Large-scale construction needs to champion health

A major British study has found that large-scale construction projects can play an instrumental role in developing workers’ understanding of health.

Funded by the Institution of Occupational Safety and Health (IOSH), the three-year project involved researchers from Loughborough University integrating themselves within construction teams working on the Thames Tideway Tunnel project (Tideway) — a 25 km, multibillion-pound sewage tunnel that will run up to 65 m under London’s River Thames and is due to be completed by 2023. The researchers observed key health and safety processes and personnel within the construction teams as well as health and safety-related documentation, activities and events.

The researchers were especially focused on ill heath, rather than accidents, which constitutes a major concern for the construction sector internationally. In the United Kingdom, for example, there are approximately 4000 worker health-related deaths per annum, compared with 39 who die as a result of accidents. The research team used interviews and ethnographic methods such as meeting observation to better understand why the construction industry has struggled to manage health effectively.

“A key issue identified related to the term ‘health’ and how it is conceptualised,” one of the researchers, Professor Alistair Gibb, said. “Health risks are challenging to manage because health is not like safety, in terms of the hazards themselves but also in terms of the way the construction sector understands and manages risk. This is what needs to be addressed to achieve real, lasting change.”

Through their immersive research approach, the team at Loughborough University came to recognise the potential of major construction projects such as Tideway. For example, they note the role that large-scale construction projects play in upskilling the workforce. Therefore, the researchers argue that construction managers, with the support of workplace health and safety (WHS) and health professionals, have much responsibility for the promotion of health. The researchers recommend interventions from occupational hygienists and the coordination of training sessions for project managers and supervisors, as well as engineers, as being worthwhile investments. These findings were published as an article in Civil Engineering, an academic journal of the Institution of Civil Engineers (ICE).

“The construction industry faces many unique challenges when it comes to managing health risks and protecting workers,” Prof Gibb said. “Across the industry there is poor understanding about the standards of health assessment which are legally required and low motivation among many employers to pay for health checks for workers who may soon move to other employers.”

The researchers also make the case that major construction projects are critical to raising health management standards, and that a consistent approach is needed across the sector. “Major projects such as Tideway are critical to developing universally high health management standards and are well-placed to champion good OH [occupational health] services and to use their expertise and influence to embed change within their own supply chains. To achieve long-lasting improvements, these standards must be adopted throughout the sector, particularly within the SMEs [small and medium-sized companies] which employ the majority of the workforce,” Prof Gibb said.

The researchers also note that continuous training of frontline workers is needed, especially to combat low-visibility health hazards such as noise and respirable dust, and to raise awareness of long-latency conditions, such as those caused by silica dust and asbestos exposure. On the significance of the study’s health focus, Mary Ogungbeje, Research Manager at IOSH, said: “For health to truly be treated like safety in construction there needs to be a shift in the perception and practices of employers and workers, and acceptance in industry that high standards should not be an exceptional practice but the necessary norm. The study highlights practical measures to help all stakeholders address barriers and improve the management of health risks in construction.”

Response from participating industry has also emphasised the need for a health focus within the sector. “This unique approach to conducting a longitudinal study with skilled researchers embedded into our construction teams has allowed us to compile legacy information in real time rather than, as has historically been the case, at the end of the project,” Tideway’s Director of Health, Safety and Wellbeing, Steve Hails, said. “This gives Tideway objective feedback during our works and informs our future direction. There are additional wider industry benefits for future projects to learn from our experiences through this approach and realising the benefits of industry working collaboratively with academia during the planning and construction phases of work.”

As part of the same project, a second journal article has been published in Safety Science; this second article explores the challenges of achieving lasting improvement in construction worker health in more detail.

Image credit: ©stock.adobe.com/au/VILevi