Health monitoring and review

It may not be possible to prevent all cases of musculoskeletal disorders (MSDs) but there are things you can do, at work, to help prevent symptoms occurring or getting worse. Health monitoring is an informal, non-statutory method of surveying your workforce for symptoms of ill health, including lower back pain. This type of occupational health management system can enable you, as an employer, to be aware of health problems and intervene to prevent problems being caused or made worse by work activities. Another important role of health monitoring is to feedback into a system that reviews the current control methods in place.

In addition, there are specific regulations dealing with Manual Handling and whole body vibration in the workplace. To ensure you are complying with your duties under these regulations you should refer to HSE guidance, if manual handling or whole body vibration are risks in your workplace. Whole body vibration is particularly prevalent in those that drive industrial and agricultural vehicles.

Examples of situations where the risk to health of drivers may be considered high are:

• Driving off-road; too fast, over rough terrain or with inappropriate vehicles;
• Driving on badly prepared surfaces in vehicles with poor suspension;
• Having to stretch and twist to operate machinery;
• Significant manual handling of loads by drivers;
• Static postures (i.e. remaining in the same position for long periods).

How to carry out health monitoring

You should:

• Consider the method and frequency of monitoring when planning and implementing control measures;
• Consult employees so that they are fully aware of the monitoring procedures, understand they are in place to help protect their health and that they know their part in them;
• Encourage employees to report symptoms they may be suffering as early as possible to stop any further aggravation. Having a system in place to do this on a regular basis, such as a brief simple questionnaire, can improve the likelihood that you get this information in the format most useful to you;
• A body map can help a person to pinpoint where they are feeling the symptoms and they can be asked to describe the sensations they are feeling;
• Ask employees whether their work caused the problem and whether they can identify what specific task caused the pain.

There are other things you can do to gain information on whether or not your workforce may be suffering. These include:

• Using administrative resources such as reviewing entries in the accident book, sickness absence records/fit notes, staff turnover etc. Although this information is already available you may need to interpret it;
• If workers are reporting symptoms consider a referral to an occupational health provider or suggest they see their GP to get treatment;
• When you have gathered all the available information it is important that you interpret this data and look for patterns in:
  • Comments from employees
  • Symptoms reported
  • Existing risk factors
  • Results of surveys

Reviewing

Reviewing the results of health monitoring provides an opportunity to look at the overall performance of your risk management control systems and may identify susceptible individuals. This process should be considered as an integral part of the management process. An effective review:

• is an opportunity to learn from experience gained in managing risk factors, signs and symptoms;
• helps determine whether interventions are effective;
• establishes whether risks have been controlled where reasonably practicable;
• Provides an opportunity to assess whether new control measures need to, or should, be introduced.

If as a result of health monitoring it looks like your controls may be failing you should review your risk assessment accordingly. You may need professional help and advice on this.

Occupational health provision or medical support/referral

You may have access to occupational health to which workers could be referred for help and advice with their symptoms. Occupational health provision is valuable for advising on management of cases.

MSD problems can be specific to an individual and each person is different and will need to be dealt with on a case by case basis, you may need to consider:

• If a task is causing or contributing to a MSD, the worker may need to stop doing that task for a time; temporarily modifying their duties could assist with recovery;
• Return to work plans, agreed by all parties and actively reviewed. If the individual has been off work, it is possible to return before all the symptoms have cleared up totally, provided that there isn't contrary medical advice;
• having systems in place to help workers to return to work.

People with MSDs usually completely recover if the problem is recognised early and treated appropriately.