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Health surveillance

What is health surveillance?

Health surveillance is any activity which involves obtaining information about employees’ health and which helps protect employees from health risks at work.

The objectives of health surveillance are

It should not be confused with general health screening or health promotion.

When is health surveillance required?

Health surveillance is appropriate when employees are exposed to residual risk of harm from hazardous substances, following all appropriate means of control, and;

The technique used should not place employees at an increased risk or cause unacceptable harm.

Situations where health surveillance may be appropriate

This is not a definitive or exhaustive list and there will be many other instances where health surveillance is required.

The most frequently and consistently reported examples of occupations and associated agents are listed in table 1 for allergic and contact dermatitis, table 2 for urticaria and table 3 for cancer. These tables are not all inclusive. Your risk assessment should identify if health surveillance is required.

Medical surveillance using an HSE appointed doctor may be necessary if workers are involved in the manufacture of pitch or potassium or sodium chromate or dichromate. For further details see Schedule 6 of the Control of Substances Hazardous to Health Regulations (as amended) 2002 and Guidance for appointed doctors (MS32).

What is suitable health surveillance for occupational contact dermatitis?

Higher level health surveillance

Higher level health surveillance is appropriate when the evidence for a hazard is clear and/or there is potential for significant exposure. For example

Action for higher level health surveillance

Higher level health surveillance should include the following measures:

Higher level health surveillance may include employee questionnaires (eg annually).

Lower level health surveillance

Lower level health surveillance is appropriate where:

Action for lower level health surveillance

Lower level health surveillance could include one or all of the following:

A sample questionnaire for skin health surveillance is available.

Who carries out health surveillance?

A ‘responsible person’ is someone in your organisation who is given the responsibility to help deliver a health surveillance system from within the workplace. They will have received training or coaching on what they need to do to perform this role effectively – which may involve training from a health professional, a health & safety professional, management or any other, as appropriate.

This person’s role in the health surveillance system should be clearly defined and they should be someone who is trusted by the workforce, with good communication/interpersonal skills.

The role of the ‘responsible person’ is to:

A ‘responsible person’ can be an employee provided with suitable training. They should know:

Detection of an adverse health effect

The ‘responsible person’ should know what action to take on finding a problem. This includes:

A responsible person, on finding any skin problems,  should advise the employer when to seek expert help.  For example, an appropriately qualified doctor or nurse will need to be called on to deal with employees with skin problems, as they may no longer be fit to be exposed, or may need restrictions placed on exposure.

Occupational health referral

Employers need to consider what you will do if skin disease means a worker is no longer fit to perform their job, or there are restrictions on what they can do.  You may need to adapt the workplace or even move affected staff to alternative duties. An occupational health provider would be able to assist with some of these decisions.

Action on health risks

Control measures need to be improved where indicators of skin disease are found. Employers should consider the following:

You should consider all the above, in tandem with the results from the subsequent health surveillance, when implementing additional or improved control measures.

Health records

A health record must be kept for all employees under health surveillance 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.

What information should be included in health records?

Individual health records should include details about the employee and the health surveillance procedures relating to them.

Employee details should include:

Recorded details of each health surveillance check should include:

Updated: 2014-08-08