The HSE describes health surveillance as 'putting in place systematic, regular and appropriate procedures to detect early signs of work-related ill health among employees exposed to certain health risks, and acting on the results’.
For employers, this means completing regular health assessments for your workforce where a risk has been identified. Those assessments should be directly linked to the attendant hazards.
For example, if employees are exposed to high levels of noise, then your employee should have regular audiometry tests. To be done effectively, this kind of occupational health (OH) work often requires face-to-face appointments, but understandably the HSE put this on hold to safeguard everyone at the height of the pandemic.
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The problem with health surveillance is that it is not everybody's idea of a thrilling subject and too often is viewed as a tick box activity - with potentially catastrophic consequences.
Just weeks ago, manufacturing giant Saint Gobain was fined half a million pounds after several of its workers were diagnosed with hand-arm vibration syndrome (HAVS). Two key things led to Saint Gobain's issues - failure to act on health surveillance information and having 'inadequate' health surveillance in place.
The ‘failure to act’ point is crucial, as health surveillance depends on everyone understanding their responsibilities. Managers or health and safety representatives must be conducting suitable and sufficient risk assessments. They must inform occupational health or management of the need for health surveillance, ensure all employees are registered on the appropriate health surveillance programme, recording and maintaining health surveillance results, and ensure prompt referral to OH if employees report ill-health symptoms relating to their working environment.
Meanwhile, occupational health providers must ensure the level of health surveillance is appropriate, report the results of all health surveillance carried out back to the employer, refer for appropriate clinical interventions, and advise about necessary workplace restrictions.
It is also important for OH professionals to report any occupational diseases identified through health surveillance to the HSE. Any breakdown in this vital chain of communications leaves employees at risk and employers open to heavy fines and future litigation.
The second charge levelled at Saint Gobain was its 'inadequate' health surveillance, and this is something we are encountering more and more, from companies of varying sizes, from smaller SMEs to blue-chip businesses.
Keen to put a tick in the box, people are failing to ensure health surveillance is undertaken by accredited OH providers and fully qualified individuals and are therefore not getting the right advice. Anecdotally, we have even heard cases of local GPs offering health surveillance to companies.
Health surveillance is a legal requirement if you have employees who are exposed to specific workplace hazards, such as noise, vibration, radiation, asbestos, lead solvents, fumes, dust and many other substances hazardous to health. It is required for an ever-growing list of classifications of substances or environments and the knowledge to deal with this does not fall under a general practitioner's remit.
By its very nature, health surveillance requires specificity and the ability to relate to a particular aspect of health or health risk. The HSE does not take it any easier on employers just because they have some form of health surveillance in place. If it is inadequate or advice is not acted upon, the fines will be the same.
Although, after a hugely testing year, most companies – and people – want to return to business-as-usual, there will be a backlog in health surveillance, and it cannot wait.
Health surveillance specialists have spent the last year adapting their services and undertaking risk assessments to ensure that, once the HSE deemed it appropriate, professional health surveillance assessments could begin again in a Covid-secure way.
With the HSE’s grace period at an end and the threat of heavy fines returning, it makes sense to seek the advice of a fully trained and medically qualified team to deliver assessments onsite at your company, at times to suit you and your employees, to ensure your workforce is fit to work, and that you, as an employer, are fully compliant.
Phil Jackson-Taft is lead occupational health nurse at OH One