Posted By A Baxter
You will need to understand what they are exposed to before agreeing to carryout health surveillance.
This is information supplied by our OH provider. Hope it helps!
Health Surveillance Guide for Managers
introduction
• Each week in the UK 500 people leave the workforce permanently because of ill health caused by work. Many of these illnesses are preventable. Managers can reduce the costs, both financial and human, by taking effective steps to control health risks at work. One important element is appropriate health surveillance for employees, which can detect the early signs of illness.
• This guide provides practical advice on the “what, who and when” for health surveillance. The list of situations is not exhaustive. Indeed, the requirement for health surveillance is driven by the outcome of the risk assessment process.
what the law says
• The Management of Health & Safety at Work Regulations 1999 (Regulation 6) require:
Every employer shall ensure that his employees are provided with such health surveillance as is appropriate having regard to the risks to their health and safety which are identified by the assessment
• Health surveillance is required if:
? an identifiable disease or adverse health effect may be related to exposure
? there is a reasonable likelihood that the disease or effect may occur under the particular conditions of work
? there are valid techniques for detecting indications of the disease or the effect
• Surveillance needs to be systematic, regular and you must act on the results. This does not require unreasonable actions e.g., creating a new job, but by making changes to the current role which are possible without a large cost (financial, structural or personal).
• It is your duty to ensure that surveillance of your employees has taken place.
what is health surveillance?
• it is not something that needs to always be done by medical professionals - supervisors should arrange to do periodic surveillance using simple questionnaires and employees should do self-checks, after basic and appropriate awareness training. (Note: self checks are not sufficient on their own to comply with the law, but a method to ensure earlier detection)
• periodic samples may be collected directly by employees, e.g. urine, to check whether substances have entered the body and whether they having effects. Individuals are not further examined unless results are “abnormal”.
• medical surveillance is done by professionals and may include questionnaires, examinations and testing of samples: blood, urine, etc.
• baseline surveillance is often required if an employee is to be exposed for the first time to a hazard which has a significant risk of causing health effects. It establishes a baseline for later results.
what information will I get after surveillance?
you will know:
? if the employee is fit to continue in the job
? whether some modification is required to the job
? if the employee is unfit to continue doing the job
This information constitutes the Health Record, and is not the same as the occupational health record, which is confidential.
what exposures may require health surveillance undertaken by Occupational Health?
This section lists the commonest hazards that require periodic health surveillance by occupational health, the justification, the frequency and the arrangements.
Noise
Justification:
• Excessive noise exposure causes cumulative damage to the hearing mechanism in the ear. Exposures ?80dBA averaged over 8 hours are excessive.
• Hearing naturally declines with age. The addition of noise-induced hearing loss can result in serious hearing problems. Noise-induced hearing loss due to work is the commonest work-related disease.
• Primary prevention of excessive noise exposure is by reduction at the source e.g. enclosures. However, this is not always possible and therefore PPE is often used e.g. ear muffs. It should not be assumed that these are sufficient protection.
• Employees that work in situations where hearing PPE is provided should have health surveillance to detect whether abnormal hearing loss is occurring.
• Exposure to ? 80 dBA increases the risk of significant deafness.
Frequency
The surveillance programme is:
? Please refer to separate audiometry guidance
Arrangements
Face-to-face interview and examination by Occupational Health Adviser (OHA):
? When notified by manager or HR
Vibration
Justification:
• Prolonged exposure to vibration can cause an illness known as Hand Arm Vibration Syndrome - HAVS (formerly known as Vibration White Finger). HAVS affects the blood vessels, nerves and muscles, ligaments and joints of the hand, arm and neck.
• If not identified early, it can lead to permanent disability, loss of sensation and permanent pain. It has no known cause apart from exposure to vibration.
• Early detection and removal from vibration work normally leads to disappearance of the symptoms. There is no effective treatment apart from ceasing vibration work. HAVS is an industrial injury and is reportable under RIDDOR.
• All individuals exposed above the HSE Action Level require surveillance by law (see Safety First, Second Nature website for guidance on Action Level).
Frequency
The surveillance programme is:
? Please refer to separate vibration guidance
Arrangements
Questionnaire followed by face-to-face interview with Occupational Health Adviser (OHA) if problem identified.
? When notified by manager or HR
Working Hours
Justification:
• There is no evidence that working more than a specified number of hours is detrimental to health. There is evidence that some medical conditions can be made worse or exacerbated by night work, although no specific medical factor rules is out.
• For the purposes of surveillance, night work is a normal course of work which includes at least three hours between 11.00 p.m. and 6.00 am. The normal course of work means a majority of days on a regular basis and would normally include those on a rotating shift. Young workers under 18 yrs are who work any time between 10.00 p.m. and 6.00 are included.
Frequency
The surveillance programme is:
? Before assignment to night work
? every 3 years to age 45; every 2 years to age 60; every 1 year thereafter, whilst night work continues
? When a significant medical condition occurs which may affect fitness e.g. diabetes
? All night workers after illness lasting >1 month
Arrangements
Questionnaire followed by face-to-face interview with Occupational Health Adviser (OHA) if problem identified.
? When notified by manager or HR
Breathing Apparatus
Justification:
• Full breathing apparatus (Full BA) requires the chest to function in a different way to the normal. Normally, the active (chest muscle) part of breathing is breathing in. The natural, elastic recoil of the chest facilitates breathing out.
• With full breathing apparatus, the active part is breathing out against the expiration valve. Breathing in is the passive part, the “push” being supplied by the gas pressure. In some systems, positive “resistance” is needed to control the expansion of the chest against the gas pressure, further increasing the strain of using Full BA. Overall, breathing is much more tiring with Full BA.
• Individuals who have medical conditions, which affect the lungs, can experience problems with full BA. Their condition can become worse. Also, because the heart is in the chest, those with heart and circulation problems may suffer significant difficulties with using Full BA, because of changes in pressure in the chest.
• As we grow older our lung function decreases and when this is added to damage, that may have been done by other agents (e.g. smoking), the lungs become more “rigid” and greater effort is required to move them. The additional stress of Full BA may then cause problems.
• Some people naturally cannot tolerate a mask on their face and can become very anxious and over breath, resulting in early exhaustion of the gas supply and reduced concentration and safety on the job.
Frequency
The surveillance programme is:
? Before starting Full BA work
? Every 3 years until 45
? Every year until retirement
? After any significant illness which may affect fitness e.g. chest infection
? After illness that lasts >1 month.
Arrangements
Face-to-face interview and examination with Occupational Health Adviser (OHA):
? When notified by manager or HR
Confined Spaces
Justification:
• Confined spaces may contain toxic gases, be dusty, be very limited in space to enter, move around and exit, be poorly lit and be noisy.
• Individuals with lung, heart and circulation problems may be adversely affected by toxic gas and dust exposure. Those with problems with muscles, ligaments and joints may be unable to move around, adopt safe working positions and escape in an emergency. Those that are overweight may not be able to safely enter or exit the space.
• Some recurring medical problems are easy to deal and compatible with working in a low hazard environment e.g. an office. However, if the condition occurs in an environment where access for medical support is difficult or further harm can be done e.g. epilepsy, confined spaces entry carries a high risk.
• Some people naturally have difficulty with entering a confined space, and will manifest behaviour which may be unsafe e.g. claustrophobia.
Frequency
The surveillance programme is:
? Before initial training for confined space entry
? Every 12 months during confined spaces refresher training
? After any significant illness which may affect fitness e.g. heart attack, chest infection
? After illness that lasts >1 month.
Arrangements
Questionnaire completed by employee and assessed by OHA:
? When attending confined spaces training
? When notified by manager or HR
Forklift Drivers
Justification:
• Forklift truck (FLT) drivers operate often in confined spaces. Annually 20 deaths and 5000 injuries occur each year. 45% of accidents are caused wholly or partly by driver error.
• FLT drivers need to be carefully selected, trained and supervised. Safe control and operation requires a reasonable degree of mental and physical fitness. Persons with disabilities are necessarily excluded, but a functional assessment is required.
Frequency
The surveillance programme is:
? Before starting FLT driving duties.
? Age 40 and at 3 yearly intervals thereafter until 60. (WorkFit guidance)
? After and injury or illness that may affect fitness e.g. eye disease, impairment of upper limb function.
? After illness that lasts >1 month.
? After an accident where the driver’s ability to driver may be impaired or where medical reasons may have caused the accident.
Arrangements
Face-to-face interview and examination with Occupational Health Adviser (OHA):
? When notified by manager or HR