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The International Powered Access Federation (IPAF) promotes the safe and effective use of powered access worldwide. Set up in 1983, IPAF is a not-for-profit members’ organisation that represents the interests of manufacturers, distributors, users, rental and training companies. It serves as a forum for all active in the world of powered access. IPAF has played a key role in promoting many of the design, safety and testing procedures that are now established in the powered access industry.

Training

The IPAF training programme for platform operators is certified by TÜV as conforming to ISO 18878. More than 80,000 operators are trained each year through a worldwide network of over 400 training centres. Training in the US is managed by IPAF’s North American subsidiary, AWPT Inc. Training generally lasts one to two days and is a mixture of theory and practice.

PAL Card

Those who successfully complete IPAF training are awarded the PAL Card (Powered Access Licence), the most widely held and recognised proof of training for platform operators. The PAL Card is valid for five years and shows the machine categories that the operator has been trained in. It also features the holder’s photo and signature, and can be verified by calling IPAF.

Joining IPAF

Membership of IPAF is open to users of platforms, manufacturers, distributors, rental and training companies. Members come from more than 30 countries, mainly in Europe and America, but also in the Middle East, the Far East and the Pacific. Members enjoy benefits including:

• Access to a wealth of valuable, practical information on legal, technical and commercial aspects of platform use.
• The chance to influence the growing body of legislation and regulations that governs platform use.

Summary

• Diffuse pleural thickening is another disease associated with exposure to asbestos.
• There were 400 new cases of disablement in the year 2008 due to this disease, although this figure is likely to be a substantial underestimate. The annual number increased during the 1990s but has remained fairly stable over recent years.
• The increase may be partly or wholly explained by the acceptance of claims under the Industrial Injuries Disablement Benefit (IIDB) scheme for unilateral (affecting only one lung) cases and other changes in data collection methods.
• An estimated 1063 cases of benign (non-cancerous) pleural disease - mostly attributable to asbestos - were seen for the first time by occupational and chest physicians who reported to the THOR surveillance schemes in 2008.

Introduction

The pleura is a two-layered membrane which surrounds the lungs and lines the inside of the rib cage. Some asbestos fibres inhaled into lungs work their way out to the pleura and may cause fibrosis or scarring to develop there. This causes the pleura to thicken and this may show up on a chest X-ray or CT scan. Pleural thickening occurs in two forms:

• Diffuse pleural thickening extends over a large area and may restrict expansion of the lungs, leading to breathlessness; and
• Pleural plaques are localised areas of pleural thickening, that don’t usually interfere with breathing.

Scale of disease including trends

An upward trend in the annual number of cases assessed for disablement benefit occurred during the 1990s but with more stable numbers of around 400 per year since 2003. The larger numbers of assessed cases in recent years may be connected with the admission of unilateral cases of disease (i.e. cases where only one lung is affected) from April 1997. Previously, Department for Work and Pensions regulations limited compensation to cases of bilateral disease, where both lungs are affected. In April 2002 a new method of collecting statistical information on claims and assessments was introduced, making the data more accurate. The large increase in cases in 2002 (380 cases compared 290 in 2001) is likely to be at least partly because of this rather than a true rise in claims. In addition the figures from April 2002 onwards include assessments where the claimant has been found to be suffering, but where there has been no loss of faculty.

The numbers of cases of pleural thickening and similar disorders reported via occupational and chest physicians under the THOR surveillance scheme under the heading of benign (non-cancerous) pleural disease, nearly all of them attributed to asbestos, are appreciably larger than those for IIDB cases. There were an estimated 1063 such cases in 2008 compared with 1008 in 2007. These numbers will include many cases falling outside the DWP definitions - in fact, analyses of SWORD data over the 5-year period 2002-2006 indicate that about three quarters of cases were classified by participating physicians as “predominantly plaques” with most of the remainder as “diffuse pleural disease” and only a small proportion as “asbestos-related pleural effusions”. Given that pleural plaques are usually asymptomatic and few of the cases reported to SWORD had other diagnoses of asbestos related disease in addition to plaques, this suggests that many of these cases were identified (via chest x-rays) following referral of individuals to chest physicians for other respiratory conditions - rather than because of the plaques themselves. The fact that appreciable numbers of pleural plaques are identified each year in this way suggests that there are likely to be substantially more individuals in the population with plaques than identified by SWORD.