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.

Occupational diseases account for far more work-related deaths than workplace accidents. HSE estimates that around 13,000 deaths each year in Great Britain are linked to past occupational exposures, primarily from occupational cancers and lung diseases. Despite this, many employers focus heavily on accident prevention while overlooking the slower, less visible harm caused by occupational disease.

Understanding occupational disease matters for three reasons: you have a legal duty to report certain diseases under RIDDOR, you have a duty to investigate and prevent recurrence, and early recognition can prevent permanent disability in your workers.

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:

• Respiratory symptoms that improve away from work: Coughing, wheezing, or breathlessness that gets better during holidays or weekends may indicate occupational asthma
• Skin problems on exposed areas: Redness, cracking, or blistering on hands and forearms suggests occupational dermatitis, particularly if the worker handles chemicals, wet cement, or cleaning products
• Tingling or numbness in fingers: Especially after using vibrating tools, this is an early sign of hand-arm vibration syndrome (HAVS). White finger attacks (blanching when cold) indicate more advanced disease
• Hearing difficulty: Gradual hearing loss in workers exposed to noise, especially if they struggle to hear conversation in background noise
• Persistent musculoskeletal pain: Particularly in the hands, wrists, or forearms of workers performing repetitive tasks

The most common occupational diseases

Occupational lung diseases are HSE's top enforcement priority in 2026/27. These include silicosis (from silica dust in construction and quarrying), occupational asthma (from over 400 workplace substances), and chronic obstructive pulmonary disease (COPD) from prolonged dust exposure. Occupational lung disease is largely irreversible once established, making early detection critical.

When you must report under RIDDOR

You must report an occupational disease under 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 RIDDOR Schedule 3
2. The worker's job involves the corresponding work activity listed in Schedule 3 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 exposure (may appear 20-50 years after exposure)
• Lung cancer: From silica dust, asbestos, diesel exhaust, or chromium VI exposure
• Bladder cancer: From historical exposure to aromatic amines (dye manufacture, rubber processing)
• Leukaemia: From benzene exposure
• Nasal cancer: From hardwood dust or leather dust exposure

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

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

Maintain accurate records of:

• Health surveillance results: Individual records retained for 40 years from date of last entry
• RIDDOR reports: Keep copies for at least 3 years
• Exposure records: COSHH monitoring records retained for 40 years (or 5 years for non-personal monitoring)
• Investigation findings: No statutory minimum, but retain as long as reasonably practicable - they may be needed for future 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.