Most of us at one time or another have complained about issues relating to our workplace. It might be too hot or too cold; perhaps the chairs are uncomfortable and our colleagues and line managers are too annoying, aggressive, passive or uncaring. Perhaps the majority of us feel undervalued and under-rewarded for our efforts. However, one issue that relatively few of us in the developed world are likely to be worried about currently is whether our occupation might lead us to an early and unpleasant death due to a disease or condition brought about by our work and its environment. This is partly because of the vast changes in work patterns which have occurred over the past half-century in developed countries. Many of our great-grandparents and grandparents toiled in hard physical work, which might have meant jobs in areas such as heavy industry, manufacturing, farming, fishing, mining or construction. Many of these occupations caused severe and long-term impact on health, and in many cases the individuals concerned did not even live to retirement age. We still need the products of industry such as steel and aluminium for our cars, and we use myriad manufactured goods, eat fresh produce and fish, burn coal, move into new houses and use new roads. However, as a society, we have effectively ‘outsourced’ many of these difficult and hazardous occupations to other, usually developing countries.

Regarding those physical occupations in hazardous environments that remain in the developed world, the suffering of previous generations has led to the creation of an effective, complex, yet sometimes ridiculed Health and Safety apparatus which has greatly diminished, but sadly not eliminated, the risks of ill-health arising from occupation. Chapter 1 of this book outlines some of the historical milestones in the evolution of our occupational health knowledge, awareness and practice. This chapter also charts the rise and fall of various industries, as they created wealth, but also human misery, in terms of their widespread toxic impact on workers’ health and life expectancy. This introductory chapter also outlines the notion that whilst hard-won experience led to detailed frameworks of Health and Safety practice that are now usually adhered to in the developed world, this is far from the case in the emerging manufacturing powerhouses of the Far East.

Despite our progress in occupational health in the developed world, there remains a substantial number of individuals whose health has been irreparably damaged by their occupation. The second chapter begins with the main features of the process whereby some recognition can be obtained for their suffering, as well as financial redress for loss of earnings and any necessary support for attainment of some quality of life. Whilst recognition and compensation can arise from some mutual agreement between former employee and employer, court action, or the threat of it, might be necessary for a final settlement. Naturally, much documentation is necessary for such actions to proceed, but expert reports are amongst the most important material needed to propel a case. From the perspective of the claimant, it is as if they wish to communicate to the court initially, look at me now and my medical impairments, which are dealt with by the medical report or reports. Subsequently, the claimant wants to establish how this happened to me, which is covered by other expert reports, notably on causation. Clearly a medical examination will provide a picture of the claimant’s health impairments, which is usually relatively straightforward to describe and justify. Causation, in terms of how a substance or substances led the claimant to his or her current plight, may be much harder to establish, and the main purpose of this book is to provide the aspiring expert report writer with my own experience to illuminate this area.

It is not always easy for solicitors mounting cases to recruit relevant experts to contribute reports on causation. If causation cannot be established, then clearly the court will not be convinced and cases may not proceed because of a shortage of appropriate expertise. This may be particularly important in cases where the claimant is suffering from life-threatening health issues and may not have the luxury of time to pursue a case. Experts might be difficult to recruit due to a general shortage of qualified individuals in a particularly narrow field, or perhaps due to sheer pressure of other commitments. Indeed, an expert’s credibility in part stems from validation supplied by their continued employment by their institution so their commitment to their employer’s demands is, of course, paramount. It is also possible that prospective experts with the appropriate research interests and experience, as well as the relevant writing and oral skills, may hesitate to offer their services for different reasons. These might include a lack of familiarity with the legal context and framework of report drafting, or insufficient confidence in whether they already possess appropriate skills and knowledge to draft an effective report. Chapter 2 supplies some guidance as to how the expert report fits into the current legal process and how their work is evaluated and employed by the claimant’s legal team, as well as the court.

The remaining chapters provide case histories where I have written reports as part of cases in various broadly themed areas, ranging from exposure to solvents and adhesives (Chapter 3), petrochemical-induced cases of bladder cancer (Chapter 4), as well as the impact of herbicides and insecticides (Chapter 5). In contrast, rather than focus on the occupational issues of the manufacturers of imported goods, Chapter 6 features the toxicity of some of the products of Far Eastern economic success. Whilst this book is not intended to be a toxicology text, I have striven to make the toxicological issues as accessible as possible to enable the arguments to be weighed and criticised. In addition, it is hoped that the book may be useful to all interested participants of the process of establishing causation in occupational toxicity proceedings.

The case histories are taken from some of the reports I prepared and submitted from 1997 to 2009. Indeed, depending on the reader’s own expertise and experience, they will form their own opinion of the quality of the reports I compiled, and they may well feel that they could have constructed considerably better drafted and more convincing arguments, given the same starting information. If this is the case, then this book will have achieved one of its aims, which is to encourage those who could ‘assist the court’ to do so and to do a better job than I could do. Of course, in any given case, neither the medical experts nor the court or the causation report writing can restore the health of the individual concerned. However, contributing one’s expertise towards achieving justice for a claimant is not only worthwhile, in terms of bringing recognition for their plight and others in the same position, but it also contributes to the evolution of the developed world’s knowledge of Health and Safety. In addition, the publicity which sometimes surrounds cases also highlights the impact of old and hazardous industries, but also the effects of new processes on health which were not anticipated or expected.

My only personal experience of the damage occupation can do to health was the impact on my father of his service as a Wireless Telegraphist in the Royal Navy in World War II. Aside from surviving four years of Arctic weather, he had many lucky escapes, such as watching a torpedo from a U-Boat pass under his ship, a bout of persistent friendly fire by a US Air Force Lightning fighter, as well as a perilously close small arms attack whilst at anchor in Norway after the Germans had officially withdrawn. Ironically, it was his day-to-day work of high-frequency radio signalling, as well as using rifle fire to ‘pot’ mines during sweeping processes, that caused lifelong and severe impairment to his hearing, which deteriorated to virtually nothing towards the end of his life. Whilst he was, of course, grateful to survive, his deafness often made his personal and professional lives profoundly difficult, although he bore it with fortitude.

Chapter 6 considers the developing world’s extremely uneven awareness of occupational health damage, albeit indirectly, through the toxicity of their products which have reached the United Kingdom. The Epilogue reflects on the gradual improvement of developing world Health and Safety, through advances in education and prosperity. Having spent the last few decades using manufacturing to generate wealth to attain Western living standards, it is to be hoped that developing countries will also see the necessity of adopting Health and Safety structures and practices, as well as improving existing ones, so that future manufacturing can be as safe for their workforces, as it should be sustainable and profitable. Every effort has been made to make this book as accurate as possible, but nothing and nobody is perfect. I am grateful to my wife Clare, my mother Jean and my family for their support during the preparation of the manuscript, and I hope that the book will be of use.