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Health surveillance
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Health surveillance

There is a requirement under health and safety law for work activities to be risk assessed. The risk assessment process helps to identify hazards (activities that could cause harm to health), consider who could be harmed and how, consider the level of risk and decide on suitable control measures that minimise the risk. 

An employer needs to do everything reasonably practicable to protect people from harm. Your line-manager should notify you of any potentially hazardous exposures in your role and also inform you of ways of protecting you from harm (control measures).  It is your duty as an employee to comply with control measures, engage in any required statutory health surveillance programme and let your employer know of any concerns about workplace hazards. As an employee, you should also inform your employer of any health concerns related to your work.

Health surveillance may be required by law if you are exposed to noise or vibration, solvents, fumes, dusts, biological agents and other substances hazardous to health, or work in compressed air.

Significant noise exposure can result in permanent and disabling hearing loss (Noise Induced Hearing Loss). The level at which employers must assess the risk to employees' health, provide them with information and training, and offer hearing protection is 80 decibels. The level at which employers must provide hearing protection and hearing protection zones is 85 decibels (daily or weekly average exposure). 

University employees exposed to this level of noise are required take part in a health surveillance programme. This would involve an appointment in the Occupational Health Service, where a qualified and suitably trained Occupational Health Adviser (OHA) will ask you some questions about your hearing, your noise exposure in previous jobs and any non-work exposure (for example, loud music or riding a motorcycle, which can also cause noise-induced hearing loss). The OHA will then check your ear canals, which is a straightforward non-invasive procedure. Providing there are no contraindications, such as a cold virus or ear infection, a hearing test will then be performed. You will be notified of the results and of any problems detected. The OHA will provide your line-manager with advice on your fitness to work with exposure to noise and of any identified need for adjustments to your work that may be required. This report will not contain any confidential medical information.

Hand-arm vibration is vibration transmitted into your hands and arms when you use handheld powered work equipment or workpieces which vibrate while being processed by powered machinery. It can cause hand-arm vibration syndrome (HAVS) and carpal tunnel syndrome (CTS). HAVS symptoms can become permanent and disabling and it is therefore important to recognise symptoms at an early stage.  Symptoms of HAVS are separated into two main categories. Sensory symptoms can include numbness and tingling in the hands, which can result in reduced strength and loss of dexterity. Vascular symptoms can include well-demarked whiteness to the finders and finding it increasingly difficult to warm up the hands.

Health surveillance for employees who are exposed to hand-arm vibration in their work is a tiered system:

Tier 1

This is pre-placement or baseline assessment and will require you to complete a questionnaire about any symptoms affecting the hands, arms and upper limbs, any relevant health history, and about your exposure to hand-arm vibration in previous jobs. As this will be your first such assessment at the University, you will have an appointment with a qualified and suitably trained Occupational Health Adviser (OHA). The OHA will go through your questionnaire with you, look at your hands and do some basic tests (including grip strength and dexterity tests). The results and any recommendations will be discussed with you. The OHA will provide your line-manager with advice on your fitness to work with vibrating tools/equipment and of any identified need for adjustments to your work. This report will not contain any confidential medical information. If no problems have been detected, you will be asked to complete a Tier 2 questionnaire in 12 months. If problems are detected, you will be asked to undertake a more detailed Tier 3 assessment or be referred directly to the Occupational Physician for Tier 3 and 4 assessments (see below).

Tier 2

This is an annual check that involves completion of a questionnaire, asking about any symptoms since your previous assessment. You will be asked to return the completed questionnaire to the Occupational Health Service (OH).  If you have reported symptoms, you will be sent an appointment to discuss this with an OHA and for completion of a more detailed assessment. If you are symptom-free you will be asked to repeat the Tier 2 questionnaire in a further 12 months. After three years of reporting no symptoms, you will be given an appointment with an OHA for review.

Tier 3

This can follow either a Tier 1 or 2 assessment, where symptoms are reported, or in between assessments if you develop symptoms. Tier 3 involves a closer examination of the hands and a range of non-invasive tests. This would be undertaken by a qualified and suitably trained OHA or an Occupational Physician (OP) who have undertaken training in HAVS. The OHA or OP will provide your line-manager with advice on your fitness to work with vibrating tools/equipment and of any identified need for adjustments to your work. This report will not contain any confidential medical information.

Tier 4

This would be an assessment and diagnosis by an OP (with training in HAVS). The OP will discuss with you any recommended adjustments to your work activities and provide your line-manager with advice on your fitness to work with vibrating tools/equipment and of any identified need for adjustments to your work. This report will not contain any confidential medical information.

If your role at the University involves working with respiratory irritants, sensitisers or other potential hazards from inhalation, there is a requirement to work within the Control of Substances Hazardous to Health (COSHH) Regulations.  Your line-manager should inform you of the results of any risk assessment associated with your role and advise you on suitable control measures to protect you from lung damage or disease.

Should the risk assessment indicate a need for it, you will be asked to attend the Occupational Health Service (OH) to meet with one of the Occupational Health Advisers (OHA).  The OHA will ask you to complete a questionnaire about allergies, any respiratory symptoms you have experienced/are experiencing, relevant health history and any exposure to respiratory irritants and sensitisers in previous jobs.  The OHA will check if there any contraindications to perform a lung function test (spirometry) such as very high blood pressure or recent surgery.  If there are no contraindications, spirometry will be performed.  The OHA will then explain the results to you.  Your line-manager will be provided with advice on your fitness to work with exposure to respiratory irritants and sensitisers and of any identified need for adjustments to your work that may be required.  This report will not contain any confidential medical information.

If any problems have been detected, the OHA may refer you to either your GP or the Occupational Physician (or both).

If your role at the University involves working with skin irritants or sensitisers, there is a requirement to work within the Control of Substances Hazardous to Health (COSHH) Regulations.  Your line-manager should inform you of the results of any risk assessment associated with your role and advise you on suitable control measures to protect your skin from damage or disease.