Journal of Public Health Medicine
Vol. 14, No. 4, pp. 37S-379 Printed in Great Britain
An asbestos hazard in North Devon
Summary In March 1990, following the careless removal of asbestosbased ceiling tiles in a leisure centre in North Devon, delay in action by the local authority meant that the risk to staff and members of the public was ignored for four months. The Director of Public Health was then approached to tackle the problem of providing advice to both leisure centre staff and the public in order to deal with the concern that had arisen as a result of the delay. There was a public statement a report to the local authority, and a 'hotline' for members of the public. Leisure centre staff members were individually interviewed by a doctor using a specially designed occupational health questionnaire and followed up as appropriate. Twenty-one chest X-rays were taken on the advice of the local chest physician. Although the level of exposure was small, and there was no significant threat to health, the incident caused major public concern, was an embarrassment to the local authority, and involved the Health and Safety Executive and considerable input from the Department of Public Health Medicine. Most importantly for a small district, it was a major public relations exercise for Public Health Medicine. This paper examines the appropriateness and effectiveness of intervention by Public Health Medicine in a situation where the risks were known to be very low but public anxiety, fuelled by compensation possibilities, was very high.
broke tiles without bagging them first, used no breathing apparatus or screening, and the work was not supervised by the council. Meanwhile, the foyer area continued to function as usual, with staff working and visitors passing through. The situation quickly became intolerable, and the contractors were asked to leave the building and to discontinue the work. Leisure centre staff were then instructed to clear up the mess left by the contractors. The following weekend coincided with significant winter storms in North Devon, and council activity was geared to manning sea defences, moving fallen trees and coping with repair work. On Monday 5 March, Environmental Health Officers took two air samples, and found that one was above the statutory control limit of 0-2 fibres/ml. Further cleaning was carried out by leisure centre staff and when samples were taken again on 8 March they were below the limit. There was then a long period without further developments, but because of pressure from staff and the likelihood of a damaging political incident, the council decided to take further action.
Public health involvement Introduction Barnstaple is a town of some 25000 people and the county town of North Devon. In 1975 the council built a modern leisure centre near the town centre, which is well used by the local population as well as the many schools in the area. Asbestolux (30 per cent amosite - brown asbestos) tiles were installed in the roof of the foyer. There had been a history of previous damage to these tiles: they had been partially replaced, drilled into or damaged. In 1989, it was agreed they should be removed completely. The work was given to a small local firm who had been used previously by the council. Before removal of the tiles, air sampling in the roof space had shown no evidence of free asbestos fibres. On the morning of 1 March, thefirmbegan work. The contractors failed to take the necessary precautions, and the workmen created a great deal of dust and mess. They
Thus, in July, some four and a half months after the event, the matter was drawn to the attention of the Director of Public Health, and advice sought. Although the overall risk to the staff and members of the public was very low, a combination of factors (the four and a half month delay, the fact that the Health and Safety Executive had never been informed, the inadequate supervision of the work and the lack of proper precautions taken) meant that the task was a complex one. Although Directors of Public Health must be prepared to criticize, they must work with their local authorities
Department of Public Health Medicine, North Devon Health Authority, Riverevale, Utchdon Street, Barnstaple, North Devon EX32 8ND. VIRGINIA A. H. PEARSON, Registrar in Public Health Medicine PETER A. SIMS, Director of Public Health Addrcn correspondence to Dr V. A. H. Pearson.
©Oxford University Press 1992
Downloaded from https://academic.oup.com/jpubhealth/article-abstract/14/4/376/1575450 by Insead user on 08 September 2018
Virginia A. H. Pearson and Peter A. Sims
377
AN ASBESTOS HAZARD IN NORTH DEVON constructively, and it is often helpful to enable councils to admit problems and rectify them quickly and effectively. The chief tasks were therefore:
On 26 July, the Director of Public Health met the Chief Executive of the Council, the Director of Services (Environmental Health and Housing) and the Director of Personnel, and spoke with the leisure centre staff to try and reassure them, and to determine a way forward. Later that evening, the full Council was addressed, indicating how the matter would proceed.
Method After the council meeting, a notice was prepared for the local press, and a 'helpline' number was published for members of the public who wished to make contact. Over the next two to three weeks, some 40 people made contact, most of whom had visited the leisure centre between 1 and 8 March to use the swimming pool. Personal letters were sent to all leisure centre staff and to any particularly anxious callers. They were reassured that the overall risk to their health was minimal, and probably no more than the asbestos exposure from breathing traffic fumes, where brake linings generate minute particles of asbestos. Members of the leisure centre staff At the time of the incident, there were 71 members of staff working in the leisure centre. An occupational health questionnaire was specially designed with the advice of the Occupational Health Department of the University of Bristol, and each person was asked to attend for an interview. Nine people declined interview, and the remaining eight non-responders were contacted again. Finally, 54 people were seen: a response rate of 76 per cent. Each member of staff was interviewed individually by the Registrar in Public Health Medicine, and could therefore discuss, in confidence, any anxieties. Each questionnaire was then discussed informally with the local consultant chest physician and, where appro-
(a) offered an interview with a doctor; (b) offered an X-ray if appropriate; and (c) received a letter, as did their GP, indicating that there was no particular health problem.
Results Nine staff members declined an interview, and eight failed to reply. These 17 people were all categorized as being in low or medium dust exposure groups (Table 1). There was an equal sex distribution among those interviewed, but no significant difference in the degree of
TABLE 1 Staff attending for occupational hearth interviews versus qualitative dust exposure levels Exposure level
Interviewed
Declined
No response
Total
High Medium Low
7 17 30
0 0 9
0 0 8
7 17 47
Total
54
9
8
71
Definitions of relative exposure levels: High: staff who cleared up the dust or worked in the foyer for extended periods while tiles were being removed. Medium: staff who regularly passed through the foyer during the day. Low: staff who worked elsewhere in the building and only walked through the foyer area (equivalent to members of the general public).
Downloaded from https://academic.oup.com/jpubhealth/article-abstract/14/4/376/1575450 by Insead user on 08 September 2018
(1) to give advice to the council on relative risks to staff and the public; (2) to ensure that the Health and Safety Executive was informed; (3) to act as spokesman to the local press and other media, and to provide a 'helpline' for enquiries from the public; (4) to provide the necessary help and advice to staff working in the leisure centre; (5) to liaise with Health Service colleagues for the provision of back-up clinical care as necessary.
priate, it was agreed that a chest X-ray was advisable. It is important to emphasize that this was not to detect any risk from asbestos exposure in March, but rather any underlying chest disease and to obtain a reasonable baseline. Eventually, 21 people were X-rayed, all with normal results. Of these, two had a history of undiagnosed haemoptysis and three had significant previous exposure to asbestos. Personal letters were sent to each person, indicating the outcome of the consultation with the consultant and the chest X-ray results as appropriate. Also, a copy of the occupational health questionnaire was given to each person, as a record of the incident. Their general practitioners (GPs) were informed of the situation at each stage, and a copy of the questionnaire (and the result of the X-ray, if one was taken) was sent for inclusion in the medical notes for future reference if necessary. The original questionnaires have been kept in the Public Health Medicine Department. In summary, every member of staff was:
378
JOURNAL OF PUBLIC HEALTH MEDICINE
TABLE 2 Staff interviews: degree of exposure by sex of employee Sex Exposure level
Female
Male
13
2 8 17
Total
27
27
2
5 9
Discussion
- ! -88, df=2, p>0-25. No significant difference.
TABLE 3 Degree of exposure by type of occupation Occupation type Exposure level
Manual
Non-manual
Managerial
High Medium Low
3 9 16
3 2 13
1 6 1
Total
28
18
8
^-11-12,^=4, p
Vol. 14, No. 4, pp. 37S-379 Printed in Great Britain
An asbestos hazard in North Devon
Summary In March 1990, following the careless removal of asbestosbased ceiling tiles in a leisure centre in North Devon, delay in action by the local authority meant that the risk to staff and members of the public was ignored for four months. The Director of Public Health was then approached to tackle the problem of providing advice to both leisure centre staff and the public in order to deal with the concern that had arisen as a result of the delay. There was a public statement a report to the local authority, and a 'hotline' for members of the public. Leisure centre staff members were individually interviewed by a doctor using a specially designed occupational health questionnaire and followed up as appropriate. Twenty-one chest X-rays were taken on the advice of the local chest physician. Although the level of exposure was small, and there was no significant threat to health, the incident caused major public concern, was an embarrassment to the local authority, and involved the Health and Safety Executive and considerable input from the Department of Public Health Medicine. Most importantly for a small district, it was a major public relations exercise for Public Health Medicine. This paper examines the appropriateness and effectiveness of intervention by Public Health Medicine in a situation where the risks were known to be very low but public anxiety, fuelled by compensation possibilities, was very high.
broke tiles without bagging them first, used no breathing apparatus or screening, and the work was not supervised by the council. Meanwhile, the foyer area continued to function as usual, with staff working and visitors passing through. The situation quickly became intolerable, and the contractors were asked to leave the building and to discontinue the work. Leisure centre staff were then instructed to clear up the mess left by the contractors. The following weekend coincided with significant winter storms in North Devon, and council activity was geared to manning sea defences, moving fallen trees and coping with repair work. On Monday 5 March, Environmental Health Officers took two air samples, and found that one was above the statutory control limit of 0-2 fibres/ml. Further cleaning was carried out by leisure centre staff and when samples were taken again on 8 March they were below the limit. There was then a long period without further developments, but because of pressure from staff and the likelihood of a damaging political incident, the council decided to take further action.
Public health involvement Introduction Barnstaple is a town of some 25000 people and the county town of North Devon. In 1975 the council built a modern leisure centre near the town centre, which is well used by the local population as well as the many schools in the area. Asbestolux (30 per cent amosite - brown asbestos) tiles were installed in the roof of the foyer. There had been a history of previous damage to these tiles: they had been partially replaced, drilled into or damaged. In 1989, it was agreed they should be removed completely. The work was given to a small local firm who had been used previously by the council. Before removal of the tiles, air sampling in the roof space had shown no evidence of free asbestos fibres. On the morning of 1 March, thefirmbegan work. The contractors failed to take the necessary precautions, and the workmen created a great deal of dust and mess. They
Thus, in July, some four and a half months after the event, the matter was drawn to the attention of the Director of Public Health, and advice sought. Although the overall risk to the staff and members of the public was very low, a combination of factors (the four and a half month delay, the fact that the Health and Safety Executive had never been informed, the inadequate supervision of the work and the lack of proper precautions taken) meant that the task was a complex one. Although Directors of Public Health must be prepared to criticize, they must work with their local authorities
Department of Public Health Medicine, North Devon Health Authority, Riverevale, Utchdon Street, Barnstaple, North Devon EX32 8ND. VIRGINIA A. H. PEARSON, Registrar in Public Health Medicine PETER A. SIMS, Director of Public Health Addrcn correspondence to Dr V. A. H. Pearson.
©Oxford University Press 1992
Downloaded from https://academic.oup.com/jpubhealth/article-abstract/14/4/376/1575450 by Insead user on 08 September 2018
Virginia A. H. Pearson and Peter A. Sims
377
AN ASBESTOS HAZARD IN NORTH DEVON constructively, and it is often helpful to enable councils to admit problems and rectify them quickly and effectively. The chief tasks were therefore:
On 26 July, the Director of Public Health met the Chief Executive of the Council, the Director of Services (Environmental Health and Housing) and the Director of Personnel, and spoke with the leisure centre staff to try and reassure them, and to determine a way forward. Later that evening, the full Council was addressed, indicating how the matter would proceed.
Method After the council meeting, a notice was prepared for the local press, and a 'helpline' number was published for members of the public who wished to make contact. Over the next two to three weeks, some 40 people made contact, most of whom had visited the leisure centre between 1 and 8 March to use the swimming pool. Personal letters were sent to all leisure centre staff and to any particularly anxious callers. They were reassured that the overall risk to their health was minimal, and probably no more than the asbestos exposure from breathing traffic fumes, where brake linings generate minute particles of asbestos. Members of the leisure centre staff At the time of the incident, there were 71 members of staff working in the leisure centre. An occupational health questionnaire was specially designed with the advice of the Occupational Health Department of the University of Bristol, and each person was asked to attend for an interview. Nine people declined interview, and the remaining eight non-responders were contacted again. Finally, 54 people were seen: a response rate of 76 per cent. Each member of staff was interviewed individually by the Registrar in Public Health Medicine, and could therefore discuss, in confidence, any anxieties. Each questionnaire was then discussed informally with the local consultant chest physician and, where appro-
(a) offered an interview with a doctor; (b) offered an X-ray if appropriate; and (c) received a letter, as did their GP, indicating that there was no particular health problem.
Results Nine staff members declined an interview, and eight failed to reply. These 17 people were all categorized as being in low or medium dust exposure groups (Table 1). There was an equal sex distribution among those interviewed, but no significant difference in the degree of
TABLE 1 Staff attending for occupational hearth interviews versus qualitative dust exposure levels Exposure level
Interviewed
Declined
No response
Total
High Medium Low
7 17 30
0 0 9
0 0 8
7 17 47
Total
54
9
8
71
Definitions of relative exposure levels: High: staff who cleared up the dust or worked in the foyer for extended periods while tiles were being removed. Medium: staff who regularly passed through the foyer during the day. Low: staff who worked elsewhere in the building and only walked through the foyer area (equivalent to members of the general public).
Downloaded from https://academic.oup.com/jpubhealth/article-abstract/14/4/376/1575450 by Insead user on 08 September 2018
(1) to give advice to the council on relative risks to staff and the public; (2) to ensure that the Health and Safety Executive was informed; (3) to act as spokesman to the local press and other media, and to provide a 'helpline' for enquiries from the public; (4) to provide the necessary help and advice to staff working in the leisure centre; (5) to liaise with Health Service colleagues for the provision of back-up clinical care as necessary.
priate, it was agreed that a chest X-ray was advisable. It is important to emphasize that this was not to detect any risk from asbestos exposure in March, but rather any underlying chest disease and to obtain a reasonable baseline. Eventually, 21 people were X-rayed, all with normal results. Of these, two had a history of undiagnosed haemoptysis and three had significant previous exposure to asbestos. Personal letters were sent to each person, indicating the outcome of the consultation with the consultant and the chest X-ray results as appropriate. Also, a copy of the occupational health questionnaire was given to each person, as a record of the incident. Their general practitioners (GPs) were informed of the situation at each stage, and a copy of the questionnaire (and the result of the X-ray, if one was taken) was sent for inclusion in the medical notes for future reference if necessary. The original questionnaires have been kept in the Public Health Medicine Department. In summary, every member of staff was:
378
JOURNAL OF PUBLIC HEALTH MEDICINE
TABLE 2 Staff interviews: degree of exposure by sex of employee Sex Exposure level
Female
Male
13
2 8 17
Total
27
27
2
5 9
Discussion
- ! -88, df=2, p>0-25. No significant difference.
TABLE 3 Degree of exposure by type of occupation Occupation type Exposure level
Manual
Non-manual
Managerial
High Medium Low
3 9 16
3 2 13
1 6 1
Total
28
18
8
^-11-12,^=4, p
