Address: Sheffield Occupational Health Project, Mudford's Buildings, 37 Exchange Street, Sheffield S2 5TR
Country: United Kingdom
Phone: 44 114 275 5760
Fax: 44 114 276 7257
Past position(s): Senior Research Fellow, Centre for Occupational and Environmental Health Policy Research, De Montfort University, Leicester
Areas of interest: Comparative occupational health services; occupational health in primary care; health and safety in steel working
Adapted in part from an unpublished article by Simon Pickvance.
The iron and steel industry is a “heavy industry”: in addition to the safety hazards inherent in giant plants, massive equipment and movement of large masses of materials, workers are exposed to the heat of molten metal and slag at temperatures up to 1,800°C, toxic or corrosive substances, respirable air-borne contaminants and noise. Spurred by trade unions, economic pressures for greater efficiency and governmental regulations, the industry has made great strides in the introduction of newer equipment and improved processes which afford greater safety and better control of physical and chemical hazards. Workplace fatalities and lost-time accidents have been significantly reduced, but are still a significant problem (ILO 1992). Steel making remains a dangerous trade in which the potential hazards cannot always be designed out. Accordingly, this presents a formidable challenge to everyday plant management. It calls for ongoing research, continuous monitoring, responsible supervision and updated education and training of workers on all levels.
Musculoskeletal injuries are common in steel making. Despite the introduction of mechanization and assistive devices, manual handling of large, bulky and/or heavy objects remains a frequent necessity. Constant attention to housekeeping is necessary to reduce the number of slips and falls. Furnace bricklayers have been shown to be at highest risk of work-related upper arm and low back problems. The introduction of ergonomics into the design of equipment and controls (e.g., crane drivers’ cabs) based on study of the physical and mental requirements of the job, coupled with such innovations as job rotation and team working, are recent developments aimed at enhancing the safety, well-being and performance of steel workers.
Steel making is one of the noisiest industries, although hearing conservation programs are decreasing the risk of hearing loss. The major sources include fume extraction systems, vacuum systems using steam ejectors, electrical transformers and the arc process in electrical arc furnaces, rolling mills and the large fans used for ventilation. At least half of noise-exposed workers will be handicapped by noise-induced hearing loss after as little as 10 or 15 years on the job. Hearing conservation programmes, described in detail elsewhere in this Encyclopaedia, include periodic noise and hearing assessments, noise control engineering and maintenance of machines and equipment, personal protection, and worker education and training
Causes of hearing loss other than noise include burns to the eardrum from particles of slag, scale or molten metal, perforation of the drum from intense impulse noise and trauma from falling or moving objects. A survey of compensation claims filed by Canadian steelworkers revealed that half of those with occupational hearing loss also had tinnitus (McShane, Hyde and Alberti 1988).
Potentially hazardous vibration is created by oscillating mechanical movements, most often when machine movements have not been balanced, when operating shop floor machines and when using such portable tools as pneumatic drills and hammers, saws and grindstones. Damage to vertebral discs, low back pain and degeneration of the spine have been attributed to whole body vibration in a number of studies of overhead crane operators (Pauline et al. 1988).
Whole body vibration can cause a variety of symptoms (e.g., motion sickness, blurring and loss of visual acuity) which may lead to accidents. Hand-arm vibration has been associated with carpal tunnel syndrome, degenerative joint changes and Reynaud’s phenomenon in the finger tips (“white finger disease”), which may cause permanent disability. A study of chippers and grinders showed that they were more than twice as likely to develop Dupuytren’s contracture than a comparison group of workers (Thomas and Clarke 1992).
Heat exposure is a problem throughout the iron and steel industry, especially in plants located in hot climates. Recent research has shown that, contrary to previous belief, the highest exposures occur during forging, when workers are monitoring hot steel continuously, rather than during melting, when, although temperatures are higher, they are intermittent and their effects are limited by the intense heating of the exposed skin and by the use of eye protection (Lydahl and Philipson 1984). The danger of heat stress is reduced by adequate fluid intake, adequate ventilation, the use of heat shields and protective clothing, and periodic breaks for rest or work at a cooler task.
Lasers have a wide range of applications in steel making and may cause retinal damage at power levels far below those required to have effects on the skin. Laser operators can be protected by sharp focus of the beam and the use of protective goggles, but other workers may be injured when they unknowingly step into the beam or when it is inadvertently reflected at them.
Radioactive nuclides are employed in many measuring devices. Exposures can usually be controlled by posting of warning signs and appropriate shielding. Much more dangerous, however, is the accidental or careless inclusion of radioactive materials in the scrap steel being recycled. To prevent this, many plants are using sensitive radiation detectors to monitor all scrap before it is introduced into the processing.
Steel workers may be exposed to a wide range of pollutants depending on the particular process, the materials involved and the effectiveness of monitoring and control measures. Adverse effects are determined by the physical state and propensities of the pollutant involved, the intensity and duration of the exposure, the extent of accumulation in the body and the sensitivity of the individual to its effects. Some effects are immediate while others may take years and even decades to develop. Changes in processes and equipment, along with improvement of measures to keep exposures below toxic levels, have reduced the risks to the workers. However, these have also introduced new combinations of pollutants and there is always the danger of accidents, fires and explosions.
Dust and fumes
Emissions of fumes and particulates are a major potential problem for employees working with molten metals, making and handling coke, and charging and tapping furnaces. They are also troublesome to workers assigned to equipment maintenance, duct cleaning and refractory wrecking operations. Health effects are related to the size of the particles (i.e., the proportion that are respirable) and the metals and aerosols that may be adsorbed on their surfaces. There is evidence that exposure to irritant dust and fumes may also make steelworkers more susceptible to reversible narrowing of the airways (asthma) which, over time, may become permanent (Johnson et al. 1985).
Exposures to silica, with resultant silicosis, once quite common among workers in such jobs as furnace maintenance in melting shops and blast furnaces, have been lowered through the use of other materials for furnace linings as well as automation, which has reduced the number of workers in these processes.
Asbestos, once used extensively for thermal and noise insulation, is now encountered only in maintenance and construction activities when formerly installed asbestos materials are disturbed and generate airborne fibres. The long term effects of asbestos exposure, described in detail in other sections of this Encyclopaedia, include asbestosis, mesothelioma and other cancers. A recent cross-sectional study found pleural pathology in 20 out of 900 steelworkers (2%), much of which was diagnosed as restrictive lung disease characteristic of asbestosis (Kronenberg et al. 1991).
Emissions generated in steel making may contain heavy metals (e.g., lead, chromium, zinc, nickel and manganese) in the form of fumes, particulates, and adsorbates on inert dust particles. They are often present in scrap steel streams and are also introduced in the manufacture of special types of steel products. Research carried out on workers melting manganese alloys has shown impaired physical and mental performance and other symptoms of manganism at exposure levels significantly below the limits currently allowable in most countries (Wennberg et al. 1991). Short-term exposure to high levels of zinc and other vaporized metals may cause “metal fume fever”, which is characterized by fever, chills, nausea, respiratory difficulty and fatigue. Details of the other toxic effects produced by heavy metals are found elsewhere in this Encyclopaedia.
Acid mists from pickling areas can cause skin, eye and respiratory irritation. Exposure to hydrochloric and sulphuric acid mists from pickling baths have also been associated in one study with a nearly twofold increase in laryngeal cancer (Steenland et al. 1988).
The predominant source of sulphur emissions in steel making is the use of high-sulphur fossil fuels and blast furnace slag. Hydrogen sulphide has a characteristic unpleasant odour and short-term effects of relatively low-level exposures include dryness and irritation of nasal passages and the upper respiratory tract, coughing, shortness of breath and pneumonia. Longer exposures to low levels may cause eye irritation, while permanent eye damage may be produced by higher levels of exposure. At higher levels, there may also be a temporary loss of smell which can delude workers into believing that they are no longer being exposed.
Oil mists generated in the cold rolling of steel can produce irritation of skin, mucous membranes and upper respiratory tract, nausea, vomiting and headache. One study reported cases of lipoid pneumonia in rolling mill workers who had longer exposures (Cullen et al. 1981).
Polycyclic aromatic hydrocarbons
PAHs are produced in most combustion processes; in steelworks, coke making is the major source. When coal is partially burnt to produce coke, a large number of volatile compounds are distilled off as coal tar pitch volatiles, including PAHs. These may be present as vapours, aerosols or adsorbates on fine particulates. Short-term exposures may cause irritation of the skin and mucous membranes, dizziness, headache and nausea, while long-term exposure has been associated with carcinogenesis. Studies have shown that coke-oven workers have a lung cancer mortality rate twice that of the general population. Those most exposed to coal tar pitch volatiles are at the highest risk. These included workers on the oven topside and workers with the longest period of exposure (IARC 1984; Constantino, Redmond and Bearden 1995). Engineering controls have reduced the numbers of workers at risk in some countries.
Over 1,000 chemicals are used or encountered in steel making: as raw materials or as contaminants in scrap and/or in fuels; as additives in special processes; as refractories; and as hydraulic fluids and solvents used in plant operation and maintenance. Coke making produces by-products such as tar, benzene and ammonia; others are generated in the different steel-making processes. All may potentially be toxic, depending on the nature of the chemicals, the type, the level and duration of the exposures, their reactivity with other chemicals and the susceptibility of the exposed worker. Accidental heavy exposures to fumes containing sulphur dioxide and nitrogen oxides have caused cases of chemical pneumonitis. Vanadium and other alloy additions may cause chemical pneumonitis. Carbon monoxide, which is released in all combustion processes, can be hazardous when maintenance of equipment and its controls are substandard. Benzene, along with toluene and xylene, is present in coke-oven gas and causes respiratory and central nervous system symptoms on acute exposure; long-term exposures may lead to bone marrow damage, aplastic anaemia and leukaemia.
High levels of work stress are found in the steel industry. Exposures to radiant heat and noise are compounded by the need for constant vigilance to avoid accidents and potentially hazardous exposures. Since many processes are in continuous operation, shift work is a necessity; its impact on well-being and on workers’ essential social support are detailed elsewhere in this Encyclopaedia. Finally, there is the potent stressor of potential job loss resulting from automation and changes in processes, plant relocation and downsizing of the workforce.
Protecting steel workers against potential toxicity requires allocation of adequate resources for a continuing, comprehensive and coordinated programme that should include the following elements:
The role of community groups and the voluntary sector in occupational health and safety has grown rapidly during the past twenty years. Hundreds of groups spread across at least 30 nations act as advocates for workers and sufferers from occupational diseases, concentrating on those whose needs are not met within workplace, trade union or state structures. Health and safety at work forms part of the brief of many more organizations which fight for workers’ rights, or on broader health or gender-based issues.
Sometimes the life-span of these organizations is short because, in part as a result of their work, the needs to which they respond become recognized by more formal organizations. However, many community and voluntary sector organizations have now been in existence for 10 or 20 years, altering their priorities and methods in response to changes in the world of work and the needs of their constituency.
Such organizations are not new. An early example was the Health Care Association of the Berlin Workers Union, an organization of doctors and workers which provided medical care for 10,000 Berlin workers in the mid-nineteenth century. Before the rise of industrial trade unions in the nineteenth century, many informal organizations fought for a shorter working week and the rights of young workers. The lack of compensation for certain occupational diseases formed the basis for organizations of workers and their relatives in the United States in the mid-1960s.
However, the recent growth of community and voluntary sector groups can be traced to the political changes of the late 1960s and 1970s. Increasing conflict between workers and employers focused on working conditions as well as pay.
New legislation on health and safety in the industrialized countries arose from an increased concern with health and safety at work amongst workers and trade unions, and these laws in turn led to further increases in public awareness. While the opportunities offered by this legislation have seen health and safety become an area for direct negotiation between employers, trade unions and government in most countries, workers and others suffering from occupational disease and injury have frequently chosen to exert pressure from outside these tripartite discussions, believing that there should be no negotiation over fundamental human rights to health and safety at work.
Many of the voluntary sector groups formed since that time have also taken advantage of cultural changes in the role of science in society: an increasing awareness amongst scientists of the need for science to meet the needs of workers and communities, and an increase in the scientific skills of workers. Several organizations recognize this alliance of interest in their title: the Academics and Workers Action (AAA) in Denmark, or the Society for Participatory Research in Asia, based in India.
Strengths and Weaknesses
The voluntary sector identifies as its strengths an immediacy of response to emerging problems in occupational health and safety, open organizational structures, the inclusion of marginalized workers and sufferers from occupational disease and injury, and a freedom from institutional constraints on action and utterance. The problems of the voluntary sector are uncertain income, difficulties in marrying the styles of voluntary and paid staff, and difficulties in coping with the overwhelming unmet needs of workers and sufferers from occupational ill-health.
The transient character of many of these organizations has already been mentioned. Of 16 such organizations known in the UK in 1985, only seven were still in existence in 1995. In the meantime, 25 more had come into existence. This is characteristic of voluntary organizations of all kinds. Internally they are frequently non-hierarchically organized, with delegates or affiliates from trade unions and other organizations as well as others suffering from work-related health problems. While links with trade unions, political parties and governmental bodies are essential to their effectiveness in improving conditions at work, most have chosen to keep such relationships indirect, and to be funded from several sources—typically, a mixture of statutory, labour movement, commercial or charitable sources. Many more organizations are entirely voluntary or produce a publication from subscriptions which cover printing and distribution costs only.
The activities of these voluntary sector bodies can be broadly categorized as based on single hazards (illnesses, multinational companies, employment sectors, ethnic groups or gender); advice centres; occupational health services; newsletter and magazine production; research and educational bodies; and supranational networks.
Some of the longest-established bodies fight for the interests of sufferers from occupational diseases, as shown in the following list, which summarizes the principal concerns of community groups around the world: multiple chemical sensitivity, white lung, black lung, brown lung, Karoshi (sudden death through overwork), repetitive strain injury, accident victims, electrical sensitivity, women’s occupational health, Black and ethnic minority occupational health, white lung (asbestos), pesticides, artificial mineral fibres, microwaves, visual display units, art hazards, construction work, Bayer, Union Carbide, Rio Tinto Zinc.
Concentration of efforts in this way can be particularly effective; the publications of the Center for Art Hazards in New York City were models of their kind, and projects drawing attention to the special needs of migrant minority ethnic workers have had successes in the United Kingdom, the United States, Japan and elsewhere.
A dozen organizations around the world fight for the particular health problems of ethnic minority workers: Latino workers in the United States; Pakistani, Bengali and Yemeni workers in England; Moroccan and Algerian workers in France; and South-East Asian workers in Japan among others. Because of the severity of the injuries and illnesses suffered by these workers, adequate compensation, which often means recognition of their legal status, is a first demand. But an end to the practice of double standards in which ethnic minority workers are employed in conditions which majority groups will not tolerate is the main issue. A great deal has been achieved by these groups, in part through securing better provision of information in minority languages on health and safety and employment rights.
The work of the Pesticides Action Network and its sister organizations, especially the campaign to get certain pesticides banned (the Dirty Dozen Campaign) has been notably successful. Each of these problems and the systematic abuse of the working and external environments by certain multinational companies are intractable problems, and the organizations dedicated to resolving them have in many cases won partial victories but have set themselves new goals.
The complexity of the world of work, the weakness of trade unions in some countries, and the inadequacy of statutory provision of health and safety advice at work, have resulted in the setting up of advice centres in many countries. The most highly developed networks in English-speaking countries deal with tens of thousands of enquiries each year. They are largely reactive, responding to needs as reflected by those who contact them. Recognized changes in the structure of advanced economies, towards a reduction in the size of workplaces, casualization, and an increase in informal and part-time work (each of which creates problems for the regulation of working conditions) have enabled advice centres to obtain funding from state or local government sources. The European Work Hazards Network, a network of workers and workers’ health and safety advisers, has recently received European Union funding. The South African advice centres network received EU development funding, and community-based COSH groups in the United States at one time received funds through the New Directions programme of the US Occupational Safety and Health Administration.
Occupational Health Services
Some of the clearest successes of the voluntary sector have been in improving the standard of occupational health service provision. Organizations of medically and technically trained staff and workers have demonstrated the need for such provision and pioneered novel methods of delivering occupational health care. The sectoral occupational health services which have been brought into existence progressively over the last 15 years in Denmark received powerful advocacy from the AAA particularly for the role of workers’ representatives in management of the services. The development of primary-care-based services in the UK and of specific services for sufferers from work-related upper limb disorders in response to the experience of workers’ health centres in Australia are further examples.
Changes within science during the 1960s and 1970s have lead to experimentation with new methods of investigation described as action research, participatory research or lay epidemiology. The definition of research needs by workers and their trade unions has created an opportunity for a number of centres specializing in carrying out research for them; the network of Science Shops in the Netherlands, DIESAT, the Brazilian trade union health and safety resource centre, SPRIA (the Society for Participatory Research in Asia) in India, and the network of centres in the Republic of South Africa are amongst the longest established. Research carried out by these bodies acts as a route by which workers’ perceptions of hazards and their health become recognized by mainstream occupational medicine.
Many voluntary sector groups produce periodicals, the largest of which sell thousands of copies, appear up to 20 times a year and are read widely within statutory, regulatory and trade union bodies as well as by their target audience amongst workers. These are effective networking tools within countries (Hazards bulletin in the United Kingdom; Arbeit und Ökologie (Work and the Environment) in Germany). The priorities for action promoted by these periodicals may initially reflect cultural differences from other organizations, but frequently become the priorities of trades unions and political parties; the advocacy of stiffer penalties for breaking health and safety law and for causing injury to, or the death of, workers are recurrent themes.
The rapid globalization of the economy has been reflected in trade unions through the increasing importance of the international trade secretariats, area-based trade union affiliations like the Organization of African Trade Union Unity (OATUU), and meetings of workers employed in particular sectors. These new bodies frequently take up health and safety concerns, the African Charter on Occupational Health and Safety produced by OATUU being a good example. In the voluntary sector international links have been formalized by groups which concentrate on the activities of particular multinational companies (contrasting the safety practices and health and safety record of constituent businesses in different parts of the world, or the health and safety record in particular industries, such as cocoa production or tyre manufacture), and by networks across the major free trade areas: NAFTA, EU, MERCOSUR and East Asia. All these international networks call for the harmonization of standards of worker protection, the recognition of, and compensation for, occupational disease and injury, and worker participation in health and safety structures at work. Upward harmonization, to the best extant standard, is a consistent demand.
Many of these international networks have grown up in a different political culture from the organizations of the 1970s, and see direct links between the working environment and the environment outside the workplace. They call for higher standards of environmental protection and make alliances between workers in companies and those who are affected by the companies’ activities; consumers, indigenous people in the vicinity of mining operations, and other residents. The international outcry following the Bhopal disaster has been channelled through the Permanent People’s Tribunal on Industrial Hazards and Human Rights, which has made a series of demands for the regulation of the activities of international business.
The effectiveness of voluntary sector organizations can be assessed in different ways: in terms of their services to individuals and groups of workers, or in terms of their effectiveness in bringing about changes in working practice and the law. Policy making is an inclusive process, and policy proposals rarely originate from one individual or organization. However, the voluntary sector has been able to reiterate demands which were at first unthinkable until they have become acceptable.
Some recurrent demands of voluntary and community groups include:
The voluntary sector in occupational health and safety exists because of the high cost of providing a healthy working environment and appropriate services and compensation for the victims of poor working conditions. Even the most extensive systems of provision, like those in Scandinavia, leave gaps which the voluntary sector attempts to fill. The increasing pressure for deregulation of health and safety in the long-industrialized countries in response to competitive pressures from transitional economies has created a new campaign theme: the maintenance of high standards and upward harmonization of standards in different nations’ legislation.
While they can be seen as performing an essential role in the process of initiating legislation and regulation, they are necessarily impatient about the speed with which their demands are accepted. They will continue to grow in importance wherever workers find that state provisions fall short of what is needed.
National and international structures concerned with workplace health and safety have developed rapidly during the last 25 years in response to growing concerns about workers’ health. Economic, social and political changes provide the context for this development.
Amongst the economic factors have been the relocation of power away from workers into multinational enterprises and supranational legislatures, rapid changes in the relative competitiveness of different states in the world economy, and technological change in the productive process. Amongst the social factors are advance of medical knowledge with consequent raised expectations of health, and the growth of scepticism about the effects of scientific and technological advances on the environment inside and outside the workplace. The political context includes the calls for greater participation in the political process in many countries since the 1960s, the crisis in social welfare in several long-industrialized nations, and a growing sensitivity to the practices of multinationals in developing countries. Organizational structures have reflected these developments.
Workers’ organizations have taken on health and safety specialists to provide guidance to their members and negotiate on their behalf at local and national levels. There has been a rapid growth in the number of organizations of the victims of occupational disease over the last ten years, which can be seen as a response to the special hardships which they face where social welfare provisions are inadequate. Both developments have been mirrored at an international level by the increased importance given to health and safety by international trade union federations, and by international conferences of workers in particular industrial sectors. The structural and legal issues related to workers’ organizations, employers’ associations, and labour relations are discussed in a separate chapter of the Encyclopaedia.
The changes in employers’ and state organizations in recent years can be seen as partly reactive and partly pre-emptive. Law introduced in the last 25 years is in part a response to concerns expressed by workers since the late 1960s, and in part regulation of the rapid development of new technologies of production in the post-war period. Constitutional structures set up in different legislatures are of course consonant with national legislation and culture, but there are common features. These include an increase in the importance attached to prevention services and training for workers, managers and health and safety specialists, the establishment of participatory or consultative organizations at the workplace and at the national level, and the reorganization of the labour inspectorates and other state bodies concerned with enforcement. Differing mechanisms have been set up in different States for the insurance coverage provided for a worker injured or made ill by work, and for the relationship of health and safety enforcement to other state bodies concerned with employment and the environment.
Organizational changes such as these create new training requirements in the professions concerned—inspectors, safety engineers, industrial hygienists, ergonomists, occupational psychologists, doctors and nurses. Training is discussed by professional and other bodies at national and international levels, with the major professions meeting in international congresses and developing common requirements and codes of practice.
Research is an essential part of planned and reactive prevention programmes. Governments are the single largest source of research funds, which are predominantly organized into national research programmes. At the international level, there are, in addition to sections of the International Labour Organization (ILO) and the World Health Organization (WHO), research institutions such as the European Joint Safety Institute and the International Agency for Research into Cancer which carry out international programmes of research in occupational safety and health.
While the ILO, WHO and other UN organizations have had a concern with occupational health written into their statutes since the Second World War or even earlier, many international bodies concerned with occupational health date back less than 25 years. Health and safety is now a significant concern of world trade bodies and regional free trade areas, with the social consequences of trade agreements often being discussed during negotiations. The Organization for Economic and Cultural Development (OECD) evaluates health and safety practices in different countries along with purely economic performance. Prolonged debate over the inclusion of a social clause in the GATT negotiations has re-emphasized this linkage.
Acceptance of the authority of national and international organizations is essential if they are to function effectively. For legislative and enforcement bodies, this legitimacy is conferred by law. For research organizations, their authority derives from their adherence to accepted scientific procedures. However, the shift of the formulation of law and the negotiation of agreements on health and safety at work to international bodies poses problems of authority and legitimacy for other organizations such as employers’ associations and workers’ organizations.
The authority of employers comes from the social value of the services or products which they provide, whereas workers’ organizations owe their position in negotiations to the democratic structures which enable them to reflect the views of their members. Each of these forms of legitimacy is more difficult to establish for international organizations. The increased integration of the world economy is likely to bring about an ever-increasing coordination of policy in all areas of occupational safety and health, with emphasis on commonly accepted standards of prevention, compensation, professional training and enforcement. The problem of the organizations which grow up in response to these needs will be to maintain their authority through responsive and interactive relations with workers and the workplace.
" DISCLAIMER: The ILO does not take responsibility for content presented on this web portal that is presented in any language other than English, which is the language used for the initial production and peer-review of original content. Certain statistics have not been updated since the production of the 4th edition of the Encyclopaedia (1998)."