The review weighs up the various approaches that have been developed for predicting recidivism in sex offenders. An outright ban on anyone with a conviction from having involvement with children may be the surest way of protecting children but is it proportionate in every case? A 100% accurate assessment tool could make other options available. Evidence from: R Mandeville-Norden et al. Child Abuse Review (2006) Vol.15 p 257 – 272 “Risk Assessment of Sex Offenders: The Current Position in the UK” Those who have a duty to manage sex offenders have large liabilities to manage too. Further detail: 6#5-6 13

The normal healthy development of infants is defined by this standard. Deviation could instigate investigations of maltreatment but the validity of such a trigger is likely to be low. Evidence from: M de Onis et al. Acta Paediatrica (2006) Vol. 95 supplement 450 “WHO Child Growth Standard” Investigations of childcare standards can lead to prolonged distress. If triggered solely by deviation form median growth there is a high risk of unnecessary distress. Further detail: 6#5-6 12

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  

The guidance sets out regulatory standards and advice for non-commercial repair work on brake and clutch linings. Although the regulations are US regulations they could be seen as representing a reasonable view. Evidence from: USEPA Aug 2006 “Current Best Practices for Preventing Asbestos Exposure Among Brake and Clutch Repair Workers” Further detail: 6#5-6 9

In this case it was found that an agency could be found to owe a duty of care towards its registered agency workers. The circumstances were unusual; this particular agency was highly regulated. Evidence from: Rice v Secretary of State for Industry High Court EWHC 1257 2006. Further detail: 6#5-6 6

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

HSE express a view that good practice would take precedence over compliance with workplace exposure levels when deciding on enforcement action. The logic is that good practice provides a sustainable degree of protection whereas compliance with exposure levels could be fortuitous. Evidence from: HSC/06/02 July 2006. “Results of Consultation on Proposals for a Workplace Exposure Limit (WEL) for Respirable Crystalline Silica” This is a helpful clarification of the WEL regime which sets both exposure limits and good practice as the basis of enforcement action. Precedence is clearly given to good practice. Further detail: 6#5-6 1

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

Political interest in the proportionality of risk control measures has re-surfaced in the UK after a long period where a precautionary approach was automatically assumed. Discussants seem to focus on the opportunity cost of excessive regulation. In our view, efforts to re-focus safety work on significant risks will depend very strongly on the lead set by the courts. To that extent, insurers will be involved in this policy initiative. Evidence from: Health and Safety Commission HSC/06/46 April 2006. “Sensible Risk Management” In our view, HSC attempts to deal with the issue of proportionality could have an influence on liability risk exposures. Regulatory interventions should be proportionate and will influence the courts. Further detail: 6#3-4 40

An offence of corporate manslaughter would be based on the common law standard “gross negligence”. In our view this will lead to rapid evolution of what is meant, in civil law, by gross negligence. One of the key difficulties with proving the offence will be proof of proximity between a management decision and cause of death. The law will probably have a retrospective effect and liability insurers will be involved if there is any prospect of interim payments being made. Evidence from: Government response to HC 540, March 2006. “Draft Corporate Manslaughter Bill” The accepted definition and scope of ‘gross negligence’ could evolve as a result of this Bill. In our view it seems likely that the current tests of gross negligence will be relaxed. Further detail: 6#3-4 39

Voice loss is a very general term including a wide range of impairments. There is detailed guidance on the prevention of voice loss but this is based on expert opinion and is untested in field research. IIAC concluded that diagnosis, causation and impairment were all too uncertain to warrant inclusion as a prescribed disease. Evidence from: Industrial Injuries Advisory Council (IIAC). Position Paper 16. March 2006. “Occupational Voice Loss” Further detail: 6#3-4 37

DEFRA have reviewed the available technologies for gene containment and ACRE support their findings. In essence, all containment strategies have weaknesses and post-release monitoring would almost always be required. Evidence from: ACRE Advice February 2006. “Advice on the implications of findings in a Defra-funded desk study: ‘Technologies for biological containment of GM and non-GM crops’” The report lists the ways in which containment can be made more likely. This should be of assistance in insurance risk assessment. Further detail: 6#3-4 36

‘Well being’ is not the opposite of ‘ill being’. Causes for one are not necessarily mirror images of causes for the other. Evidence from: CD Ryff et al. Psychother Psychosom (2006) Vol.75 p 85–95 “Psychological Well-Being and Ill-Being: Do They Have Distinct or Mirrored Biological Correlates?” The problem is that duty of care will be established on the basis of linear logic: if x is a cause of stress then stop doing x or provide more of the opposite of x. The logic has been assumed rather than validated. This research shows the assumption is unsound in more ways than it was sound. Further detail: 6#3-4 34

The research provides some evidence that non-specific arm pain is a different phenomenon to specific upper limb disorders. The evidence come from studies of risk factors. Evidence from: K Walker-Bone et al. Occupational Medicine (2006) Vol. 56 p 243 – 250 “Risk factors for specific upper limb disorders as compared with non-specific upper limb pain: assessing the utility of a structured examination schedule” The main risk factors for diagnosable disorders were age,sex and general health. Some effect of work could be detected. For RSI there was no detectable effect of work. This casts doubt on any efforts to prevent RSI. Further detail: 6#3-4 30

The study provides support for the use of cognitive behavioural therapy (CBT) in enabling people to cope with back pain. The beneficial effect seems to last at least 5 years. Evidence from: SJ Linton et al. Spine (2006) Vol.31(8) p 853 – 858 “A 5-Year Follow-Up Evaluation of the Health and Economic Consequences of an Early Cognitive Behavioral Intervention for Back Pain: A Randomized, Controlled Trial” The findings cast some doubt on occupational causation and injury status. Further detail: 6#3-4 28

Evidence from: The Industrial Injuries Advisory Council (IIAC) IIAC Annual Report 2005/6 The annual report confirms the intention to publish a literature review and opinion on the prescription of occupational back pain and cervical spondylosis. Comment In response to a call for comments, the UK’s leading back pain charity, BackCare, indicated that prescription might reinforce unhelpful beliefs about non-specific back pain and the role of work. The best advice for those with non-specific back pain is to remain active and this includes going to work. Expert reviews [e.g. in the development of the Faculty of Occupational Medicine (FOM) guidelines] have consistently concluded that non-specific back pain is not caused by work and neither is it prevented by following standard ergonomic recommendations. Prescription would be possible if IIAC considered that work more than doubled the risk of back pain. More than 20% of the workforce has problems with back pain every year. The numbers involved

This session of the Committee was set in motion by fears that the new Directive would restrict the use of medical MRI scanners. The effect would be to encourage the use of ionising radiation (X rays) as an alternative. The Committee concludes that the Directive was not as well advised as it could have been. Clarification of the meaning of exposure action levels is provided; it is a very precautionary standard. Evidence from: House of Commons Science and Technology Committee. June 2006 “Watching the Directives: Scientific advice on the EU Physical Agents (Electromagnetic Fields) Directive” Our long-held view has been that the action levels included in the Directive do not form a reasonable basis for judging breach of duty of care in civil cases. We see no reason to revise this view on reading the Committee report. Further detail: 6#3-4 26

Standard N95 face mask dust filters were found not to perform well enough against particles < 100 nm effective diameter. Evidence from: A Balazy et al. Ann. Occup. Hyg. (2006)Vol. 50(3) p. 259–269 “Manikin-Based Performance Evaluation of N95 Filtering-Facepiece Respirators Challenged with Nanoparticles” N95 filters were tested for their ability to exclude nano particles (sodium chloride). Standard procedures require that penetration in excess of 5% be regarded as failure. Particle diameters ranged from10 to 300 nm diameters with a mode at 30 nm. At flow rates of 85 l/min there was significant penetration of nanoparticles. Penetration was reduced for the so-called high fit masks. There were no failures at 30 l/min. Penetration peaked at 40 to 50 nm. 30 l /min represents light work load, 85l/min represents heavy work load. Filters must pass the 85l/min condition. Comment The N95 filters tested here were, by current standards, not adequate. The question that is not answered

For information: There are several potential uses for nanotechnology in the food industry. Current regulation could be effective in controlling intentional usage. Evidence from: Advisory Committee for Novel Foods and Processes ACNFP/76/3 Discussion Paper. March 2006. “Nanotechnology and Food” The only example of control of food additives relates to the specification for microcrystalline cellulose, where the presence of small particles (<5 microns) is limited because of uncertainties over their safety. New additives would be assessed by the European Food Standards Agency (EFSA). Further detail: 6#3-4 18

With appropriate precautions the hides from cattle reared in the same herd as a BSE case animal can be used without significant risk to consumers. Commercial losses to third parties are predictable if procedures are not followed accurately. Evidence from: The EFSA Journal. May (2006) 367 p 1 – 25 “Opinion on the BSE risk from cohort animals: bovine hides and skins for technical purposes” Further detail: 6#3-4 15