The Evolution of Occupational Health Risk Reduction in Great Britain

Introduction
In Britain, the 1974 ‘Health and Safety at Work Act’ established that ‘it shall be the duty of every employer to ensure so far as is reasonably practicable the health, safety and welfare of his employers’, and created the Health and Safety Executive, HSE, which regulates most risks to health and safety at work in Great Britain. In 1988, HSE published the ‘Tolerability of Risk Framework’ introducing the ‘ALARP Principle’ - where risks are below a level that is ‘intolerable’, but above a level that is ‘broadly acceptable’, they should be reduced to a level that is ‘As Low As is Reasonably Practicable’, ALARP. This Framework is the cornerstone for risk regulation.

Methods
This presentation uses examples to trace the ongoing evolution of approaches to risk reduction within this Framework, and continuing challenges.

Results
Examples are:

Introduction of:
• simplified ‘control banding’ for exposure to chemicals, aimed at small and medium employers;
• guidance moving beyond physical to psychosocial hazards (work-related stress);
• a ‘toolkit’ to promote leadership and worker engagement in construction using behavioural change;
• horizon scanning to inform regulatory thinking on emerging trends.
Development of:
• statistical modelling that could compare the relative impact of potential regulatory interventions on long-latency diseases;
• quantified risk zones for biohazards from commercial composting.
Evidence from:
• monitoring exposure to carcinogenic MbOCCA, that duty holders are reducing risks to meet exposure limits rather than ALARP;
• studying bakery workers, that workplace health surveillance and exposure control are insufficient to prevent clinically significant allergic sensitization.

Additionally, we discuss whether the Framework fits the broader societal detriments of not undertaking a work activity – the well-being paradox that
‘good work is good for you, but work can also harm your health’.

Discussion
Approaches to reducing risks to occupational health and safety are evolving, and must continue to do so.