Silent killers: working with dangerous substances: abstract

Background Dangerous substances like asbestos, dust and industrial fumes pose a profound hazard to workers across industries. In the Netherlands, annually 4100 deaths in workers can be attributed to occupational diseases, of which 2700 cases are caused by work-related cancer. However, until now, data was missing on risk-perception among companies, employers and managers, and the (lack of) use of preventive and risk-reducing measures in the workplace. In this study, answers and insights into dangerous substances as an occupational hazard across Dutch workplaces were identified. These quantitative data are combined with more qualitative data to promote health in the workplace by inspiring a national campaign on the prevention of occupational diseases resulting from exposure to hazardous substances at work. Methods In this cross-sectional study, a survey was conducted among 2288 employers/managers in companies across 17 industries in the Netherlands. Participants were stratified based on sector and company size. Participant scores were weighed to create a representative sample of the Dutch working population in these industries. Statistical analyses included descriptive analyses, t-tests and chi-square tests for statistical significance (P<0.05). Results The study demonstrated great variety in the type of dangerous substances used across sectors. Overall, allergenic substances were most frequently used (38%), and 18% of all respondents reported to work with carcinogens. The risk perception of exposure was low: 10% of the respondents estimated that their workers were regularly exposed to dangerous substances. Furthermore, only 30% of the companies actually measured the level of exposure of workers. About 80% of the companies reported to take some form of measures to reduce the risk of exposure, however these measures were mostly aimed at the individual worker e.g., providing protective equipment like gloves and masks (85%). Organizational or technical measures, including rotating schedules for workers and mechanical ventilation, were far less often made available (about 50%). Furthermore, three out of four participants thought that their workers are capable (and responsible) to provide for their own occupational safety. However, whether this is true often goes unchecked. The study also showed several significant differences in risk perception and risk management between small and large companies, e.g. large companies took more radical measures to prevent exposure and to educate workers, compared to small companies (P<0.05). Conclusions The risk perception of exposure to dangerous substances across Dutch workplaces seems low, and exposure risks are likely to be underestimated. Furthermore, there is lack of ownership when it comes to preventing occupational hazards. Companies rather seem to rely on the workers’ own initiative and knowledge with regard to occupational safety, and take the most simple measures to promote health in the workplace. These might not be the most effective measures in practice. In the field of occupational health and safety it is commonly known that elimination of the hazard (Substitution), Technical and Organizational measures are more effective than Personal protection (the STOP-principle). The results of this study serve as critical input to promote a new integrated approach on the prevention of occupational diseases resulting from exposure to hazardous substances.