Health surveillance



What is health surveillance?

Health surveillance is a system of ongoing health checks* and is important to help:-

  • detect ill-health effects at an early stage (allowing employers to put in place more efficient preventative controls)
  • employees raise concerns about how work affects their health
  • highlight insufficient workplace controls and/or the need to provide training to employees, e.g. on the impact of health effects and how they should use protective equipment.

Is health surveillance required in my workplace?

Health surveillance is required if all of the following criteria are met:-

  • there is an identifiable disease or adverse health effect relating to the work
  • it is likely that the disease or health effect may reasonably occur
  • valid techniques are available to detect early signs of the disease or health effect and
  • the techniques do not pose a risk to employees.

In addition, certain health and safety legislation stipulates a requirement to consider health surveillance for a number of work related hazards, particularly for employees who are exposed to:-

  • noise, vibration or ionising radiation, e.g. x-rays
  • certain solvents, fumes, dusts, biological agents and other substances hazardous to health
  • asbestos, lead or work in compressed air.

How do I set up a system of health surveillance?

Where risk assessments identify the need for health surveillance, it is important to establish the form this should take so that it adequately addresses the risks and potential ill-health effects employees may be exposed to.

Employers should involve employees and their safety representatives in the setting up of health surveillance and provide them with information on the purpose and importance of health surveillance and how that might be undertaken.

Health surveillance might involve one or more of the following:-

  • employees looking for simple signs of health problems, e.g. self examination for skin damage from the use of chemicals
  • employees completing health screening questionnaires
  • technical checks, e.g. of employees hearing by a competent occupational health doctor, nurse or technician
  • statutory medical surveillance, e.g. for some work with asbestos or work with ionising radiation, by an appointed doctor approved by the HSE.

What should I do with the results?

Where, as a result of health surveillance, an employee is found to have an identifiable disease or adverse health effect the employer must act on those results, e.g.:-

  • ensure that a suitably qualified person provides the employee with appropriate information and advice, e.g. on treatment
  • undertake a specific risk assessment for the individual and implement suitable control measures including any medical advice provided
  • consider assigning the employee to alternative work where there is a lower or no risk of further exposure
  • review the health of any other employees who have been similarly exposed
  • determine if a case of ill-health is reportable under RIDDOR.

Health records must be retained for all employees under health surveillance. These must be kept for at least 40 years from the date of last entry as there is often a long period of time between exposure and the onset of ill-health.

*Other legal requirements for monitoring health, not formally classed as health surveillance include eyesight tests for users of Display Screen Equipment, health fitness assessments for night workers and fitness to drive or operate cranes and forklift trucks. There is no specific legal requirement to carry out health surveillance for, e.g. manual handling, work related upper limb disorders and work related stress. In these cases other methods of monitoring the health of employees should be provided, e.g. general health check-ups, checking sickness records, encouraging early reporting of symptoms.

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