BC DISEASE NEWS

A WEEKLY DISEASE UPDATE

9 June 2017 Edition 188

PAGE | 2

CONTENTS

PAGE 2

Welcome

PAGE 3

Deliberating Applications to

Set Aside and Denton:

Redbourn Group Limited v

Fairgate Development

Limited [2017] EWHC 1223

(TCC)

PAGE 4

Agreeing Extensions of Time –

A Quick Reminder:

Emmanuel v The

Commissioners for Her

Majesty’s Revenue and

Customs [2017] EWHC 1253

(Ch)

PAGE 5

Further MedCo ‘Shell’

Companies Suspended

3rd Class Action Brought

Against Slater and Gordon

TUC Produces Report on PPE’s

Relationship with Women at

Work

PAGE 6

Acrylic Compounds and

Occupational Asthma

PAGE 7

Metabolic Syndrome Among

Long-Haul Truck Drivers

PAGE 8

Feature

Working in Cold

Temperatures: Risks and

Duties

Welcome

Welcome to this week’s edition of BC Disease News.

In the last week, MedCo have suspended 23 ‘shell’ organisations that have shown

non-compliance with the latest Ministry of Justice ‘qualifying criteria’. In other

news, Slater and Gordon have been threatened with a 3rd

class action lawsuit,

as a consequence of their unsuccessful acquirement of Quindell in 2015.

We examine the approach adopted by Mr Justice Coulson in the High Court, who

applied the principles of Denton v TH White Limited [2014] EWCA Civ 906, when

deliberating his decision over whether to set aside a default judgment.

We also delve into 2 of the latest studies on work-related diseases published in

academic journals. The first considers the existence of a link between

occupational asthma and acrylic compounds while the second looks at the

relationship between long haul driving and metabolic syndrome.

In this week’s feature, we provide an overview of the risks facing workers in cold

conditions and the duties on employers.

Any comments or feedback can be sent to Boris Cetnik or Charlotte Owen.

As always, warmest regards to all.

SUBJECTS

Relief from Sanction Test and Setting Aside – Extension of Time – Suspension of

Medical Reporting Organisations – Slater and Gordon Shareholder Lawsuit –

Suitability of PPE for Women in Industry – Asthma and Acrylic – Long Haul Driving

and Metabolic Syndrome – Cold Working Conditions.

mailto:boris.cetnik@bc-legal.co.ukmailto:charlotte.owen@bc-legal.co.uk

PAGE | 3

Deliberating Applications to Set Aside and Denton: Redbourn Group Limited

v Fairgate Development Limited [2017] EWHC 1223 (TCC)

In Redbourn Group Limited v Fairgate Development Limited [2017] EWHC 1223 (TCC), Mr Justice Coulson applied the 3 limbed test for relief

from sanctions, established in Denton v TH White Limited [2014] EWCA Civ 906, when refusing to set aside a default judgment.

The Claimant commenced proceedings on 23 December 2016 for unpaid invoices and damages for alleged wrongful repudiation of

contractual relations which the Defendant became aware of on 3 January 2017. 5 days before a defence was due under the CPR, the

Defendant applied for an extension of 28 days, but was only granted 7 days. In any event, after 28 days had passed, on 22 February

2017, the Defendant had still failed to file the defence. The Claimant obtained judgment in default against the Defendant on 9 March,

which the Defendant sought to set aside, filing an application on 14 March 2017. It was only on 11 May 2017, 1 week before the hearing,

that a defence and counterclaim was filed.

While the Defendant submitted that CPR 13.3 warranted the judgment being set aside, Claimant counsel argued that CPR 3.9, on relief

from sanctions, ought to be taken into account. Both provisions are presented below:

Accordingly, at paragraph 17, HHJ Coulson, in agreement with the Claimant, stated:

‘My view, prior to being shown any authorities, was that r.3.9 was plainly relevant to any application to set aside: after

all, there is no greater sanction than judgment being entered in default of a defence, and no more important relief

from sanction than being allowed to set aside that judgment, so as to be able to put forward a defence ... the

relevance of r.3.9 to any application under r.13.3 has been specifically endorsed by the Court of Appeal in Gentry v

Miller [2016] 1 WLR 2696, an important authority not referred to in either counsel's skeleton argument and, more

significantly, not referred to in the notes in the White Book under r.13.3 (an omission which should be rectified in the

next edition)’.

SETTING ASIDE

Firstly, HHJ Coulson discussed the position in Law on setting aside, which has, historically, mirrored the test used for summary judgments,

addressing 2 key questions.

Was there a realistic prospect of success?

‘Realistic’ has been interpreted in Law as meaning ‘more than merely arguable’ (ED & F Man Liquid Products v Patel [2003] EWCA Civ 472)

and the opposite of ‘fanciful’ (Swain v Hillman [2001] 1 All ER 91).

PAGE | 4

HHJ Coulson’s acknowledgment of this,

therefore assisted him in assessing the

Defendant’s conduct against their

probability of success. He deemed their

defence to be ‘evasive’, due to a

combination of delay, the supply of

compromised evidence given by a ‘bad

leaver’ and the non-admission/bare denial

nature of the Defendant’s response. HHJ

Coulson doubted their ‘credibility’ and

found it to be ‘wholly unpersuasive’,

emphasising: ‘a defendant in FDL's position

is required to do much more ... there is

nothing to indicate that giving them still

further time would make any difference to

the outcome’.

Further, at paragraph 30, he surmised:

‘Thus the delays and the absence of any

detailed evidence from those involved at

FDL (the effect of which is apparent on the

face of the draft defence and

counterclaim) strongly suggest that FDL

does not have a defence with a realistic

prospect of success’.

Was there a failure to act promptly?

Answering this question, HHJ Coulson

calculated that the extension benefitting

the Defendant, amounted (de facto) to

‘over three and a half months’, which

represented a ‘wholesale failure to comply

with the CPR’ and thus, it would be wrong to

place the Defendant in a better position

than the rules would otherwise afford.

Casting judgment over the Law solely

concerning setting aside, HHJ Coulson

held, at paragraph 74:

‘I will exercise my discretion in RGL's favour

under r.13.3, and I will not set aside the

judgment in default. However, in case I am

wrong on either of the two elements in

r.13.3(1) and (2), I go on to address the

three stages of Denton (seriousness of

failure, the reason for it, and all the

circumstances of the case)’.

GRANTING RELIEF FROM SANCTIONS

The judge went on to consider all 3 limbs of

the Denton test, in turn.

Was the breach serious and what was the

reasoning behind it?

In short, Mr Justice Coulson could not find

any good reasoning behind the delay,

while on the question of ‘seriousness’, he

highlighted, at paragraph 80, ‘the recent

trend in cases concerned with late

amendments, such as Su-Ling v Goldman

Sachs International [2015] EWHC 759

(Comm), where Carr J made plain that, on

the recent authorities, the absence of a

proper explanation for delay will often,

without more, lead to the application to

amend being refused’.

Reaching a conclusion, the judge found

the Defendant’s ‘failure in allowing

judgment in default to be entered was

serious’.

Have all other circumstances been

considered?

Under his analysis, HHJ Coulson simply

stated, at paragraph 84:

‘... even if I was wrong on either of the

elements of CPR r.13.3, I would conclude

that, in accordance with Denton, FDL

have not made out a case to be granted

relief from sanctions. So the application to

set aside judgment would still fail’.

After having extensively covered all of the

relevant CPR provisions, HHJ Coulson, in his

concluding statements, refused to entertain

the Defendant’s application to set aside the

judgment in default. At paragraphs 85-87,

he emphasised that there was ‘no realistic

prospect of defending this claim in

principle or advancing their own

counterclaim ... I am particularly struck by

the complete absence of any explanation

– let alone excuse – for any of the relevant

delays. Those would separately lead me to

exercise my discretion against FDL and to

refuse to set aside judgment’.

This case, it would seem, clarifies the

correct approach that should be taken by

judges when deciding if it would be wise to

set aside a default judgment. It is as

important to assess the prospective merit of

a defence as it is to retrospectively punish

a defaulting party for CPR breaches under

the Denton principles.

Agreeing Extensions of

Time – A Quick

Reminder: Emmanuel v

The Commissioners for

Her Majesty’s Revenue

and Customs [2017]

EWHC 1253 (Ch)

Guidance on when it would be appropriate

to agree an extension of time has recently

been handed down in the case of

Emmanuel v The Commissioners for Her

Majesty’s Revenue and Customs [2017]

EWHC 1253 (Ch).1

The case was one of bankruptcy, in which

HMRC, as petitioning creditor, had sought

an extension of time during proceedings,

which the appellant refused.

When considering costs, HHJ Karen Walden

Smith made some useful comments. She

stated:

‘Further, in my judgment the appellant

ought to have agreed to the short extension

of time being sought by HMRC. The

appellant’s refusal to cooperate was

contrary to the overriding objective and, it

would seem, that the stance taken was for

a tactical advantage. The appellant takes

the costs consequences of not succeeding

on the point’.

The judge took into consideration the fact

that HMRC’s request for an extension was

made in advance of the deadline and that

the appellant’s response to the request was

delayed until very shortly before the

deadline. Further to this, there was no

prejudice to the claimant caused by

HMRC’s delay and they were still able to file

evidence, in response, before the relevant

hearing. The judge continued by

referencing the decision in Hallam Estates

PAGE | 5

Ltd v Baker [2014] EWCA Civ 661, in which

Jackson LJ stated:

‘… A variety of circumstances may arise in

which one or other party (however diligent)

may require a modest extension of time.

Under rule 1.3 the parties have a duty to

help the court in furthering the overriding

objective. The overriding objective includes

allotting an appropriate share of the court’s

resources to an individual case. Therefore

legal representatives are not in breach of

any duty to their client, when they agree to

a reasonable extension of time which

neither imperils future hearing dates nor

otherwise disrupts the conduct of the

litigation. On the contrary, by avoiding the

need for a contested application they are

furthering the overriding objective and also

saving costs for the benefit of their own

client’.

This is a useful reminder for all litigants when

either requesting, or agreeing, an extension

of time with another party.

Further MedCo ‘Shell’

Companies Suspended

Last week, we discussed MedCo’s decision

to suspend 23 Medical Reporting

Organisations and 14 Direct Medical

Experts from its computer system, as they

failed to upload medical data within time

limits expressed in the terms and conditions

of their user agreements.2 This week,

another 21 ‘shell’ companies have been

suspended on the same grounds as the 134

MRO’s in November 2016, bringing the total

up to 155 since the latest government-

enforced criteria was introduced.3

MedCo was designed to provide victims of

whiplash with independent medical

diagnoses, but in edition 163 of BC Disease

News (here), we reported on the termination

of 134 ‘shell’ companies, uncovering the

clear ambition of ‘parent’ (tier 1)

companies to circumvent the process of

randomly allocating expert advice, by

acquiring additional work through

instructed entities (tier 2) owned and

managed by themselves.

This came as an unanticipated shock to the

Personal Injury industry, as, just a month

beforehand, the Ministry of Justice released

updated guidelines on the ‘qualifying

criteria’ of Medical Reporting Agencies, in

the hope of preventing malpractice, newly

defining them as:

‘... an organisation whose principle function

is to provide medico-legal reporting

services and which is— (i) independent1 ;

(ii) properly staffed and resourced; and (iii)

directly and solely responsible for all work

associated with receiving instructions via

the MedCo portal and instructing a

medical expert to provide an initial

medical report’.4

It can be deduced from this most recent

round of suspensions that companies are

not heeding warnings precluding non-

compliance and are still attempting to

undermine the transparency and validity of

the scheme.5

Will this be the last occurrence of ‘shell’

company deception that MedCo is forced

to act upon?

3rd Class Action

Brought Against Slater

and Gordon

In edition 184 of BC Disease News (here), we

discussed Slater and Gordon’s intention to

issue proceedings, by the end of May,

against Watchstone Group PLC, formerly

known as Quindell, for £600 million, on the

basis that:

‘… but for fraudulent misrepresentation it

would not have entered into the transaction

at all’.6

This transaction, of course, refers to the

acquisition of Quindell’s professional

services division, which has been the

subject of several BC Disease News articles,

given significant investment losses of up to

95%, following the deal.

Yesterday, it was announced to the

Australian Stock Exchange (ASX), that legal

representation has been instructed on

behalf of Babscay Pty Ltd, who will become

the 3rd

firm to commence shareholder

action against the publicly listed PI Law

Firm.

In an official ASX statement, S&G gave

further details about their correspondence

with Johnson Winter & Slattery Lawyers

(JWS), who will represent the legal interests

of Babscay Pty Ltd:

‘While details of the proposed claim have

not been provided, the letter from JWS sets

out that the claim will be based on

allegations that the company’s financial

statements in each of the financial years

ended 30 June 2013, 2014 and 2015

contained misleading representations’.7

TUC Report on PPE’s

Relationship with

Women at Work

The Trade Union Congress (TUC), in April of

this year, published a report, titled:

‘Personal protective equipment and

women’, which was a culmination of a 2016

TUC survey of 2,655 workers and a 2016

Prospect/Women in Science and

Engineering survey of 3,086 workers.8

Research intended to establish how

Personal Protective Equipment (PPE) is used

by women in the emergency services, retail

and manufacturing, engineering and

scientific research industries, with results

showing that, in many instances, PPE

providers are failing to supply female

workers with adequate protection.

The Personal Protective Equipment

Regulations 2002 and the Personal

Protective Equipment at Work Regulations

1992 (as amended) impose employers’

duties, namely that they must supply PPE

(with training) to employees without cost

and ensure their continuing suitability, so to

guard off potential health and safety

hazards. Under the Regulations, PPE

extends from clothing one might expect,

like hi-vis jackets and work boots, to more

niche apparel, such as eye and ear

protection, knee pads, safety harnesses,

https://www.bc-legal.co.uk/images/pdf/163-BC-Disease-News---11.11.2016-Edition-163.pdfhttps://www.bc-legal.co.uk/images/pdf/184-BC-Disease-News-2017-05-12-Edition-184.pdf

PAGE | 6

anti-stab jackets and respiratory protective

equipment (RPE).

Inappropriate PPE can risk the injury of

employees, but may also cause pain and

general discomfort too. As women become

increasingly visible in working environments

where PPE is mandatory, if PPE design

processes are still influenced by male bias

and are inconsiderate to the vast physical

differences that men and women exhibit,

then female employees may be risking their

occupational safety.

Statistics obtained through the survey

conveyed that:

Only 29% of women feel that the

PPE they wear is tailored with their

gender specific requirements in

mind.

57% of respondents believed their

work was ‘sometimes’ or

‘significantly’ hampered by PPE,

with 95% of emergency services

staff holding this belief.

For those wearing protective

trousers, 41% thought they were

‘inappropriate’, with only 10%

claiming the opposite.

For those compelled to wear

overalls, 35% deemed them to be

‘improper for the task at hand’,

with just 10% satisfied.

Of the pregnant women

questioned, 50% expressed that

they were under pressure to adjust

their work patterns and workloads

in order to cope with a lack of

suitable PPE.

Despite legal obligations

underpinning employers, only

85% of women were regularly

provided with PPE; and 10% of

contributing employers failed to

replace PPE when it was

dysfunctional, while less than 50%

paid for cleaning services to

maintain PPE.9

In a press release, at the end of April,

General Secretary of the TUC, Frances

O’Grady, was ‘shocked’ to read the written

responses of women in front line services,

many of whom had been precluded from

carrying out their jobs ‘safely’, as they were

not supplied with the ‘right protective

clothing’. He highlighted the desperate

need to ‘ensure protective uniforms come

in men’s and women’s sizes’.10

Concluding the report, the TUC suggests

that, in order to drastically improve the

provision of PPE for female workforces,

employers should avoid approaching PPE

suppliers who have failed to assess the

appropriate functioning and adequate

range of sizing that both male and female

workers would need to perform their roles.

Further, employees should be given the

opportunity to model multiple types of PPE

before issue and also provide feedback on

their designated PPE after use, while

employers should make sure to work closely

with safety committees and labour union

representatives to drive the overall progress

of suitable PPE in the workplace.

Acrylic Compounds

and Occupational

Asthma

A recent article, published in Occupational

Medicine, reported on cases of

occupational asthma caused by acrylic

compounds, which were recorded in the

SHIELD surveillance scheme, between 1989

and 2014.11

In the past, there have been

case reports which discuss respiratory

sensitisation to acrylic compounds in

operating theatre staff, optical laboratory

technicians, assembly and manufacturing

operatives, beauticians, automotive

repairers, printers, a graphic arts worker, a

secretary, a plumber, dental personnel

and model makers. The aim of this

research was to divulge all notifications to

SHIELD where occupational asthma had

been caused by sensitisation to acrylic

compounds, in order to illustrate both

common, and new, examples of

occupational exposures.

Acrylics, or poly-acrylates, have been used

since the 1930s as adhesive resins, surface

coatings, synthetic textiles, printing ink and

hard plastic. The most commonly

produced acrylic is methyl acrylic, which is

traditionally involved in the manufacture of

poly methyl acrylic (PMMA), which is used to

make hard contact lenses and transparent

replacements for glass such as Perspex. It

is also used as a dental filler and adhesive,

orthopaedic bone cement, histological

fixation medium and gel for nail extensions.

Skin sensitisation to acrylics was recognised

as early as the 1940s and has been found

in assembly workers, dental staff and nail

technicians.

SHIELD is the Midland Thoracic Society’s

Surveillance Scheme of Occupational

Asthma.12

It is a voluntary scheme, by which

respiratory and occupational physicians

contribute towards the reporting of cases.

Cases are noted when positive clinical

diagnosis of occupational asthma proves

‘more than likely’, provided there is

evidence of occupation-related asthma,

demonstrating a worsening of symptoms,

and a symptomless latent interval, prior to

the onset of symptoms. Pre-existing

asthma, only exacerbated by work, was not

included.

Out of 1,790 occupational asthma cases

reported to SHIELD in the West Midlands,

between 1989 and 2014, 20 were due to

acrylic compounds, of which 8 were

predominantly due to methyl methacrylate.

The latency period between first exposure

and onset of symptoms ranged from 5

months to 26 years, with a median of 36

months. There were 11 patients with atopy

(the genetic tendency to develop allergic

diseases such as asthma, eczema and

hayfever).

A variety of exposures and industries were

implicated, including: manufacturing,

health care, beauty, printing and

education. Agents containing acrylic

compounds were commonly sourced in

adhesives, emulsions, coatings and bone

cement, printer ink, nail extensions, dental

filler and injection moulding substances. A

novel presentation was found in teachers

exposed to floor adhesives.

A strength of this study was its large size,

while its main weakness was that specific

inhalation challenge (SIC) testing did not

confirm the patients’ respiratory sensitivity,

when exposed to the suspected causal

PAGE | 7

agent. SIC testing is used in many

European studies, perhaps because it is

required if compensation is sought. In the

UK, however, objective demonstration of a

work-related pattern for asthma (including

a latency period and relief from symptoms

when away from work), obtained through

repeated peak flow testing, plus a history of

exposure to a sensitising agent, would

usually be sufficient for awarding

compensation under the government

Industrial Injuries Disablement Benefit (IIDB)

scheme.

The role of atopy in occupational asthma

due to low-molecular-weight agents (e.g.

the molecules that combine to make

acrylics) remains controversial. Some

studies report that atopy confers an

increased risk of occupational asthma, and

some found no association. This remains

unclear for some agents commonly

associated with occupational asthma, such

as isocyanates and platinum salts. In the

current study, 55% of patients were atopic,

which is a little higher than reported in

earlier studies.

Although 1% of occupational asthma cases

reported to SHIELD during the 25 year

period were attributed to acrylic

compounds, interestingly, 26% of all SHIELD

notifications are for workers employed in

occupations associated with reported

cases of sensitisation to acrylic compounds

(health and dental care, assembly, plastic

moulding, beauty, laboratory work). Thus,

many workers exposed to acrylic are also

exposed to other agents associated with

occupational asthma.

The researchers concluded that acrylic

compounds remain an important cause of

asthma at work, and exposure can occur in

a wide variety of industries.

Metabolic Syndrome

Among Long-Haul Truck

Drivers

A recent study has found high prevalence

and severity of metabolic syndrome

among truck drivers in the USA.13

Long-haul truck driving typically includes

long work hours, shift work and irregular

work schedules, which have been shown to

worsen sleep duration and quality.14

It has

previously been suggested that work

organisation and sleep factors can induce

components of metabolic syndrome

(MetS).15

The definition of metabolic syndrome is that

the individual meets 3, or more, of the

following 5 criteria:

1. obesity in the waist area;

2. high triglycerides (a type of fat

found in blood – some

triglycerides are essential but

levels that are too high increase

the risk of heart disease);

3. low high-density lipoprotein (HDL)

cholesterol (‘good’ cholesterol,

which helps to reduce levels of

‘bad’ cholesterol);

4. high blood pressure;

5. high blood glucose.

The components of metabolic syndrome,

both independently and synergistically,

can elevate the risk of atherosclerotic

vascular disease and type 2 diabetes.

Atherosclerotic vascular disease is the

build-up of plaques in the arteries, and can

occur in any arteries of the human body.

When plaque deposits in the arteries of the

heart, this can lead to angina and heart

attack, and when found in the arteries of

the neck, this can lead to stroke. Type 2

diabetes is when the pancreas does not

produce enough insulin, or when cells in

the body fail to respond normally to insulin.

The study population featured 262 truck

drivers, 115 of whom supplied blood

samples which underwent analysis. Most of

the drivers (83%) worked irregular

schedules, and more than 70% reported

working more than 11 hours per day.

Drivers reported an average of 6.9 hours of

sleep on work days and 8.3 hours on non-

work days. Never, or rarely, benefitting

from good quality sleep on work days was

reported by 38% of the participants. Every

driver met the diagnostic criteria for at least

one measure of MetS, while the vast

majority of the sample (80%) met the

criteria for between 2 and 4 measures of

MetS. The most prevalent result was

meeting 4 of the criteria, which was the

case for 33 drivers (29%). Overall, 58% met

the criteria of 3 or more measures for MetS.

The most common measure of MetS was a

waist circumference of more than 102 cm,

which was found in 91 drivers (79%).

Among the work organisation variables

(work hours, length of sleep and quality of

sleep, etc.), work day sleep quality was the

only significant predictor of MetS. By

contrast with earlier studies, long working

hours16

and shift work17

18

were not linked

with a higher prevalence of MetS.

The researchers concluded that the

frequency and severity of MetS among

long-haul truck drivers in the USA is high,

with abdominal obesity, high triglycerides

and low HDL cholesterol being particularly

predominant. High blood pressure and

high blood glucose levels were less

common, perhaps due to the obligatory

legal requirements which regulate the

health of professional drivers.

This study highlights the need for further

studies into the causes and effects of poor

sleep quality between shifts, as well as

further studies into work-related risks of

MetS.

PAGE | 8

Feature

Working in Cold Temperatures: Risks and Duties

INTRODUCTION

Very cold temperatures can cause hypothermia, or dangerous overcooling of the body, which can be fatal in the absence of medical

attention. Frostbite, or freezing of the extremities, is also possible, along with trench foot and chilblains.19

Cold-related illnesses can be

caused by cold temperatures, strong/cold winds, dampness and cold water.20

According to the Health and Safety Executive’s Construction

Industry Advisory Committee, workers are particularly at risk from cold when the ambient temperature is below 10 °C. At an air temperature

of 10 °C, if the wind speed is 20 miles per hour, the effective temperature is 0 °C.21

Average temperatures in the UK can be below 10 °C

from November to April.22

23

In this feature we look at the potential side effects of working in cold environments, what the health consequences are at different

temperatures and the legal obligations placed on employers to prevent them.

WHO IS AT RISK?

Anyone working in a cold environment may be at risk of cold stress. Some workers may be required to work outdoors in cold environments

and for extended periods, for example construction workers, those in fishing and agriculture, caretakers, police officers, emergency

response and recovery personnel. Indoor workers may also be exposed to cold environments, for example, working with frozen food or

other cold processes or products.

Cold temperatures can cause blood thickening, increase in blood pressure and tightening of the airways. As such, people who already

have chronic health conditions may also be more vulnerable, for example, those with Chronic Obstructive Pulmonary Disease (COPD)

have a significantly increased risk of ill-health and hospitalization during periods of cold weather.24

LONG-TERM EXPOSURE TO COLD

A few studies have investigated the effects of long-term exposure to cold working conditions. Work in the cold has been linked with

respiratory disorders, musculoskeletal disorders, cardiovascular diseases and skin disorders25

(general exposure to the cold is also

associated with all of these26

). For example, a study of seafood industry workers in Norway found that workers, who often felt cold, had

significantly increased prevalence of symptoms from muscles, skin and airways while working.27

In addition, exposure to cold can increase

the manifestation of symptoms of some underlying chronic diseases.

Let us now look at each of these in turn.

RESPIRATORY DISORDERS

Jammes and colleagues found that daily exposure to temperatures between 3 and 10 °C, for 6 hours, elicited a modest, but significant,

airflow limitation, accompanied by bronchial hyper responsiveness, with the effects beginning within 6 months of exposure.28

It has also

been reported that chronic hyperventilation of cold dry air in cross-country skiers, for several years, may induce permanent bronchial

disorders and induce ventilatory limitations during intense exercise.29

Studies have found that the risk for chronic bronchitis and bronchitis

symptoms is elevated among outdoor workers,30

but studies tend to focus on populations living in cold areas, such as Finland. A review of

health problems in cold work by Mäkinen and Hassi recommends that work activity is planned, so as to avoid, or minimise, very high

physical activity levels.31

A HSE report on respiratory disorders reveals that participants in the 2009/10, 2010/11, and 2011/12 Labour Force Surveys, who reported

having breathing or lung problems made worse by work, were asked to identify, in general terms, what it was about their work that was

contributing to their ill health. 20% reported that it was the ‘general work environment (uncomfortable – hot/cold/damp/wet/dry/etc)’.32

PAGE | 9

MUSCULOSKELETAL DISORDERS

Studies of indoor work at cold temperatures, particularly in the food processing industry, have found that musculoskeletal symptoms are

more frequent in cold store work and similar conditions compared to normal temperature work, and symptoms seem to increase with

longer time spent working in cold conditions.33

Local cooling may increase the risk of musculoskeletal disorders in the neck-shoulder

region, shoulders, wrists and lower back,34

and a study of seafood processing workers in Norway found that work in a moderate cold

environment (including, for example, a moderate ambient temperature but contact with cold seafood products) is a strong risk factor for

all types of musculoskeletal problems.35

One review reported that the risk of carpal tunnel syndrome (CTS) was 2.2-fold with repetitive wrist

movements, when compared with non-repetitive movements, and 9.4-fold for repetitive movements with cold exposure. Another article

reported that work in cold environments gave an odds ratio of 3.52 for CTS,36

while a study of frozen food workers found that cold and

repetitive movements were risk factors for CTS.37

It has also been reported that repetitive work in cold surroundings causes greater muscle

fatigue, which could put a worker at greater risk of ‘overuse’ injuries.38

A study of workers in a meat processing factory found that the

unadjusted incidence of tenosynovitis/peritendinitis among female sausage packers was statistically higher than that of female sausage

makers of the same age.39

The most notable difference between the work conditions of these groups was the ambient temperature. The

packers worked in a temperature of 8-10 ºC, whereas the sausage makers worked at 20 ºC. Similarly, a study of workers in a meat

processing factory in Colombia found that there was a high prevalence of musculoskeletal disorders among the workers who faced greater

exposure to cold, especially in the low back, neck and shoulders.40

A 1997 study of patients, selected from a GP register in Greater

Manchester, reported that men who worked frequently in very cold or damp conditions had a 4-fold and 6-fold risk respectively of shoulder

pain and disability.41

A 2010 review found that neck-shoulder symptoms were negatively related to frequent outdoor work.42

However, in

their review, Mäkinen and Hassi point out that, although the literature tends to suggest that there is an association between cold exposure

and musculoskeletal disorders, many of the epidemiological studies have methodological limitations.43

A large, more recent, Swedish

study, found that construction workers in colder environments were at greater risk of developing low back and neck pain than those in

warmer environments.44

Further, exposure to cold, such as being outdoors early on a winter morning, is the main trigger for symptoms of vibration white finger.45

CARDIOVASCULAR HEALTH

Mäkinen and Hassi did not find any epidemiological studies that examined cardiovascular problems with an emphasis on work in cold

environments, though they did find some studies which were suggestive of the fact that function of those with hand-arm vibration syndrome

lessens in cold weather. However, exposure to cold is strenuous for the heart, and its increased workload may be exacerbated by physical

activity or work in the cold. Studies have found that blood pressure is higher in winter among those with hypertension,46

and that this effect

is greater in older patients,47

A Korean study compared workers who spent time in a cold area, more than once per day, with workers who

were not exposed to cold, finding that the group exposed to cold had higher blood pressure.48

Analysis of data from two large studies found that more cardiovascular disease events were reported in the winter in both investigations.49

There was a significant increase in risk of first incidence of cardiovascular disease during cold spells of the British Regional Heart Study

(BRHS), particularly among those who had ever smoked. No increased risk was found in the PROSPER study.

In addition, a study in the Czech Republic found that cold spells were associated with increased mortality from ischemic heart disease

(IHD).50

The excess mortality, due to IHD, was most pronounced in the younger age group (0-64 years), and there were larger increases in

the number of heart attacks than the number of deaths, due to chronic heart disease.

SKIN HEALTH

Abnormal skin responses to cold usually occur when subjects are exposed to moderate cold (0 to 15 ºC) for prolonged periods.51

Chilblains

are caused by repeated exposure of skin to temperatures from just above freezing, to as high as 15 °C (60 °F).52

The cold causes damage

to the small blood vessels in the skin. Damage is permanent, and symptoms, such as redness and itching return with further exposure. It

typically occurs on the cheers, ears, fingers and toes. There may also be blistering, inflammation and ulceration in severe cases.

Cold urticaria is a hypersensitive reaction to cold, which presents with hives or wheals, either during exposure to cold, or when the skin is

warming up after exposure. Other symptoms, such as headache, vertigo, dyspnea or anaphylactic shock may also occur.

PAGE | 10

RISK CONTROL

The HSE does not have specific guidance for working below 13 °C, though some British Standards offer advice in this area, and employers

can demonstrate compliance by alternative means.53

The HSE advise that ‘when people are too cold’ employers can take steps, such as

designing processes that minimise exposure to cold areas and cold products where possible, providing appropriate protective clothing

for cold environments, introducing systems to limit exposure (e.g. flexible working patterns and job rotation), and providing sufficient breaks

for employees to have hot drinks and warm up.54

The United States National Institute of Occupational Safety and Health (NIOSH) offers recommendations for employers and workers.55

Recommendations for employers include:

Schedule maintenance and repair jobs in cold areas for warmer months;

Schedule cold jobs for the warmer part of the day;

Reduce the physical demands of workers;

Use relief workers or assign extra workers for long, demanding jobs;

Provide warm liquids to workers;

Provide warm areas for use during break periods;

Monitor workers who are at risk of cold stress; and

Provide cold stress training that includes information about: worker risk, prevention, symptoms, the importance of monitoring

oneself and co-workers, treatment, and personal protective equipment.

Recommendations for workers include:

Wear appropriate clothing: wear several layers of loose clothing as layering provides better insulation; avoid tight clothing as it

reduced blood circulation;

Make sure to protect the ears, face, hands and feet in extremely cold weather: boots should be waterproof and insulated; wear

a hat;

Move into warm locations during work breaks;

Limit the amount of time outside on extremely cold days;

Carry cold weather gear, such as extra socks, gloves, hats, jackets, blankets, a change of clothes and a thermos of hot liquid;

Include a thermometer and chemical heat packs in your first aid kit;

Avoid touching cold metal surfaces with bare skin; and

Monitor your physical condition and that of your coworkers.

The CCOHS provides detailed information about clothing, footwear and face and eye protection, along with advice about other aspects

of work in cold.56

They also provide a useful summary of the health concerns and recommendations for preventative action in the following

table:

PAGE | 11

Source: Canadian Centre for Occupational Health and Safety: OSH Answers Fact Sheets

EMPLOYERS’ DUTIES

Employers have general duties to ensure health and safety under the Health and Safety at Work Act 1974 to assess and control risks from

work under the Management of Health, Safety, and Welfare Regulations (MHSWR). These legal requirements cover working outside, in the

cold.

The Approved Code of Practice (ACoP) states that the temperature should provide reasonable comfort, without the need for special

clothing and where this is not possible, due to hot or cold processes, or access to the outside environment, all reasonable steps should be

taken to achieve a temperature as close as possible to ‘comfortable’. However, where maintaining these standards would be impractical,

as a result of food, or other processes or products, needing to be kept cold, or rooms needing to be open to the outside; employers should

apply the following measures as appropriate: enclosing or insulating the product (e.g. localised refrigerated enclosures including hoppers

or conveyers); pre-chilling the product; keeping chilled areas as small as possible; exposing the product to workroom temperatures as

briefly as possible; insulating with duckboards or other floor coverings, where workers have to stand for long periods (unless special footwear

is provided which prevents discomfort); and undertaking draught exclusion using baffles and self-closing doors. Additionally, suitable

protective clothing and rest facilities should be provided where local heating or cooling does not supply reasonable comfort. Where

practical, systems of work, such as task rotation, should ensure that any individual worker is only exposed to an uncomfortable temperature

for a limited period of time.

In relation to PPE, worn by employees, the Personal Protective Equipment (PPE) at Work Regulations require employers to consider the work

environment, which includes the weather, if the work is outside. So, adequate protective clothing should be provided where exposure to

cold is unavoidable and presents a hazard. However, when the body is forced to work, the production of heat rises. To maintain a balance

between heat production and heat loss, insulation must decrease. Well-designed cold weather clothing allows the wearer to remove

PAGE | 12

layers, or open vents and let the excess heat escape. This prevents overheating, and also chilling, which can be a serious problem in the

cold. Sweat can accumulate in poorly designed clothing and continues to evaporate during periods of rest, making the body cold.

CASE LAW

Many of the cases that deal with injuries sustained in extreme cold, are for the injury known as Non Freezing Cold Injury, or NFCI. NFCI

occur when tissue fluids do not freeze [which usually occurs at around (-)0.5°C], but local temperatures remain low for several hours, or

days. It can lead to life-long cold sensitivity and chronic pain. This condition is often seen in the hands, or feet, and is typically found in

soldiers, sharing similarities with ‘trench foot’, suffered by soldiers in WWI. It has been suggested by some in the medical profession that

soldiers from hot countries, such as those in the Commonwealth, are particularly sensitive to NFCI.57

In edition 127 (here) we discussed the decision in Billett v Ministry of Defence [2015] EWCA Civ 773, in which the Ministry of Defence

appealed against a decision awarding damages, after it had admitted liability in respect of a NFCI sustained by the claimant. The

claimant was employed by the Ministry as a lance corporal and whilst undertaking a field exercise whereby he was required to live

outdoors in freezing cold weather and snow for six days, he suffered a NFCI to his feet, due to unsatisfactory footwear, provided to him by

the army. The claimant continued to suffer symptoms in cold weather, even after his employment with the army ceased. These included:

- Tremors;

- Burning sensations in hands and feet, painful in cold weather;

- Pins and needles in feet;

- Swollen and painful joints;

- Unable to gauge temperature with feet;

- Sweats;

- Reduced sensation in feet;

- Cold hands and feet with poor circulation;

- Fear of cold conditions.

The claimant’s principal financial claim related to loss of future earning capacity and it was accepted that if the claimant lost his current

job, he would have been at a disadvantage in finding new employment by consequence of the injury. This was accepted by both parties’

medical experts who stated:

‘We agree that Mr Billett:

Has a disadvantage on the labour market for some occupations due to his injuries. He will have to avoid jobs that

require him to work outside and therefore will be more limited in terms of choice’.

The judge, at first instance, accepted that the claimant had sustained minor NFCI to his feet and that he suffered ongoing symptoms, as

a result including being permanently sensitised to cold and experiencing pain in his feet. When determining quantum, he found that the

claimant was ‘disabled’ according to the term defined in paragraph 35 of the Explanatory Notes to the Ogden Tables, but, only just. As

such, the correct basis for assessing the claimant’s loss of future earning capacity was deemed to be through the use of Ogden Tables A

and B, rather than a Smith v Manchester award (this was discussed in detail in edition 127). Thus, the claimant was awarded a total of

£99,062.04 for loss of future earning capacity and £12,500 for PSLA. The defendant appealed and one of the grounds for this was that the

claimant was not ‘disabled’ within the definition set out in the Ogden Tables.

Lord Justice Jackson, handing down judgment in the Court of Appeal, addressed the issue of disability at paragraphs 81-92. Specifically,

at para 89, he stated that: ‘the focus of the inquiry should be upon what he [the claimant] cannot do as a result of the injury to his feet’.

He went on to state at paragraphs 91 and 92 that:

‘The judge concluded that the claimant’s NFCI had a substantial adverse effect on his ability to carry out normal

activities. In view of the factual evidence which the claimant and Ms Knight gave and which the judge accepted,

he was entitled to reach that conclusion. The judge’s overall conclusion on the disability issue at para [59] of the

judgement was:

“His condition qualifies as a disability…but only just”.

The judge was entitled to reach that conclusion. I therefore reject Mr Browne’s first argument’.

https://www.bc-legal.co.uk/images/pdf/127%20BC%20Disease%20News%20-%2005.02.2016%20Edition%20127.pdf

PAGE | 13

Notwithstanding this conclusion, LJ Jackson did reduce the award for loss of future earning capacity to £45,000, based on a different

adoption of the Ogden tables.

A similar injury was seen in the case of Patterson v Ministry of Defence [2012] EWHC 2767 (QB), in which the claimant originated from the

Caribbean Island of St Vincent and served in the army in Iraq. During this period, he was deployed to Norway for cold weather survival

training, which included learning to ski cross-country and downhill, including at night, and building a snow hole in temperatures of

approximately minus 20 °C. As a result, he suffered a burning pain in his feet and sustained an NFCI injury. He was discharged from the

army and subsequently brought a claim against the Ministry of Defence, claiming that his injury was caused by the Ministry's negligence,

or breach of statutory duty. The claim was settled by payment of £75,000 in respect of damages and an agreed order that the Ministry

should pay the costs of the claim. It was at this stage that there became a dispute as to whether the injury was a disease. Mr Justice Males,

sitting in the High Court, held, at paragraph 48:

‘Thus NFCI is not caused or contributed to by any virus, bacteria, noxious agent or parasite. It is simply a case where

blood fails to reach the cells in the nerves, skin and muscle of the claimant's feet as result of exposure to weather or

environmental conditions. Although it involves no trauma in the sense of the direct application of force to the body,

the mechanism is essentially the same as occurs in a case of trauma such as when a tourniquet is applied to a limb

or a victim is stabbed. The result is damage or injury to the body parts affected, but this cannot be regarded as a

“disease”. I accept the defendant's submission that if NCFI is a “disease”, so too are such conditions as chilblains,

hypothermia, frostbite, sunstroke, sunburn and heat blisters which are no more than the result of exposure to weather

conditions, and that this would be stretching the meaning of “disease” to surprising lengths which cannot have been

intended. I accept also that it is significant that nowhere in Dr Roberts' detailed report on NFCI is there any suggestion

that it constitutes a disease. While none of these factors is determinative by itself, together they amount to a compelling

and in my judgment correct case that NFCI is not a “disease”’.

Cold injuries are not seen in the armed forces in isolation, but, as we have highlighted earlier in this feature, pose a risk to many

occupations. A useful illustration of this can be found in Mr D Bragg v Gilbert Foods [1996] WL 34910386, in which the applicant (this was a

claim brought in the employment tribunal) worked 10 hour days with tasks involving the removal of frozen meat from a vat full of ice-cold

water. No gloves were provided for this task by the defendant. This was an operation that was carried out every 10 or 15 minutes and, as

a result of the repeated dipping into the cold water, their fingers and hands became numb. The Tribunal was satisfied, on the balance of

probabilities, that the applicant complained to his supervisor from January 1996 onwards about the failure to provide gloves, despite

requesting that gloves be made available and also made complaints on three or four occasions in 1996 to a partner in the respondents'

undertaking. The respondents failed to do so, notwithstanding the requests that were made by the applicant and other employees. The

respondents contended that suitable gloves were offered free of charge, but the Tribunal found, as a fact, that such gloves were not

available, either on a paid basis, or free of charge. The applicant thereafter became ill with pneumonia, between 18 March and 8 April,

and when he returned to his place of work, the working conditions had worsened. He, once again, complained about the unsatisfactory

employment conditions, i.e. the absence of glove protection, and, since he had not received occupational satisfaction, chose to resign.

The Personal Protective Equipment Regulations 1992, which applied to the respondents' premises from January 1993 onwards, required

the respondents to provide the employees’ appropriate protective clothing and equipment free of charge. These provisions appl ied in

situations where there was a change in temperature, or cold conditions, operated. The Tribunal was satisfied, having considered the

Regulations, that the failure to provide equipment in cold conditions amounted to a breach of these Regulations.

CONCLUSION

Working in cold environments poses a risk of injury to several groups of employees, including those working in the construction, food and

agricultural industries and the armed services. The type of injury suffered will depend upon how low the temperature reaches in any given

environment, ranging from skin conditions, cardiovascular problems and respiratory diseases.

Whilst there is no legal limit on how low temperatures are allowed to reach in the workplace, Unison say that the ideal temperature for most

occupations is 16 °C and the HSE says that workers are particularly at risk from cold when the ambient temperature is below 10 °C. Clearly,

this is unavoidable in some occupations, but in these instances, employers should be aware of their obligations and provide the necessary

PPE and other preventative measures, in line with their statutory duties.

If they do not, the case law, discussed in this feature, shows that there is a real risk of employers being held liable for any resulting injuries.

PAGE | 14

References

1 Gordon Exall, ‘Agreeing Extensions Of Time: Refusal To Agree Contrary To The Overriding Objective Has Consequences In Costs’ (Civil

Litigation Brief June 5 2017) accessed 7 June 2017.

2 John Hyde, ‘MedCo disciplines dozens of doctors for late reports’ (1 June 2017 Law Society Gazette)

accessed 1 June 2017.

3 Neil Rose, ‘MedCo kicks out more shell companies’ (6 June 2017 Litigation Futures) accessed 7 June 2017.

4 ‘QUALIFYING CRITERIA FOR MEDICAL REPORTING ORGANISATIONS REGISTERED WITH MEDCO’ (24 October 2016 Ministry of Justice)

accessed 7 June 2017.

5 John Hyde, ‘Whiplash clampdown continues as shell businesses thrown out’ (7 June 2017 Law Society Gazette)

accessed 7

June 2017.

6 Neil Rose, ‘Slater & Gordon to sue Quindell vendor for £600m over “fraudulent misrepresentation”’ (11 May 2017 Legal Futures)

accessed 8 June

2017.

7 Gazette Newsdesk, ‘Slater and Gordon faces third legal battle over shareholder losses’ (8 June 2017 Law Society Gazette)

accessed 8 June 2017.

8 Elaine Knutt, ‘Women still put at risk by wrong PPE, TUC survey finds’ (8 May 2017 Health + Safety at Work)

accessed 6 June 2017.

9 ‘Personal protective equipment and women: Guidance for workplace representatives on ensuring it is a safe fit’ (April 2017 TUC)

accessed 6 June 2017.

10 ‘UK study shows less than one-third of women workers have properly fitting PPE’ (1 June 2017 Safety + Health)

accessed 6 June 2017.

11 Walters, G. I., Robertson, A. S., Moore, V. C. & Burge, P. S. Occupational asthma caused by acrylic compounds from SHIELD

surveillance (1989–2014). Occup Med (Lond) 67, 282–289 (2017). https://academic.oup.com/occmed/article-

abstract/67/4/282/3744546/Occupational-asthma-caused-by-acrylic-compounds?redirectedFrom=fulltext (Accessed 8th June

2017).

12 Shield - Surveillance Scheme for Occupational Asthma. Available at: http://www.occupationalasthma.com/shield.aspx. (Accessed:

8th June 2017).

13 Lemke, M. K., Apostolopoulos, Y., Hege, A., Wideman, L. & Sönmez, S. Work organization, sleep and metabolic syndrome among

long-haul truck drivers. Occup Med (Lond) 67, 274–281 (2017). https://www.ncbi.nlm.nih.gov/pubmed/28419354 (Accessed 7 June

2017).

14 Hege, A. et al. Surveying the Impact of Work Hours and Schedules on Commercial Motor Vehicle Driver Sleep. Safety and Health at

Work 6, 104–113 (2015). http://www.sciencedirect.com/science/article/pii/S2093791115000104 (Accessed 8 June 2017).

15 Caruso, C. C. Negative Impacts of Shiftwork and Long Work Hours. Rehabil Nurs 39, 16–25 (2014).

http://onlinelibrary.wiley.com/doi/10.1002/rnj.107/full (Accessed 8 June 2017).

16 Kobayashi, T., Suzuki, E., Takao, S. & Doi, H. Long working hours and metabolic syndrome among Japanese men: a cross-sectional

study. BMC Public Health 12, 395 (2012). https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-395 (Accessed

7 June 2017).

17 Mohebbi, I., Shateri, K. & Seyedmohammadzad, M. The relationship between working schedule patterns and the markers of the

metabolic syndrome: Comparison of shift workers with day workers. International Journal of Occupational Medicine and

Environmental Health 25, 383–391 (2012). http://europepmc.org/abstract/med/23055229 (Accessed 7 June 2017).

18 Szosland, D. Shift work and metabolic syndrome, diabetes mellitus and ischaemic heart disease. International Journal of

Occupational Medicine and Environmental Health 23, 287–291 (2010). https://www.degruyter.com/view/j/ijmh.2010.23.issue-

3/v10001-010-0032-5/v10001-010-0032-5.xml (Accessed 7 June 2017).

19 http://www.nhs.uk/conditions/chilblains/Pages/Introduction.aspx .

20 http://articles.extension.org/pages/66813/cold-related-conditions-and-agriculture .

21 Risk Assessment for Cold Weather Work. Seton UK Available at: http://www.seton.co.uk/legislationwatch/article/risk-assessment-cold-

weather-work/ (Accessed: 11th May 2017).

http://www.civillitigationbrief.com/2017/06/05/agreeing-extensions-of-time-refusal-to-agree-contrary-to-the-overriding-objective-has-consequences-in-costs/http://www.civillitigationbrief.com/2017/06/05/agreeing-extensions-of-time-refusal-to-agree-contrary-to-the-overriding-objective-has-consequences-in-costs/https://www.lawgazette.co.uk/news/medco-disciplines-dozens-of-doctors-for-late-reports/5061326.articlehttp://www.litigationfutures.com/news/medco-kicks-shell-companieshttp://www.litigationfutures.com/news/medco-kicks-shell-companieshttps://consult.justice.gov.uk/digital-communications/medco-framework-review-call-for-evidence/results/revised-qualifying-criteria-24-10-16.pdfhttps://consult.justice.gov.uk/digital-communications/medco-framework-review-call-for-evidence/results/revised-qualifying-criteria-24-10-16.pdfhttps://www.lawgazette.co.uk/news/whiplash-clampdown-continues-as-shell-businesses-thrown-out/5061405.articlehttps://www.lawgazette.co.uk/practice/quindell-owner-waits-on-53m-slater-and-gordon-claim/5060847.articlehttps://www.lawgazette.co.uk/practice/slater-and-gordon-faces-third-legal-battle-over-shareholder-losses/5061425.article?utm_source=dispatch&utm_medium=email&utm_campaign=%20GAZ141016https://www.lawgazette.co.uk/practice/slater-and-gordon-faces-third-legal-battle-over-shareholder-losses/5061425.article?utm_source=dispatch&utm_medium=email&utm_campaign=%20GAZ141016https://www.healthandsafetyatwork.com/personal-protective-equipment/women-still-put-risk-wrong-ppe-tuc-survey-findshttps://www.tuc.org.uk/sites/default/files/PPEandwomenguidance.pdfhttp://www.safetyandhealthmagazine.com/articles/15757-uk-study-shows-less-than-one-third-of-women-workers-have-properly-fitting-ppehttp://www.safetyandhealthmagazine.com/articles/15757-uk-study-shows-less-than-one-third-of-women-workers-have-properly-fitting-ppehttps://academic.oup.com/occmed/article-abstract/67/4/282/3744546/Occupational-asthma-caused-by-acrylic-compounds?redirectedFrom=fulltexthttps://academic.oup.com/occmed/article-abstract/67/4/282/3744546/Occupational-asthma-caused-by-acrylic-compounds?redirectedFrom=fulltexthttps://www.ncbi.nlm.nih.gov/pubmed/28419354http://www.sciencedirect.com/science/article/pii/S2093791115000104http://onlinelibrary.wiley.com/doi/10.1002/rnj.107/fullhttps://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-395http://europepmc.org/abstract/med/23055229https://www.degruyter.com/view/j/ijmh.2010.23.issue-3/v10001-010-0032-5/v10001-010-0032-5.xmlhttps://www.degruyter.com/view/j/ijmh.2010.23.issue-3/v10001-010-0032-5/v10001-010-0032-5.xmlhttp://www.nhs.uk/conditions/chilblains/Pages/Introduction.aspxhttp://articles.extension.org/pages/66813/cold-related-conditions-and-agriculturehttp://www.seton.co.uk/legislationwatch/article/risk-assessment-cold-weather-work/http://www.seton.co.uk/legislationwatch/article/risk-assessment-cold-weather-work/

PAGE | 15

22 Weather statistics for London. yr.no Available at: https://www.yr.no/place/United_Kingdom/England/London (Accessed: 11th May

2017).

23 Met Office. UK climate. Available at: http://www.metoffice.gov.uk/public/weather/climate/ (Accessed: 11th May 2017).

24 Met Office, Cold weather and your health. Met Office Available at: http://www.metoffice.gov.uk/health/yourhealth/cold-weather-

and-health (Accessed: 11th May 2017).

25 Mäkinen, Tiina M., and Juhani Hassi. “Health Problems in Cold Work.” Industrial Health 47, no. 3 (July 2009): 207–20.

26 Adverse health effects of exposure to cold. (2017). Available at: http://www.euro.who.int/en/health-topics/noncommunicable-

diseases/chronic-respiratory-diseases/news/news/2013/02/how-cold-weather-affects-health/adverse-health-effects-of-exposure-to-

cold (Accessed: 11th May 2017).

27 Bang, Berit E., Lisbeth Aasmoe, Laila Aardal, Gerd Sissel Andorsen, Anne Kristin Bjørnbakk, Cathrine Egeness, Ingrid Espejord, and

Eva Kramvik. “Feeling Cold at Work Increases the Risk of Symptoms from Muscles, Skin, and Airways in Seafood Industry Workers.”

American Journal of Industrial Medicine 47, no. 1 (January 1, 2005): 65–71. doi:10.1002/ajim.20109.

28 Jammes, Yves, Marie José Delvolgo-Gori, Monique Badier, Chantal Guillot, Ghislaine Gazazian, and Laurence Parlenti. “One-Year

Occupational Exposure to a Cold Environment Alters Lung Function.” Archives of Environmental Health: An International Journal 57,

no. 4 (July 1, 2002): 360–65. doi:10.1080/00039890209601422.

29 Vergès, Samuel, Patrice Flore, Marie-Philippe Rousseau Blanchi, and Bernard Wuyam. “A 10-Year Follow-up Study of Pulmonary

Function in Symptomatic Elite Cross-Country Skiers – Athletes and Bronchial Dysfunctions.” Scandinavian Journal of Medicine &

Science in Sports 14, no. 6 (December 1, 2004): 381–87. doi:10.1111/j.1600-0838.2004.00383.x.

30 Kotaniemi, Jyrki-Tapani, Jari Latvala, Bo Lundbäck, Anssi Sovijärvi, Juhani Hassi, and Kjell Larsson. “Does Living in a Cold Climate or

Recreational Skiing Increase the Risk for Obstructive Respiratory Diseases or Symptoms?” International Journal of Circumpolar Health

62, no. 2 (May 2003): 142–57.

31 Mäkinen, Tiina M., and Juhani Hassi. “Health Problems in Cold Work.” Industrial Health 47, no. 3 (July 2009): 207–20.

32 HSE, Work-related respiratory disease in Great Britain 2016 http://www.hse.gov.uk/statistics/causdis/respiratory-diseases.pdf

(Accessed 11th May 2017).

33 Pienimäki, T. “Cold Exposure and Musculoskeletal Disorders and Diseases. A Review.” International Journal of Circumpolar Health

61, no. 2 (2002 2002): 173–82.

34 Sormunen, Erja, Jouko Remes, Juhani Hassi, Tuomo Pienimäki, and Hannu Rintamäki. “Factors Associated with Self-Estimated Work

Ability and Musculoskeletal Symptoms among Male and Female Workers in Cooled Food-Processing Facilities.” Industrial Health 47,

no. 3 (2009): 271–82. doi:10.2486/indhealth.47.271.

35 Aasmoe, Lisbeth, Berit Bang, Cathrine Egeness, and Maja-Lisa Løchen. “Musculoskeletal Symptoms among Seafood Production

Workers in North Norway.” Occupational Medicine 58, no. 1 (January 1, 2008): 64–70. doi:10.1093/occmed/kqm136.

36 Yagev, Yaron, Mark Gringolds, Isabella Karakis, and Rafael S. Carel. “Carpal Tunnel Syndrome: Under-Recognition of Occupational

Risk Factors by Clinicians.” Industrial Health 45, no. 6 (2007): 820–22. doi:10.2486/indhealth.45.820.

37 Chiang, HC, SS Chen, HS Yu, and YC Ko. “The Occurrence of Carpal Tunnel Syndrome in Frozen Food Factory Employees.” Gaoxiong

Yi Xue Ke Xue Za Zhi = The Kaohsiung Journal of Medical Sciences 6, no. 2 (1990 1990): 73–80.

38 Oksa, Juha, Michel B. Ducharme, and Hannu Rintamäki. “Combined Effect of Repetitive Work and Cold on Muscle Function and

Fatigue.” Journal of Applied Physiology 92, no. 1 (January 1, 2002): 354–61.

39 Kurppa, Kari, Eira Viikari-Juntura, Eeva Kuosma, Matti Huuskonen, and Pertti Kivi. “Incidence of Tenosynovitis or Peritendinitis and

Epicondylitis in a Meat-Processing Factory.” Scandinavian Journal of Work, Environment & Health 17, no. 1 (1991): 32–37.

40 Piedrahı ́ta, Hugo, Laura Punnett, and Houshang Shahnavaz. “Musculoskeletal Symptoms in Cold Exposed and Non-Cold Exposed

Workers.” International Journal of Industrial Ergonomics 34, no. 4 (October 2004): 271–78. doi:10.1016/j.ergon.2004.04.008.

41 Pope, D. P., P. R. Croft, C. M. Pritchard, A. J. Silman, and G. J. Macfarlane. “Occupational Factors Related to Shoulder Pain and

Disability.” Occupational and Environmental Medicine 54, no. 5 (May 1, 1997): 316–21. doi:10.1136/oem.54.5.316.

42 Hildebrandt, V. H., P. M. Bongers, F. J. H. van Dijk, H. C. G. Kemper, and J. Dul. “The Influence of Climatic Factors on Non-Specific

Back and Neck-Shoulder Disease.” Ergonomics 45, no. 1 (January 1, 2002): 32–48. doi:10.1080/00140130110110629.

43 Mäkinen, Tiina M., and Juhani Hassi. “Health Problems in Cold Work.” Industrial Health 47, no. 3 (July 2009): 207–20.

44 Burström, Lage, Bengt Järvholm, Tohr Nilsson, and Jens Wahlström. “Back and Neck Pain due to Working in a Cold Environment: A

Cross-Sectional Study of Male Construction Workers.” International Archives of Occupational and Environmental Health 86, no. 7

(October 1, 2013): 809–13. doi:10.1007/s00420-012-0818-9.

45 HSE Health Surveillance - Guidance for Occupational Health Professionals

http://www.hse.gov.uk/vibration/hav/advicetoemployers/havocchealth.pdf (Accessed 20 December 2016).

46 Minami, J., Y. Kawano, T. Ishimitsu, H. Yoshimi, and S. Takishita. “Seasonal Variations in Office, Home and 24 H Ambulatory B lood

Pressure in Patients with Essential Hypertension.” Journal of Hypertension 14, no. 12 (December 1996): 1421–25.

47 Brennan, P. J., G. Greenberg, W. E. Miall, and S. G. Thompson. “Seasonal Variation in Arterial Blood Pressure.” Br Med J (Clin Res Ed)

285, no. 6346 (October 2, 1982): 919–23. doi:10.1136/bmj.285.6346.919.

https://www.yr.no/place/United_Kingdom/England/Londonhttp://www.metoffice.gov.uk/public/weather/climate/http://www.metoffice.gov.uk/health/yourhealth/cold-weather-and-healthhttp://www.metoffice.gov.uk/health/yourhealth/cold-weather-and-healthhttp://www.euro.who.int/en/health-topics/noncommunicable-diseases/chronic-respiratory-diseases/news/news/2013/02/how-cold-weather-affects-health/adverse-health-effects-of-exposure-to-coldhttp://www.euro.who.int/en/health-topics/noncommunicable-diseases/chronic-respiratory-diseases/news/news/2013/02/how-cold-weather-affects-health/adverse-health-effects-of-exposure-to-coldhttp://www.euro.who.int/en/health-topics/noncommunicable-diseases/chronic-respiratory-diseases/news/news/2013/02/how-cold-weather-affects-health/adverse-health-effects-of-exposure-to-coldhttp://www.hse.gov.uk/statistics/causdis/respiratory-diseases.pdfhttp://www.hse.gov.uk/vibration/hav/advicetoemployers/havocchealth.pdf

PAGE | 16

48

Kim, Joon-Youn, Kap-Yeol Jung, Young-Seoub Hong, Jung-Il Kim, Tae-Won Jang, and Jung-Man Kim. “The Relationship between

Cold Exposure and Hypertension.” Journal of Occupational Health 45, no. 5 (2003): 300–306. doi:10.1539/joh.45.300.

49 Sartini, C. et al. Effect of cold spells and their modifiers on cardiovascular disease events: Evidence from two prospective studies.

Int J Cardiol 218, 275–283 (2016). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917887/ (Accessed 11th May 2017).

50 Davídkovová, H., Plavcová, E., Kynčl, J. & Kyselý, J. Impacts of hot and cold spells differ for acute and chronic ischaemic heart

diseases. BMC Public Health 14, 480 (2014).

51 Page, Elizabeth Heller, and Neil H. Shear. “Temperature-Dependent Skin Disorders.” Journal of the American Academy of

Dermatology 18, no. 5, Part 1 (May 1988): 1003–19. doi:10.1016/S0190-9622(88)70098-5.

52 NIOSH Cold stress - Cold related illnesses https://www.cdc.gov/niosh/topics/coldstress/coldrelatedillnesses.html (Accessed 20

December 2016).

53 http://www.hse.gov.uk/temperature/coldstress.htm .

54 HSE, Managing workplace temperature http://www.hse.gov.uk/temperature/thermal/managers.htm (Accessed 20 December 2016).

55 CDC - NIOSH Workplace Safety and Health Topic - Cold Stress - Recommendations. Available at:

https://www.cdc.gov/niosh/topics/coldstress/recommendations.html (Accessed: 11th May 2017).

56 Government of Canada, C. C. for O. H. and S. Cold Environments - Working in the Cold : OSH Answers. (2017). Available at:

http://www.ccohs.ca/ (Accessed: 11th May 2017).

57 Angus Crawford, ‘Army “To Pay For Cold Injuries”’ (16 June 2009 BBC News) accessed

7 June 2017.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917887/https://www.cdc.gov/niosh/topics/coldstress/coldrelatedillnesses.htmlhttp://www.hse.gov.uk/temperature/coldstress.htmhttp://www.hse.gov.uk/temperature/thermal/managers.htmhttps://www.cdc.gov/niosh/topics/coldstress/recommendations.htmlhttp://www.ccohs.ca/http://news.bbc.co.uk/1/hi/uk/8101291.stm

PAGE | 17

Disclaimer

This newsletter does not present a complete or

comprehensive statement of the law, nor does it

constitute legal advice. It is intended only to provide

an update on issues that may be of interest to those

handling occupational disease claims. Specialist

legal advice should always be sought in any

particular case.

© BC Legal 2016.

BC Legal is a trading name of BC Legal Limited which

is registered in England and Wales under company

number 08963320. We are authorised and regulated

by the Solicitors Regulation Authority. The registered

office is 1 Nelson Mews, Southend-on-Sea, SS1 1AL.

The partners are Boris Cetnik and Charlotte Owen.

More details on the firm can be found at www.bc-

legal.co.uk

http://www.bc-legal.co.uk/http://www.bc-legal.co.uk/

PAGE | 18

Directors: B. Cetnik, C. Owen

Registered Office: 1 Nelson Mews, Southend-On-Sea, SS1 1AL

BC Legal is a trading name of BC Legal Limited which is registered in England and Wales under company number 08963320

We are Authorised and Regulated by the Solicitors Regulations Authority (SRA No 617698)