The long shadow of exposure: confronting the hidden burden of harmful substances

In health and safety, we are rightly focused on preventing immediate incidents: the fall, the collision, the moment where something goes wrong and changes a life forever. But harmful and hazardous substances, the theme of this issue of Safety Management, operate on a different timescale. Their scale of risk, however, is equally as dangerous as any immediate workplace accident or injury.

This is the uncomfortable reality of occupational health today; while we have become increasingly effective at managing acute safety risks, chronic exposures remain an under-recognised threat to which we can easily attribute thousands of deaths each year. 

Take asbestos. Despite a UK wide ban in 1999, its legacy is far from over. It remains present in thousands of buildings, creating a risk for those who might come into contact with stray fibres.

Mike Robinson: "What we choose to control today will define what others are forced to endure tomorrow."

That’s everyone from students in classrooms to patients in hospitals, from technicians to asbestos specialists (and everyone else in between). Consistently, year-on-year, around 5,000 people in the UK die from historic asbestos exposure, making it the single largest workplace killer. Not a killer in a past tense, but one that is active, and whose impacts will be felt well into the next century.  

Silica exposure presents a similarly stark challenge for the workers of today and tomorrow. Silicosis is entirely preventable, yet it continues to affect workers in hundreds of workplaces, across sectors from construction to manufacturing.

The rise of new materials and new fabrication techniques has, in some cases, intensified exposure risks, reminding us that progress in one direction can introduce risks in another, if not carefully managed and mitigated.

We are also grappling with emerging concerns around so-called ‘forever chemicals’. Their persistence in the environment and the human body raises fundamental questions about how we assess risk in the long term.

When a substance does not readily break down, the traditional boundaries of workplace exposure begin to blur, extending into our communities and ecosystems.

Even environments perceived as low risk are not immune. Indoor and ambient air quality, whether in offices, healthcare settings or commercial kitchens, plays a critical role in long-term health outcomes.

Exposure to particulate matter may not trigger immediate alarm, but over time, it contributes to a cumulative burden that we are only just beginning to fully understand.

So, what does safety leadership look like in the face of risks that are not immediately visible?

First, it requires a fundamental shift in perspective; from reacting to harm, to anticipating it. The absence of symptoms today cannot be mistaken for the absence of risk. We must invest in monitoring, in research, and in early intervention, even when the business case is not immediately obvious.

Second, we must recommit to prevention at every level. The hierarchy of control remains our most powerful tool, yet too often we default to personal protective equipment as the primary safeguard. PPE is essential, but it should never be the cornerstone of our strategy. Eliminating or reducing exposure at source is not only more effective – it’s a safety imperative.

Above all, we must recognise that this is not solely a workplace issue. Hazardous substances move through supply chains, across environments, and into everyday life. Addressing them requires collaboration between industries, regulators, and public health bodies. There is a tendency, in complex areas such as this, to accept a degree of uncertainty as inevitable. But uncertainty must not become an excuse for delay or a justification for inaction. 

The long shadow of exposure challenges us to think differently, and it calls us to lead differently. It asks us to act not just for the present workforce, but for workers we will never meet, whose names we’ll never know. And that is the essence of true safety leadership: a willingness to take responsibility for outcomes that lie beyond our line of sight, to intervene before harm has a voice, and to place long-term health on equal footing with immediate safety. Because what we choose to control today will define what others are forced to endure tomorrow; and there can be no stronger mandate for action than that.

Mike Robinson FCA is Chief executive of the British Safety Council