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What Is Health Surveillance?

What Is Health Surveillance

What Is Health Surveillance?

Health surveillance is any activity that involves obtaining information about your employees’ health to help protect them from potential risks in the workplace. Some health surveillance practices are required by law, while others, such as health monitoring, are carried out as good practice. 

Workplace control measures are not always reliable but implementing health surveillance can help ensure that any potential ill health effects are detected as early as possible. You should bear in mind, however, that health surveillance is not a substitute for other measures to control exposure, such as:

  • Improved processes
  • Elimination of exposure
  • Good management practice

What is the purpose of health surveillance?

Health surveillance protects and maintains your employees’ health by detecting any adverse health changes that have come about because of work. An efficient health surveillance programme can help your business:

  • Evidence the effectiveness of existing control measures
  • Identify areas that may adversely affect your employees’ health

When is health surveillance required?

Some staff members may need to take part in health surveillance as part of their contract, with emphasis on those who are exposed to hazardous substances or potentially dangerous processes at work. A typical health surveillance programme will include baseline (recorded at the beginning of employment), ongoing, and exit health surveillance. Examples of health surveillance tests include: 

  • Skin examinations
  • Hand and arm or full-body vibration tests (HAVS)
  • Lung function tests, including peak flow and spirometry
  • Hearing or vision tests – e.g., audiology or keystone
  • Medical tests –blood, urine, blood pressure, and ECG
  • Physical tests – musculoskeletal, dexterity, function, height, and weight
  • Industry-specific health questionnaires

Health surveillance safety considerations

Health surveillance may be appropriate if:

  • It does not pose a risk to the employee
  • There is a potential exposure risk in the workplace that may be hazardous to health
  • There is a suitable test available to detect the level of exposure
  • Exposure to potential workplace health hazards have been reported or can be detected

Who can carry out health​​​ surveillance?

Where medical exams are involved, determine the medical professional’s knowledge and expertise, and remember, they should be fully aware of the working environment. Having established your medical professional’s expertise, you must also select a qualified individual to interpret the results.

Occupational health personnel can include:

  • Physicians
  • Advisors
  • Technicians

A database containing accredited occupational health providers​ can be found here.

As well as performing health assessments and carrying out medical exams, your medical professional may also carry out:

  • Confined spaces medicals
  • Night/shift workers’ assessments
  • Drivers’ medicals
  • New recruit assessments
  • Assessments for employees’ changing roles within the company
  • Assessments for young workers, like new apprentices, students, or those under 18

Current employees may also be able to help with the above if they are trained, competent, and accredited.

What is the difference between health surveillance and health monitoring?

Health surveillance is legally required for personnel with a significant risk of exposure to specific hazards associated with a work activity. Health monitoring, on the other hand, is an informal system where the ill effects from work activities are not correlational. For example, a warehouse packer may suffer from lower back pain, but this ailment is also common in the wider population.

Health surveillance process

The following six steps provide an outline of the health surveillance process:

1.     Conduct a health surveillance risk assessment

Conduct a risk assessment to identify circumstances that require health surveillance according to specific health and safety regulations, namely the Control of Substances Hazardous to Health Regulations 2002 (COSHH).

Health surveillance should also be implemented if your risk assessment indicates all of the following criteria apply:

  • There is an identifiable disease or adverse health condition related to the work being carried out
  • Valid techniques are available to detect indications of the disease or condition
  • The disease or condition is likely to occur under particular work conditions
  • Surveillance is expected to help protect and maintain the health and safety of the employees to be covered

Hazardous substances

A common reason for initiating a health surveillance program is due to potential exposure to hazardous substances. These can be:

  • Biological agents such as bacteria, viruses, and fungi
  • Natural substances such as grain, flour, or enzyme dusts
  • Substances generated by work, such as soldering or welding fumes
  • Chemical products used or produced at work, such as adhesives or cleaning agents

If your risk assessment suggests your employees’ health is at risk, you should update or review your risk assessments and implement tighter control measures.

2.     Type of health surveillance required

The type of health surveillance depends on the particular hazards present and the level of exposure to each employee.

3.      Determine the risk to the individual

The health surveillance requirement depends on both the task and the individual involved. For instance, some people may be at a higher risk of ill health due to prolonged or frequent exposures to hazards that aggravate any existing medical conditions.

4)     Formal health surveillance request

Once the need for health surveillance has been identified, a formal request should be submitted to the relevant occupational health team. This should include details of employees who require health surveillance.

5)     Begin health surveillance

Once the formal request is approved, the individuals who require health surveillance will be contacted by the occupational team to organise their sessions.

6)     Records results and review

The occupational health practitioner will record employees’ results and determine any further health surveillance requirements. The findings might result in changes that need to be made to operations or processes, including the use of better PPE or a buddy system for when employees are working on potentially hazardous tasks.

It is best practice to regularly review results to account for any changes to the employee’s condition or exposure risk levels.

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