Occupational Health

by Anna Harrington

Health surveillance

The purpose of health surveillance is to gather health-related data that indicates the health of a defined population and to monitor for adverse effects of exposure to a defined hazard.

Within the workplace, this definition is defined as a system used to detect early signs of work-related ill health in employees exposed to certain risk. It is necessary to implement health surveillance where the legislation states its necessity and where there is a recognised and robust method available to provide screening.

The benefits include

  • Identifying early cases of harm occurring
  • Surveillance helps you to monitor the effectiveness of the control measures
  • You can use it to educate and encourage employees to follow procedures and reduce the risks.

Health surveillance in the workplace can also relate to the gathering of health data to be used for the promotion of general health and wellbeing (public health). Examples of such surveillance include the measurement of and screening for cardio-vascular risk factors and diabetes screening.

Legislation

Below are some of the most common types of work-related health surveillance and the relevant pieces of legislation:

  • Lung function testing – Control of Substances Hazardous to Health, Regulations, 2002, (COSHH)
  • Biological monitoring (blood, urine, sweat, saliva) – COSHH and Control of Lead at Work 1995
  • Audiometry – Control of Noise at Work Regulations, 2005
  • Hand-arm vibration screening – Control of vibration at Work Regulations, 2005
  • Eye sight screening – Display Screen Equipment Regulations, 1992
  • Skin surveillance – COSHH.

Implementing health surveillance

If it is to be effective, it is necessary for interested parties to work together to create and implement a health surveillance programme.

The programme should be documented and guided through policy, which needs to state

  • The aim –who requires health surveillance and why
  • Appropriate levels of surveillance
  • Roles and responsibilities (remembering that, with the appropriate training and OH support, it is not always necessary to have qualified occupational health personnel undertaking the surveillance)
  • Recording and action to be taken on the receipt of results, monitoring and evaluation (see HSG 61, Health surveillance at work, HSE, 1999).

Adverse results/effects

The presence of an abnormal result can cause the individual anxiety, as they will be concerned about their health and also the effect the result might have on their job.

On the receipt of abnormal results

  • The employee exposure will need to be reduced or possibly ceased
  • Investigations will need to be made to establish exposure levels
  • You will need to survey other employees to identify whether any other employees are suffering with abnormalities
  • Any employees with abnormal results will need to see their doctor for treatment
  • In addition, a submission to RIDDOR should be sent to notify them of the occurrence.

It is necessary for an occupational health professional to oversee the health surveillance programme. In relation to hand-arm vibration screening, it is prudent to use an occupational health professional who has obtained a certificate in hand-arm vibration screening.

Environmental monitoring

The aim of environmental monitoring is to recognise and evaluate the risks to employee health from exposure to hazardous agents and substances. It is likely that the appropriate piece of legislation will detail exposure limits and the management of risk needs to be appropriate to these limits.

The benefit of environmental monitoring is to ensure legislative compliance and to prevent employee illness relating to workplace hazards.

Reporting occupational diseases

The purpose of formal reporting systems is to collect data nationwide, to discover the extent of ill-health caused by work.

Formal reporting systems as listed on the HSE web-site are:

  • RIDDOR – forms are available on the HSE website; RIDDOR requires employers, self-employed and those in control of premises to report and keep record of reporting
  • Labour force survey
  • THOR (voluntary reporting by specialist doctors), which includes
  • SWORD – respiratory disease
  • Epiderm – skin disease
  • SOSMI – psychiatric illness
  • MOSS – rheumatology
  • OPRA – occupational health physicians
  • THOR GP (reporting system for the 270 doctors who have undertaken a post-graduate qualification in occupational medicine)
  • HSE inspectors, whose reporting systems will include
  • Industrial disease disablement scheme
  • Asbestos-related illness
  • Lead surveillance – HSE medical inspector or appointed doctor
  • Enforcement
  • Risk control indicators – HSE inspectors
  • Working conditions survey – HSE
  • Fit3 surveys – HSE.

RIDDOR require the employer to report illness, near misses, dangerous occurrences and work injuries lasting over seven days. Records must be kept for at least three years.

It is recognised that these systems are dependent upon individuals to report and they are therefore not thought to give absolute figures.