What is health surveillance?
Health surveillance is a system of ongoing health checks. 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.
Health surveillance is important for:
- detecting ill-health effects at an early stage, so employers can introduce better controls to prevent them getting worse
- providing data to help employers evaluate health risks
- enabling employees to raise concerns about how work affects their health
- highlighting lapses in workplace control measures, therefore providing invaluable feedback to the risk assessment
- providing an opportunity to reinforce training and education of employees (e.g. on the impact of health effects and the use of protective equipment)
Your risk assessment should be used to identify any need for health surveillance. You should not use health surveillance as a substitute for undertaking a risk assessment or using effective controls.
Health surveillance can sometimes be used to help identify where more needs to be done to control risks and where early signs of work-related ill health are detected, employers should take action to prevent further harm and protect employees.
When putting in place a health surveillance programme, avoid blanket coverage for all employees as it can provide misleading results and waste money.
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 eg fitness to dive, operate cranes, forklift trucks or health assessments requested by night employees
Is health surveillance required in my workplace?
The starting point is your risk assessment. Through this you will have found out the hazards in your workplace, identified who is at risk and taken measures to do something to control the risks.
Where some risk remains and there is likely to be harm caused to your employees, you will need to take further steps. Consider health surveillance if your employees are at risk from:
- Noise or vibration
- Solvents, dusts, fumes, biological agents and other substances hazardous to health
- Asbestos, lead or work in compressed air
- Ionising radiation
Control measures may not always be reliable, despite appropriate checking and maintenance, so health surveillance can help make sure that any ill health effects are detected as early as possible.
Help on how to carry out a risk assessment can be found on HSE’s risk management website. Your trade association may also have useful advice and guidance. For complex situations and work with very hazardous material or agents you may wish to seek help from a competent advisor.
If you have already carried out health surveillance as described here, factor in the results in your revised risk assessment.
Do I need health surveillance?
If there is still a risk to health after the implementation of all reasonable precautions, you may need to put a health surveillance programme in place, see: Health surveillance Decision-making map. Health surveillance is required if all the following criteria are met:
- There is an identifiable disease/adverse health effect and evidence of a link with workplace exposure
- It is likely the disease/health effect may occur
- There are valid techniques for detecting early signs of the disease/health effect
- These techniques do not pose a risk to employees
What sort of health surveillance do I need?
Where your risk assessment shows that you need to implement health surveillance, you will need to put into place a programme that adequately addresses the risks and potential ill-health effects your employees may be exposed to.
In its simplest form, health surveillance could involve employees checking themselves for signs or symptoms of ill health following a training session on what to look for and who to report symptoms to. For examples employees noticing soreness, redness and itching on their hands and arms, where they work with substances that can irritate or damage the skin.
A responsible person can be trained to make routine basic checks, such as skin inspections or signs of rashes and could, eg, be a supervisor, employee representative or first aider. For more complicated assessments, an occupational health nurse or an occupational health doctor can ask about symptoms or carry out periodic examinations.
HSE provides a range of industry-specific guidance and much of this includes advice on which jobs may require health surveillance and what you need to do in response.
There are also a number of high-hazard substances or agents where the law requires that the health surveillance programme includes statutory medical surveillance. Statutory medical surveillance involves a medical examination and possibly tests by a doctor with appropriate training and experience. The doctor must have been appointed by HSE.
