Work Related Health Issues

What do we mean by shift work?
There is no specific definition of shift work in law, but it usually means: A work activity scheduled outside standard daytime hours, where there may be a handover of duty from one individual or work group to another. A pattern of work where one employee replaces another on the same job within a 24-hour period.

Standard daytime hours are considered as:
A work schedule involving an activity during the day, commonly for a period of eight hours between 7.00 am and 7.00 pm. There are usually two periods of work, one in the morning, the other in the afternoon, separated by a lunch-time break.
Work during the afternoon, night or weekend, typically with periods of the work schedule outside standard daytime hours. Extended work periods of 12 hours or more, often associated with compressing the working week; rotating hours of work; split shifts, where work periods are divided into two distinct parts with several hours break in between; overtime; standby/on-call duties.

What are the undesirable effects of shift work?
Research has shown that there can be undesirable consequences for those working shifts outside standard daytime hours, particularly those covering the night or with early morning starts. For example, shift work may result in:
 Disruption of the internal body clock; fatigue; Sleeping difficulties.
 Disturbed appetite and digestion; reliance on sedatives and/or stimulants; social and domestic problems, which in turn can affect performance, increase the likelihood of errors and accidents at work and might have a negative effect on health.
Disruption of the internal body clock (circadian rhythms)

By nature, humans are active and perform best during the day and need to sleep at night when performance is generally poorer. We follow this innate pattern because of an internal body clock, located in the brain which sets the daily cycle of biological activities, such as chemical and hormone release that influence body activity. For example, heart rate, blood pressure and body temperature are increased during the day. At night they are reduced, and we slow down and feel sleepy. This daily cycle is known as the circadian rhythm and explains why we eat and sleep at similar times each day. External factors or cues such as daylight, mealtimes, clocks and working hours help to regulate this internal body clock, and play an important role in keeping our bodies in step with the world around us.

Our internal body clock can change gradually, but for most people it is resistant to the abrupt changes in the sleep/wake cycle that are required by shift-work schedules or flying across time zones. This can cause our natural daily rhythms to become out of tune with those of the world around us. This is the reason why we can feel ‘out of sorts’ and less able to function to the best of our ability when we do not get enough sleep. The adjustment of our internal body clock to an abrupt change in the sleep/ wake cycle may take days or weeks. It will start to adjust body functions after a few days of shift work, but at different rates, so behaviours that rely on a regular cycle such as digestion, alertness and sleep are disturbed. The adjustment may be more successful in specialised work environments, such as submarines and oil rigs, where the effects of external cues are minimised. However, our internal body clock will never fully adjust, even for workers on permanent night shifts. Those regular night workers who change back to daytime routines during rest days will continue to suffer the consequences of a disrupted internal clock, as it attempts to reset to daylight rhythms during days off.

Sleep disturbance/loss
A consensus view by scientists who study human performance and safety is that sleep is a powerful and vital biological need. Insufficient and disturbed sleep, chronic sleep loss and being awake for prolonged periods, increases the risk of errors and accidents. Day sleep is usually lighter and shorter in duration and therefore less restorative than night sleep. It's more often disturbed because of warmer temperatures and daytime activity such as the phone ringing, noisy children or domestic responsibilities. While we can rearrange some external cues, for example meal times, it is difficult to control all influential sleep/wake cues, particularly daylight. For example exposure to bright light at dawn after a night shift may make you less inclined to sleep.

People’s adaptability means that we can, if we need to, resist our internal body clock and function for periods with either reduced sleep or even no sleep at all. The cost of resisting this need to sleep is known as a ‘sleep debt’. The desire to recover this debt can be very hard to resist, particularly when external cues or our body’s internal body clock are driving us to sleep. Research reveals that when we are sleep deprived and/or fatigued, performance is affected and errors are more likely. This particularly applies to tasks that require:
Vigilance and monitoring; decision making; awareness;
Fast reaction time; tracking ability; memory.

Fatigue
Fatigue is the decline in mental and/or physical performance that results from prolonged exertion, lack of quality sleep or disruption of the internal body clock. The degree to which a worker is prone to fatigue is also related to workload. For example, work that requires constant attention, is machine paced, complex or monotonous will increase the risk of fatigue. A poor balance between the demands of work and the time provided for rest and recovery, resulting for example, from poorly designed shift-work schedules and long working hours is likely to result in chronic fatigue. Levels of fatigue are also affected by personal factors such as home life or individual characteristics. You will need to be aware of these factors when you carry out your risk assessment, but you are not expected to control them. The consequences of fatigue include reduced alertness, poor and slow perception and sleepiness. Chronic fatigue has also been associated with a number of long-term health problems.

Errors, productivity and accidents
For shift working to be financially viable, you need to maintain a satisfactory level of productivity and safety. Fatigued shift workers may perform less well than those working standard daytime hours, especially during periods of low alertness. The consequences of this could range from relatively minor events to serious accidents. Take both ends of this spectrum into account when you are assessing the cost- effectiveness of shift working as the social and financial costs of frequent minor events may equate over time to those associated with a rarely occurring serious accident.

Health effects
As well as chronic fatigue, there is some evidence associating long-term exposure to shift work and
the following ill health effects:
 Gastrointestinal problems such as indigestion, abdominal pain, constipation, chronic gastritis and peptic ulcers;
 Cardiovascular problems such as hypertension, coronary heart disease; increased susceptibility to minor illnesses such as colds, flu and gastroenteritis. Shift work may also exacerbate existing health problems such as diabetes, asthma, epilepsy and psychiatric illness. Moreover, the effectiveness and potential toxicity of some drugs may var depending on the time they are taken as the dose- response patterns of many drugs follow a circadian pattern.

Shift workers, particularly those who work at night, may be at risk of ill health because shift work can disrupt our body clock (by interfering with the production of hormones by the body), disturb sleep and cause fatigue. In recognition of the particular risks to night workers, the WTR include aright for these workers to receive free health assessments. Individual and social factors may also contribute to the risk of ill health effects. Consequently, not everyone will experience or have the same pattern or degree of health problems. An individual’s attitude, behaviour, lifestyle, age, sex and family history plus the conditions they work in, will all play a part.

Disruption of family and social life
A happy social and domestic life is an important foundation for health and well- being. The amount and quality of time spent with family and friends can, however, be affected by unusual patterns of work. A worker who experiences a disrupted social or domestic life may feel isolated, moody or depressed, which can affect their health and performance at work. A work schedule that clashes with domestic responsibility can lead to a compromise between routines suited to work and those suited to less conflict at home. Shift workers, especially those who are primary carers, may spend more time with their family or fulfilling their domestic duties at the cost of sleep. This will result in fatigue and its consequent implications for health and safety.

Situations where you will need to consider safety issues in relation to noise include where:
 you use warning sounds to avoid or alert to dangerous situations.
 working practices rely on verbal communications.
 there is work around mobile machinery or traffic.

There are many ways of reducing noise and noise exposure. First, think about how to remove the source of noise altogether, for example housing a noisy machine where it cannot be heard by workers. If that is not possible, investigate: 
 using quieter equipment or a different, quieter process 
 engineering/technical controls to reduce at source the noise produced by a machine or process 
 using screens, barriers, enclosures and absorbent materials to reduce the noise on its path to the people exposed
 designing and laying out of the workplace to create quiet workstations
 limiting the time people spend in noisy areas

When should personal hearing protection be used? 
Hearing protection should be issued to employees: 
 where extra protection is needed above what has been achieved using noise control 
 for short-term protection, while other methods of controlling noise are being developed You should not use hearing protection as an alternative to controlling noise by technical and organisational means. Employees to whom you provide hearing protection should receive training in how to use it.

Detecting damage to hearing
If the risk assessment indicates that there is a risk to health for employees exposed to noise, they should be placed under suitable health surveillance (regular hearing checks). The Control of Noise at Work Regulations 2005 require employers to take action to prevent or reduce risks to health and safety from noise at work.

The Control of Vibration at Work Regulations 2005  says you must prevent or reduce risks from exposure to vibration at work. Follow the Assess, Control and Review model. Pay particular attention to:

Identify and assess 
Construction sites have a range of different activities involving vibrating tools and machinery.
Consider:
 Who – think about your employees. What equipment are they using? Vibration risks come from many sources including hand-held power tools (such as grinders or road breakers) and hand-guided equipment (like pedestrian controlled floor saws). Give particular consideration to anyone who has a known problem caused by vibration (eg through health surveillance) or those with pre-existing medical conditions of the hands and circulation.

 What – estimate or assess likely exposures from the tasks you are doing. This does not need to be complex, particularly for small sites. As a simple guide workers may at high risk (ie exposure above the Exposure Limit Value) if they regularly use
hammer action tools for more than about an hour per day or some rotary and other action tools for more than about 4 hours per day, at medium risk (ie exposed above the Exposure Action Value) if they regularly operate the same tools for more than about 15 minutes per day or 1 hour per day respectively.

Further information on assessing vibration exposures is available. Look at manufacturers / suppliers information and trade association or other industry databases. You can also use HSE's vibration calculator and ready reckoner. Seek  specialist help if you are unsure.
 Where – consider where the work is taking place. For example, adopting an awkward posture can increase the force needed to apply and control tools. This increases the vibration levels passing into the user's hand and arm.

Control
Where the risks are judged to be low, simple and inexpensive controls will suffice.  For higher risks, you will have to do much more to protect workers. Give priority to the greatest risks first.  Prevent: Where possible think about eliminating or reducing the amount of vibration. Consider:
 eliminating unnecessary vibrating tasks at the design stage and using prefabricated components
 using an alternative process that does not expose workers to vibration. For example:
o block splitters instead of cut-off saws
o bursting or crushing instead of pneumatic drilling
o isolating workers from tasks creating vibration; eg by using a breaker attachment for an excavator or remote controlled equipment instead of a hand-held breaker
 A more detailed list of processes that eliminate or reduce vibration risks.

Even if you stop some of the risk this way, you may still do other work that can create significant vibration. Control the risk by:
 Equipment – don't buy or hire a problem if you don't have to. Select low-vibration tools and equipment.  Make sure it is also correct for the work you are doing. Equipment that is unsuitable, too small or not powerful enough may mean the task takes much longer and exposes workers to unnecessary vibration.

 Work practices – the right equipment still has to be used correctly. Check how it should be operated to ensure you get reduced vibration levels. Promote techniques that reduce grip  force. Improve the design of workstations to limit the loads on hands, wrists and arms caused by any possible poor posture. Devices, such as jigs and suspension systems, can be used to take the weight and vibration of the tools away from the worker.

 Rest and rotate workers – limit the time workers are exposed to vibration for long, continuous periods. Rotate workers where tools require continual or frequent use.

 Gloves and warm clothing – provide protective clothing if needed to keep workers warm and dry. Maintain core body temperature as this encourages good blood circulation. Use gloves to keep hands warm but be aware that they do not provide any protection from vibration.

Train 
Tell workers about the risks from vibration and how to use the controls properly. 

Review 
Supervise:Ensure that controls are effective and properly used.

Maintain:  Effective maintenance can make big differences to vibration levels.  Loose or worn parts of tools and plant create extra vibration. Blunt, damaged or inefficient tools have increased vibration and also mean tasks can take longer, increasing exposure levels. 

Monitor: Check the controls to ensure they are effective. This might mean: 
 Exposure monitoring – there is no legal requirement to continually monitor and record vibration exposure. A period of monitoring can help you understand when and how long workers use particular tools and help with your risk assessment.
 Health surveillance – appropriate health surveillance is needed if workers are exposed above the Exposure Action Value or are considered to be at risk for any other reason. If this finds
a problem, you need to:
o review the effectiveness of your current vibration controls and improve these where appropriate
o take action to prevent further harm to the person concerned

Construction dust is not just a nuisance; it can seriously damage your health and some types can eventually even kill. Regularly breathing these dusts over a long time can therefore cause life- changing lung diseases.
There are three main types:
 silica dust – created when working on silica- containing materials like concrete, mortar and sandstone (also known as respirable crystalline silica or RCS);
 wood dust – created when working on softwood, hardwood and wood-based products like MDF and plywood;
 Other ‘general’ dust – created when working

on other materials containing very little or no silica. The most common include gypsum (eg in plasterboard), limestone, marble and dolomite.
 Anyone who breathes in these dusts should know the damage they can do to the lungs and airways.
The main dust-related diseases affecting construction workers are:
o lung cancer;
o silicosis;
o chronic obstructive pulmonary disease (COPD);
o asthma.
Some lung disease, like advanced silicosis or asthma, can come on quite quickly.

However, most of these diseases take a long time to develop. Dust can build up in the lungs and harm them gradually over time. The effects are often not immediately obvious. Unfortunately, by the time it is noticed the total damage done may already be serious and life changing. It may mean permanent disability and early death.

The law
The Control of Substances Hazardous to Health Regulations 2002 (COSHH) cover activities which may expose workers to construction dust. There are three key things you need to do:
 Assess (the risks)
 Control (the risks)
 Review (the controls)

Assess (the risks)
Assess the risks linked to the work and materials. Examples of high-risk tasks are listed in Table 1. High dust levels are caused by one or more of the following:
 Task – the more energy the work involves, the bigger the risk. High-energy tools like cut-off saws, grinders and grit blasters produce a lot of dust in a very short time;
 Work area – the more enclosed a space, the more the dust will build up. However, do not assume that dust levels will be low when working outside with high-energy tools;
 Time – the longer the work takes the more dust there will be;
 Frequency – regularly doing the same work day after day increases the risks. Control (the risks)

Use the following measures to control the risk. Examples of controls for common high-risk
tasks are given in Table 1.

Stop or reduce the dust
Before work starts, look at ways of stopping or reducing the amount of dust you might make. Use different materials, less powerful tools or other work methods. For example you
could use:
 The right size of building materials so less cutting or preparation is needed;
 Silica-free abrasives to reduce the risks when blasting;
 A less powerful tool – eg a block splitter instead of a cut-off saw;
 A different method of work altogether – eg a direct fastening system. Control the dust
 Even if you stop some dust this way, you may do other work that could still produce high dust levels.
In these cases the most important action is to stop the dust getting into the air. There are two main ways of doing this:

 Water – water damps down dust clouds. However, it needs to be used correctly. This means enough water supplied at the right levels for the whole time that the work is being done. Just wetting the material beforehand does not work.
 On-tool extraction – removes dust as it is being produced. It is a type of local exhaust ventilation (LEV) system that fits directly onto the tool. This ‘system’ consists of several individual parts – the tool, capturing hood, extraction unit and tubing. Use an extraction unit to the correct specification (ie H (High) M (Medium) or L (Low) Class filter unit). Don’t just use a general commercial vacuum.

Respiratory protective equipment (RPE)
Water or on-tool extraction may not always be appropriate or they might not reduce exposure enough. Often respiratory protection (RPE) has to be provided as well. You will need to make sure
that the RPE is:
 Adequate for the amount and type of dust – RPE has an assigned protection factor (APF) which shows how much protection it gives the wearer. The general level for construction dust is an APF of 20. This means the wearer only breathes one twentieth of the amount of dust in the air;
 Suitable for the work – disposable masks or half masks can become uncomfortable to wear for long periods. Powered RPE helps minimise this. Consider it when people are working for more than an hour without a break;
 Compatible with other items of protective equipment;
 Fits the user. Face fit testing is needed for tight- fitting masks;
 Worn correctly. Anyone using tight-fitting masks also needs to be clean shaven.
Remember: RPE is the last line of protection. If you are just relying on RPE you need to be able to justify your reasons for this.

Other controls
Depending upon the work you are doing you may have to combine these measures with other controls. Think about:
 Limiting the number of people near the work;
 Rotating those doing the task;
 Enclosing the work to stop dust escaping. Use sheeting or temporary screens;
 General mechanical ventilation to remove dusty air from the work area (eg in enclosed spaces such as indoors);
 Selecting work clothes that do not keep hold of the dust. You also need to make sure workers are doing the job in the right way and are using controls properly. Train workers:
 About dust risks and how this can harm their health;
 How to use the dust controls and check that they are working;
 How to maintain and clean equipment;
 How to use and look after RPE and other personal protective equipment (PPE);
 What to do if something goes wrong.

Review (the controls)
 You may already have the right controls in place, but are they all working properly?
Check the controls work by:
 Having procedures to ensure that work is done in the right way;
 Checking controls are effective. Does the work still seem dusty? You might need to carry out dust exposure monitoring;- involving workers. They can help identify problems and find solutions;

 Maintaining equipment:
– follow instructions in maintenance manuals;
– regularly look for signs of damage. Make repairs; – replace disposable masks in line with manufacturer’s recommendations;
– properly clean, store, and maintain non- disposable RPE. Change RPE filters as  recommended by the supplier;– carry out a thorough examination and test of any on-tool extraction system at least every 14 months.

 Supervising workers. Make sure they:
– use the controls provided;
– follow the correct work method;
– attend any health surveillance where it is needed.

 You may have to put a health surveillance programme in place. You may need advice for this
from an occupational health professional.

What’s the problem?
Manual handling injuries are part of a wider group of musculoskeletal disorders (MSDs). The term ‘musculoskeletal disorders’ includes injuries and conditions that can cause pain to the back, joints
and limbs. Heavy manual labour, repetitive handling, awkward postures and previous or existing injuries or conditions are all risk factors for developing MSDs. Work may also make worse an injury which was not caused at work, such as a sports injury.
What does the law say?

The Management of Health and Safety at Work Regulations require you to assess the risks to the health and safety of your workers. Where this identifies hazardous manual handling of loads, you should also comply with the Manual Handling Operations Regulations (the Manual Handling Regulations). The Manual Handling Regulations set out a clear hierarchy of measures you must follow to prevent and manage the risks from hazardous manual handling:
 Avoid hazardous manual handling operations, ‘so far as reasonably practicable.
 Assess the risk of injury to workers from any hazardous manual handling that can’t be avoided.
 Reduce the risk of injury to workers from hazardous manual handling to as low as
reasonably practicable.

Workers have duties too. They should:
o Follow systems of work in place for their health and safety;
o Use properly any equipment provided for their health and safety;
o Cooperate with you on health and safety matters;
o Inform you if things change or they identify hazardous handling activities;
o Take care to make sure their activities do not put others at risk.

Avoid hazardous manual handling
Eliminate handling the load
Can you eliminate hazardous manual handling by not moving loads, for example, by looking at whether the work could be done in a different way:
 Does the item really need to be moved, or can the activity be done safely where it already is by redesigning the task?
 Can products or materials be delivered directly to where they will be used?

Automation or mechanisation
If handling the load cannot be avoided, consider whether the operations can be automated or mechanised to eliminate the manual part of the handling. The best time to make decisions about this is when plant or systems of work are being designed.
o Can you use materials handling equipment or mechanical aids to eliminate or reduce the risks you identify in your risk assessment? Can you use, for example, a conveyor, a chute, an electric-powered pallet truck, an electric or hand-powered hoist, or a lift truck to reduce the risk of injury?
o Can you use robotics technology, for example, in production lines?
o When introducing automation or mechanisation, make sure you avoid introducing new risks (for example, when maintaining equipment or when things break down).
o Make sure your workers are trained to use any equipment you introduce, such as lift trucks.

Assess the risks
Where you identify risks from hazardous manual handling in your workplace that cannot be avoided, you must do a manual handling risk assessment to help you decide what you need to do to manage these risks. Make sure your workforce is fully involved in the risk assessment process. Consider risks arising from:
 The task;
 The load;
 The working environment;
 Individual capacity;
 Any materials handling equipment or handling aids used;
 How you organise and allocate work;
 The pace, frequency and duration of the work.

Make sure you take account of the individual requirements of workers who may be especially at risk, for example:
 New or expectant mothers;
 People with disabilities, which may make it more difficult to do a particular task;
 Those returning to work after a recent manual handling injury, who may be on a phased return to work;
 Inexperienced new, young or temporary workers;
 Older workers;
 Contractors, homeworkers or lone workers;
 Migrant workers who may not have English as their first language. You also need to take account of psychosocial risk factors. These may affect workers’ psychological responses to their work and workplace conditions. Examples are high workloads, tight deadlines and lack of control over the work and working methods, which may make people more likely to develop MSDs.

What is DSE?
DSE are devices or equipment that have an alphanumeric or graphic display screen and includes display screens, laptops, touch screens and other similar devices.

What are the health risks with DSE?
Some workers may experience fatigue, eye strain, upper limb problems and backache from overuse or improper use of DSE. These problems can also be experienced from poorly designed workstations or work environments. The causes may not always be obvious and can be due to a combination of factors.

Consulting your employees on DSE
Workplaces where employees are involved in taking decisions about health and safety are safer and healthier. Collaboration with your employees helps you to manage the potential health problems associated with DSE in a practical way by:
 helping spot the risks;
 making sure health and safety controls are practical;
 increasing the level of commitment to working in a healthy way.

How to control the risk
You need to assess the risks associated with using DSE equipment and any special needs of individual staff. You should use your assessment to decide what needs to be done and check that
action is taken. Make a record of your significant findings. Any record you produce should be simple and focused on controls.

Getting comfortable
The following may help users:
 Forearms should be approximately horizontal and the user’s eyes should be the same height as the top of the screen.
 Make sure there is enough work space to accommodate all documents or other equipment. A document holder may help avoid awkward neck and eye movements.
 Arrange the desk and screen to avoid glare, or bright reflections. This is often easiest if the screen is not directly facing windows or bright lights.

Health and Safety
 Adjust curtains or blinds to prevent intrusive light.
 Make sure there is space under the desk to move legs.
 Avoid excess pressure from the edge of seats on the backs of legs and knees.
A footrest may be helpful, particularly for smaller users.
Well-designed workstations

Keyboards and keying in (typing)
 A space in front of the keyboard can help you rest your hands and wrists when not keying.
 Try to keep wrists straight when keying.
 Good keyboard technique is important – you can do this by keeping a soft touch on the keys
and not overstretching the fingers.

Using a mouse
■ Position the mouse within easy reach, so it can be used with a straight wrist.
■ Sit upright and close to the desk to reduce working with the mouse arm stretched.
■ Move the keyboard out of the way if it is not being used.
■ Support the forearm on the desk, and don’t grip the mouse too tightly.
■ Rest fingers lightly on the buttons and do not press them hard.
Reading the screen
 Make sure individual characters on the screen are sharp, in focus and don’t flicker or move. If they do, the DSE may need servicing or adjustment.
 Adjust the brightness and contrast controls on the screen to suit lighting conditions in the room.
 Make sure the screen surface is clean.
 When setting up software, choose text that is large enough to read easily on screen when sitting in a normal comfortable working position.
 Select colours that are easy on the eye (avoid red text on a blue background, or vice versa).

Changes in activity
Breaking up long spells of DSE work helps prevent fatigue, eye strain, upper limb problems and backache. As the employer you need to plan, so users can interrupt prolonged use of
DSE with changes of activity. Organised or scheduled rest breaks may sometimes be a solution.
The following may help users:
 Stretch and change position.
 Look into the distance from time to time, and blink often.
 Change activity before users get tired, rather than to recover.
 Short, frequent breaks are better than longer, infrequent ones.

Timing and length of changes in activity or breaks for DSE use is not set down in law and arrangements will vary depending on a particular situation. Employers are not responsible for providing breaks for the self-employed.

Portable computers
These same controls will also reduce the DSE risks associated with portable computers. However, the following may also help reduce manual handling, fatigue and postural problems: Consider potential risks from manual handling if users have to carry heavy equipment and papers.

Health and Safety
 Whenever possible, users should be encouraged to use a docking station or firm surface and a full-sized keyboard and mouse.
 The height and position of the portable’s screen should be angled so that the user is sitting comfortably and reflection is minimised (raiser blocks are commonly used to help with screen height).
 More changes in activity may be needed if the user cannot minimise the risks of prolonged use and awkward postures to suitable levels.
 While portable systems not in prolonged use are excluded from the regulations some jobs will use such devices intermittently and to support the main tasks. The degree and intensity of use may vary. Any employer who provides such equipment still has to risk assess and take steps to reduce residual risks.

DSE user training
You must provide information, instruction and health and safety training to users to help them identify risks and safe work practices. When training users, consider explaining:
 the risks from DSE work and the controls you have put in place;
 how to adjust furniture;
 how to organise the workplace to avoid awkward or frequently repeated stretching movements;
 how to clean the screen and mouse;
 who to contact for help and to report problems or symptoms;
 how to use the Display screen equipment (DSE)

Providing eye tests and any necessary spectacles for DSE work
There is no evidence to suggest that DSE work will cause permanent damage to eyes or eyesight. Eye tests are provided to ensure users can comfortably see the screen and work effectively without
visual fatigue. If a user or a potential user requests an eye test you are required to provide one. If the test shows that the user needs glasses specifically for DSE work, you must pay for a basic pair of frames and lenses. Eye tests are not an entitlement for the self- employed. Users are entitled to further tests if DSE work is considered to cause them visual fatigue and at regular intervals after the first test. The arrangements you make to provide eye and eyesight tests can vary. For example, some employers let users arrange tests for themselves (and give the employer the bill); others prefer to send all their staff to be tested by one optician. The following may help you when setting up your
arrangements:

Health and Safety
Make sure users understand what you will and won’t pay for.
You only need to provide glasses for the DSE work. If users’ normal glasses are suitable for DSE work,
you don’t need to pay for them. You don’t have to pay for expensive frames or lenses.

Review
DSE assessments need to be reviewed when:
 major changes are made to the equipment, furniture, work environment or software;
 users change workstations;
 the nature of work tasks change considerably;
 it is thought that the controls in place may be causing other problems.

Cold environments
 Ensure the personal protective equipment issued is appropriate
 Provide mobile facilities for warming up, and encourage the drinking of warm fluids such as soup or hot drinks
 Introduce more frequent rest breaks
 Consider delaying the work – can it be undertaken at warmer times of the year without compromising on safety?
 Educate workers about recognising the early symptoms of cold stress

Hot environments
 Reschedule work to cooler times of the day
 Provide more frequent rest breaks and introduce shading to rest areas
 Provide free access to cool drinking water
 Introduce shading in areas where individuals are working
 Encourage the removal of personal protective equipment when resting to help encourage heat loss
 Educate workers about recognising the early symptoms of heat stress

Working in the sun
Too much sunlight is harmful to your skin. It can cause skin damage including sunburn, blistering and skin ageing and in the long term can lead to an increased risk of skin cancer. Skin cancer is one of the most common forms of cancer in the UK with over 50,000 new cases every year. A tan is a sign that the skin has been damaged. The damage is caused by ultraviolet (UV) rays in sunlight. 

Who is at risk?
If work keeps you outdoors for a long time your skin could be exposed to more sun than is healthy for you. You should take particular care if you have:
 fair or freckled skin that doesn't tan, or goes red or burns before it tans, red or fair hair and light coloured eyes, a large number of moles.