Fatemeh Afrasiabi and 70 others · Prevention of Future Deaths report

Evidence submitted as part of the investigations and issues that have been raised with me by the bereaved suggest that many of those who escaped were exposed to significant smoke inhalation. The smoke will have contained multiple toxic substances and it is of note that the building was known to contain asbestos. It is likely that almost all of those who died in the fire, died as a result of smoke inhalation, although this evidence has not yet been tested in court. It has also been brought to my attention that fire fighters involved in 9/11 have since suffered health problems related to fumes and dust that they inhaled in their response to the fire following that terror attack in New York. Asbestos is known to be associated with an increased risk of respiratory illness especially mesothelioma, which may present many years, not unusually decades, after the exposure.

Real concern has been expressed to me by the bereaved in relation to the health of survivors, especially children and I have been informed that no physical health screening programme has been put in place to monitor the health of survivors on an on-going basis.

There was extensive Health and Safety involvement on site following the fire and monitoring of the area by Environmental Health.

This may have mitigated some if not all of the risks to onsite workers. I understand that fumes and dust from the site that passed to the surrounding environment is not thought to have significantly raised the risks of health damage to local residents compared to breathing the usual London air.

Extensive support for mental health issues has been offered by Central and North West London NHS Trust in the aftermath of the fire to date, to bereaved, survivors and residents. I understand that funding remains in place for this until March 2019.

The Metropolitan Police, The London Fire Brigade and Local Authorities each have occupational health provision for those employed by them and further the Metropolitan Police extended their services to those persons independently contracted but assisting with the police investigation.

1. That no structured health screening programme is in place for those who were exposed to risks of smoke and dust inhalation during the Grenfell Tower fire.

2. That those subject to smoke and dust inhalation are at risk of developing health conditions in particular respiratory illness after particulate and poison inhalation.

3. That there may have been exposure to asbestos during and after the fire that could possibly cause late onset health issues such as mesothelioma.

4. That without an appropriate system of health screening, there is a risk that illness may arise unnoticed or present later in survivors, first responders and site workers, and thus reduce their life expectancy.

5. That the NHS needs to undertake a risk evaluation and then consider an appropriate regular health screening programme for survivors of the fire and first responders and site workers.

6. That survivors and first responders and site workers, need to be given access to guidance and/ or information that would help them to understand what could be the health consequences of being exposed to the hazardous environment of the site of the fire.

7. That the NHS needs to oversee and co-ordinate and provide appropriate mental health support for all those affected by their involvement in the incident, be they survivors, bereaved, local residents or first responders or other workers involved in the aftermath. The potential impact of this disaster is very wide ranging.

8. It may be that the provision of some care services, for physical or psychological damage may be provided by occupational health services outside the NHS, however a scale and risk assessment of need and care provision needs to be undertaken to minimise persons affected slipping through the net and being lost from appropriate supportive services.