Health Surveillance Legal Requirements

April 8, 2013

The purpose of routine monitoring of the health of employees is to detect any adverse health effects arising from exposure to hazards in the workplace. The following health surveillance techniques can be applied to fit within the overall risk prevention programme.

• Examination of accident, ill health and absence records
• Examination of pension records
• Inspection of readily-detectable conditions by a suitably competent person
• Enquiries about symptoms by an occupational health nurse or suitably-qualified occupational physician
• Medical surveillance by a suitably-qualified occupational physician
• Direct measurement of adverse health effect
• Biological effect monitoring
• Biological monitoring.

Employers’ Duties

• Under the Health and Safety at Work, etc Act 1974, employers have a general duty to ensure, so far as is reasonably practicable, the health, safety and welfare at work of all employees.
• Under the Management of Health and Safety at Work Regulations 1999, employers must assess the risks to the health of their employees presented by all aspects of work.
• Before they employ a young person (under the age of 18), employers must undertake a specific risk assessment in relation to the health risks the young person will be exposed to in the course of his or her work.
• If more than five people are employed, the significant findings of the risk assessment must be recorded.
• Following the risk assessments, employers must take appropriate steps to reduce the risks to the health of their employees as far as is reasonably practicable, i.e. implement appropriate risk control measures.
• Employers must inform their employees, and others affected by employees’ work, of the findings of the risk assessment and the steps being taken to reduce the risks to their health at work.
• Employers must provide suitable training and information to their employees to enable them to comply with the risk control measures being implemented.
• Employers must monitor the implementation of risk control measures and manage non-compliance to reduce the risks to employee health to the lowest practicable level.
• Employers must provide appropriate health surveillance if the risk assessment identifies such a need.
• Employers must act on the significant findings of any health surveillance and reduce the risks to employee health from exposure to health hazards.
• Employers must appoint one or more competent persons to assist them in carrying out health risk assessments and health surveillance.

Statutory Health Surveillance Requirements
The provision of health surveillance, sometimes termed medical surveillance, is a requirement of the following regulations:

• The Management of Health and Safety at Work Regulations 1999 (MHSWR) require that every employer shall ensure that employees are provided with such health surveillance as is appropriate to the risks to their health and safety, as identified by the risk assessment.
• The regulations do not specify for how long the records of health surveillance are to be retained.
• The Control of Substances Hazardous to Health Regulations 2002 (COSHH) require that where it is appropriate for the protection of the health of employees who are, or are liable to be, exposed to a substance hazardous to health, the employer shall ensure that such employees are under suitable health surveillance.
• Health surveillance is to be applied to specified processes, such as chrome plating, and to substances where there is a reasonable likelihood of adverse health effects and where there are valid techniques for detecting such effects. The records of such health surveillance are to be retained in a suitable form for at least 40 years after the date of the last entry.
• The Control of Lead at Work Regulations 2002 require that every employee who is, or is liable to be, exposed to lead shall be under suitable medical supervision if the exposure is likely to be significant or if the relevant doctor so certifies. The regulations specify both the frequency at which medical surveillance tests should be carried out and the types of tests required. As with COSHH, the records of medical surveillance are to be kept for at least 40 years from the date of the last entry.
• The Control of Asbestos Regulations 2012 require that each employee who is exposed to asbestos is under adequate medical surveillance. The regulations specify both the frequency at which medical examinations should be carried out and the types of tests to be required. As with the COSHH and the Lead Regulations, the records of medical surveillance should be kept for at least 40 years from the date of last entry.
• The Ionising Radiations Regulations 1999 require that employees who belong to any of the following categories are under adequate medical surveillance by an employment medical advisor or appointed doctor.
  – Classified persons and persons who the employer intends to classify
  – Employees who have been overexposed and are not classified persons
  – Employees who are engaged in work with ionising radiation subject to conditions imposed by an employment medical advisor or appointed doctor (preventing them from working at all or under conditions with ionising radiation).
• Health records for these employees should be kept for 50 years from the date of the last entry.
• Oil acne or skin cancer must be reported under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995, as amended.

It is therefore prudent, in accordance with the requirements of the MHSWR, to apply suitable health surveillance procedures in industries where adverse health effects are most likely to be observed, e.g. in areas where dermatitis, noise-induced hearing loss or vibration white finger are most likely, or where compliance with the requirements of regulations ultimately relies on the performance of PPE.

Health surveillance should be applied in any work situation where the health of the individual ultimately relies on the performance of PPE such as personal hearing protectors, protective clothing or Respiratory Protective Equipment (RPE).