Gordon’s exposures in the 1980s saw him disabled with two separate and life-wrecking silica-related diseases.

The UK regulator concedes that “significant risks still occur at and below” the UK’s current limit. This recognition came in an HSE presentation, ‘Current picture of health risks and exposure to respirable crystalline silica in Great Britain’, posted on the regulator’s website in 2017 but subsequently removed (Hazards 148).

The lung cancer risk is 40 per cent higher, HSE also admits. Silica trails only asbestos as a cause of occupational cancer deaths, according to HSE’s 2012 cancer burden study. It estimates the annual silica-related cancer toll at between 592 and 998 deaths, averaged at 789.

Then there’s COPD – the wheezy, breath-snatching conditions bronchitis and emphysema – tuberculosis, and kidney diseases and autoimmune conditions like arthritis and the SLE developed by Gordon (Hazards 126).

Scarred workers

But it is the other occupational disease Gordon developed, silicosis, that many fear most. It turns the lungs progressively into a stiff, inert, useless mass of scars.

It isn’t a disease that is dying out. Extrapolating from European estimates in a July 2019 paper by Professor John Cherrie, a member of HSE’s Workplace Health Expert Committee, you reach a figure of over 150,000 UK workers who could be exposed above the current limit, with a near 1-in-3 risk of life-sapping silicosis.

A 2019 Occupational and Environmental Medicine study of UK silica cases co-authored by researchers from HSE’s Centre for Workplace Health concluded: “Silicosis remains an important health problem in the UK affecting workers of all ages across a wide range of industries traditionally associated with silica exposure.”  It added “the majority of workers reported to have silicosis were still of working age.”

The authors noted: “Silicosis was reported in young workers across all industry groups, with around one in six of all silicosis cases affecting workers under the age of 46 years.”

It also means the disease is occurring in the current generation of workers for whom a substantial part – or in some cases all – of their exposures occurred in the period after the current silica exposure standard was introduced.

Even at 0.1mg/m³, the current limit, HSE’s now buried 2017 analysis of the risks estimates 30 in every 100 workers exposed over a working lifetime will, like Gordon, develop life-sapping silicosis. With an estimated 600,000 workers exposed in the UK, this suggests deaths from silica-related cancers, respiratory and other diseases could now number thousands each year.

The HSE estimates revealed if you halve the level to 0.05mg/m³ – a standard successfully enforced in many other jurisdictions in Europe, Canada, the USA, Australia and beyond – this drops to just five in a hundred, six times fewer victims.

Graphic from Current picture of health risks and exposure to respirable crystalline silica in Great Britain, HSE, December 2017. The damning evidence has been removed from HSE’s website.

It is a standard that is neither impractical nor world-leading. The 0.05mg/m³ limit itself is twice that used in some jurisdictions.

Portugal has a limit of 0.025mg/m³, a quarter the limit in Britain. The Australian state of Victoria works to a recommended limit of 0.02mg/m³, with the country’s federal government actively considering a shift from 0.05mg/m³ to a tighter standard nationwide. Canadian provinces including British Columbia and Quebec also go lower than their national standard of 0.05mg/m³ and work to the 0.025mg/m³ standard, a level at which the silicosis risk is almost eliminated.

What’s stopping HSE?

A January 2023 report from the All Party Parliamentary Group (APPG) for Respiratory Health, Improving silicosis outcomes in the UK, recommended HSE “assesses and determines the data and technology needed to allow the UK to reduce the WEL [workplace exposure limit] for work with silica to 0.05mg/m³.”

Jim Shannon, the chair of the APPG, said: “It is apparent from the evidence we received that industry views silicosis as a major issue that needs to be addressed.”
He added: “The tragedy is that silicosis is entirely preventable and yet hundreds of thousands of workers are exposed to silica dust every year.

“Silicosis is rarely the recorded reason for death but it causes significant co-morbidities – it increases the likelihood of developing other health issues such as tuberculosis, chest infections, heart failure, arthritis, kidney disease, chronic bronchitis, chronic obstructive pulmonary disease (COPD) and lung cancer.”

ACTION Don’t swallow HSE’s dust line. Send an e-postcard to HSE demanding it introduce a more protective UK silica exposure limit no higher than 0.05mg/m³ and with a phased move to 0.025mg/m³. www.hazards.org/HSEstopkillingus

Shannon’s right – and HSE misses almost all the cases. Its latest statistics on silicosis, published in November 2022 and permed from several sources, record about 25 silicosis cases and an average of 12 deaths each year. That’s all it’s got.

“Available sources are likely to substantially underestimate the annual incidence of silicosis,” the HSE statistics document notes.

The UK regulator told Hazards it could provide no estimates at all on any of the other conditions associated with occupational silica exposure, adding: “We have no information on how many people die of other causes while suffering from silicosis as a co-morbid condition.” 

Defending its adherence to a less protective standard, HSE said the current level of 0.1mg/m³ “is identical to the binding occupational exposure limit value that European Union member states have only recently needed to implement via an amendment to the Carcinogens and Mutagens Directive (CMD).”

HSE told Hazards this standard reflected “current uncertainties about the reliability of measurements for RCS at or below 0.05mg/m³ in all workplace environments.”

There are grounds to treat HSE’s statement with some caution. Firstly, the European Commission estimates that at 0.1mg/m³ level more than 340,000 EU workers can be expected to die from related lung cancers alone between 2010 and 2069.

And the EU figure is an upper limit – countries including Finland, Germany, Italy and Spain have enforced a 0.05mg/m³ standard, with Portugal lower still at 0.025 mg/m³.
Still, HSE has told Hazards repeatedly it is not ‘technically feasible’ to introduce a safer silica standard because if you can’t measure it, you can’t enforce it.

It is a position it reiterated in a 24 March 2023 response to Hazards, noting “HSE require evidence before proposing a reduction” in the workplace exposure limit for respirable crystalline silica, “to allow an assessment of the availability of technology available to achieve the lower levels, the cost-benefit of doing so, and ensure a suitable means of measuring compliance with the WEL at lower levels.”

Don’t look, don’t see

Each point raises serious questions about HSE’s reluctance to move. Implementation of a more protective limit elsewhere, including across all of North America, with available monitoring technology scrutinised and performing satisfactorily and to the right resolution, has not caused practical difficulties.

HSE’s case is weakened further as firms switch to ‘real-time monitoring’, with the APPG noting: “We recommend that the HSE takes active steps to look into real time monitoring systems as a matter of some urgency.”

Adrian Eccles, a technical products manager with Trolex, which has pioneered this method of monitoring (below), said it is happening elsewhere.

BREATHTAKING ERROR HSE’s if you can’t measure it, you can’t enforce it line doesn’t measure up. Real-time monitoring can capture accurately silica levels much lower than 0.05mg/m³, half the current UK standard and a level enforced successfully in countries including Australia, Canada and the USA.

“Our units are used across the globe in factories and construction sites, where they are utilised to give real time information to help protect the health of the employees, with many other major industrialised nations such as Australia, USA and Canada having lower exposure levels than we currently have in the UK, our real time silica monitor is a great tool in the tool box to help reduce exposure, because if you don’t know what’s there, how can you protect the workers?”

Real-time monitoring has another strength – it can identify work activities that lead to atypically high exposures. “The benefits of obtaining instantaneous dust concentrations…  are that multiple measurements can be quickly made to investigate the source or cause of dust exposure, and dust controls and positioning of workers can be adjusted in real time,” Eccles said.

On one construction site in England, real-time monitoring was able to identify plumes of silica dust becoming airborne every time a telehandler operative slammed his cab door. Cleaning protocols were improved to prevent build-up of dust in the cab.

HSE says it won’t act without a cost-benefit analysis, but in March 2023 told Hazards: “HSE does not produce estimates of the annual cost in Great Britain of occupational RCS exposure-related morbidity and mortality.”

HSE added: “Work to measure RCS exposures at lower levels in air samples is being undertaken by HSE.

“HSE's Science and Research Centre is actively involved in developing improved and more sensitive measurement methods and HSE may be in a position to review the limit in the future.”

Australia reviewed available evidence and technology and decided inaction was not an option. It moved to 0.05mg/m³ in July 2022, and is currently considering a three-year shift to 0.025. The country is also set to ban extremely high silica engineered stone, a manufactured product composed of silica dust bonded together with resin and used in kitchen counter tops as a cheaper alternative to granite or marble.

“We know that if we are going to eliminate silicosis and other dust diseases we must reduce the exposure standard to the recommended health-based level 0.02mg/m³,” Liam O’Brien told Hazards.

O’Brien, the assistant general secretary at the Australian Council of Trade Unions (ACTU) who led the successful silica campaign for a tighter standard, said: “We are hopeful that with recent improvement in measuring technology that these changes should not be far away.”

Australia’s current standard, for now set at half that in place in Britain, is having an impact.

“There is increasing awareness. Unions are regularly undertaking inspections in workplaces and undertaking their own measuring of airborne contaminants. These actions are forcing employers to take greater efforts to control dust levels in workplaces,” O’Brien said.

A 2022 Curtin University study supported by ACTU estimated the shift from a 0.1mg/m³ to a 0.05mg/m³ exposure standard will save thousands of lives each year, and possibly 80,000 plus lives over a working lifetime.

A form of cruelty

In Britain, Gordon says his life would be “totally different” had he been better protected from silica. “It's ravaged my body and means I have to be supported and cared for in almost every aspect of my daily life,” he said.

Gordon’s union, PCS, brought in law firm Thompsons Solicitors Scotland to act in a compensation case. In late 2022, the Scottish government confirmed ministers had agreed to settle the case for £3.5 million. The payout would make it possible for all the proper care he needs to be put in place, Gordon said.

Thompsons said it was believed to be among the largest settlements for a worker diagnosed with silicosis and systemic lupus erythematosus (SLE). Gordon’s lawyer Claire Campbell, a partner at Thompsons who specialises in cases involving industrial lung disease, said: “What this disease has done to Mr Walters is truly appalling. Silicosis and SLE are extremely cruel conditions but can be prevented by making sure people working with stone are properly protected.”

Liam O’Brien, who led the successful Australian trade union campaign for a tighter silica standard, has some advice for UK unions seeking that added protection.

“Safety regulators are useless,” the ACTU assistant general secretary said. “Unions have been at the forefront of the fight to protect workers from hazardous dust. Whether it be our efforts to ban asbestos and now the deadly engineered stone or our campaigns for greater compensation and support for victims of dust disease.”

In Britain, waiting for HSE to act isn’t working. Workers are continuing to have what HSE admits are inadequately controlled exposures, with an exposure limit it knows will see hundreds and in all likelihood thousands of workers each year develop life shortening and disabling diseases.

It is not a survivable position.

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DUST LIES

The Health and Safety Executive (HSE) said there was neither the evidence nor the costings to justify tightening the exposure standard for lung-shredding silica dust. But Hazards editor Rory O’Neill reveals HSE has expunged key evidence from its website and has ‘no information’ on the total number of workers dying nor any intention to determine related costs for one of the most potent workplace killers.

SILICA ACTION!

Send an e-postcard to HSE demanding it introduce a more protective silica standard no higher than 0.05mg/m³ and with a phased move to 0.025mg/m³.