Recognise and report occupational diseases

What occupational disease means for employers

An occupational disease is a health condition caused or made significantly worse by work. Unlike a workplace accident - which is a single, identifiable event - occupational disease typically develops gradually through repeated exposure to harmful substances, physical agents, or working conditions.

You must report certain occupational diseases under RIDDOR, investigate their cause and prevent them recurring. Spotting them early can also prevent permanent disability in your workers.

When you must report under RIDDOR

You must report an occupational disease under Regulation 8 of RIDDOR 2013 when two conditions are met simultaneously:

1. A doctor provides a written diagnosis that your worker has one of the diseases listed in Regulation 8
2. The worker's job involves the corresponding work activity specified there for that disease

Both conditions must be satisfied. A diagnosis of carpal tunnel syndrome alone is not reportable - the worker must also use percussive or vibrating tools as part of their job. Similarly, a worker who uses vibrating tools but has not received a written medical diagnosis does not trigger a report.

Occupational cancers

Any cancer attributed to occupational exposure to a known carcinogen or mutagen must be reported. Common occupational cancers include:

• mesothelioma from asbestos, which may appear 20 to 50 years after exposure
• lung cancer from silica dust, asbestos, diesel exhaust or chromium VI
• bladder cancer from past exposure to aromatic amines in dye manufacture or rubber processing
• leukaemia from benzene
• nasal cancer from hardwood or leather dust

The long latency period for occupational cancers means the exposure may have occurred decades ago, possibly under a previous employer. You must still report it if the diagnosed worker is your employee.

Diseases from biological agents

Report any disease attributed to occupational exposure to a biological agent, including:

• Legionnaires' disease (from contaminated water systems)
• Leptospirosis or Weil's disease (from contact with rat urine - affects farm workers, sewer workers)
• Hepatitis (from needlestick injuries in healthcare)
• Q fever (from farm animal contact)
• Anthrax (from handling contaminated animal products)

How to recognise occupational disease

The difficulty with occupational disease is that symptoms often resemble common non-work conditions. A worker with occupational asthma may appear to have ordinary asthma. Occupational dermatitis looks like eczema. Hand-arm vibration syndrome mimics Raynaud's disease. The key distinction is whether work exposure is causing or worsening the condition.

Warning signs to watch for

Train managers and supervisors to notice patterns:

• Coughing, wheezing or breathlessness that gets better during holidays or weekends may indicate occupational asthma.
• Redness, cracking or blistering on the hands and forearms suggests occupational dermatitis, particularly if the worker handles chemicals, wet cement or cleaning products.
• Tingling or numbness in the fingers, especially after using vibrating tools, is an early sign of hand-arm vibration syndrome (HAVS). White finger attacks (blanching in the cold) show more advanced disease.
• Gradual hearing loss in workers exposed to noise often shows first as difficulty following conversation against background noise.
• Persistent pain in the hands, wrists or forearms of workers doing repetitive tasks can signal a musculoskeletal disorder.

The most common occupational diseases

Occupational lung diseases include silicosis (from silica dust in construction and quarrying), occupational asthma and chronic obstructive pulmonary disease (COPD) from prolonged dust exposure. They are largely irreversible once established, so early detection matters.

Occupational dermatitis is caused by repeated contact with irritants such as water, detergents and solvents, or by allergic sensitisation to substances such as epoxy resins, chromates in cement and rubber chemicals. It is common in hairdressing, healthcare, catering, cleaning, construction and manufacturing.

Musculoskeletal disorders such as carpal tunnel syndrome, tendonitis and tenosynovitis affect workers doing repetitive hand and arm movements, using vibrating tools or working in awkward postures. Those caused by specific work activities may be reportable.

Noise-induced hearing loss develops gradually and is permanent, and workers may not notice it until the damage is significant.

Hand-arm vibration syndrome damages blood vessels (white finger), nerves (numbness and tingling) and muscles (reduced grip strength) in workers who regularly use vibrating tools.

Your duty to investigate

Reporting is not the end of your obligations. When a worker develops an occupational disease, you have a duty to investigate the cause and take action to prevent the same thing happening to other workers.

Your investigation should consider:

• What exposure caused or contributed to the disease
• Whether your risk assessment identified this risk
• Whether your control measures were adequate and properly maintained
• Whether health surveillance (if in place) should have detected the problem earlier
• Whether other workers have similar exposure and may be at risk
• What additional controls are needed to prevent recurrence

Update your risk assessment based on findings. If the disease reveals that your controls are inadequate, you must improve them - not simply record the outcome.

Keeping occupational health records

• Keep individual health surveillance records for 40 years from the date of the last entry.
• Keep copies of RIDDOR reports for at least 3 years.
• Keep COSHH exposure monitoring records for 40 years, or 5 years for non-personal monitoring.
• Investigation findings have no statutory minimum, but keep them as long as you reasonably can, because they may be needed for civil claims or enforcement action.

The long retention periods reflect the latency of occupational diseases. A worker exposed to silica dust today may not develop silicosis for 10-20 years. Exposure records from decades ago may be critical evidence in a future claim or investigation.

If your business closes, offer health surveillance and exposure records to HSE for safekeeping. Destroying these records could leave former workers without evidence of their occupational exposure.

What to do if you suspect a worker has an occupational disease

If a worker reports symptoms that may be work-related, or if a manager notices warning signs:

1. Encourage the worker to see their GP and mention the possible work connection
2. Refer the worker to your occupational health provider if you have one
3. Review the worker's exposure history and risk assessment
4. Consider whether temporary changes to duties are appropriate while investigation is ongoing
5. If a doctor provides a written diagnosis linking the condition to work, check whether it is RIDDOR reportable
6. Report via the HSE RIDDOR online system if required
7. Investigate the root cause and update controls

Do not wait for a formal diagnosis before reviewing your controls. If there is reason to believe a worker's health has been affected by work, act immediately to investigate and improve protections for all exposed workers.