BusinessMedical - Health Surveillance

Health surveillance

Under European and UK legislation, employees who are exposed to certain hazards in the workplace require regular health surveillance to:

Detect ill-health effects at an early stage
Identify anyone at particular risk of disease
Prevent disabling illness/disease
Check on whether your control measures are working
Protect the health of employees
Help people stay in work

Health Record - Every worker who needs health surveillance should have a health record. Health records are important and useful because they provide a record of:

The work that has involved exposure to certain workplace health hazards.
The outcome of any previous health surveillance.

A health record is different to a clinical record and does not include confidential clinical data. A health record should be kept for as long as the person is employed by your company. You may need to retain health records for up to 50 years but this depends on specific legislation (e.g. asbestos)

Click HERE to download our Health Surveillance information document (PDF).

Some health surveillance assessments that we do: -

Exposure to Noise at Work
Exposure to Vibration at Work
Expose to Chemicals at Work - skin surveillance
Exposure to Substances at Work - respiratory surveillance
Appointed Doctor Medicals

Exposure to Noise at Work

Hearing loss can occur from prolonged exposure to noise. Hearing may also be damaged by sudden extreme loud noises. Noise exposure can also cause tinnitus (ringing or buzzing in the ears).

Under Control of Noise at Work Regulations 2005 there is a specific requirement to provide health surveillance (audiometric hearing tests) for workers at risk. Health surveillance is required for all employees frequently exposed above 85dB, and also for particular individuals at risk exposed to noise above 80dB.

A health (surveillance) record of the outcome, and fitness to work in a noisy environment, must be kept by management.

Further information for employers is available in the HSE leaflet - See links page.

Exposure to Vibration at Work

Hand Arm Vibration Syndrome (HAVS) is a medical condition caused by vibration transmitted from work processes into employees' hands and arms from:

operating hand-held power tools such as road-breakers, grinders or chain saws
hand-guided equipment such as lawn mowers or plate compactors
holding materials being processed by machines such as pedestal grinders.

Identifying signs and symptoms at an early stage is important. It will allow you, as the employer, to take action to prevent the health effects from becoming serious for your employee. The symptoms include any combination of:

tingling and numbness in the fingers;
not being able to feel things properly;
loss of strength in the hands;
the fingers going white (blanching) and becoming red and painful on recovery

Workers using tools which transmit vibration may require health surveillance in the form of regular checks for Hand Arm Vibration Syndrome (HAVS) or Carpal Tunnel Syndrome symptoms and signs under the Control of Vibration at Work Regulations 2005.

We have a tiered system of screening for symptoms and signs – initial paperscreen, nurse review, doctor review - depending on the results at each stage.

Hand Arm Vibration Syndrome (HAVS) is reportable under the RIDDOR regulations to HSE.

Further information for employers is available in the HSE leaflet - See links page.

Exposure to Chemicals at Work - skin surveillance

Where employees are exposed to “substances hazardous to health” they may require regular health surveillance under the Control of Substances Hazardous to Health 2002 Regulations COSHH).

Health surveillance is appropriate where there is exposure to substances known to cause:

skin irritation
dermatitis
skin sensitisation
de-pigmentation
oil acne
skin cancer

This might mean simple skin inspection programmes by a responsible person or medical surveillance, depending on the substance and the risk of exposure.

Health (surveillance) records of the outcome need to be kept by the employer.

Exposure to Substances at Work - respiratory surveillance

Certain chemical substances can cause sensitisation in employees and result in occupational asthma e.g isocynates, wood dust, flour dust, laboratory animals.

Where employees are working with, or are regularly exposed to, known respiratory sensitisers then a programme of health surveillance is needed under COSHH. This might mean a simple questionnaire for symptoms, or it may require lung function tests by the occupational health nurse adviser.

Exposure to respirable silica dust at work may require health surveillance. The type of surveillance would require discussion, depending on the level of risk, frequency and length of exposure, type of dust etc. A chest X-ray may be required in some cases.

Some dusts, fumes, mists or gases can cause Chronic Obstructive Pulmonary Disease. Employees exposed to these may require health monitoring in the form of a questionnaire or possibly lung function tests. A health record should also be kept of the outcome.

Further information is available in an HSE leaflet - see links page.

Appointed Doctor Medicals

Health and safety law requires pre-employment and periodic medicals for workers who are exposed to certain defined hazards, such as asbestos, lead and radiation. These ‘statutory medicals' have to be carried out by an appointed doctor who is designated by HSE. The nature and frequency of the medical is described in the relevant legislation and supporting guidance.

Lead medicals

Under The Control of Lead at Work Regulations 2002, employees carrying out duties with exposure to lead will require a medical review by an HSE appointed doctor.

Asbestos medicals

Under the Control of Asbestos at Work Regulations 2006, employers must ensure that each of his employees who is exposed to the action level of asbestos is under adequate medical surveillance by an HSE appointed doctor.

Ionising radiation medicals

Fitness for work with ionizing radiation medicals required by an HSE appointed doctor under the Ionising Radiations Regulations 1999 (IRR99).