Using Leading Indicators to Protect Worker Lung Health

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5 September 2023

Using Leading Indicators to Protect Worker Lung Health

We are lucky to live in an era in which workplace safety matters. It was not long ago asbestos manufacturers and the companies who insured them sent employees to work in health compromising environments.

Though it’s not as actively mined, asbestos, as well as other harmful airborne agents like silica and coal dust, are still a significant hazard to lung health in construction and manufacturing industries. Asbestos is especially present in demolition; silica is found in most mineral deposits and prevalent during construction activities, such as bricklaying and concrete work, stone laying and rock drilling. Inhalation of its crystalline form leads to silicosis, lung cancer, COPD, and emphysema. In low concentrations, exposure to either of these airborne agents can take as few as 10 years to turn to lung disease, such as cancer. In higher concentrations, life-threatening diseases can develop within five.

What is an exposed worker?

The American (NIOSH) and Canadian Occupational Exposure Limit (OEL) for asbestos is 0.1 fibres/cubic centimetre over an 8-hour workday. Crystalline silica OEL is 0.025 mg/m3, and coal mine dust is 1 mg/m3 for the same workday.

What happens when an individual is exposed?

In the case of asbestos and silica, fibers lodge themselves into lung tissue and form scar tissue leading to multiple diseases and sometimes an early death. For a full explanation of what happens when these substances enter the human body, watch this informative two-minute video.

How do I begin to take care of a worker’s lung health?

First, we must examine how we presently measure health and safety success.

As you know, your organization’s safety performance is measured in several ways, including total recordable incident frequency (TRIF), near misses, lost time claims (LTC) and disabling injury. But, in truth, these measures are not good indicators for lung health because they are reactive. Incident and injury rates may be at an all-time low in your company, but you could have a worker on the brink of irreparable lung damage, and symptoms may not show up for years.

In the U.S., 4,500 people lose their lives each year as a result of lung cancer, lung disease and other occupational illnesses, according to OSHA. In Canada, occupational cancer is now the leading cause of compensated work related deaths in the country, exceeding those from traumatic injuries and disorder, according to Surehire.

These statistics are representative of “lagging indicators” as opposed to “leading”; they measure the absence of injury rather than the presence of safety. Though lagging indicators have, up until now, helped to enforce strict worksite rules, such as training, protective gear and engineering controls, every worksite cannot be created equal, and maintaining lung health is a long-term play.

Creating Leading Indicators to Protect Workers

The first piece of advice I give to employers about protecting their workers against harmful airborne agents is “Always start with a baseline lung health check followed up with annual testing.”

Baseline and annual testing is not only a best practice, but can result in identification of disease and early intervention to save a worker’s life. Here are some steps you can take to introduce leading indicators into your lung health safety plan.

Get a baseline lung health test.

Ideally, this test is performed before an employee enters any work site, and may be part of your fit-for-work testing. Baseline lung function tests inform employers of any pre-existing conditions, the overall health of the individual, and they allow for early disease intervention and protect your organization from future claims.

In workplace testing, a baseline lung health test consists of the following:

  • Collecting the individual’s health history (Learn more in "Why do you need my medical history before fitness to work testing?")
  • Chest x-ray with radiologist’s report
  • Lung function (or pulmonary function) tests, including a lung health questionnaire, spirometry screen, quantitative mask fit, and fit-to-wear respirator questionnaire
  • Pulmonary Physician/Specialist consultation for result interpretation/review and recommendations
  • Occupational Health nurse consultation

If there are signs of pulmonary dysfunction, testing follows up with:

  • Pulmonary Physician/Specialist consultation for result interpretation/review and recommendations
  • Occupational Health nurse consultation

Set up an annual lung health surveillance program.

The primary purpose of any health monitoring program is early detection. Like a steel toe boot policy, annual monitoring protects your workers and can lead to disease reversal or cessation.

Employers can expect the steps for a lung health monitoring program to be similar to baseline testing, but sometimes modified to meet the needs of a worker’s specific risks in their current work environment.

Train your employees beyond basic legislated compliance.

When you invest in ongoing training for employees you increase employee morale, increase productivity, retain your talent and feed a culture of continuous learning.

Put safety culture first.

Ensuring workplace compliance according to your province’s or state’s occupational health and safety codes sends a message to your health officer you are serious about keeping your worksite operating and protecting the health of workers. Investing in your employee training, holding regular safety meetings, and doing workplace lung health testing communicates to your employees you are willing to do whatever it takes to care for them.

Focus on Future Health of Your Team

Compromised lung health is unlike any other “incident” we record on our worksites. Harmful airborne agents are a silent killer. When we send a worker into an exposed zone, we put them at risk. Long-term health problems are very expensive to employers. Increased health insurance costs, increased Workers' Compensation claims, hiring and turnover costs, damage to company reputation, and much more damages an employer's bottom line when attention is not paid to leading indicators in lung health.