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.

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)’.