Health surveillance

Health surveillance is any activity involving getting information about employees’ health to keep them safe at work.

Health surveillance shouldn’t be confused with health screening or wellness promotions and campaigns which are separate from your health and safety policy. It should be considered part of the overall management of work-related risks to health and safety.

Carrying out medical surveillance is required for compliance with various parts of UK health and safety legislation, such as the Control of Substances Hazardous to Health Regulations. Apart from the legal side, benefits of a health surveillance regime include protecting the health of employees with early detection of illness, musculoskeletal disorders or disease, and evaluating health hazards and current control measures with real data.

Health surveillance test results need to be interpreted by someone with the right knowledge, skills and experience and action taken to eliminate or minimise exposure to employees.

Key actions to develop a programme for health surveillance

Identify and assess health hazards in the workplace, who is at risk and existing control measures.
Check the reliability of control measures and whether all risks are captured and addressed, including noise, vibration, exposure to solvents, fumes, dusts, biological agents, asbestos, lead, ionising radiation and compressed air. Put a health surveillance programme in place if a risk to health is still there after implementing all reasonable precautions, and if the following criteria are met: - safekeeping of completed accident records (i.e. security of personal information);

- evidence of a link between an identifiable disease or adverse health effect and a workplace exposure

- it’s likely the disease or health effect may happen and/or

- there are techniques for detecting early signs of the disease/health effect which doesn’t pose a risk to employees.
Get advice from an occupational health professional to help you work out which type of health surveillance programme would suit your needs.

- Consider using a variety of different techniques, depending on working practices and processes.
Consult your workforce before setting up a health surveillance programme to make sure they understand the need and how they can help.
Provide suitable information, instruction and training for anyone who may be exposed to hazards identified in your risk assessments. This should include matters such as use of control measures, personal protective equipment (PPE), cleaning procedures, etc.

Decide the appropriate level of health surveillance for each type of exposure. There are several levels of health surveillance:

- self-checks by an employee (to complement the following)

- basic checks by a responsible person trained to identify straightforward signs and symptoms

- examination by a qualified person, such as an occupational nurse or audiologist;

- clinical examination by (or supervised by) a doctor

- biological monitoring or biological effect monitoring by, or supervised by, a doctor.
New starters to hazardous work processes must undergo health surveillance before they start so a baseline assessment is available for them.
Continue health surveillance at appropriate intervals for as long as the individual is exposed to the risk, and keep records in accordance with the HSE’s guidance. Some regulations state the required interval between examinations; otherwise your occupational health provider should be able to assist.
Take steps to prevent further harm to the individual where health surveillance shows that an employee’s health is being affected.
Remember to consider pre-existing conditions or circumstances that could make an individual more susceptible to risks in the workplace. e.g. being pregnant or breast feeding, having asthma or a skin condition, or taking certain medications. A specific risk assessment will be needed for them.