Hello

,I'm seeking advice on handling a specific situation regarding a mandatory health screening for a forklift driver in the UK.

I have an employee who is an experienced forklift driver and has a confirmed diagnosis of COPD (Chronic Obstructive Pulmonary Disease).

The Situation:

1. We conduct yearly health screenings for all our forklift operators, which includes a respiratory to assess fitness 

2. The employee currently refuses to undergo our company's on-site respiratory test

3. The employee confirms that he undergoes a full, annual respiratory function test at the hospital as part of his ongoing COPD management

The Question:

Given that we cannot legally force him to take our test:

Can I legally and safely accept his most recent yearly hospital respiratory test results in lieu of the company's screening test, and consequently sign him off as medically fit to operate the forklift?

My Proposed Solution (Seeking Confirmation):

1. Ask the employee for written consent to share his recent hospital test data with our company's Occupational Health (OH) provider

2. Have the OH provider review the hospital's spirometry results and the relevant medical reports

3. Have the OH provider issue a formal "Fit for Work" certificate specifically for the forklift role, based on the external data

Is this the most reasonable and legally defensible course of action under HSE guidelines (and considering the Equality Act 2010)? Are there any specific pitfalls or documentation requirements I should be aware of?

Any professional insight would be greatly appreciated. Thank you.

A medical diagnosis is different from OH surveillance or medical screening. The first is an examination to establish  what is “wrong “ with a particular person and what treatment they might require. This will not be shared with an employer nor would your OH people be able to accept this diagnosis since they don’t “own” it.  Based on that if your employee is refusing to   accept your screening programme then you have no choice but to sack them as you cannot prove that your work is not  causing ill health except… we are not clear why your FLT drivers are having this test in the first place. Is it a fitness to work test, so that you need to know that they are capable of operating a FLT eg eyesight(which can be corrected  with spectacles) or hearing( which you can do something about) or musculoskeletal issues( which might it make it difficult  for them to drive) etc. Not sure how a lung function tests fits in with this reasoning.

The other reason for the testing is health surveillance ie there is something in the job that is could cause health issues  for the employee and you need to confirm that the controls that you have introduced are actually working. So why are you asking the employee for a lung function test so they can drive a FLT?

I am curious as to how respiratory checks determine the "fitness" of an FLT driver who is presumably sat down most of their working hours? Respiratory checks typically undertaken where the process presents airborne hazards to employees and used to validate the effectiveness of control measures against dust and/or sensitisers.

So long as they are following medical advice and their health is not in free fall (frequent and recurring absence) I am struggling to understand why you need a piece of paper which like an MOT is only valid on date and time of issue.

What is the perceived danger or hazard with someone you currently have driving an FLT continuing to do so?

If they drive to work then they must have notified the DVLA. Suitable for road driving suitable for FLT.

Thank you all for your feedback.

We are asking the employee for a lung function test because our recent Air Monitoring Assessment results concluded that "operatives in this area are likely to be exposed to significant concentrations of Inhalable Dust—specifically, concentrations greater than 25% of the exposure limit (COSHH Trigger Value, or CTV)". 

Based on that information I would be focusing on controlling the dust that will be making everyone ill.

Originally Posted by: peter gotch

Hi Vera

Your last comment provides some more context and I wonder whether your FIRST step should be about considering whether the CONDITIONS are as safe as reasonably practicable before homing in on and individual worker's fitness to do their job.

I don't think that the idea of a Control Trigger Level is included in legislation or HSE guidance but seems to be a construct by occupational hygienists (a construct that I think has merit), so see e.g. Low-Toxicity-Dusts-and-Good-Control-Practice-11_08_21.pdfgeometry dash lite

So, in the absence of a specific Workplace Exposure Limit for any particular dust EH40 sets levels of 10mg per metre cubed for inhalable dust and 4mg per metre cubed for respirable dust and EH40 does comment that this automatically "triggers" the application of COSHH.

But then it is case of considering how much BELOW that "trigger" an employer should be thinking about what controls to put in place, with the BOHS paper linked above setting out some of the positions taken by some organisations.

Hence, may be your first step should be to assess what types of dust your workforce are exposed to and whether there are relatively easy ways of further reducing exposure. 

As with many COSHH type scenarios, there are circumstances where you can conclude that you don't have a problem and so don't need to do much, circumstances where you clearly have a problem and need to take action and the ones in the middle where you need the best evidence to help you decide what to do. 

....and you appear to be in that border line zone. May be you need MORE evaluation of the status quo, and detailed consideration of the pros and cons of various options for further mitigation.

Before focusing on an individual’s fitness for work, the first priority should be evaluating whether conditions are as safe as reasonably practicable. Assessing the type and level of dust exposure, even below WELs, and considering practical control improvements is key. The concept of a Control Trigger Level, while not legally defined, can help guide decision-making in that grey area where exposure isn't clearly safe or unsafe.

Originally Posted by: Roundtuit

I am curious as to how respiratory checks determine the "fitness" of an FLT driver who is presumably sat down most of their working hours? Respiratory checks typically undertaken where the process presents airborne hazards to employees and used to validate the effectiveness of control measures against dust and/or sensitisers.

So long as they are following medical advice and their health is not in free fall (frequent and recurring absence) I am struggling to understand why you need a piece of paper which like an MOT is only valid on date and time of issue.

What is the perceived danger or hazard with someone you currently have driving an FLT continuing to do so?

If they drive to work then they must have notified the DVLA. Suitable for road driving suitable for FLT.

That is a good question, let me break it down so that you get a better understanding of the reasons behind it…

Why respiratory checks get linked to FLT drivers?

• Respiratory checks (spirometry, questionnaires, etc.) are usually tied to health surveillance under COSHH (dusts, fumes, sensitisers) – not the actual role of driving.
• If an FLT driver’s role includes exposure to dust, exhaust emissions, isocyanates, flour, wood dust, welding fumes, etc., they may get pulled into the surveillance programme.
• If there are no such exposures, respiratory checks for the driver role alone don’t make much sense.

 “Fitness” in an occupational health sense

• Employers sometimes ask for “FLT medicals” or “fitness certificates.” These are not a statutory requirement in the same way as, say, an HGV licence medical.
• HSE guidance says it’s about ensuring someone can operate equipment safely – e.g. no conditions that would cause sudden incapacity (blackouts, severe breathing difficulty, uncontrolled diabetes, epilepsy).
• For FLT drivers, the biggest concerns are:
  • Ability to see, hear, and react.
  • Not being at risk of sudden loss of consciousness.
  • Being able to sustain alertness and attention.
• Respiratory function only really becomes relevant if the workplace is physically demanding (climbing, manual handling) or if reduced lung function could increase risk in emergencies (e.g. evacuation from cab in a fire).
  • Although in this example dyspnoea (shortness of breath) is a potential issue to driving the FLT – COPD potentially aggravated by the workplace dust

The “MOT” point you raise

• You’re right – any assessment is only valid for the day it’s done. Someone could be fit today and unfit tomorrow.
• What health surveillance and fitness checks actually do is:
  • Create a baseline record of health.
  • Identify early trends (e.g. spirometry picking up declining lung function before symptoms are obvious).
  • Provide evidence that the employer has taken reasonable steps under health and safety law.
• It’s more about systematic monitoring than a one-off guarantee.

DVLA comparison

• If someone is fit to hold a driving licence, they are generally fit to operate an FLT – but:
  • DVLA standards apply to road safety, not workplace-specific hazards.
  • An employer has separate duties under COSHH etc to ensure workers are medically fit for the particular environment.
  • For example, someone with moderate asthma might drive fine on the road but could deteriorate badly if exposed to warehouse dusts.

So what’s the actual hazard with letting someone carry on driving?

• If there are no respiratory exposures, probably none – and the medical adds little.
• If there are exposures (dusts, fumes, sensitisers), the risk is long-term health deterioration and possible acute attacks while driving.
• In practice, many companies commission “FLT medicals” more as a liability shield than because HSE mandates them – it demonstrates they’ve considered fitness-to-operate in case of an incident.