This is a revised and updated version of the 2001 circular to Local Authority health and safety Inspectors and is due for further review in 2008. Inspectors will expect duty holders to interpret their statutory obligations to protect the health and safety of call centre (or similar) employees, in the manner described in this guidance. Issues such as acoustic shock, verbal abuse, voice strain and work pace monitoring are more specific to call centre work; the rest of the guidance reflects general guidance on office work. Rest breaks and consultation are strongly emphasised. Call centre work employs around 3% of the UK workforce. The true scale of risks to health and safety and the accuracy and effectiveness of the proposed control measures remain highly uncertain. Evidence from: HSE LAC Number: 94/2 October 2006. “Advice regarding call centre working practices” Given that most of the risks are risks of perception rather than objective hazards and outcomes, cultural and comme

A relatively powerful study of the potential link between welding work and cause or aggravation of Parkinson’s Disease and diseases of a similar nature. It provides strong evidence that a history of welding work is not significantly associated with these outcomes. Evidence from: G Marsh et al. JOEM (2006) Vol.48#10 p 1031 – 1046 “Employment as a Welder and Parkinson’s Disease among Heavy Equipment Manufacturing Workers” Further detail: 6#7-8 20

The study shows that the concepts of burnout and depression are strongly correlated. This was the first attempt to measure this in a large cohort. The study lends weight to the idea that burnout precedes depression. If so, prevention of burnout would help prevent occupational depression. Job strain seems to be a strong predictor of burnout and of depressive symptoms but not of depressive disorder. The apparent contradiction could just be a measure of the low conversion rate from burnout to depression or, that job strain is not a predictor of depression. Previous history of mental disorder is a very strong predictor of burnout, depressive symptoms and current depression. Evidence from: K Ahola et al. JOEM (2006) Vol.48#10 p 1023 – 1030. “Contribution of Burnout to the Association between Job Strain and Depression: the Health 2000 Study” High job strain was predictive of burnout OR = 7.4 (95% CI = 5.6 to 9.6). High job strain was also predictive of depressive symptoms (OR of

Evidence from: M Kabuto et al. Int J cancer. (2006) Vol.119 p 643 – 650 “Childhood leukemia and magnetic fields in Japan: A case-control study of childhood leukemia and residential power-frequency magnetic fields in Japan” The study reinforces the observation of a statistical association between domestic emf exposure and incidence of one kind of childhood leukaemia. G Berg et al. Am. J. Epidemiol. (2006) Vol.164#6 p 538 – 548 “Occupational Exposure to Radio Frequency/Microwave Radiation and the Risk of Brain Tumors: Interphone Study Group, Germany” No statistically significant association between occupational exposure and risk of diagnosed outcome was observed. S Lonn et al. Am. J. Epidemiol. (2006) Vol.164#7 p 637 – 643 “Mobile Phone Use and Risk of Parotid Gland Tumor” There was no statistically significant association between phone use (intensity, cumulative use or duration) and diagnosed outcome. Further detail: 6#7-8 16

Evidence in support of a causal association between night shift work and stomach ulcers. In this study the association with night shift work was moderate to strong but there was no attempt to identify which aspect of night shift work, or associated lifestyle choices, could provide a mechanism. Night shift work is of increasing prevalence, H Pylori infection is very common. Evidence from: A Pietroisti et al. Occ Env Med (2006) Vol.63 p 773-775 “Shift work increases the frequency of duodenal ulcer in H pylori infected workers” The prevalence of duodenal ulcer was higher in night shift workers than in day time workers; 29% vs. 9%. Odds ratio = 3.9 (95% CI = 2.1 to 7.5). Further detail: 6#7-8 15

The study finds weak evidence of an increased risk of rheumatoid arthritis in those with exposure to asbestos dust. Evidence from: CW Noonan et al. Environ Health Persp. (2006) Vol. 114 p 1243 – 1247. “Nested Case–Control Study of Autoimmune Disease in an Asbestos-Exposed Population” This was very much a preliminary study but raises the possibility of compensation claims for asbestos related lung disease to include some element of compensation for arthritis. It seems very unlikely that any claim would be for arthritis alone. Further detail: 6#7-8 10

The study confirms that there is no risk-free exposure to Radon. It also finds no interaction between radon and smoking; the risks are simply additive. In our view, this means that compensation issues should remain separate; material contribution should not be an issue. Evidence from: S Darby et al. Scand J Work Env Health (2006) Vol.32 supp1 p 1-16. “Residential Radon and lung cancer – detailed results of a collaborative analysis of individual data on 7148 persons with lung cancer and 14,208 persons without lung cancer from 13 epidemiological studies in Europe.” For lifelong non-smokers, the risks of lung cancer at 100 Bq/m³ and 400 Bq/m³ were estimated to be 1.2 and 1.6 respectively, relative to no radon exposure. For those smoking 15 – 20 cigarettes per day the relative risk of lung cancer would be 25.8 at 0 radon exposure, 29.9 at 100 Bq/m³ and 42.3 at 400 Bq/m³. Further detail: 6#7-8 3

The established associations between silicosis and TB and with pneumoconiosis were confirmed. Support for an association with liver cancer in men is demonstrated. There was very weak, support for links with kidney disease and, lung cancer. Evidence from: A Marinaccio et al. Occ Env Med (2006) Vol. 63 p 762-765 “Retrospective mortality cohort study of Italian workers compensated for silicosis” There was no association with cardiovascular disease. Further detail: 6#7-8 1

Evidence from: SC Larsson et al. Int. J. Cancer (2006) Vol.119 p 2186 – 2189 “Coffee consumption and stomach cancer risk in a cohort of Swedish women” S Coon et al. Env Health Persp (2006) Vol.114 p 1872 – 1876 “Whole-Body Lifetime Occupational Lead Exposure and Risk of Parkinson’s Disease” E Carragee et al. Spine (2006) Vol.31#25 p 2942 – 2949 “Does Minor Trauma Cause Serious Low Back Illness?” Evidence for compensation-related deterioration. MA Nunno et al. Child Abuse & Neglect (2006) Vol. 30 p 1333–1342 “Learning from tragedy: A survey of child and adolescent restraint fatalities” Further detail: 6#9-10 30 BB

Evidence from: S Rohrmann et al. Am J Epidemiol. (2006) Vol.164 p 1103–1114 “Ethanol Intake and Risk of Lung Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)” A Smith et al. International Journal of Epidemiology (2006) Vol.35 p 1504–1513 “Childhood leukaemia and socioeconomic status: fact or artefact? A report from the United Kingdom childhood cancer study (UKCCS)” W Anees et al. Thorax (2006) Vol.61 p 751 – 755 “FEV1 decline in occupational asthma” CM Villaneuva et al. Am J Epidemiol (2007) Vol.165 p148–156 “Bladder Cancer and Exposure to Water Disinfection By-Products through Ingestion, Bathing, Showering, and Swimming in Pools” PR Salameh et al. European Journal of Epidemiology (2006) Vol.21 p 681–688 “Chronic bronchitis and pesticide exposure: a case–control study in Lebanon” Further detail: 6#9-10 29 BB

Evidence from: EC C(2006) 6839 “FP7 theme 4 Nanosciences, Nanotechnologies, Materials and New Production Technologies -Nmp” 14th November 2006 DEFRA news release “Atypical scrapie found in sheep flock considered to be TSE-free” DoH news release 15th Jan 2007. “Advice to pregnant women during lambing season” JS Felton et al. Carcinogenesis (2006) vol.27#12 p.2367–2370 “REVIEW: A meat and potato war: implications for cancer etiology” M Fischer et al. Accident Analysis and Prevention (2007) Vol.39 p94–105 “Hyperactive children as young adults: Driving abilities, safe driving behavior, and adverse driving outcomes” Further detail: 6#9-10 28 BB

Evidence from: MMWR Weekly (2006) Vol.55(48) p 1293 – 1296 “Alcohol and Other Drug Use among Victims of Motor-Vehicle Crashes — West Virginia, 2004—2005” DWP Com 7003 “Completion of the review of the scheduled list of prescribed diseases” Further detail: 6#9-10 27 BB

Evidence from: HESA News 14th Nov 2006 A silent pandemic: industrial chemicals are impairing the brain development of children worldwide DEFRA 28th Sept 2006 Organic Statistics England Further detail: 6#7-8 33 BB

Evidence from: JD Holder et al. JOEM. (2006) Vol.48#10 p 1047 – 1053 “Fire-fighter Heart Presumption Retirements in Massachusetts 1997–2004” K Kreiss et al. JOEM (2006) Vol.48#10 p 1062-1069 “Risk Factors for Asthma among Cosmetology Professionals in Colorado” MMWR weekly (2006) Vol.55(28) p 1040-1042 “Chikungunya Fever Diagnosed Among International Travelers — United States, 2005—2006” NIOSH RI 9668 “Effectiveness of Selected Diesel Particulate Matter Control Technologies for Underground Mining Applications: Isolated Zone Study, 2004” DWP Press Release 18th Oct 2006 “Labour market figures – employment above 29 million for first time” EEA Report No9/2006 ISSN 1725-9177 “Greenhouse gas emission trends and projections in Europe 2006” Further detail: 6#7-8 32 BB

Evidence from: DB Richardson. Occ. Env. Med (2006) Vol.63 p 734-740 The impact on relative risk estimates of inconsistencies between ICD-9 and ICD-10 L Storgaard et al. Epidemiology (2006) Vol.17 p 674-681 Genetic and Environmental Correlates of Semen Quality: A Twin Study R Hauser et al. Epidemiology (2006) Vol.17 p 682-691 Altered Semen Quality in Relation to Urinary Concentrations of Phthalate Monoester and Oxidative Metabolites C Beseler et al. JOEM (2006) Vol.48#10 p 1005-1013 Depression and Pesticide Exposures in Female Spouses of Licensed Pesticide Applicators in the Agricultural Health Study Cohort Further detail: 6#7-8 31 BB

Evidence from: DP Gross et al. Occ. Env. Med (2006) Vol.63 p 404 – 410 “Does functional capacity evaluation predict recovery in workers’ compensation claimants with upper extremity disorders?” Epidemiology (2006) Vol.17 p 506 – 511 “Transient Exposure to Coffee as a Trigger of a First Nonfatal Myocardial Infarction” H Nishiura et al. Epidemiology (2006) Vol.17 p 576 – 581 “Still Protected Against Smallpox? Estimation of the Duration of Vaccine-Induced Immunity Against Smallpox” MMWR Weekly August 18th (2006) “Adult Blood Lead Epidemiology and Surveillance — United States, 2003–2004” Federal Institute for Risk Assessment. Press release 31st Aug 2006. “Indications that styrene has a tumorigenic effect in humans” GESTIS international database on hazardous substances Environment Agency Press Release 17th August 2006. “Fire & Rescue Service’s role in pollution prevention recognised” Further detail: 6#5-6

Evidence from: JJ Ho et al. Accident Analysis and Prevention (2006) Vol.38 p 961 – 968 “Estimation of reduced life expectancy from serious occupational injuries in Taiwan” A Magrez et al. Nano Letters (2006) Vol.6#6 p 1121 – 1125 “Cellular Toxicity of Carbon-Based Nanomaterials” MJ Seed et al. Allergy (2006) Vol.61 p 648 “Prediction of asthma hazard of thiamine” WT Gallo et al. Occ.Env. Med. (2006) Vol.63 p 683 – 687 “The impact of late career job loss on myocardial infarction and stroke: a 10 year follow up using the health and retirement survey” H Virkkunen et al. Occ. Env. Med. (2006) Vol.63 p 378 – 386 “The triad of shift work, occupational noise, and physical workload and risk of coronary heart disease” Those exposed to all factors of this triad had approximately a twice greater CHD risk than those exposed to none of them. In retrospect, this study was worthy of much greater attention than was given at the time. Further d

Evidence from: MC Turner et al. Int. J. Cancer. (2006) Vol.118 p 3124-3132 An overview of the association between allergy and cancer A Navas-Acien et al. Environ. Health. Persp. (2006) Vol.114 p 641 – 648. Arsenic Exposure and Type 2 Diabetes: A Systematic Review of the Experimental and Epidemiologic Evidence KZ House et al. PNAS (2006) Vol.103. p 12291 to 12295 Permanent carbon dioxide storage in deep-sea sediments A Schreier et al. J. Psychiatric. Res. (2006) Vol.40 p 283 -292 Clinical characteristics of Major Depressive Disorder (MDD) run in families – A community study of 933 mothers and their children MM Weissman et al. Am J Psychiatry. (2006) Vol. 163 p 1001 – 1008 Offspring of Depressed Parents: 20 Years Later J Szabo et al. Bioelectromag. (2006) Vol.27 p 451 – 457 Occupational 50 Hz Magnetic Field Exposure Measurements Among Female Sewing Machine Operators in Hungary Further detail: 6#5-6 55 BB

Evidence from: Weightmans 4th May 2006. “CIT Robberies raise PI claims” USEPA “High Production Volume Information System” PD Darbre. J Applied Tox. (2006) Vol.26 p 191 -197 “Metalloestrogens: an emerging class of inorganic xenoestrogens with potential to add to the oestrogenic burden of the human breast” Food Standards Agency Project T07011 “Immunochemical reactivity to peanuts and nuts in allergic individuals” EFSA Scientific Report (2006) Vol.84 p 1 – 102 “Dimethoate” USEPA “Ships as Artificial Reefs” Further detail: 6#5-6 54 BB

The potential market for biodegradable plastics is very significant. Ones that incorporate natural rubber latex could be problematic due to the potential for allergy problems. Evidence from: J Shey et al. Industrial Crops and Products (2006) Vol.24 p 34 – 40 “Properties of baked starch foam with natural rubber latex” The paper reports the development of natural starch based plastic packaging incorporating natural rubber latex. The packaging offers tensile property improvements and great resistance to water damage. It is fully biodegradable. It would however require a thin plastic layer to protect it from water damage. The US EPA estimated that in 2003 there were 24 million tonnes of plastic in municipal solid waste. Comment Latex allergy is among the most common of allergies.

The report presents a very extensive analysis of evidence but seems to us to have jumped to precautionary conclusions e.g. that RCF could cause mesothelioma or lung cancer. Evidence from: CDC/ NIOSH May 2006-123 “Occupational Exposure to Refractory Ceramic Fibers” Much is made of the formation of pleural plaques in those with high exposures to RCF. By analogy with asbestos. Further detail: 6#5-6 45

It seems likely that having low influence at work and low support from a supervisor is predictive of new onset severe depression in women on a five year timescale. The risk is approximately double for each exposure variable. But is a failure to offer social support or, not to allow the worker to determine their own job, a breach of duty? Evidence from: R Rugulies et al. American Journal of Epidemiology (2006) Vol. 163#10 p 877 – 887 “Psychosocial Work Environment and Incidence of Severe Depressive Symptoms: Prospective Findings from a 5-Year Follow-up of the Danish Work Environment Cohort Study” A very high proportion of the cohort were not in work at the end of the 5 year period. Further detail: 6#5-6 44

Links between heart disease and psychosocial job characteristics were found to entirely explicable by teenage risk factors. Evidence from: T Hemmingsson et al. International Journal of Epidemiology (2006) Vol.35 p 616 to 622 “Is the association between low job control and coronary heart disease confounded by risk factors measured in childhood and adolescence among Swedish males 40–53 years of age?” Risk factors for heart disease were more common among those teenagers who later took jobs with low control. There was no independent association with low job control in middle age. Further detail: 6#5-6 43

Perhaps unsurprisingly the group of people who report feeling exhausted is more likely to include people with ill health. Causal direction and validity cannot be determined from this study but the study will inspire such investigations. Evidence from: T Honkonen et al. J Psychosom. Res. (2006) Vol. 61 p 59 – 66 “The association between burnout and physical illness in the general population—results from the Finnish Health 2000 Study” Is burnout work related? On present evidence it is not possible to determine whether the physical illness reduced the capacity to cope, or the burnout caused the physical illness, or burnout and physical illness are both the result of some other pathological mechanism. If a physical, objective health outcome was associated with occupational stress, the scope for claims would be greatly increased. Further detail: 6#5-6 42