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LARRYL  
#1 Posted : 18 December 2014 16:57:57(UTC)
Rank: Forum user
LARRYL

We have an employee who has silicosis from his previous employment, he visits a specialist twice yearly as well as our own health provider, he seems to think that we should be sending our employees for x-rays every few years as part of our medical process, I will check again with our own nurse but I cant see anything in COSHH about it and was wondering if anyone can point me in the right direction as I,m sure I,ve looked this up before and found out its only required if there is a medical issue, we manufacture granite worktops.
jay  
#2 Posted : 18 December 2014 18:22:56(UTC)
Rank: Super forum user
jay

Granite can contain up to 30% Crystalline silica. Therefore, depending upon your COSHH Assessment & Controls , i.e how the granite is "processed", it is more likely than not that health surveillance may be required. There is cross over guidance in the form of COSHH essentials for stonemasons: Silica--Advice for managers http://www.hse.gov.uk/pubns/guidance/st0.pdf There is guidance for employees:- http://www.hse.gov.uk/pubns/indg463.pdf Apparently, an Improvement Notice was served quite some time ago to Granitewoods Ltd http://www.hse.gov.uk/no...p?SF=CN&SV=300420578
johnmurray  
#3 Posted : 18 December 2014 20:13:33(UTC)
Rank: Super forum user
johnmurray

He thinks you should be exposing workers to regular exposure to ionising radiation just to check their health? And you are considering it? Someone is living on another planet. I'd just say no.
LARRYL  
#4 Posted : 19 December 2014 09:17:50(UTC)
Rank: Forum user
LARRYL

Jay - thanks for reply, put me on the right track (G404) and found what I was after. John - I don't want to expose them but you just cant say no as you must realise, see below: If the risk of exposure is low you may decide, with the health professional, that health surveillance (involving an x ray and symptom enquiry) is unnecessary. Where there is a reasonable likelihood of silicosis developing, health surveillance will be necessary. You need to consider, in discussion with your health professional, the risk of silicosis or tuberculosis developing due to RCS and decide what health surveillance is appropriate. The health professional may, in any case, recommend an X ray as part of the clinical investigation of an individual who reports new or worsening respiratory or other symptoms. Health surveillance is never an alternative to the proper control of exposure. It is not the same as health screening or health promotion. What would health surveillance involve? Health surveillance for silicosis could require chest x-rays at intervals in addition to enquiries about new or worsening breathing symptoms. Baseline assessment is always appropriate where there is a risk of silicosis. Discuss the need for a chest x-ray at the start of employment, with the health professional.
Palmer20061  
#5 Posted : 19 December 2014 09:57:38(UTC)
Rank: Forum user
Palmer20061

I would have thought occupational hygiene monitoring for respirable crystalline silica (RCS) exposure (personal & static) to see if there is an issue. Occupational health surveillance should include spirometry to check for issues - I would have thought only if this identifies a potential issue should you then consider -x-rays. As John says I wouldn't think you'd want to unnecessarily expose people to ionising radiation.
johnmurray  
#6 Posted : 19 December 2014 10:38:46(UTC)
Rank: Super forum user
johnmurray

Justification of Individual Medical Exposures 6. (1) No person shall carry out a medical exposure unless— (a)it has been justified by the practitioner as showing a sufficient net benefit giving appropriate weight to the matters set out in paragraph (2); and (b)it has been authorised by the practitioner or, where paragraph (5) applies, the operator; and (c)in the case of a medical or biomedical exposure as referred to in regulation 3(d), it has been approved by a Local Research Ethics Committee; and (d)in the case of an exposure falling within regulation 3(e), it complies with the employer’s procedures for such exposures; and (e)in the case of a female of childbearing age, he has enquired whether she is pregnant or breastfeeding, if relevant. http://www.legislation.g...0/1059/regulation/6/made Use of ionising radiation 25 A full size PA chest X-ray may only be justified on individual clinical grounds, taking account of the criteria that apply to the use of ionising radiation in medical surveillance examinations, as detailed in the Ionising Radiation (Medical Exposure) Regulations 2000 (as amended 2006).9,10 Therefore, the indication for a radiological examination should be made on an individual case basis. The appointed doctor should consider the medical and occupational history, respiratory symptoms and findings on clinical examination, together with the potential information which could be obtained through radiography and its clinical relevance. ##This means that routinely obtaining a chest X-ray at every examination cannot be justified## http://www.hse.gov.uk/pubns/ms31.pdf
John J  
#7 Posted : 19 December 2014 14:27:43(UTC)
Rank: Super forum user
John J

The answer is no due to (slightly) increased risk of cancer from the process. The money should be spent on improving your processes to reduce exposure to silica and improve your controls.
jay  
#8 Posted : 19 December 2014 16:33:02(UTC)
Rank: Super forum user
jay

As mentioned previously, if your control measures are adequate and you have confirmed via exposure monitoring that the RCS dust level are swell below the WEL, and keep your controls maintained etc, then you do not need health surveillance. Health surveillance for those exposed to respirable crystalline silica (RCS) http://www.hse.gov.uk/pubns/guidance/g404.pdf There is also an Sector Information Minute from the HSE in "Silica dust – guidance on risk and enforcement" addressed to All HSE and LA visiting staff i.e it is the guidance for enforcement
jay  
#9 Posted : 19 December 2014 16:34:02(UTC)
Rank: Super forum user
jay

johnmurray  
#10 Posted : 23 December 2014 09:28:48(UTC)
Rank: Super forum user
johnmurray

John J wrote:
The answer is no due to (slightly) increased risk of cancer from the process. The money should be spent on improving your processes to reduce exposure to silica and improve your controls.
Not so slight. Invasive imaging exposes the individual to ionising radiation. Not taken into account is: That each successive exposure is cumulative. The employee could [easily] be at the end a long chain of exposures, some of which may have been computerised tomography scans. So, when ordering-up yet another xray, the "practitioner" may well be unaware of previous exposures.
John J  
#11 Posted : 24 December 2014 00:38:10(UTC)
Rank: Super forum user
John J

We'll have to disagree John. Modern x-Ray technique means the dose is a lot less than it used to be. You are right about the cumulative effects but you'd be looking around ten x-rays to see a noticeable rise in cancer risk. Either way diagnostic x-rays without cause are not acceptable
johnmurray  
#12 Posted : 24 December 2014 18:06:17(UTC)
Rank: Super forum user
johnmurray

John J wrote:
We'll have to disagree John. Modern x-Ray technique means the dose is a lot less than it used to be. You are right about the cumulative effects but you'd be looking around ten x-rays to see a noticeable rise in cancer risk. Either way diagnostic x-rays without cause are not acceptable
Really. A standard chest xray may well be very low risk, but since a ct scan would be the new normal for problems such as silicosis, I do not think it a negligible risk (1:2500). An xray for a company medical is way over the top.
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