Most organisations still treat air quality as a facilities issue. It is not. It sits squarely in the middle of workforce risk, insurance exposure and operating margin.
What I see repeatedly is organisations treating respiratory risk as background noise until it turns up in absence data, insurance renewals or a compensation claim. By that point, the damage is already costed in. In 2024/25, 1.9 million UK workers were affected by work-related illness, while occupational lung disease continues to contribute to around 11,000 deaths each year from past exposure. That is not an unavoidable occupational hazard. It is a long-tail liability created by weak controls, poor visibility and avoidable exposure, and it continues to surface in Health and Medical Occupational (PMI/HMO) claims across employer-funded policies.
The Rising Business Imperative
The Health and Safety Executive (HSE) reports that 40.1 million working days were lost in 2024/25 due to work-related illness and injury, with ill health accounting for most of that burden. Respiratory illness remains a significant contributor, particularly where airborne particulates, vapours and poorly managed exposure continue to go unchecked.
Those cases do not disappear once the immediate incident passes. They re-emerge later through employer liability claims, Industrial Injuries Disablement Benefit (IIDB) pathways and rising insurance costs. For mid-sized and large employers, the economic impact is material, with work-related ill health and injury estimated to have cost Britain £21.6 billion in 2022/23.
That cost lands at exactly the wrong time. Employers are already dealing with labour shortages, retention pressure and rising benefits spend. Respiratory risk simply adds another preventable drag on productivity and margin.
Mechanisms of Respiratory Harm
The route from poor air quality to respiratory claim is not complicated. It is usually just ignored for too long.
Poor indoor air quality and unmanaged occupational exposure create entirely preventable respiratory harm. Under COSHH, employers are required to control exposure to hazardous substances including dusts, fumes, vapours and isocyanates. Yet in practice, control is often inconsistent, monitoring is irregular and compliance becomes performative. That is how preventable exposure becomes occupational asthma, chronic obstructive pulmonary disease (COPD) and long-term respiratory impairment.
HSE data shows that 15–20% of adult-onset asthma cases are linked to workplace exposure, while around 19,000 new lung or breathing conditions each year are either caused or worsened by work. In my experience, the operational failure is rarely a complete absence of controls. It is fragmented execution: outdated COSHH registers, inconsistent respiratory protective equipment (RPE) use, and no meaningful exposure surveillance until symptoms begin to show.
By then, the claim is already forming.
Quantifying the Claims Burden
Respiratory claims are expensive, slow-moving and, in many cases, entirely avoidable.
HSE data continues to show around 12,000 deaths from occupational lung disease each year linked to historical exposure. In 2023 alone, there were 2,218 mesothelioma deaths, many of which fall within compensation pathways such as claims under the Pneumoconiosis etc. (Workers’ Compensation) Act via PWC1 submissions.
This is where the financial burden becomes harder to ignore. Respiratory disease does not just create isolated claims; it distorts the full cost profile of workforce risk. Employer-funded PMI/HMO policies absorb the immediate treatment burden, while employer liability and disability-linked claims extend the cost tail. Lung disorders continue to affect thousands of workers, with recent estimates putting the figure at around 5,000 cases, and insurers price that risk accordingly. Where exposure is underreported or poorly evidenced, premiums rise to reflect uncertainty as much as incidence.
Finance leaders should be looking at this through a much wider lens. Poor respiratory control does not just drive direct medical claims. It also feeds absence, disability exposure and group income protection utilisation, particularly when respiratory-related absence is contributing to the 9.4 working days lost per employee recorded in 2024.
Sector-Specific Vulnerabilities
Respiratory exposure is not evenly distributed. Some sectors carry far more risk and most already know where the pressure points are.
Construction and manufacturing remain among the most exposed, with asbestos legacy exposure, silica dust and industrial fumes continuing to drive pneumoconiosis and related claims. In hospitality, poor ventilation and bioaerosol exposure create a quieter but growing risk. In office environments, the issue is often underestimated altogether, despite volatile organic compounds (VOCs) from cleaning chemicals, printers and poor ventilation continuing to affect respiratory health.
The regulatory expectation is already clear. Under the Workplace (Health, Safety and Welfare) Regulations, indoor air quality should meet or exceed outdoor standards. Yet many employers still operate with fragmented compliance, where policies exist but controls do not hold consistently in practice. That is exactly how risk accumulates unnoticed. It is also worth noting that 35% of occupational lung disease deaths are attributed to COPD, a reminder that respiratory harm is not confined to high-profile industrial exposure alone.
Operational and Financial Fallout
Respiratory risk rarely stays contained within one function. It spreads quickly across operations, finance and governance.
HR teams absorb the impact first through prolonged absence, reduced productivity and more complex case management. Conditions such as occupational asthma are already driving an estimated 13,000 new cases each year, adding sustained pressure to absence management and employee support functions.
Finance teams then carry the downstream cost through higher deductibles, premium inflation and claims volatility. Risk teams inherit the regulatory burden through HSE scrutiny, enforcement exposure and audit pressure. Together, these pressures move directly into EBITDA.
Insurers are not treating this lightly either. Claims history, absence patterns and exposure controls are now under much closer review at renewal, particularly where underwriting standards align with more sophisticated risk frameworks such as those used by Swiss Re. Boards that continue to ignore respiratory exposure are not simply accepting health risk. They are accepting preventable financial and legal risk, including the kind of negligence exposure that makes employer defence materially harder to sustain.
Implementing Robust Controls
This is one of the clearer workforce risks to fix, but only if leadership treats it as a measurable operating issue rather than a compliance exercise.
First, commission a full COSHH review supported by real-time air monitoring to establish an exposure baseline against HSE Workplace Exposure Limits (WELs). Without credible exposure data, most organisations are managing this risk on assumption.
Second, treat RPE as a control system, not a procurement task. That means fit-testing, training, enforcement and routine review, particularly in environments where the 15–20% workplace contribution to adult-onset asthma remains a live risk.
Third, modernise ventilation and filtration. HVAC performance should be aligned to ASHRAE-grade standards capable of reducing particulate load, VOC concentration and bioaerosol build-up.
Fourth, build respiratory surveillance into annual occupational health pathways so early symptoms are identified before they become chronic claims.
Fifth, work with insurers as risk partners, not just claims payers. Shared exposure data and validated reductions in incidents create a stronger basis for premium negotiation than retrospective claims defence ever will.
Air quality is not a workplace perk. It is a controllable risk with direct implications for claims, cost and continuity. Organisations that still treat respiratory exposure as a background issue are underwriting their own avoidable losses. Audit the exposure, fix the controls and force the issue onto the board agenda this quarter. Waiting for the claim is the most expensive way to respond.