Health Surveillance Services
Health Surveillance is the systematic monitoring of the workforce to identify the early signs of work-related ill health in employees exposed to certain health risks at work.
It means putting in place procedures to achieve this. These procedures may include:
- simple methods, such as looking for skin damage on hands from using certain chemicals;
- technical checks on employees, such as hearing or breathing tests;
- more involved medical examinations, including blood or urine tests.
Health surveillance should not be confused with health promotion, general health checks and sickness absence management.
The Health and Safety at Work etc Act 1974 (HSAW74) provides the framework for health and safety management in the UK. Whilst there is no specific provision made for health surveillance in HSAW74, health surveillance is a pre-requisite for maintaining a workplace that is, so far as is reasonably practicable, without risks to health.
The Management of Health and Safety at Work Regulations 1999 as amended make a specific provision for health surveillance in Regulation 6.
Regulation 6 requires that:
“Every employer shall ensure that his employees are provided with such health surveillance as is appropriate having regard to the risks to their health and safety which are identified by the assessment.”
Other Regulations, such as the Control of Substances Hazardous to Health Regulations, the Noise at Work Regulations, also include specific health surveillance requirements.
When is health surveillance required?
Health surveillance is required where you answer ‘yes’ to ALL the following:
- is the work known to damager health in some particular way?
- Are there valid ways to detect the disease or condition?*
- Is it reasonably likely that damage to health may occur under the particular conditions at work?
- Is surveillance likely to benefit the employee?
* valid techniques are those that are precise enough to detect something wrong that could be caused by exposure to a particular health risk; and which are safe and practicable in a workplace setting.
Checklist for setting up Health Surveillance programme
- Identify what chemical, biological, and physical agents and work activities may cause ill health, including routine, maintenance and emergency procedures.
- Assess the risk of ill health from the work activities
- Design and implement control measures, including a monitoring mechanism for the control measures
- Determine whether health surveillance is appropriate – is it a statutory requirement under specific regulations? Is it required under the Management Regulations?
- Identify all those who may be exposed to the health risk and involve them and their representatives in the management plan
- Identify the most suitable health surveillance procedures – consider the type of hazard, the degree of risk, the likely health effects, the nature of the disease process, affected employees, relevant procedures – seeking specialist advice if appropriate
- Design a health surveillance system and allocate responsibility for implementing and evaluating the system.
- Draw up a suitable matrix listing the various jobs, the individuals working in these jobs against the various health surveillance programmes and arranging for the health surveillance to be completed by the competent person / Health Surveillance Nurse.
- A database recording each workers requirement for health surveillance, the type of surveillance, the dates and results of surveillance and the dates for review should be maintained.
- Identify a route for managing any health issues that are identified during the surveillance programme.
- The results of the health surveillance should feedback into the risk management process.
- Arrange for the storage of records both current and leavers for 40 years from date of last surveillance.
- Monitor and evaluate the health surveillance programme in light of changes to systems of work and legislation.
- Include all of these arrangements in an Occupational Health Policy. This is increasingly required by the HSE Inspectors to demonstrate that the process is understood and implemented correctly.