The Construction Toolkit That Could Save Lives

Health and well-being is a topical subject and a current in the construction industry. Through this article I would like to explain how National Grid tackled the issue of stress, using a new process I helped design.

It is essential for business and construction to avoid assuming men know what to do about stress levels. Another risk may include thinking men don’t want help. It all starts by talking about it. We don’t have to have all the answers but let’s begin and learn from it. If we don’t know what Construction workers want, let’s ask them and listen to what they say. It’s likely it won’t be much different to what the rest of us want or need. But if we ask them, they’ll know we care, and that’s what matters.

How National Grid took initiative

Construction workers within National Grid learned about site safety by Health & Safety Reps. The Reps had never received training in stress and mental health. So, National Grid felt the subject of anxiety hadn’t been discussed. Managers also struggled to support staff if they took time off for stress. The issue felt like the ‘elephant in the room,’ and they began a campaign to correct this. I helped design a toolkit that recognised stress early. It equipped managers with tools to approach a vulnerable employee. It also covered how to support them. The benefit of this was greater confidence when discussing the subject. It improved how easy it felt to talk about personal issues. It also increased their understanding of what people needed and helped.

Some of us are lucky enough to learn the tools we need to help us cope well in life. Loneliness, when working away from home or balancing work with home life, can be tough. So can be handling marital breakdown or losing someone we love. If we haven’t managed to deal with these or have them taught to us by parents, then we can feel ill-equipped. Communication is crucial and talking about our emotions can bring stability in our routine. Not talking can have significant effects on our health. Some of the time we ‘learn’ what is acceptable, or unacceptable in our behaviour from the habits we are surrounded by. If it is ‘negative’ to express our emotions, then we are likely to stay closed off. Another issue is that men often find it more challenging to talk about feelings than women. 


The difference of emotional state between the genders

Women experience emotions on both sides of their brains. They have many connections within the brain to the part of it responsible for language. It is much easier for women to express what they are feeling. Men still experience emotions but find it tougher to explain. For men, it can be much harder to find the right words. So, some men may choose not to speak about things, and for some, it may feel more as if they can’t. Others may use different coping mechanisms such as withdrawing or avoiding things. Some may channel their distress by taking exercise or team sports and seem to avoid talking. Because men do this, it doesn’t mean they want to, and it doesn’t mean someone may not be able to help. They may be well received were they to offer. The key to helping men is to provide help but in a way that appeals to them. To do that well keep the process simple.

Helping is much easier to do when you know someone well, such as a good friend. The question ‘how are you?’ isn’t coming from management and doesn’t feel threatening. It’s also easier to ask for help from a friend rather than a professional. So, National Grid implemented a toolkit. Reps knew to look out for someone they knew may be struggling with stress. They didn’t try to resolve the problem; they offered a helping hand of a friend.

The 4 symbols that represent what this toolkit looks like

The Buddy Toolkit

I developed better expertise with this process over time and revised it. I called it a Buddy toolkit or ‘looking out for your mates.’ I extended it beyond Health and Safety Reps to the workers whenever I introduced this. It was important workers didn’t have to look out for everyone they knew but watched out for their best mate. It was also important not to feel they had to fix how someone was feeling or make them feel better. All you do is watch out for your mate and check in with them. When you’ve asked how they are if they are unhappy and you think you can help offer your thoughts. Talk about when you’ve experienced something similar. If you don’t think you can help, direct them towards someone, you know who can. Whether that someone is on-site or off-site does not play a role. Make it your business to know what services are available then you’ll know you tried and they’ll feel valued. Keep in touch and check in again a few days later.

With the Buddy toolkit, you also pair people up within your project team. If someone is new to the team, a more experienced site worker would be better paired with them for a few weeks. That is so they can show the new person the ropes but also look out for them. Often, we are at our most isolated when lonely, and we don’t know anyone. That is a risk for mental health. It’s also the time when men are most likely to find out what is and isn’t ok in that culture. If they are new in, need help but don’t ask, the buddy system gives them someone they can approach.

We all need support in life, and this toolkit helps. What this achieves is simple; you show you care and they feel that. If they are going to reach out, then they’ll come to you. So, look, watch and ask how they are, if you see they aren’t themselves at any time.

Article by Sue Firth, Business Psychologist for Express Medicals

Health surveillance and hazard control in the workplace

Health surveillance and hazard control in the workplace

Health surveillance is a process of on-going monitoring of employees when they’re working in circumstances that could be harmful for their health.
Companies need to have health surveillance when hazards such as noise, manual handling, biological agents or other factors influence the workplace. Employers sometimes wrongly consider surveillance as a method for preventing harmful situations. Although this may seem like the most convenient approach, it can not avoid exposure to dangerous situations. Complete prevention of these serious situations, as far as possible, is the most appropriate way of controlling risks to health.
Health surveillance can be considered part of health risk management. It requires a systematic approach for early detection of diseases and follow-ups to prevent progression. It can be valuable for employees to know that an effective health control programme is in place.

Hierarchy of hazard control

The system is used in this industry to minimize or even eliminate exposure to hazards. The infographic below is used by the National Institute for Occupational Safety and Health (NIOSH).

New training keeps offshore workers safe in transit

This month, our doctors have been reviewing and updating their skills, to ensure we can offer trusted training, following Oil and Gas UK’s new requirements for offshore medical workers.

New medical requirements mean offshore workers have to pass medicals ensuring they are fit to use Emergency Breathing Systems. This kit is designed to keep them safe should there be an accident on any helicopter.

We’ve been involved in certification for offshore workers for many years: correct assessments are vital when workers are close to unpredictable weather and potentially life-threatening conditions. The latest changes to process were recommended by the Civil Aviation Authority. This was introduced following a helicopter crash in 2013, which resulted in the death of four offshore workers.

Oil and Gas UK, the industry’s member organisation, has now changed the training for workers that go offshore, to ensure they’re fit for work. This is done by using a new compressed gas emergency breathing system. This new assessment is vital to ensure anyone using the system is aware of the risks and mitigations around barotrauma. Also known as decompression sickness, a range of injuries caused by changes in air or water pressure can occur.

Workers are now required to complete survival course in-water training exercises. With a compressed-air emergency breathing apparatus (EBS) it is ensured that they can correctly operate the equipment, in a controlled environment. That’s where Express Medicals comes in.

Before taking part in the course, trainees must have an assessment of their medical fitness to participate. A worker who needs to be certified for offshore work and has not already completed the survival training will now also need an assessment of their fitness.

Express Medicals makes this assessment at the same time as the standard Oil and Gas UK assessment and will issue a certificate ‘fit for training’.

Objective of medical assessment

The objective of the fitness for in-water EBS training is to:

  1. Ensure trainees have understood the nature of the hazard of barotrauma, that some medical conditions may increase the risk, and the importance of providing an accurate medical history.
  2. Classify trainees as either ‘fit’ or ‘unfit’ for in-water EBS training.
  3. Ensure all trainees have received explanation of risk mitigation and measures in general. As well as that trainees with medical conditions have received personalised risk mitigation advice relevant to their condition.
  4. Provide documentary confirmation of fitness status, for employers and training providers.

How we assess

The candidate completes a questionnaire. One of our medical staff will sit with them and clarify any positive answers.  At this stage, we discuss the hazard and risk of barotrauma, and ensure the candidate has had sufficient opportunity to provide an accurate medical history. For candidates without any relevant medical history, we can then certify fitness to participate in training without need for further tests or physical examination.

For candidates with a history of relevant medical condition(s), we will examine the respiratory and/or ENT systems, and/or performance of lung function tests. Unless we obtain a clear history of absolute contraindication to training (in which case the examining doctor may directly certify unfitness for training).

If the examining doctors suspect a clinical diagnosis relevant to EBS in-water training, despite lack of history, they will undertake clinical examination and/or lung function testing and/or other relevant tests considered appropriate.

Some conditions that might affect fitness to train are:

  • Lung conditions, for example –   Asthma, Chronic Obstructive Pulmonary Disease or COPD, Pneumothorax, Sarcoidosis or a history of Bullae.
  • Ear Nose and Throat conditions, for example – difficulty in clearing their ears, tracheostomy, perforated tympanic membrane etc.

Why training has changed

Following a helicopter crash off Sumburgh in August of 2013 in which four passengers died (two from drowning, one from cardiac arrest, and one from an incapacitating head injury) the Civil Aviation Authority directed the UK oil and gas industry to introduce a more easily deployed emergency breathing system. The ‘PSTASS’ (Passenger Short-Term Air Supply System) compressed-air breathing apparatus was introduced to service for passengers on offshore helicopter flights in the UK sector of the North Sea in 2015.


New – Silica medicals extended across our clinic network

We’re delighted to announce that silica medicals are now available at every one of our 15 clinics across the UK.

The railway industry is becoming increasingly aware of the dangers to workers caused by dust in ballast, which contains silica particles.

It’s a threat to health that some have likened to the danger from asbestos – and employers have reacted responsibly, to avert a similar long-term health catastrophe.

How it effects workers?

Workers inhale silica dust when handling ballast, or when they drill into concrete, bricks or tiles. It’s a real risk in many common construction situations. Last year, Volker Rail won a Railstaff Award for their initiative, “Positive Intervention to Control Exposure to Ballast Dust”.

Now rail companies are working closely with occupational health providers, ensuring their testing includes specific silica tests to maintain a high level of commitment to staff safety.

Express Medicals Ltd tests for silicosis and related conditions at clinics throughout the UK, and is seeing an increase in customer requests.

“Testing for silicosis is an important feature of railway medicals and we work closely with a number of companies to ensure workers are silica free, or to find out if they should receive early intervention and treatment if we find they’ve been exposed to levels that might cause harm,” explains Dr Dan Hegarty, CEO of Express Medicals Ltd.

“We anticipate a significant rise in the number of these medicals throughout 2018 as awareness of the various diseases caused by dust-borne particles continues to be of concern. It’s vital to test early, to help prevent the onset of silicosis.”

Silicosis is a serious lung disease which can affect any workers who breathe in silica dust. In most cases the condition develops over a long period of time. However, if a large amount of silica is inhaled over a short period of time, for example a few months, then it’s possible to suffer from a rapid onset acute form of silicosis. Sufferers usually present with a cough and increasing breathing difficulties upon exercise.

There is an increased incidence of some other medical problems in people diagnosed with silicosis including:

  • COPD (chronic obstructive pulmonary disease) which also causes breathing difficulties
  • RA (rheumatoid arthritis)
  • TB (tuberculosis)
  • Lung cancer.

The role of correct PPE, including well-fitting face masks, is paramount.

A good occupational health provider will also help employers ensure they’re meeting their requirements under the COSHH Regulations 2002, by contributing to briefing sessions to advise on occupational lung diseases, including silicosis. What is silicosis? How does it affect sufferers? What does it do to the lungs? How is breathing disturbed? Why is it associated with some other medical conditions? Is it very dangerous? How quickly does it develop? Is it likely to interfere with fitness and the ability to work? Is forced retirement inevitable?

At Express Medicals we have created a four point process to assist managers. You should consider:

1). How best to educate your workers about the risks from silica?

2). Who to include in your health surveillance programme?

3). Who to appoint as the responsible person to organise and oversee the programme?

4). The appointment of an OH provider.

The OH provider will act as a significant advisory partner to your health & safety staff and the management team. Its services will include questionnaires, medical examinations, chest X-rays (when appropriate) and liaison with GPs / other health professionals. A provider like Express Medicals will be skilled in handling situations in which silicosis (or any other occupational disease) is detected, supporting individual sufferers and supporting employers.

The role of an occupational health provider in relation to silicosis falls within the much wider remit of health & wellbeing and health surveillance. The benefits of providing health & wellbeing services are increasingly recognised by employers because, in helping to protect the health of a workforce, such services positively affect morale, retention and performance in any company. A workforce that is cared for will be more motivated, more efficient and will likely boost company performance.

A good occupational health provider will provide valuable up-to-date information to your health and safety staff and management team. They are essential partners in developing effective health and wellbeing programmes, to ensure staff are motivated and efficient.

For information about occupational health services, please contact us and we shall be delighted to advise you.

020 7500 6900


Dr Dan Hegarty, CEO of Express Medicals Ltd, has more than 21 years’ experience of occupational health in the railway sector. Here he considers some aspects of crystalline silica dust and the complication of silicosis.

The Health and Safety Executive [HSE] provides helpful information on its website.

A very useful HSE guidance leaflet is ‘G404. Health surveillance for those exposed to respirable crystalline silica (RCS)’.





Sugar, sugar

As part of Diabetes Week, our medical staff was out and about with clients, testing their staff for blood sugar levels. This is where we discovered some surprises.

Lifestyle, diet and exercise levels all affect the onset of Type 2 Diabetes. Whether it’s four sugars in four teas a day, multiple energy drinks to kick start your day or unhealthy fast foods on the way home.

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I was delighted to answer the call from Express Medicals Limited looking for specialist input as part of ‘Stress Awareness Week’. One of their clients, Dragados, had asked for a speaker to help everyone understand the subject of stress, what it does and how to tackle it.

It was an early start at Bank underground station: the talks started at 7.30am. Their questions and interaction were fascinating – here I’m revisiting some of the key points I made, so that you can read what I covered too.

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The fun of walking

When we think of exercise we think of sports, the typical but structured process of a regular routine. Either where we join other people or work out in the gym on our own. This requires a lot of effort and often doesn’t suit us all.

Instead, think of a simple process: moving more often!

Many of us are far more sedentary than is good for us. If going to a gym or organised sport feels too much of a commitment, aim for something simpler!

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The deadly sound of silence

Mike Stallard, non-executive director at Express Medicals tells the story of his health incident as a warning to others.

I was very lucky in more ways. When the chance to retire came in my mid-50s, I grabbed the opportunity. I had longed to move to France, so a dream came true. So here I was, having a relaxing meal with friends in a French restaurant and thinking how lucky I was.

There’s that word again – lucky.

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