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Authors: Michael Blastland

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People spend a fortune on cigarettes, but what would you sell half an hour of your life-expectancy for? Governments put a value on MicroLives, as they do with MicroMorts. The UK National Institute for Health and Clinical Excellence (NICE) has guidelines that suggest the National Health Service will pay up to £30,000 if the treatment is expected to prolong life by one healthy year. That’s around 17,500 ML. This means that NICE prices a MicroLife, or half an hour of your remaining life-expectancy, at around £1.70, almost exactly what the Department of Transport says it would pay to avoid a MicroMort.

Does this mean the government ought to pay you £1.70 for every two cigarettes you resist or for every day that you keep that extra inch off your waistline? Possibly, except that it wouldn’t work like that: we could all claim to resist hundreds of cigarettes a day, non-smokers especially.

Now that Norm is into middle age and full of regret for the burgers that slipped through in earlier life,
*
puffing hard to put time back in the bank, it’s interesting to note that he hasn’t become pure, merely smug. A 22-minute run might buy him an extra hour of life, but one effect is that he feels happier about spending it in the pub.

His behaviour is known as risk compensation, related to the idea in
Chapter 15, on transport, that we all have an in-built risk thermostat. Taken your vitamins? Great. Eat extra chips!

Figure 21:
Scandinavian orange juice
But if you live longer than your friends, who will you talk to?

There’s experimental evidence to support this.
11
In one trial, in a culture of heavy smokers, some participants were given pills and told they could have a cigarette break. All the pills were placebos. But those who thought they’d taken a vitamin pill were far more likely to go for a smoke (89 per cent to 62 per cent). In another study surveying people’s sense of vulnerability, those who took vitamin pills somehow thought they were less likely to be hurt in an accident.

So if you’ve banked some health, you might feel free to spend it. How these attitudes and behaviours shake out – some beneficial, some compensatory and harmful – takes some calculating, except for vitamin pills, which don’t do most people much good anyway. But it does suggest that the risk calculation for healthy behaviour also needs to take account of the cream cake afterwards.

A summary of the research on exercise suggests that it still brings substantial benefits, although less weight loss than you might hope, perhaps because people eat more.
12
The research does not suggest that exercise leads people to eat so much more that they become fatter on average, contrary to much online gossip. But do mind that you don’t seek too much cake compensation for all your hard work.

18
HEALTH AND SAFETY

N
EARLY HOME
, Norm saw a line of plastic bollards outside his house where the road swerved up and over a small hill. At either end was a traffic light, in the middle a van and generator. On the back of the van was written ‘Urgent Response Vehicle’. Beneath this: ‘Limited to 56 m.p.h.’. Next to the van stood a man studying a plan.

‘What’s up?’ said Norm.

‘Two-way traffic control, sir.’

‘Oh right. Because …?’

‘Bollards. Can’t have a lane closure without traffic control. Asking for a head-on.’

‘Right, so the traffic lights are for the cones. And the cones …?’

‘Protect the traffic lights.’

‘…?’

‘Well we can’t have lights just stood there in the road like that without diverting the traffic, can we?’

‘So the cones are for the lights and the lights are for … This might sound stupid, but can’t you just …?’

‘Remove it all? No sir. Traffic lights are traffic control. Bollards is protection. Without one the other’s a hazard, obviously.’

‘You’re not digging up the road, then?’

‘Why would we do that?’

‘Right. And you are, if you don’t mind …?’

‘Fire regs compliance. At present, the site lacks an assembly point.’

‘Assembly point … for …?’

‘Self and Eric.’

He pointed to another man reading a newspaper.

‘A designated offsite site-assembly point is required to be signified – in the field there, for instance – where in the event of fire or explosion or other cause leading to site evacuation we can establish that all personnel are accounted for. Mind that cable, sir.’

‘You’re ensuring that your own presence is compliant?’

‘Exactly.’

‘To count two of you?’

‘Indeed.’

‘When one of you does the counting?’

‘Meaning?’

‘Well, why not just
not
come?’

‘You some kind of Marxist, sir?’

‘No, I mean just don’t come. Then you won’t run the risk of being non-compliant.’

‘Then how would we know?’

‘Know what?’

‘If it was compliant for inspection?’

‘Right … er… gotcha … Thanks.’

‘Just serving the community, sir.’

DOES THE STORY
of Norm and the bollards ring true – everything you always thought about health and safety? Funny, isn’t it, how we love a story if it confirms that we’re right?

We’re good at filtering evidence, as we saw in
Chapter 10
, on Big Risks. So much so that we’ll sometimes believe stories that are absurd – provided they fit our preconceptions.

Like the story that throwing sweets into the audience at pantomimes is banned – to take one daft example. Except that it’s not.
1
Rumours otherwise are just a popular myth that Britain’s Health and Safety Executive (HSE) tries hard to dispel, but people are too willing to believe. Conker fights are OK too: ‘Realistically the risk from playing conkers is
incredibly low and just not worth bothering about’, says the HSE. But the myths persists. Loony laws are too good a story.

So for all its efforts, the HSE’s reputation is probably sealed by the stories about it. ‘Elf and safety’ is a curse, a joke. In the league of comic villains it beats the mother-in-law.

‘One of the most well-worn and dispiriting phrases in the English language,’ said Judith Hackitt, chair of … the Health and Safety Executive.
2

And now and then, in the name of health and safety, strange things do get said, which hardly help the myth-busting. Take John Adams, who was told the windows in his block needed coating with plastic lest people walking below during a storm, as they do, obviously, at just the spot and moment a window blew out, copped a shower of shards.
3

Official statistics record two deaths that year from glass injury. They don’t say whether these were caused by windows shattering in a storm. It seems unlikely. When Adams asked if there had been a risk assessment, he was told ‘it could happen’, which we suppose is an assessment of sorts. Meanwhile, the lift in his seven-floor block was out of order for long stretches. There were 634 deaths on stairs that year. Norm’s story is in a long, absurdist tradition with just enough evidence to make it almost plausible. In popular demonology, Health-and-Safety-Man might as well be a villain on
Doctor Who
.

Psychologists talk of a cognitive bias for zero-risk, a preference for the certain elimination of a small risk over the probable reduction of a greater one. After all, what is safety but the absence of danger? So if you believe in a safer world, picking on risks you think you can cut out altogether may seem to make a kind of sense, almost whatever it takes.

Hearing all this, health and safety sounds like the preserve of zealots. Mind you, it can be equally tempting to see the other side the same way, as
Daily Mail
-style ‘elf-an-safety-bureaucracy-gone-mad’ ranters who fancy themselves freedom fighters. Any chance of moderation?

Because, needless to say, there’s plenty of room in the middle of this argument. After all, what would you do – fit plastic to the windows, mend the lift, both or neither? We’d mend the lift, though not only for safety. We guess most people would do the same. Funnily enough, the Health and Safety Executive itself is often on that same middle ground,
while it is others who whip up wild health and safety fears to stop things they don’t like (see
Chapter 9
, on drugs, for the anthropologist Mary Douglas’s ideas of risk as a form of social control).

Not all health and safety is a joke. Nor are those who campaign about it necessarily fighting over trivial, residual risks.
Hazards
magazine – another clue in the name – argued in 2012 that the HSE was ignoring evidence of an occupational cancer epidemic (see pp. 200–201) that kills 15,000 people a year. The magazine is free with phrases such as ’corporate killers’.
4

So although irked by its extremes and absurdities, Norm has reason to be grateful to health and safety, especially for a long-term shift in attitudes to workplace accidents. Even in 1974, when the HSE was formed, 651 employees were recorded as killed at work, an average risk of 29 MicroMorts per year. By 2010 this had fallen to 120, equal to 5 MicroMorts per year, an 82 per cent decrease.
5

Self-employment is more dangerous. Fifty-one self-employed people were killed in 2010, equivalent to 12 MicroMorts per year, more than twice the risk for employees. Injuries have also fallen dramatically: days off work through injury and illness are down by about a third in the past ten years alone.
6

Britain also fares well in comparison with other EU countries: excluding road transport deaths, workers in Britain were on average exposed to 10 MicroMorts per year, compared with 17 in France, 19 in Germany, 26 in Spain, 35 in Poland and 84 in Romania,
7
according to Eurostat. Tempting though it is to say that this is because the riskiest job anyone has in modern Britain is standing in a shop or sitting at a computer, Britain manufactures about as much as France (though much less than Germany).

In the US, the Bureau for Labor Statistics provides an extraordinary glimpse of the fate of 130 million workers in 2010.
8
It records that 4,547 were killed, a rate of 35 MicroMorts per worker per year. The most common cause was highway accidents, which are excluded from the European figures. Without them, the US rate is around 28 MicroMorts per year, about the same as Spain.

The second most common cause of death in the US, larger even than
falls, is ‘assault and violent acts’, comprising 18 per cent of all workplace fatalities. This included 506 homicides (down from 860 in 1997). So each year US workers face on average around 4 MicroMorts’ risk of being murdered at work, not much less than the average risk to UK workers from all causes. Perhaps they need body armour rather than safety helmets.

Reliable statistics about the wider world are harder to find. For example, India reported 222 fatal accidents at work in 2005, which was rather an understatement according to the International Labour Organisation (ILO), which reckoned the true number nearer 40,000.
9

Among 2 billion workers worldwide in 2008, the ILO estimated 317 million injuries requiring more than four days’ absence, and 320,000 people killed at work.
10
Only 22,000 of these deaths were reported through official channels. The rest are a ‘guesstimate’, giving an average of 160 MicroMorts per year per worker, compared with 6 in the UK.

All these figures are averages. They include armies of workers toiling over computers, which might cause stress, repetitive strain and back injury but are seldom fatal, and which tend to pull the average mortality risk down. Other occupations pull it up. The history of coalmining, for example, is spotted with disaster, such as the 1,099 miners killed at Courrières in France in 1906, or the gas explosion that killed 439 in Senghenydd, Wales, in 1913. Behind these terrible events there was a steady stream of fatalities in smaller accidents, with that frightening regularity of the apparently unique and unpredictable.

Records of mining accidents began in the UK in 1850, and since then more than 100,000 coalminers have been killed and hundreds of thousands injured or suffered illness. The years 1910 and 1911 were two of the most dramatic, with violent confrontation between miners and mine-owners. Following strikes and rioting in South Wales, Winston Churchill sent in the troops. There were 1,308 deaths among 1,100,000 miners in 1911
11
– that is 1,190 MicroMorts per year, or around 5 per shift, as if every miner on every shift went sky-diving every other day.

The Coal Mines Act of 1911 set up rescue stations and was intended to improve safety. Even so, around 1,000 miners were killed year after year, and in 1938 the tally was still 858 deaths, or 1,100 MicroMorts a
year. Following nationalisation in 1947, mine safety steadily improved, until by 1961 there were ‘only’ 235 deaths in accidents, a risk, after taking account of the declining workforce, of 400 MicroMorts a year, or around 2 per shift. This improved further, but even though there are now only 6,000 coalminers in the country,
12
a spate of accidents in recent years has brought a return to the fatality rates of the 1960s: in 2005–10 the fatality rate was reported to be the equivalent of 430 MicroMorts per year. Privatised mines were accused of cutting corners.
13

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