What is health surveillance?
Health surveillance is a programme of ongoing health checks which allow for early identification of ill-health and helps to identify any corrective action needed.
These health checks may be required by law for employees who are exposed to noise or vibration, ionising radiation, solvents, fumes, dusts, biological agents and other substances hazardous to health, or work in compressed air.
A check list for your current health surveillance programme ...
- How are your needs assessed?
Does your occupational health provider have an in-depth understanding of your business, the hazards and risks and tailor the health surveillance to match your health and safety risk assessments, ensuring you only have the health surveillance you need?
Are you requested to provide all the necessary data sheets before the surveillance takes place?
Does your provider compare this year’s results to previous years’ and give you information about any changes?
Does your provider give you an option to deliver tailored health promotion advice integrated with surveillance?
Does your provider assess risk behaviour and provide you not only with fitness certificates but also a report on your company’s risk profile and any measures they have noticed that you might want to consider to improve the working environment/behaviour of staff.
Does your provider offer training for managers and employees based on the risk profile of the business?
Do you know how often the people delivering the surveillance undertake training and whether this is by an accredited training provider who keeps up to date with any changes in equipment and legislative requirements?
Do we need health surveillance in our organisation?
Physical agents such as -
- Mowing machines and other parks machinery e.g. Leaf blowers, petrol driven strimmers, hedge trimmers;
- Portable power tools such as abrasive wheel cutters, chainsaws, power drills etc;
- The use of compressors and pneumatic drills for highways maintenance;
- The use of woodworking machines such as circular saws, bandsaws, planning machines, sanders, routers etc;
- The use of vehicles with power driven machinery e.g. Refuse vehicles, gully emptiers;
- Noise exposure from work related leisure activities, e.g. discos, concerts;
- Asbestos, lead, working with compressed air. Medical examinations may be needed under the specific regulations applying in these cases.
Hazardous substances such as -
- Wood dust (wood machinist, carpenter or technician in a school workshop);
- Tar and pitch (employees engaged in building maintenance);
- Mineral oil (vehicle workshops); Solvents (painters);
- Electrical solder fumes (technicians); Welding fumes (welder);
- Some pesticides (gardener);
- Some glues/resins, curing of epoxy resins (carpenters, painters);
How do I decide?
The Health & Safety Executive advise that when putting in place a health surveillance programme, avoid blanket coverage for all employees as it can provide misleading results and waste money. Controlled use of most substances in modest amounts will not result in the need to put employees on a health surveillance programme; your risk assessment will help you work out who is at risk and how.
When reading this guidance, remember that health surveillance is a particular legal requirement and should not be confused with:
- Activities to monitor health where the effects from work are strongly suspected but cannot be established;
- Workplace wellbeing checks, such as promoting healthy living;
- Fitness to work examinations e.g. fitness to drive, operate cranes, forklift trucks or health assessments requested by night employees.
What is an employee’s responsibility in Health Surveillance?
It is important that employees understand any hazards within their workplace, the reason for health surveillance and both their responsibility in engaging with health surveillance and the employer’s responsibility in ensuring appropriate health surveillance is provided as necessary.
Employees should also be aware and report any signs of work-related ill-health to their manager. This can be an important part of a health surveillance programme to pick up possible ill-health effects.
This usually involves employees being trained about what signs of disease or illness to look for and when and how to do so; and how to report any signs or symptoms to an Occupational Health service.
What about our agency workers?
The Health & Safety Executive’s advice is that you are not legally required to do health surveillance for workers who are not your employees, as the duty lies with their employer, but you do need to give them suitable information. Many organisations have an agreement with the agency for inclusion of these workers. Either way, make sure that all parties are clear about who will do what, including record-keeping.
What is a baseline health assessment?
A baseline health assessment is carried out when a person takes up or changes a job. This is tailored to the job and the hazards which might be associated with the job. Its purpose is to provide baseline information that can be compared with later results from health surveillance.
What types of tests are used for health surveillance?
The types of tests carried out are dependent on the type of job and hazards associated with a job.
For example if someone is handling chemicals that can affect their skin, they would undergo regular skin checks.
Dusts or fumes may require lung function tests and noise exposure would require hearing tests.
How often is testing carried out?
The frequency of testing is also dependent on the hazard and the results of the test. The employee is advised at the end of each test when further testing is recommended and this is noted on their fitness certificate.
What happens with the results?
The real value from health surveillance will only be seen if managers take appropriate action in response to the results, and then check whether what has been introduced has been effective. Where health surveillance shows that an employee’s health is being affected by their work, the Occupational Health Service will advise managers on any restrictions or control measures which need to be put in place to protect the employee concerned.
Are health records kept?
A health record must be kept for all employees under health surveillance by the employer. Records are important because they allow links to be made between exposure and any health effects. Health records, or a copy, should be kept in a suitable form for at least 40 years from the date of last entry because often there is a long period between exposure and onset of ill health.
These records should include details about the employee and the health surveillance procedures relating to them and there are specific details that must be included (Health & Safety Executive).
Health records are different from clinical records held by the Occupational Health Service in that they do not contain confidential clinical details and can therefore be kept securely with other confidential personnel records. Records, which include medical information arising from clinical examination, are held in confidence by the doctor, nurse or other occupational health professional and can only be released to the individual or anyone else with the written consent of the individual.