Health surveillance

1. What is health surveillance?

Health surveillance is any activity that involves getting information about an employees' health to help protect them from health risks at work. Some are required by law (health surveillance) and others are carried out as good practice (health checks).

Workplace control measures may not always be totally reliable. Carrying out health surveillance can help make sure that any potential ill health effects are detected as early as possible.

It is not a substitute for other measures to control exposure such as

• improved processes
• elimination of exposure
• good management practice.

All other measures to protect workers should be tried first.

Some professions require statutory medicals which are not detailed here, such as

• divers
• pilots
• HGV drivers
• offshore workers
• those exposed to asbestos
• safety critical work – such as tower crane operators.

The Health and Safety Executive (HSE) have guidance on statutory medical examinations​.​​

​Purpo​se of health surveillance

The purpose is to maintain and protect the health and safety of employees. This is by early detection of adverse changes to health as a result of workplace exposures. This can help you

• evidence the effectiveness of existing control measures
• identify where they may still be having an impact on employee health.

This film shows various professionals speaking about employers’ responsibility to manage occupational health conditions.​

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When it is it required

Some employees may need to take part in a health surveillance programme as part of their existing contract. This could include baseline (recorded at the start of employment), ongoing and exit health surveillance. It may also be required as a result of potential hazardous exposures at work.

It can include various types of tests.

• Skin examination.
• Hand and arm or full body vibration tests (HAVS).
• Lung function tests - such as peak flow and spirometry.
• Hearing or vision tests – such as audiology or keystone.
• Medical tests – such as blood, urine, ECG and blood pressure
• Physical tests – such as musculoskeletal, dexterity, function, height and weight.
• Confidential health questionnaires which are industry specific and require a detailed recorded history.

Health surveillance may be appropriate if

• it does not pose a risk to the employee
• there is a suitable test available to detect level of exposure
• there is a potential risk of a workplace exposure that may be hazardous to health
• exposure to potential workplace health hazards have been reported or can be detected.

You can find out whether your organisation needs health surveillance by using the de​​​cision making map on the HSE site.

​Visit the HSE site to find out if your organisation needs health surveillance

Who can perform health​​​ surveillance

Where specific medical examinations are involved, establish the medical personnel’s knowledge and expertise in these areas. They should be aware of the working environment. You also need to establish who will be responsible for interpreting the results.

Occupational health personnel can include

• physicians
• advisors
• technicians.

They can perform health assessments and carry out medical examinations. They may also carry out

• confined spaces medicals
• night workers assessment
• drivers medicals, such as LGV and fork lift trucks
• assessments for new employees within the organisation or those changing roles
• assessments for young workers, such as new apprentices, students or those under 18.

Employees may be able to help if they are

• trained
• competent
• accredited.

They can organise and carry out basic health checks such as questionnaires.

You can download our health surveillance employer’s pack for more information.

Go to our health surveillance employer’s pack publication

Carry out a risk assessment

The starting point is to carry out a risk assessment. This will help identify

• hazards
• who is at risk
• control measures
• what level of health checks or surveillance is required.

If you find that your employees’ health may be at risk, you are advised to update or review your risk assessments and put control measures in place.

Find out how to carry out a risk assessment

Hazardous substances

A common reason for carrying out health surveillance is due to potential exposure to hazardous substances that could be damaging to health. These can be

• biological agents such as fungi, bacteria, viruses
• natural substances such as grain, flour or enzyme dusts
• substances generated by work, such as soldering or welding fumes, or wood dust
• chemical products used or produced at work, such as adhesives or cleaning agents.

You can find out more about this in our hazardous substances guide​.

Fin​d out more

You can find out more about health surv​​eillance on the HSE website.

Visit the HSE site to find out more about health surveillance​