Confined Spaces: Why the UK needs better data - and better First Aid training

When it comes to confined space safety, we're flying blind.

In the UK, the Health and Safety Executive (HSE) only records fatalities in confined space incidents. That’s it. If someone gets seriously injured, suffers brain damage, or is permanently disabled but doesn’t die, it doesn’t show up in the official data.

This is not just a gap in reporting. It’s a serious failure to understand the scale of risk in some of the most dangerous working environments in our economy. And it’s costing people their health, their livelihoods, and sometimes their lives.

A hidden crisis of life-changing injuries

The lack of accurate data on all confined space incidents - fatal and non-fatal - means we’re missing a huge part of the picture. It’s impossible to put effective, preventative strategies in place when we don’t even know how often these accidents are happening or how bad the outcomes are.

But I can tell you from experience: the outcomes are often devastating.

In many cases, people survive a confined space incident, but the consequences are life-altering. If someone is starved of oxygen, even for a few minutes, the result can be brain damage. These aren’t just statistics. These are people with families, careers, and futures. And right now, they’re not being counted.

Millions of confined space entries. No accurate picture.

Globally, it’s estimated that there are between 10 and 15 million confined space entries each year, with thousands of them happening right here in the UK. The majority of these entries happen in industries like:

• Utilities

• Oil and gas

• Wastewater treatment

• Shipbuilding

• Construction

Despite this huge volume of activity, we have no accurate data to reflect how often things go wrong, or what happens when they do. I can say with confidence however, that many of the businesses operating in these sectors are not prepared to deal properly with a confined space casualty or patient if it goes wrong.

The First Aid training gap is dangerous

One of the biggest issues this throws up is the lack of tailored first aid training for those working in confined spaces. The HSE currently makes no specific stipulation for it. As a result, companies often tick the box with basic first aid training that simply doesn’t cut it in a confined space environment.

This is not good enough.

The only course of its kind – Built from frontline experience

There’s only one training course in the UK that truly meets the unique needs of casualty care in a confined space environment – and it’s the one I developed.

The Confined Space Casualty Care programme was born out of real-world experience from my years working as a paramedic and as a member of the HART (Hazardous Area Response Team).

Time and time again, I attended incidents where the life-changing injuries sustained by casualties could have been avoided, or at the very least reduced, if appropriate, situation-specific first aid had been delivered at the scene, in those critical first minutes. Too often, workers had no idea how to help because they simply hadn’t been trained for the unique dangers confined spaces present. They were left waiting for specialist rescuers like us to arrive, and by then, it was often too late. That’s exactly the shortfall this course is designed to fix.

Confined spaces are uniquely hazardous. We’re talking about low oxygen levels, toxic gases, engulfment, restricted movement, and difficult access for rescue. You cannot expect a first aider who’s been trained for a workplace office scenario to suddenly know what to do when someone collapses underground in a sewage tank. And yet, that’s what’s happening across the country every single day.

A history of underinvestment

Companies underinvest in training because the regulations don’t demand anything better. The consequence? Poorer outcomes for casualties. More long-term injuries. Lives changed forever.

I believe we can do better. And I want to lead that change.

Confined Space Casualty Care: A new standard

That’s why I developed the Confined Space Casualty Care training programme. It’s the only training of its kind, designed specifically for the realities of first response in confined environments. It prepares responders to make the right decisions in the most dangerous situations, and it gives casualties a better chance of survival—and recovery.

This isn’t about ticking a box. It’s about saving lives and protecting futures.

What needs to happen next

But we need more than just better training. We need better data. We need to know who survived, who didn’t, and what went wrong. We need the HSE to collect, analyse, and publish information on all confined space accidents—not just the fatalities. Only then can we truly understand the risks and take meaningful steps to reduce them.

Until that happens, we’ll remain stuck in a cycle of underreporting, under preparation, and unnecessary suffering. Let’s change that.

Let’s lead the change

Let’s fight for better data, better standards, and better training, for the good of everyone who enters a confined space to do their job and expects to come home safe.

Learn more about our specialist Confined Space Casualty Care training here.

By David Nice