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The Society of Radiographers (SoR) has campaigned for "darkroom disease" to be recognised as an occupational illness since 1982, but had to wait until 1995 for a successful court judgement. In the past 15 years, 12 SoR members have received a total of £577,000 compensation. All but one of the cases were settled out of court. Individual settlements ranged from £10,000 to £135,000, and the SoR currently has 12 cases in progress. According to the SoR, "As long as the Department of Health continues to fight cases instead of improving working conditions, we will continue to see employers addressing complaints with haphazard and makeshift changes which are ineffective and expensive."

David Ogden worked as a radiographer at Airedale Hospital from 1979, but in 1991 his doctor advised him to give up work as a radiographer. Since 1987 he had suffered attacks of breathlessness severe enough for him to be admitted to hospital. In 1995, a Sheffield Court found Airedale Health Authority guilty of negligence and awarded Mr Ogden £62,000. He has since had to retrain as an occupational therapist.

During the court case it emerged that the hospital had ignored advice from their own consultants to install ventilation in one of the X-ray areas. In the same year, 1987, several radiographers at the hospital reported persistent cold-like symptoms, sore eyes and laryngitis. Despite this, staff were not given protective equipment, and the hospital did not monitor fume levels or staff, warn them about the hazards of the chemicals they used, or implement procedures for dealing with spills. Even during the trial, the hospital still had not produced a COSHH assessment for the X-ray areas.

The judge said that by 1985 the hospital "knew or ought to have known that some of these irritant chemicals were, or might well be, sensitisers ... [and] by 1987 the symptoms of which the radiography staff were complaining made it as plain as a pikestaff that chemical fumes were having an irritant effect on staff's eyes and respiratory tract."

The judge decided that Ogden was indeed suffering from occupational asthma, having been being sensitised to X-ray chemicals at work, and that the sensitisation was due to the hospital's negligence. He said the hospital's failure to protect Mr Ogden "against exposure by providing exhaust ventilation, warnings as to the dangers and/or protective equipment was in my judgement plainly negligent." The judge said that for want of inexpensive precautions by the hospital, Mr Ogden's career as a radiographer had been ended.

By 1991 the SoR had become so concerned about the number of its members reporting symptoms of "darkroom disease" that it decided to do a survey. Over 2,800 (almost a quarter of the SoR's members) responded. The survey found large numbers of radiographers suffering from symptoms associated with darkroom disease. Over two-thirds of respondents had noticed a processor problem, showing that fumes were being released, and over a third of the departments had no fume control or ventilation system whatsoever. According to the SoR, "Unfortunately, the research shows that the legal requirements of COSHH were not met in X-ray departments, and continue to be inadequately implemented. Over 85% of departments responding to the survey broke the law requiring risk assessments and 38% continue to do so."

The SoR repeated the survey in 1997. Although fewer respondents were suffering from symptoms, there was a small increase in the number of radiographers reporting chemical smells or crystal deposits in the processing area, tell tale signs of fumes escaping from the processor. According to the SoR, "This last area has serious implications, as a leak must have been very long standing, and maintenance irregular, for crystals to have developed."

Several factors could be responsible for the increased reporting of darkroom disease since the 1980s, including changes in X-ray processing methods. There was a move to automatic processing, which runs at higher temperatures, and silver is being recovered from processing waste. X-ray film processing fumes contain over a dozen different chemicals. Most of these have occupational exposure limits, but when workers are exposed to cocktails of chemicals, they may cause more damage together than on their own. The SoR explains this - synergism - as "the chemical equivalent of trade unionism, where the effects of the chemicals together are greater than the sum of the parts. However, in the case of chemicals, the effects of combination are far from beneficial for workers" (Preventing the darkroom disease: health effects of toxic fumes produced in x-ray film processing, Society of Radiographers, 1991; Synergy, November 1997 p. 12).

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