Disease, Illness, & Injury

Considering the extensive list of hazards that we’ve already looked at, it's unsurprising that there are just as many, if not more, resulting afflictions and injuries. Here we shall take a detailed look at the afflictions that pose a risk to our safety, if for no other reason than to spread awareness and understanding. The following stands as no advice in the treatment of any injuries. If you or someone you know suffers from one of these afflictions seek immediate professional healthcare. Sources for this section include the HSE website, the NHS (national health service) (UK) website, and the CDC (centre for disease control) (US) website. 

Anthrax

Anthrax is an infectious disease caused by the bacteria Bacillus Anthracis. It is a naturally occurring bacteria in soil and is typically non harmful to humans in this environment. However, animals are much more susceptible to contracting this disease, with infected animals being the main source of contraction for humans. Interacting with or consuming infected animals and products can lead to infection. Anthrax isn’t contagious between humans, meaning it is very unlikely to be spread as a cold or the flu would be. Inhalation of anthrax spores can lead to infection, resulting in a swelling of the lymph nodes in the chest, spreading throughout the body in the later stages of the infection. Severe breathing problems and bodily shock are the symptoms of the late stages of the illness, which is almost always fatal without treatment. With treatment, approximately 55% of those infected survive, though the chance of contracting this illness is not that high to begin with. Once again, the risk of developing Anthrax is possible due to bacteria potentially lying dormant on the animal hair that used to be used as a binder for lath and plaster. If present, the bacteria can be disturbed during demolition and inhaled.   

Asbestosis

Asbestosis is the given name for a lung affliction similar in contraction and presentation to silicosis. It is specifically attributed to the inhalation of asbestos dust or fibres over prolonged periods of time. Whilst exposure to asbestos is far less common now than it was in the past, asbestosis still presents itself in many people who have dealt with the material in the past. This is due to the long “incubation” time of this affliction, with many years of exposure typically being required to become ill in this way. Prolonged exposure to asbestos fibres leads to fibrosis of the lung tissue, in turn leading to shortness of breath as well as many other respiratory affiliations. 

Aside from the fact that asbestos itself is carcinogenic, and as such exposure to it greatly increases the risk of developing associated cancers, asbestosis can lead to different types of cancers, such as asbestos related lung cancer like mesothelioma. 

Surveys should be carried out before undertaking any work in areas suspected of containing asbestos products. Untrained operatives should not attempt to remove or handle asbestos, and special licensed companies are required to be called in to dispose of any asbestos products.  

Asbestos related lung cancer/Mesothelioma

According to Cancer Research UK, an average of 2700 people are diagnosed with Mesothelioma every year. Mesothelioma is a type of cancer that affects the tissue that covers the lungs, and in some rare cases the tissue that covers the abdominal organs. Almost all cases of Mesothelioma are attributed to exposure to asbestos. Over time, asbestos fibres that have entered the lungs can cause cells to mutate and become cancerous, leading to Mesothelioma.

Chemical burns

Chemical burns are burns caused on the skin by harsh corrosive chemicals such as brick acid, drain cleaners, and paint stripper. Aside from the initial pain associated with harsh chemicals coming into contact with the skin, there are several associated complications that may result from exposure. Contact of the skin with these chemicals can cause a sore sensation, damage to the tissue, blistering, as well as a number of other dermatoses (skin conditions). If left untreated, these wounds can lead to infection and possible necrosis of the tissue. It goes without saying that the exposure of more sensitive body parts to chemicals, such as the eyes, can lead to very serious health implications. The best course of action if contact with harsh chemicals is made is to seek immediate medical advice, though by following safety procedures, we can aim to minimise the risk of exposure.  

Work with chemicals should be carried out in a clean and well-ventilated area, with the use of all appropriate PPE stated by the manufacturer of the product. This PPE will typically include the use of gloves, safety goggles, as well as respiratory protection.  

Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is a broad term for a number of lung conditions that are associated with breathing difficulties. The most notable of these conditions are emphysema and bronchitis. Emphysema is the name of a condition attributed to long term smoking or exposure to dust, resulting in damage to the alveoli (air sacs) of the lungs. Bronchitis refers to the extended inflammation of the airways within the lungs, usually from the same sources as emphysema; both conditions leading to symptoms such as a shortness of breath and an increased susceptibility to lung infections.  

A good portion of those that suffer from COPD do not realise that they have it and assume that some of the symptoms are due to poor health in other aspects, such as being overweight or unfit. However, there is a good chance that symptoms are caused in construction workers by the conditions that they are in. Improper safety precautions and a lack of proper PPE usage can lead to extended periods of time in the presence of harmful dust or vapours. This directly contributes to ill health and increases the chances of developing COPD. 

Cuts, scratches, and scrapes

Cuts and scratches are a common occurrence on site whilst carrying out construction tasks. There are many sharp and rough objects that we work with, and as such the chance of getting cuts and scrapes is quite high. These small accidents are generally not that serious, though care should be taken to keep them clean and covered up so that infection does not set in. To prevent minor injuries such as these, care should be taken to wear gloves and long sleeve arm coverings when handling rough materials and equipment. At the end of the day though, these minor afflictions are unfortunately inevitable within construction.  

More severe injuries of this nature are a risk associated with power tools and sharp blades. Care should be taken when using these tools, and the standard operating procedures dictated by the manufacturer should be adhered to minimise the risk of injury. 

Dermatosis and Dermatitis

Dermatosis and Dermatitis are two similar descriptors relating to skin ailments, though the two are not interchangeable. Dermatosis is the general term that categorises any condition that affects the skin. This can be, but is not limited to, psoriasis or eczema, and is generally used to describe non-inflammatory conditions. Dermatitis specifically refers to inflammation of the skin and can used to describe allergic reactions as well as irritation of the skin.  

With the many harsh chemicals and materials that we use within the construction industry it’s important to know how to protect ourselves and our skin. Lime based products such as cement, gypsum plaster products, chemicals, and insulation to name a few irritants, are all materials that we’re very likely to encounter daily whilst at work. Each of these, and the many other corrosive or irritant materials that follow, all come with their own potential risks in terms of how they might harm us. Lime cement for example is a desiccant, drawing moisture out of the surfaces it comes into contact with. Contact with the skin over prolonged periods can lead to dryness and irritation. It is especially dangerous when coming into contact with the eyes, as it will begin to draw out the moisture, producing a burning sensation and possible resulting vision damage. 

Therefore, it’s extremely important that we always follow the safety precautions recommended by the manufacturer as well as following appropriate legislation relating to safe working practices - namely wearing appropriate PPE where required. 

Dismemberment

Dismemberment is a very serious affliction that is most frequently caused by accidents involving power tools. Dismemberment refers to the detachment of a body part. Specific injuries within construction associated with dismemberment include the loss of fingers or toes. With many power tools and machines on site such as powered saws and heavy plant, there are several ways that improper usage could lead to dismemberment. In the event of this affliction, immediate medical care should be sought. To prevent/ reduce the risk of dismemberment, all safety precautions should be taken when using power tools, such as ensuring fingers and hands are kept away from moving parts, and that all appropriate guards are fitted.  

Eye injuries

Eye injuries are a common occurrence on site, most often among those that do not wear appropriate eye protection. Eye injuries can range from minor scleral lens scratches all the way up to permanent blindness in one or both eyes. As previously discussed, harsh chemicals entering the eyes can cause damage to these sensitive organs, though the most common type of eye injury stems from flying chips or debris. This can occur during the use of power tools such as saws or cutters, where loosened waste material is flung away from the blade at very high speeds. Objects that hit the eye at high speeds can enter the eyeball, as well as scratch the outer scleral lens. Extremely unpleasant material such as sharp metal splinters or shards of glass may also enter the eye during demolition or material cutting. This obviously brings the risk of cutting damage occurring in the eye. The use of hand tools, such as when splitting blocks or bricks with a bolster may also lead to debris being directed towards the eye at high speeds. 

To ensure appropriate levels of eye safety, safety rated eye protection should always be worn in accordance with the manufacturer's instructions as well as the method statement and risk assessment.  

Heat burns

There are many sources of heat that we may encounter at work, ranging from the more mundane things like hot water from the kettle to more niche exposure such as blow torches or plant exhausts. Regardless of the specifics, contact of the skin with hot surfaces or liquids can result in serious burns. Whilst burns come in a few categories of severity, all of them are quite unpleasant and can result in afflictions to the skin such as blistering, the peeling of skin, swelling, as well as some dermatoses. Improper treatment of burns can also lead to infection of the afflicted area. To prevent burns, safety precautions should be taken with appropriate PPE being worn around the use of heat. Guards should be fitted in scenarios where skin could encounter heated surfaces.  

Hearing damage

Hearing damage is an overlooked aspect within the construction industry, especially in the case of the older generations of operatives. Our hearing is a very delicate sense, and prolonged exposure to the loud tools that we regularly use can permanently harm our ears. There are a variety of tools/equipment that omit loud noises during their use, though really this can be combated using proper ear defenders/protection. 

Heat exhaustion/Heat stroke

Heat exhaustion is a condition in which the body overheats, typically caused by over exertion in hot weather. Heat exhaustion can cause headaches, nausea, dizziness, or drowsiness, as well as a feeling of confusion. If not dealt with as soon as possible, heat exhaustion can quickly develop into the more serious condition known as heat stroke, which can be life threatening. 

Heat stroke is one of the most serious heat related conditions and occurs in individuals when their internal temperature becomes too high. At extreme internal temperatures, usually around 40 degrees Celsius (104F), the body loses its ability to regulate further increases of heat, losing the ability to sweat and cool itself down. This extreme condition, if left untreated, can cause a loss of consciousness and seizures, and will eventually lead to death. Heat stroke needs to be treated as soon as possible and should be pre-emptively prevented when working in hot weather.  

To combat both conditions, regular breaks should be taken out of the sun, plenty of fluids and electrolytes should be consumed, and loose, breathable clothing should be worn. If any of the symptoms of heat exhaustion begin to appear in an individual whilst working in the heat, it’s important for them to cool down immediately through resting.   

Hypothermia and frostbite

Hypothermia is a serious condition that presents in the opposite scenario to heat stroke, where the internal body temperature drops to a dangerously low level (35C/95f and below). At this low temperature, like heat stroke, the body loses its ability to regulate its temperature, becoming unable to effectively warm itself. The symptoms of hypothermia include extreme shivering and skin that is cold to the touch, a slowed heart rate, as well as impaired cognitive function. It goes without saying that hypothermia generally presents in people and animals during the colder winter months, though exposure to the cold without proper clothing at any time of the year can leave one susceptible to the condition.  

Frostbite is another cold weather condition in which damage to the tissue of the body is caused by prolonged exposure to the cold. It typically presents at temperatures lower than freezing, and most often affects the extremities, such as the fingers or toes, nose, and ears. Extreme cases of frostbite that are left untreated can lead to gangrene and may require the amputation of affected areas. 

To keep ourselves warm on site during the colder weather, it's important to wear proper cold weather clothing, such as insulated garments like long johns and vests, as well as ensuring enough outer layers, like jumpers and insulated coats. Where applicable, in extreme conditions, gloves should be worn in conjunction with proper foot insulation, to minimise the risk of developing frostbite. Special heated areas should be allocated on site to allow for operatives to warm themselves at break times or if they become too cold. Welfare facilities such as kettles should also be provided to allow operatives to warm themselves with hot drinks or soups.  

Irritants

Within the construction industry there are a plethora of irritants that we may encounter, with most of them being waste or byproducts of the construction process. Fine particulates such as cement or plasterboard dust, as well as vapours and liquids such as brick acid, are all common construction irritants. Whilst encountering these materials may not directly injure us in the ways that we might otherwise get hurt on site, they still have the potential to irritate our eyes, skin, and lungs. In these scenarios, the damage is ordinarily minimal, and 1 time exposure is very unlikely to cause any lasting damage, though we should still try to minimise our exposure to these irritants.  

Contact with irritants such as these can cause dry skin, itchy or sore rashes, as well as a wide range of other dermatological conditions. To minimise our exposure to these materials, gloves should be worn as frequently as possible, and care should be taken to wash hands before eating or touching one's face. Steps should be taken to reduce the number of particulates in the working environment, namely by ensuring proper ventilation and extraction.    

Lacerations

Lacerations refer to deep cuts on the skin and typically require professional medical attention such as stitches. Deep cuts can take a long time to heal and can be very serious if arteries or internal organs are injured. In most cases of lacerations occurring, immediate medical attention is required. There are many ways in which these injuries can occur, though most of the time they are caused by improper power or hand tools usage. Sharp blades, as well as demolition related waste materials like broken glass pose a serious risk of lacerations. To prevent injury in this way, care should be taken to follow all relevant health and safety requirements. 

Lead poisoning

Exposure to lead, and the associated illness “lead poisoning” are less common now than they have ever been, though it’s still a risk that can present itself in some situations in modern construction. Whilst lead poisoning affects children more than adults, symptoms of affliction may include high blood pressure, headaches, bodily pain, as well as issues with fertility. Lead poisoning used to be far more prominent in the past due to its usage in many construction materials, namely as a component of old-fashioned paint, as well as a waterproofing material. We still use lead to this day in roofing applications due to its fantastic malleable properties, though the chance of developing lead poisoning from this material is low if appropriate safety guidelines are adhered to.  

Lead poisoning is generally contracted through the inhalation or ingestion of lead particulates, often through the welding of lead, or the inhalation of lead paint dust. When sanding old timber components such as windows or doors, the painted finish may be lead based. As such, it’s important to wear an appropriate mask when performing this task. It’s also important to wear a FFP3 mask when welding lead, so as not to inhale lead vapour particulates. Care should be taken to thoroughly wash one's hands after handling lead, even if gloves are worn, which they always should be. 

Leptospirosis/Weil’s disease

Leptospirosis, also known as Weil’s disease, is an infection contracted from the Leptospira bacteria, and can cause chest pains, shortness of breath, and jaundice in extreme cases. It is a very treatable illness, and documented cases are incredibly infrequent in the UK, though the specific conditions for contraction of the infection are often associated with unclean areas. Leptospira bacteria is found in the urine of infected animals, most often rats and mice, though farm animals are typically susceptible to the infection. The bacteria enter the human body through the eyes, mouth, or open wounds, after contact with infected soil, water, or contaminated surfaces. Areas where construction is being carried out are more likely to see the presence of rats or mice, typically in and around piles of construction rubbish, especially areas with food or food waste that has been left lying around. Infected rats will urinate around this area, leaving contaminated surfaces wherever they travel.  

The beginning of this infection presents in a high temperature, headaches, nausea, as well as full body soreness. Untreated infections can lead to swollen appendages, jaundice, rashes, and a bloody cough. Antibiotics can effectively treat the illness within a couple of days, with most remedied cases resulting in no lasting effects.  

To prevent the contraction of this illness, it's important to always wash our hands before eating or touching our face, making sure that we wear gloves when handling waste materials, and ensuring that any open wounds are covered suitably and regularly attended to. 

To minimise the likelihood of vermin lingering around the site, the timely and appropriate disposal of construction waste, as well as food or food waste should be undertaken responsibly. 

Sepsis / Septicaemia

Sepsis and Septicaemia are two related and extremely serious illnesses that are caused by bacteria entering the bloodstream. In most cases of Septicaemia, bacteria enter the bloodstream through open wounds or lacerations on the skin and can rapidly lead to blood poisoning. This poisoning of the blood leads to sepsis if untreated, a life-threatening condition in which the body's response to the infection can lead to organ failure or death. Even if treatment is begun early in the infection, this illness is still very serious, leading to an average of 5 people in the UK dying every hour, and a mortality rate for the late stages of sepsis being around 40%. 

Prevention of this ailment comes in the form of ensuring the proper care of open wounds and deep lacerations. Care should be taken to cover up healing wounds whilst carrying out tasks that pose the risk of infection such as handling rubbish.  

Silicosis

Silicosis is a disease that afflicts the lungs, caused by prolonged exposure/inhalation of silica dust. Silica is a naturally occurring material, and silica dust is a byproduct of the creation and destruction of silica-based products. Most of the materials that we associate with masonry or brick laying are silica based, with the main materials being cement board, bricks and blocks, cement, and plaster. All of these materials produce silica dust when cut, and the inhalation of this dust over a long period of time, typically many years, can lead to the condition known as silicosis. 

Once silica dust enters the lungs, it can cause inflammation of the tissue, and over time this leads to fibrosis - a hardening of the scarred lung tissue. Lung tissue affected by fibrosis suffers from an extreme decrease in effectiveness at absorbing oxygen, and as such, the larger the fibrosis affected areas become, the less oxygen the body can absorb. This can lead to a shortness of breath and a feeling of a tight chest.  

Silicosis typically presents itself in people that are exposed to silica dust on a regular basis anywhere from 5 to 20 years on average, and is mostly associated with plasterers, bricklayers, as well as operatives that carry out a lot of demolition. Silicosis that has progressed to a high level can lead to fatalities in the form of respiratory failure, though this is very far down the line. Those that are affected by silicosis are also at a much greater risk of other afflictions, the most notable of those being an increased risk of lung cancer, heart failure, as well as serious chest infections. Silicosis is considered by most researchers in this specific area to be the next asbestosis, in the sense that we still don’t fully understand the ramifications of long-term exposure over multiple generations. 

Through the use of PPE and safe work practices we can help to reduce the chances of developing silicosis. When working in the proximity of any dust, but namely silica dust in this instance, it's important that we ventilate the area as well as possible, and wear an appropriate level of respiratory protection. We can wet an area down with water or use sprinklers if appropriate to keep dust out of the air. Other methods of reducing the number of particulates in the air include setting up LEV (Local exhaust ventilation) systems.  

Splinters

It should come as no surprise that splinters are a common occurrence within the construction industry, especially within the scope of carpentry. By handling as much timber as we do, there is a great risk of getting splinters, especially from older, more flaky timber. Most of the time these splinters are not that superficial and can be easily pulled or dug out of the skin, though some splinters can be quite unpleasant. For the most part seasoned operatives are going to have rough hands with thick skin, reducing the number of splinters we’re susceptible to, though this doesn’t make us impervious to them. If in doubt, disinfectant should be applied to the area as splinters can leave us susceptible to infection. Small splinters can often go unnoticed, especially those in obscure places, and can quickly become infected. In these instances, the splinter should be removed, and the area needs to be sterilised. We can minimise the chance of getting splinters by wearing gloves when handling materials. Whilst this is the recommended procedure stated by most health and safety organisations as well as most employers on larger sites, they can impair the sense of touch that is required for accurate carpentry. 

Sunburn

Sunburn is a specific type of heat burn caused by prolonged unprotected exposure to the sun. Skin that is burnt by the sun will become red, hot and very sore/sensitive to touch, and makes wearing clothes very painful. After a while the skin will begin to peel in the afflicted areas, and the skin may begin to blister. The pain of sunburn can be eased by using a special after sun lotion, though the actual damage of the sun and its harmful UV rays have already been inflicted at this point. Bad cases of sunburn can increase the risk of developing skin cancer later in life. Sunburn can be prevented by covering up skin in the sun, as well as wearing an appropriate SPF level of sun cream. Regular applications of the cream should be made when sweating whilst working.  

Suspension trauma

Suspension trauma is a condition describing injuries acquired during and after a fall in which the operator is connected to an anchor point via a harness. When falling whilst connected to a harness, there are several associated conditions that can occur within the victim. Obviously, these injuries are preferable in comparison to the injuries sustained from hitting the ground after a fall, though they are still not ideal. The sudden stop caused by the suspension in a harness can cause whiplash, bruising, pelvic injuries, as well as injuries sustained from swinging into something during the suspended stop. The most serious condition acquired during suspension trauma involves blood clots forming in the lower legs due to restricted blood flow caused by the harness during suspension. It can take a while, especially at very high heights, for a suspended operative to be rescued from their position. Periods of suspension lasting longer than 10 minutes can cause blood clots to form due to the restricted blood flow. These blood clots can travel throughout the body once freed, causing serious damage throughout the internal body. Therefore, it is extremely important to use harnesses that have suspension trauma loops attached. This is a system created by 3m that allows for the user to “stand up” whilst suspended and relieve the constriction of the legs caused by the harness. 

Tetanus

Tetanus, informally known as lockjaw, is a condition caused by tetanus bacteria entering the body through open wounds. Tetanus bacteria can be found in the earth as well in the excrement of farmyard animals. If the bacteria enter the body through an open wound, they begin to rapidly multiply and will release a toxin that causes stiffness and spasms in the muscles. These spasms and stiffness make it hard to breathe and swallow, and make it hard to open one's mouth, thus leading to the name lockjaw. Tetanus also presents in afflicted victims with fevers and a rapid heartbeat. If left untreated, tetanus can thrive within the body for months before the victim dies from complications due to the symptoms of the illness. 

Approximately 10% of patients with the illness pass away even with treatment, though the chances of contracting the disease in the first place is extremely low, with only 4 recorded incidents in 2019 in England. This is due to the mass vaccination of school children, with the majority of those who do contract the illness being those who are not vaccinated. Tetanus usually presents its first symptoms an average of 10 days after the bacteria has entered the body. In a similar fashion to many of the other bacteria that make their way into the body through cuts or lacerations, it’s important when working in dirty conditions to keep any scratches covered, and to always wear appropriate PPE.