Health Surveillance in Health and Safety

Health surveillance

Essentially, a health surveillance programme is a series of ongoing checks on employees to establish a baseline and ensure that their work is not adversely affecting them. Health surveillance aims to provide early identification of potential ill health. The data collated enables employers to implement better controls to prevent the development or exacerbation of pre-existing conditions. The data can also be used to further inform and train employees on the illhealth effects they are exposed to and the importance of protection.

The Health and Safety Executive (HSE) recommends that health surveillance is required in work-related circumstances where:

  • a particular disease or health condition is known to be related to the work undertaken
  • it is likely that the disease or condition may occur
  • valid techniques are available to detect the early signs of the disease or health issue
  • these techniques do not pose a risk to employees

Legal requirements

Under the Health and Safety at Work, etc Act 1974, employers have a duty to ensure, so far as is reasonably practicable, the health, safety and welfare at work of all employees. In addition, the Management of Health and Safety at Work Regulations 1999 require employers to assess the risks related to the work undertaken by their organisation.

Health surveillance is a requirement of Control of Substances Hazardous to Health Regulations 2002, Control of Lead at Work Regulations 2002, Control of Asbestos at Work Regulations 2012 and the Ionising Radiations Regulations 2017.

Health surveillance should not be used as a substitute for undertaking a risk assessment or using effective controls.

Establishing the need for health surveillance

Managers are responsible for carrying out risk assessments for their team members to establish the risks and potential ill-health effects on those who carry out particular work tasks. Relevant activities could include anything involving hazardous substances, the use of vibrating equipment or work in noisy environments. Additional information, such as from the following sources, can also be used to assess the risks and confirm whether a health surveillance programme is needed:

  • safety data sheets
  • warning labels
  • EH40 Workplace Exposure Limits
  • the Department of Health & Social Care website
  • trade associations

Type of health surveillance programme and set up

The risk assessment will determine the level of health surveillance required. A programme can be anything from employees carrying out self-assessments (e.g. visual checks for signs of dermatitis for those who do wet work) on a regular basis to annual lung function assessments carried out by a medical practitioner for employees who are likely to be exposed to asbestos-containing materials.

If the skills to design and set up a programme are not present in the organisation, competent assistance can be sought through a certified medical practitioner or external consultancy. However, the programme will require an internal stakeholder to assist in its management and roll-out. Programmes should take into consideration elements such as shift patterns, annual leave and sick leave to ensure all at risk of exposure can be assessed equally and consistently assessed.

The programme should be implemented for employees who have been identified as at risk and regularly reviewed to assess its progress. Outcome records must be kept and recommendations actioned. Adding health surveillance to the health and safety committee agenda is a good way of ensuring it is kept on the radar.

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