13 May 2020
BOHS Return to Work Guidance highlights important post-lockdown issues
Protecting workers’ health during the COVID-19 pandemic
The British Occupational Hygiene Society, the Chartered Society for worker health protection has highlighted areas of risk that have not been addressed by government guidance on a safe return to work. In guidance released last week http://www.bohs.org/return-to-work-guidance/ to help its members and leaders of organisations tackle the challenges of returning to work after lockdown, it addresses safety-critical issues, as well as those which are specific to tackling the challenges of the virus.
The Society is concerned that businesses must focus on the potential health risks of opening premises and restarting processes after such a protracted shutdown. The importance of the issue has been highlighted by the recent disaster in India, where the restarting of a plant after COVID-19 led to fatalities.
“Many businesses had to shut down premises in a hurry and with no idea how long it would be before they started up again. That means that all of the processes that are there to keep people safe from harmful exposures to chemicals, biological agents and other hazards have not been in operation. A proper plan and risk assessment is needed before starting up processes and bringing people back to work,” said Kelvin Williams, President of the Society. “Our members are experts in preventing harmful exposures. We wanted to provide usable and practical advice to help people properly assess the risks. This sort of advice needs to be written by people who actually understand real working environments.”
The Society was the first in Britain to recognize the broader issues of health risks arising from the lockdown, writing to the science minister, Amanda Solloway, at the beginning of the lockdown to highlight the need to plan for the return to work. On the 23rd March, the CEO, Kevin Bampton wrote to Mrs. Solloway to say, “The unprecedented shutdown of plants, workplaces and processes designed to be in continual operation will give rise to really serious challenges.” The letter went on to highlight the sorts of concerns that needed to be addressed.
“Systems will be prone to biological infestation such as legionella, seals and protections will degrade, corrosions and instability will be a feature of chemical storage, carcinogenic dusts will accumulate. All of these things need to be planned for on an industry-specific basis so as to avoid a second wave of acute and chronic ill-health and a stuttering restart of the British economy because of health and safety concerns.”
The Society remains concerned that these issues are not an integral part of the risk assessments outlined in the government’s guidance provided about a safe return to work. BOHS convened an Expert Group of industry specialists, drawing upon national and international best practice. Many of the experts are actively involved in bringing Britain’s industry back online.
“Our focus has been on providing a usable framework for leaders, responsible persons and our members to help take a strategic view of the problem and plan before people are on the ground,” said Society Secretary, Alex Wilson. “We don’t want the return to work to be slowed by people having to check for risks after people have been deployed and we certainly don’t want the sort of outcomes we have seen in India. Of course, we need to focus on ensuring workplaces cannot become hotspots for COVID-19 transmission, but there are other real dangers to address and we wanted to highlight this to our members and to others.”
The guidance is freely available at http://www.bohs.org/return-to-work-guidance/ and the Society welcomes feedback and queries from businesses and organisations to help make it better. BOHS, which has been at the forefront of protecting Britain’s workers and is best known for its work in eliminating asbestos, legionella and dust exposure in the workplace will also be offering other online resources in the coming weeks.
27 April 2020
BOHS on Public Covering of Nose and Mouth to Prevent the Spread of COVID-19
There is much debate about “face masks” being worn in public.
It is generally accepted that covering one’s mouth when coughing is appropriate to prevent spreading infection. Coughing into a tissue or handkerchief is maybe better. This is sometimes called “respiratory etiquette”. That is because these measures prevent droplets that carry infection from being sprayed far enough to be inhaled by others.
As we contemplate returning to work and to public spaces, it seems we are unlikely to see relaxing of social distancing rules so much as the adoption of measures to help relieve the extent of lockdown. Measures that enhance respiratory etiquette may assist in reducing the risk of people unwittingly infecting others and therefore could potentially make an important contribution to controlling infection spread. We note however that scientific evidence on the benefits of public covering of nose and mouth to prevent the spread of COVID-19 is limited and inconclusive.
BOHS notes that public spaces are invariably other people’s work-spaces and therefore we would welcome measures that people take to help prevent themselves from inadvertently spreading COVID-19, including enhanced respiratory etiquette. This would include the use of face coverings, such as cloth masks, that may help control the spread of the virus by reducing droplet spread. However, proper hygiene is required to ensure that this is effective.
We caution that widespread public use of face coverings may have unintended consequences such as giving a false sense of security with the effect of reducing diligence in observing hygiene and social distancing measures. Nevertheless, provided the parameters for recommending the use of face coverings in the public arena are clearly established and supported by good advice on use, BOHS would support such measures to help minimize exposure at the source.
We do not endorse the private use of respiratory protective equipment by the general public for personal use, except where it is to support people in situations of particular vulnerability. Respirators and PPE are used to protect individuals (such as healthcare workers and others at high risk of being exposed to exhaled droplets). Such equipment only works well when it is properly fitted and used in combination with a management system and other personal protective and decontamination measures.
Our concern is that personal choices about enhanced respiratory etiquette for use in public places do not override the duties of employers to ensure that properly risk-assessed and planned measures are in place in each workplace to manage social distancing, hygiene and, where necessary deploying equipment to protect workers from harmful health exposures.
As stated above the literature on this subject is limited, but will no doubt evolve over the coming months. BOHS has established expert groups to regularly review the position and provide guidance that reflects consensus on scientific evidence and matters of best practice.
02 April 2020
BOHS expresses apprehension about the reporting of WHO recent findings on COVID-19 airborne transmission
The British Occupational Hygiene Society, one of the world’s most authoritative organisations on exposure to harmful substances and organisms and worker health, has expressed apprehension about the reporting of World Health Organisation’s recent findings on COVID-19
The WHO recently reviewed research, https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations, mainly from China, has indicated that cases of infection have not resulted from airborne transmission of the virus carried in very small droplets that may be capable of travelling over distances greater than 1 meter. Ensuing reports that “COVID-19 is not airborne” have circulated on various social Media sites.
BOHS President, John Dobbie expressed concerns that this could lead to dangerous misunderstandings. “While the evidence of airborne transmission has not been consistently found in studies reported to the WHO, it should be cautioned that airborne transmission may be possible in specific circumstances and in particular healthcare settings involving many common medical procedures.”
“Of greater concern to BOHS is the alternative message that the broader public might mistakenly take from it. Some may think that the inference that it is not transmitted by airborne methods is effectively telling us that one can only get it by touch (i.e. direct skin contact). The droplets caused by coughs and sneezes are the primary means by which the infection is spread, so people need to maintain social distance and hygiene precautions.”
In addition, BOHS has been actively working to ensure that health workers are equipped with proper-fitting and suitably graded protective equipment and emphasised the importance of following the scientific principles and standards that govern the optimal choices for protection.
“There’s still a lot that we don’t know about this virus,” John added, “But what we do know is that having the right equipment for the right healthcare context is vital to the safety of NHS workers and to prevent the spread.”
30 March 2020
BOHS statement on respiratory protective equipment for the protection of NHS staff
The British Occupational Hygiene Society welcomes the announcement of further advice on Protective equipment by NHS for its workers. The science in this area is rapidly evolving as we get to understand COVID-19 better and the likely effectiveness of protection. In particular, we are aware of scientific evidence that indicates current guidance on respiratory protective equipment (RPE) requires urgent review to ensure the protection of NHS staff.
We seek to bring to the attention of those involved in framing new guidance the latest scientific insights which are currently being looked at by a variety of health & occupational hygiene organisations.
These organisations are currently working independently to produce summaries for any forthcoming guidance or future revisions. Work addresses matters such as RPE deployment; for example, the suitability of surgical masks, FFP3 disposable respirators or powered filtering hoods and masks for various tasks. BOHS endorses any move to prioritise the use of powered RPE as the most effective protection for health workers in critical risk areas. We are confident that the guidance will reflect the NHS’s care in ensuring that current stock RPE effectively prevent reinfection by staff through exhalation as well as preventing infection of staff. BOHS endorses all efforts to ensure that staff are guided to the best RPE selection, fit, removal and maintenance.
BOHS is convening a standing expert group to monitor and review the scientific evidence and is working collaboratively with others to provide support to any public sector organisation involved in the protection of its workers who seek clarity on the science and application of RPE in the current COVID-19 crisis.
Kelvin Williams, President-elect of BOHS commented: “Amongst the many challenges for the NHS is keeping abreast of the rapidly changing science to keep its workers safe. BOHS welcomes the review of its guidance and is offering its expertise to ensure the NHS has timely access to the best international scientific information”.