In the recent BBC article, it was declared that nine out of 10 NHS trusts have asbestos in their hospitals.
With the backing of Jo Stevens MP, chair of the All Party Parliamentary Group for Occupational Health and Safety, the government has been urged to conduct an audit to discover the extent of asbestos presence within the trusts, and whether a management plan has been established for dealing with it.
If managed carefully, asbestos in a hospital does not pose a risk to patients or staff. However, any disturbance of the material has the potential to endanger lives. In fact, the BBC found “352 claims were made against health trusts between January 2013 and December 2017 by people who had developed asbestos-related diseases in NHS buildings” – resulting in £16.4million of compensation paid out to victims.
Here, Denis Morgan, technical and training manager for Asbestos at SOCOTEC, discusses the importance of asbestos management within the UK’s NHS trusts and hospitals to safeguard the health of those using the premises.
Exposure to asbestos fibres can pose severe health risks to those inhaling asbestos fibres, with the most common being mesothelioma, a cancer of the chest lining, and asbestosis, a chronic lung disease.
Many hospital buildings were constructed years before the ban on asbestos containing materials, meaning that the hospitals – like any other building constructed before 2000 – are likely to contain asbestos in a multitude of applications and materials. Asbestos containing materials (ACMs) include:
- asbestos lagging used as thermal insulation on pipes and boilers
- sprayed asbestos used for thermal insulation, fire protection, partitioning and ducts
- asbestos-insulating board (AIB) used for fire protection, thermal insulation, partitioning and ducts
- some ceiling tiles
- floor tiles
- cement roofing and guttering
- textured coatings
The presence of asbestos in hospitals, and other public buildings, is not surprising given their age and it should not in itself be a significant cause for concern. Greater emphasis should be given to the control measures that are in place at these hospitals and how the materials are being safely managed. The encouraging element of the BBC article is that the 198 hospitals are aware of the asbestos in their buildings, indicating that they are meeting their requirements to have a record of the location of asbestos in the buildings they control.
It is a legal requirement, under the Control of Asbestos Regulations 2012, that asbestos in healthcare premises (and other non-domestic properties) should be managed. Many NHS trusts and hospitals will already be managing the presence of asbestos in their buildings and will have robust procedures for preventing accidental disturbance of the material. However, the more concerning numbers here would arguably be the 32 hospitals that failed to respond to the information request, raising questions around their records, knowledge and management of asbestos containing materials; more work should be done to continue raising awareness around the risks and responsibilities to ensure compliance.
According to the guidance, hospitals – along with any other non-domestic premises - should take the following steps to manage the asbestos:
- Undertake an inspection and maintain a register of asbestos-containing materials (ACMs) in the hospital
- Assess the risks associated with ACMs in the hospital or premises
- Devise a plan for managing asbestos in the hospital
- Make sure staff, visitors and contractors know the risks and precautions they need to take
- Keep the management of asbestos in the hospital under review
If undisturbed, the asbestos present is not considered a health hazard as the fibres will remain encapsulated. Refurbishment or maintenance works can all pose a risk of disturbing the asbestos, which is why knowing the location of asbestos containing materials is fundamental to long-term safe management.
Within the guidance, duty holders are defined as the people responsible for maintenance/repair and/or access/egress from the hospital. Within all hospital buildings, these people must understand that they have the legal responsibility to locate and assess the risk posed by asbestos containing materials as well as develop a risk management plan.
While funding cuts are stretching NHS resource, asbestos management should remain a fundamental priority for trusts to mitigate the risk of asbestos-related diseases. With trusts paying out more than £16.4million in compensation as a result of asbestos within their buildings, safe management of these materials should be the primary aim, with removal being an option for items in bad condition or liable to damage/degradation. Of course, undertaking asbestos removal works within a hospital environment is extremely challenging and costly. With pressure on bed space and funding, hospitals will struggle to justify the proactive removal of asbestos containing materials, which can be safely managed in situ with the correct processes and procedures.
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