Hygiene Without Numbers.

I have been a member of both British and Dutch Occupational Hygiene Societies and a ‘hygienist’ (AKA: ‘exposure scientist’) for >30 years. During my attendance at a recent meeting in Manchester between Occupational Health and Safety specialists from companies contributing to the IMA-Europe Dust Monitoring Programme and representatives of the UK’s Health and Safety Executive (HSE), I was intrigued and amazed to note that the following title showed up in the programme: ‘Hygiene Without Numbers’. I wondered, did HSE finally discover the key to the Holy Grail, or were they trying to put the genie back into its bottle given that UK Business needs help with cutting red tape nowadays (https://cutting-red-tape. cabinetoffice.gov.uk/)? In truth, the ‘Hygiene Without Numbers’ concept presents nothing new since it basically boils down to the old ‘COSHH Essentials’ concoction (Russell et al., 1998) in a new wineskin. The old mantras of ‘measurements are expensive’, ‘measurements delay control measures’, ‘with statistics you can prove anything’, and of course ‘if you provide enough guidance on best practices everything will be well-controlled’ made up the gist of the message. If ‘hygiene’ was as simple as suggested in the ‘Hygiene Without Numbers’ concept, we would have solved the problem of hazardous working conditions and evolving health risks a long time ago. Numbers are indeed not required for approaches like control banding, which entail moving from hazard assessment to control without an exposure assessment step. Such numberless interventions may be appealing to policymakers, who face the hefty task of creating meaningful and economically feasible guidelines for workplace health. However, treating workers’ exposure to chemical, biological, or physical agents as a static entity that can be satisfactory controlled by guidance sheets is factually wrong and ignores the intrinsic variability of occupational exposure. An individual’s work tasks and circumstances can produce very different exposures from minute-to-minute, from hour-to-hour, from shift-to-shift, from week-to-week, and from season-to-season. Furthermore, individuals performing the same job in the same location might, more often than not, have considerably different average exposures (as has been convincingly shown in this journal; Kromhout et al., 1993; Symanski et al., 2006). Ignoring temporal and personal variability in occupational exposures might lead to underestimated health risks and wrongly advised risk management measures. In order to control hazardous exposures well, we must carefully collect numbers (perform measurements), especially in situations where exposure situations are not obvious (e.g. respirable crystalline silica), or in situations where exposures are not restricted to a point source and direct interaction with the exposure source is essential and needed (e.g. a nurse providing care to a Ann. Occup. Hyg., 2016, 1–2 doi:10.1093/annhyg/mev096