There is limited evidence to support the theory that mismatch between work demands and functional capacity would increase the risk of a pain problem. The evidence is highly inconsistent but the theory cannot be discounted altogether. Evidence from: HH Hamberg van Reenen et al. Scand. J. Work and Environ. Health. (2006) Vol. 32#3 p 190 – 197 “Is an imbalance between physical capacity and exposure to work-related physical factors associated with low-back, neck or shoulder pain?” Further detail: 6#5-6 40

Regulations provide very clear guidance as to the types of interventions required to protect workers from injury or adverse symptoms caused through the use of display screen equipment. This review examines all the literature related to assessing the benefits of these and other interventions. No clear benefits could be found for any interventions, save for a possibility that alternative pointing devices could be beneficial. The accuracy of the DSE regulations could be called into question. Evidence from: S Brewer et al. J Occup Rehabil. (2006) Vol. 16 p 325 – 358 “Workplace interventions to prevent musculoskeletal and visual symptoms and disorders among computer users: A systematic review” The most positive finding here was possibly that DSE style interventions had not been shown to do harm. Further detail: 6#5-6 39

The claimant succeeded in demonstrating a relevant breach of duty. The causal relevance of breach of the Display Screen Equipment Regulations is bolstered by this judgement. Scientific support for this judgement is far from clear. Evidence from: Denton Hall Legal Services v Kathryn H Fifield [2006] EWCA Civ 169 Perhaps the regulator intended that the courts assume a causal link whenever there is evidence of a breach of duty? Further detail: 6#5-6 36

One conference presentation was selected for reporting here. It clearly states the limited knowledge base available for the accurate regulation of vibration exposure. There is little doubt that vibration exposure can be harmful. However, in our view, current Regulation of exposure must have been developed on the basis of something other than just objective scientific evidence. Such Regulation may be of questionable relevance to proof of negligence and causation in civil cases. Evidence from: NIOSH publication No. 2006-140 “Proceedings of the First American Conference on Human Vibration” We do not know whether there is any disorder specific to whole-body vibration, or what disorders are aggravated by exposure to whole-body vibration. We do not know the relative importance of vibration and other risk factors in the development of back disorders. Further detail: 6#5-6 33

The EC scientific committee once again find that there is next to no evidence of adverse health effects of exposure to electromagnetic fields. Evidence from: EC Scientific Committee on Emerging and Newly Identified Risks 19th July 2006 “Preliminary opinion on possible effects of electromagnetic fields (EMF) on human health.” Further detail: 6#5-6 31

The review finds evidence for an increased incidence of breast cancer among women who work the night shift for several decades. There is no reason to conclude that the association is causal. Evidence from: Health Council of the Netherlands Report No. 2006/15E, June 29, 2006 “Night work and breast cancer: a causal relationship?” In the Committee’s opinion, the research findings do not, at present, justify recommending special measures for women who perform night work for prolonged periods in addition to the current breast cancer screening programme. If new, scientifically sound research findings were to produce evidence of a causal relationship then one could consider what specific measures need to be taken. Further detail: 6#5-6 30

The study finds evidence of a weak link between shift work and increased risk of circulatory disease. Evidence from: F Tuchsen et al. Occ. Env. Med. (2006) Vol.63 p 451 – 455 “A 12 year prospective study of circulatory disease among Danish shift workers” The risk of incident circulatory disease was related to shift work even after all other variables had been corrected for. RR = 1.3 (95% CI = 1.1 to 1.6). The attributable fraction of circulatory disease in the whole population was estimated to be 5% (i.e. nationally, among workers, 5% of circulatory disease was attributable to shift working). Further detail: 6#5-6 29

The study finds evidence in support of an association between rotating shift work and death due to ischaemic heart disease. There was no association with cerebrovascular disease. Evidence from: Y Fujino et al. Am. J. Epidemiol. (2006) Vol. 164 p 128 – 135 “A Prospective Cohort Study of Shift Work and Risk of Ischemic Heart Disease in Japanese Male Workers” Compared with the day workers, the rotating-shift workers had a significantly higher risk of death due to ischemic heart disease (RR = 2.32, 95% (CI) = 1.37, 3.95) whereas fixed-night work was not associated with ischemic heart disease (RR = 1.23, 95% CI = 0.49, 3.10). Further detail: 6#5-6 28

The study adds weight to the view that exposure to environmental tobacco smoke could be associated with an increased risk of early, spontaneous abortion. Evidence from: L George et al. Epidemiology (2006) Vol.17 p 500 – 505 “Environmental Tobacco Smoke and Risk of Spontaneous Abortion” Abortion is an indivisible outcome. The relative risk of spontaneous abortion was increased for women exposed to ETS; OR = 1.7 (95% CI = 1.2 to 2.4) and for women who smoked; OR = 2.1 (95% CI = 1.4 to 3.3). Further detail: 6#5-6 25

This reasonably high quality study found evidence that exposure to environmental tobacco smoke was associated with a small increase in risk of glucose intolerance [a pre-diagnostic indicator of diabetes] within a 15 year timescale. Evidence from: TK Houston et al. BMJ (2006) Vol. 332 p 1064 – 1069 “Active and passive smoking and development of glucose intolerance among young adults in a prospective cohort: CARDIA study” For risk assessment purposes it would be helpful to know how many people have no other predispising vulnerability to developing diabetes. Further detail: 6#5-6 24

The report clearly asserts that lung cancer, heart disease and sudden infant death syndrome are causally related to exposure to environmental tobacco smoke. Asthma is not caused by exposure but there is limited evidence that frequency and intensity can be increased by it. Evidence from: United States Department of Health and Human Services. June 2006 “The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General.” For heart disease and for lung cancer the independent additional risk from ETS exposure is of the order of 25%. Those who regard exposure to risk being equivalent to material contribution would probably regard this as compensable but, so far, legal precedent in the UK would tend to exclude this as a cause of action in its own right. Further detail: 6#5-6 23

HSC have implemented the requirement to set reduced levels of protection when work with asbestos is described as sporadic. Evidence from: HSC/06/55 July 2006. “A comparison of the risks from different materials containing asbestos” At the 9 May meeting, the Commission agreed that including in the Approved Code of Practice (ACoP) a peak exposure level of 0.6 fibres per cm³ in the air measured over a ten minute period would provide a useful determinant of when exposure might be considered to be sporadic and of low intensity. Exactly how this ties in with the Compensation Act 2006 remains to be seen. It is highly likely that claims will be made when known exposures are below the level described as sporadic. Would they be in breach or not? Further detail: 6#5-6 11  

In hamsters, co-exposure to crocidolite and one strain of SV40 virus had the effect of amplifying the risk of mesothelioma from asbestos. SV40 has not been conclusively shown to be a cause of mesothelioma in humans, and in our view, is unlikely to be. Evidence from: B Kroczynska et al. PNAS (2006) Vol.103#38 p 14128 – 14133 “Crocidolite asbestos and SV40 are cocarcinogens in human mesothelial cells and in causing mesothelioma in hamsters” The joint potency of virus and asbestos was higher in hamsters. Given joint and several liability for asbestos exposure it seems unlikely anyone would bring SV40 into play. Further detail: 6#5-6 10

The effect of the Barker judgement was reversed within a matter of weeks. This Bill provides that joint and several liability applies to these kinds of claims. Evidence from: Hansard: Amendments agreed 19th July 2006. “Compensation Bill” The absolute language used in this bill is intended to give rise to a guarantee of compensation for mesothelioma cases. However the language used is absurd and will give rise to uncertainties. Included is the possibility that exposure to asbestos the day before a diagnosis of mesothelioma is made, could be found responsible for the disease. There are other scenarios where the Act will give offence against natural justice. There is growing concern that contribution to risk should be measured in a more rational way. The real tests will come when an administrator or public body has a duty to minimise exposure to past liabilities. Further detail: 6#5-6 8  

The report concludes that clustering of childhood leukaemia cases occurs on a 5km geographical scale. That some of these clusters coincide with the location of nuclear industry sites is a matter of chance. Evidence from: Committee on Medical Aspects of Radiation in the Environment (Comare) 11th report. “The distribution of childhood leukaemia and other childhood cancers in Great Britain 1969–1993.” The result is of general use in assessing the meaning of any reported cluster. Further detail: 6#5-6 5

ACRE advised that if the nematode could be shown to die out naturally if released into the wild then it would be safe for us as a pesticide in the UK. Evidence from: Minutes: Advisory Committee on Releases into the Environment ACRE/06/M3 “Application to release an entomopathogenic nematode, Steinernema carpocapsae ACRE/06/P12” One of the items at the ACRE meeting was a discussion of the potential use of a nematode S. Carpocapsae to control pests in green houses and commercial turf activities (e.g. golf). The view was that there was some but small potential for harm to non target organisms. If the nematode could be shown to die out naturally in the wild the applicant would be likely to succeed in obtaining a recommendation for licensing. Comment It is illegal to introduce non-native species into the UK; Wildlife and Countryside Act (1981), unless a licence is obtained. Given that the nematode is non-native it would not be very difficult to identify the likely source of any d

The report highlights the unintentional but ubiquitous contamination of food by man made chemicals. Sources are diverse but high levels in some foods could be thought to predominate and therefore be the principle source of exposure. Foods with high levels are recorded here. Evidence from: World Wildlife Fund September 2006 “Chain of Contamination: The Food Link” The report lists chemicals and foods which contain them in large quantities. Further detail: 6#5-6 3

The Agency has determined that all products containing carbofuran (a widely used pesticide) are not eligible for re-registration. A small number of uses will be permitted until 2010. The immediate effect is a 98% reduction in use. High acute exposure is potentially fatal but there are no suspected ‘long tail’ effects of exposure. Evidence from: USEPA August 2006. “Interim Re-registration Eligibility Decision: Carbofuran” The case provides a clear example of the commercial impact of regulatory activity. D&O policies could provide a remedy. Further detail: 6#5-6 2

Evidence from: H Boggild. Scand J Work Env Health (2006) Vol. 32(1) p 20 – 21 “Ischaemia and low-back pain – is it time to include lumbar angina as a cardiovascular disease?” D Ambroise et al. Scand J Work Env Health (2006) Vol. 32(1) p 22 – 31 “Update of a meta analysis on lung cancer and welding” RG Ellis-Behnke et al. PNAS March (2006) Vol.103(13) p 5054 – 5059 “Nano neuro knitting: Peptide nanofiber scaffold for brain repair and axon regeneration with functional return of vision” DA Moneret-Vautrin et al. Allergy (2006) Vol.61 p 507 – 513 “Probiotics may be unsafe in infants allergic to cows milk” Further detail: 6#3-4 46BB  

Evidence from: CDC MMWR Weekly. May 2006 Vol. 55(20) p 563 – 564 “Update: Fusarium Keratitis — United States, 2005—2006” HSE Publications July 2006. WEB13 Prevention of heat illness in mines Further detail: 6#3-4 45BB

Evidence from: AD Penman et al. J Prev Chron Disease (2006) Vol.3#3 “The Changing Shape of the Body Mass Index Distribution Curve in the Population: Implications for Public Health Policy to Reduce the Prevalence of Adult Obesity” HSE Research Report RR390 (2006) “Further investigation of possible musculoskeletal and cognitive deficit due to welding in divers identified in the ELTHI diving study” E Ferguson et al. HSE Research Report (2006) RR469 “‘Lay Conceptualizations of occupational disease’” Scientific Committee on Emerging and Newly Identified Health Risks SCENHIR/005/06 “The Safety of Human-derived Products with regard to Variant Creutzfeldt-Jakob Disease” R Lucas et al. WHO Publications (2006) “Solar Ultraviolet Radiation” Further detail: 6#3-4 44BB

Evidence from: JD Brender et al. J Occ Env Med (2006) Vol.48 p 565 – 572. “Maternal Residential Proximity to Waste Sites and Industrial Facilities and Oral Clefts in Offspring” MW Haut et al. J Occ Env Med (2006) Vol. 48 p 615 – 624 “Corpus Callosum Volume in Railroad Workers With Chronic Exposure to Solvents” The EFSA Journal. July (2006) 383 p 1 – 7 “Opinion on the safety of a Thermo-Mechanical Process to Convert Category 2 and 3 Animal By-Products (ABPs) into Bio-Fuel” NHS Press Release 2006/0234 “New NHS guidance to support victims of abuse” Further detail: 6#3-4 43BB

Evidence from: US EPA Feb 2006 EPA 600/R-05/004aF “Air Quality Criteria for Ozone and Related Photochemical Oxidants” FSA Press Release 16th March 2006. “Farley’s Recalls Soya Formula” Neutral Citation Number: [2006] EWHC 166 (QB) Case No: HQ 04X03327 “Between C and D” KM Venables et al. Occup Environ Med (2006) Vol.63 p 159–167. “Occupational health needs of universities: a review with an emphasis on the United Kingdom” JM teWaterNaude et al. Occup Environ Med (2006) Vol.63:187–192. “Tuberculosis and silica exposure in South African gold miners” MH Ward et al. Epidemiology (2006) Vol.17 p 375 – 382. “Risk of Non-Hodgkin Lymphoma and Nitrate and Nitrite From Drinking Water and Diet” SJ Chang et al. J Occ Env Med (2006) Vol.48 p 394 – 399 “Electrocardiographic Abnormality for Workers Exposed to Carbon Disulfide at a Viscose Rayon Plant” Further detail: 6#3-4 42BB

Evidence from: Industrial Injuries Advisory Council Position Paper 17 “Interstitial Fibrosis in Coal Workers” HA Cowie et al. Occup Environ Med (2006) Vol.63 p 320–325. “Dust related risks of clinically relevant lung functional deficits” Friends of the Earth May 2006. “Nanomaterials, sunscreens and cosmetics: small ingredients big risks” Further detail: 6#3-4 41BB