Health Surveillance

Health surveillance means having a system in place to look for early signs of ill health caused by substances and other hazards at work. It includes keeping health records for individuals and may involve routine self-checks, questionnaires or medical examinations to inform the employer (or self employed person) if corrective action is needed.

Health Surveillance is not needed for most workers but in some situations and for some exposures / activities it is required by law.

Much if not all health surveillance is governed by statue and / or Health and Safety Executive guidance. However the frequency and types of surveillance should be entirely governed by exposure to health hazards. So if you are not exposed then you do not need any monitoring.

National Services Scotland

What is Health Surveillance and why is it important 

 - Detecting ill health effects at an early stage so that employers can introduce better controls to prevent them from getting worse.

 - Providing data to help employers evaluate health risks.

 - Enabling employees to raise concerns about how work affects their health.

 - Highlighting lapses in workplace control measures, therefore providing invaluable feedback to the risk assessment.

 - Providing an opportunity to reinforce training and education (e.g. on the impact of health effects and the use of protective equipment)

Health surveillance can sometimes be used to help to identify where more needs to be done to control risks and where early signs of work-related health are detected, employers should take action to prevent harm and protect employees.

 

Skin Health Surveillance

As a healthcare employer that provides high quality patient care we need to ensure that those who provide that care are fit and well, and part of that means looking after our skin.

Work related skin problems are common within the health and social care sector, as employees have to carry out hand hygiene on a frequent basis and their skin can also regularly be exposed to chemicals or other materials used in the manufacture of personal protective equipment (PPE) such as gloves.

NSS cannot eliminate all known risks to the skin health of staff.  Therefore, it is essential that measures are implemented to detect any health problem that might arise through an effective skin health surveillance programme, this allows for preventative action to be taken in order to safeguard the health of the employee. Skin health surveillance also helps inform future risk assessments and control measures and can provide assurance that workplace controls are adequate. 

It is the manager’s responsibility within each area to identify those who require to be part of the skin surveillance programme and ensure there are enough Responsible Persons within their area to complete the required surveillance as per our policy, a link to which can be found below.

Training for Responsible Persons can be arranged through the Occupational Health Department.

If you require additional information you can contact the NSS Occupational Health Advisors through HR Connect Contact Us / Occupational Health

NHS Golden Jubilee

Skin Health Surveillance

As a healthcare employer that provides high quality patient care we need to ensure that those who provide that care are fit and well, and part of that means looking after our skin.

Work related skin problems are common within the health and social care sector, as employees have to carry out hand hygiene on a frequent basis and their skin can also regularly be exposed to chemicals or other materials used in the manufacture of personal protective equipment (PPE) such as gloves.

NHS Golden Jubilee cannot eliminate all known risks to the skin health of staff.  Therefore, it is essential that measures are implemented to detect any health problem that might arise through an effective skin health surveillance programme, this allows for preventative action to be taken in order to safeguard the health of the employee.  Skin health surveillance also helps inform future risk assessments and control measures and can provide assurance that workplace controls are adequate. 

It is the manager’s responsibility within each area to identify those who require to be part of the skin surveillance programme and ensure there are enough Responsible Persons within their area to complete the required surveillance as per our policy, a link to which can be found below.

Training for Responsible Persons can be arranged through the Occupational Health Department.

A learnpro module is also being developed.

Public Health Scotland

Public Health Scotland content is being designed for this page, in the interim please refer to the National Services Scotland Tab for support. 
If you require additional information you can contact the NSS Occupational Health Advisors through HR Connect Contact Us / Occupational Health.
    • RPE - When should my employer provide RPE?National Services Scotland

      The law requires employers to prevent or control the exposure of employees and others (e.g. subcontractors) to hazardous substances at work.

      Before using RPE, exposure should be controlled by other measures (such as local exhaust ventilation), which are reasonably practicable. In other words, RPE should only be used as a last choice of protection when working with hazardous substances such as gases, solvents, powered chemicals, mists and sprays or entering a confined space.

      You could need RPE:

      • While you are arranging to install other control measures.
      • For clearing up a spill.
      • For maintenance.
      • During temporary failure of a control measure at source, e.g. sudden failure of LEV.
      • For cleaning, e.g. low pressure washing of a dusty shed.
      • For short, one-off procedures.
      • When needed in addition to other control measures for safe working.

       

    • Health Surveillance - What needs to be included in a record of health surveillance?National Services Scotland, Public Health Scotland

      What needs to be included in a record of health surveillance?

      Record:

      • The persons name and National Insurance number
      • The substance they are exposed to, and when (start date, frequency of use)
      • The surveillance test that is done on them, and the tester
      • The outcome e.g. passed / retest / failed (but not the test data).

      Remember that a Health Surveillance record is different to a medical record.

      Medical records are generated by a health professional, namely a Dr or Nurse, who is competent as regards the hazard, risks and likely health effects. The information contained in a Medical Record depends on the nature of the medical carried out. ALSO the Medical Record is medical-in-confidence material and it is the responsibility of the health professional that has created it to ensure that nobody else gets access without informed consent from the individual whose medical record it is.

      Further information on health surveillance overview is available.

    • Health Surveillance - What is it?Healthcare Improvement Scotland, National Services Scotland, NHS Education for Scotland, Public Health Scotland, Scottish Ambulance Service

      Health surveillance is a system of ongoing health checks.

      These health checks may be required by law for employees who are exposed to noise or vibration, ionising radiation, solvents, fumes, dusts, biological agents and other substances hazardous to health, or work in compressed air.

      Health surveillance is important for:

      • detecting ill-health effects at an early stage, and ensure better controls to prevent them getting worse
      • providing data to help employers evaluate health risks
      • enabling employees to raise concerns about how work affects their health
      • highlighting lapses in workplace control measures, therefore providing invaluable feedback to the risk assessment
      • providing an opportunity to reinforce training and education of employees (eg on the impact of health effects and the use of protective equipment)

      Risk assessment should be used to identify any need for health surveillance. Health surveillance should not be used as a substitute for undertaking a risk assessment or using effective controls.

      Health surveillance is needed to:

      • protect workers who are at an increased risk
      • identify work-related ill health at an early stage so that steps can be taken to treat the condition and prevent further damage
      • give early warning that protective control measures are no longer effective

      Health surveillance does not reduce the need to eliminate or manage health risks.

      Health surveillance is a particular legal requirement and should not be confused with:

      • activities to monitor health where the effects from work are strongly suspected but cannot be established
      • workplace wellbeing checks, such as promoting healthy living
      • fitness to work assessments such as fitness to drive forklift trucks or health assessments requested by night workers

      Types of Health Surveillance:

      • Animal Allergy - including laboratory animals
      • Hand arm vibration (HAVS)
      • Pathogens or biological agent work
      • Respiratory sensitiser
      • Skin irritants and sensitiser
    • Pre employment - health assessmentsHealthcare Improvement Scotland, National Services Scotland, NHS Education for Scotland, Public Health Scotland, Scottish Ambulance Service

      Many medical conditions and virtually all minor health problems have minimal implications for work and should not be a bar from employment.

      For most jobs no agreed advisory medical standards exist and for many jobs there need be no special health requirements. 

      Where questions about health are included on job application forms this should be only to seek information that may be necessary to enable any modifications to the interview process.  

      The reason for the employment health assessment should be confined to fitness for the proposed job and only medical questions relevant to the employment should be asked.

    • Health Surveillance - When is it required?Healthcare Improvement Scotland, National Services Scotland, NHS Education for Scotland, Public Health Scotland, Scottish Ambulance Service

      Criteria for conducting health surveillance includes when:

      • an individual being exposed to a hazardous substance that is linked to an identifiable disease of adverse health effect
      • there is reasonable chance that the disease or adverse health effect may occur under the conditions of work
      • there are valid techniques of detecting the disease or adverse health effect

      Health surveillance is likely to be necessary where there is exposure to:

      • carcinogens—in practice valid tests and techniques do not exist but the a health record is needed
      • dangerous pathogens, e.g., hepatitis B, HIV and TB
      • certain sensitisers, such as  substances that may cause occupational asthma, e.g., laboratory animals, mineral oils, wood dust, solder fumes
      • substances that may cause dermatitis, e.g., latex
      • noise and vibration
    • Health Surveillance - Roles and responsibilitiesHealthcare Improvement Scotland, National Services Scotland, NHS Education for Scotland, Public Health Scotland, Scottish Ambulance Service

      Manager responsibilities

      • After a carefully conducted, suitable and sufficient COSHH risk assessment inform OH of the potential need for health surveillance
      • Ensure prompt referral to OH if a member of staff reports ill health symptoms that could be related to their working environment, e.g., respiratory/skin problems
      • Ensure that where reasonably practicable any recommendations from OH are implemented

      OH responsibilities

      • Ensure that health surveillance is undertaken on staff identified as requiring it and at the appropriate level, e.g., one off registration for carcinogen work or initial face-to-face assessment and follow up assessment for laboratory animal workers. The level of health surveillance will depend on the assessed health risk of exposure and individual susceptibility.
      • Report the results of all health surveillance carried out and maintain the COSHH Health Record
      • Report any occupational diseases identified through health surveillance to the manager for Accident and incident reporting and investigation through for reporting to the Health and Safety Executive under the Reporting of Injuries, Disease and Dangerous Occurrences Regulations (RIDDOR)
      • Maintain a recall system to ensure that the named contact person is advised when an individual's health surveillance is due as well as supplying information about non-attendees

      Employee responsibilities

      • Comply with the health surveillance programme
      • Early reporting to management and OH any possible work related ill health symptoms