A SENSIBLE APPROACH TO HEALTH SURVEILLANCEIan Waldram & Darrin Hawkes

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HEALTH SURVEILLANCE

DEFINITION:

“SYSTEMATICALLY WATCHING OUT FOR EARLY SIGNS OF WORK-RELATED ILL HEALTH IN EMPLOYEES EXPOSED TO CERTAIN HEALTH RISKS.”

MAY INCLUDE:

• Looking for/asking about signs

• Measurements

• Medical examinations

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SENSIBLE HEALTH SURVEILLANCE

RISK-BASED:IDENTIFY HEALTH HAZARDS (PLAN)

• How does the hazard affect the body?

• Workplace Exposure Limits [WELs] or other Action Points?

IMPLEMENT CONTROLS (DO)

• Prevent exposure(s); control exposure(s)

ARE THESE EFFECTIVE? (CHECK)

• Measure residual exposure(s)

• Look for ill health evidence/indicators

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TYPICAL DEFICIENCIES

NO SYSTEMATIC HEALTH RISK ASSESSMENTS (HRA)

‘RANDOM’ HEALTH-RELATED PROCEDURES

INDIVIDUAL HEALTH SURVEILLANCE DATA ONLY

• No analysis of data, no link to controls

• No systematic feedback to employer

• No formal review, to optimise surveillance

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REPEATED SURVEYS AND ASSESSMENTS,NO IMPROVEMENT ACTIONS

THE RANGE OF HEALTH HAZARDS

PHYSICAL

• Noise

• Hand-arm vibration

• Ionising radiation, diving

CHEMICAL

• Liquid, vapour/fume, gas

DUST

• Asbestos

BIOLOGICAL

PSYCHO-SOCIAL

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A SENSIBLE APPROACH

1. WHO MIGHT BE EXPOSED?

• Identify Similar Exposure Groups (SEGs)

• Review current controls: improvements needed?

2. FOR EACH SEG, ARE LIKELY EXPOSURES SIGNIFICANT?

• Assess/measure ‘reasonable worst case’ exposures

• Consider Health Surveillance unless << WEL

3. CAN SPECIFIC ILL HEALTH SYMPTOMS BE DETECTED?

NEED COMPETENT ADVICE FOR:

• Controls review

• Exposure measurements

• Health Surveillance plan

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OFFSHORE OPERATIONS EXAMPLE

HRA FOR EACH FACILITY (OFFSHORE, ONSHORE)

• Occ. Hygienist for higher hazards

• H&S Advisor for lower hazards

SEGS IDENTIFIED

• Office/generic

• DSE users

• Catering

• Operations

• Drilling

• Maintenance

• Painters

• Cleaners

• Shifts

• NDT

• Medic/First Aiders

• New/expectant mothers

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OPTIMISED SURVEILLANCE

NO EXPOSURES NEAR WEL/ACTION POINT

• Reactive only

APPROACHING WEL/AP

• Workplace monitoring

• Include job-related checks in ‘routine medicals’

AT/ABOVE WEL/AP

• Specific monitoring + 100% health surveillance

• Review results, reduce intensity if no evidence of control failures

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OTHER ESSENTIALS(NOT COVERED BY THIS PRESENTATION)

WORKER INVOLVEMENT, INCLUDING

• Suitable information, instruction, training

• Contractors

‘PERSON ACCOUNTABLE’ FOR THE OVERALL SYSTEM

INTEGRATED HEALTH AND SAFETY

RECORDS

CONTINUAL IMPROVEMENT PROCESS

• Regular reinforcement

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FURTHER INFORMATION

UNDERSTANDING HEALTH SURVEILLANCE AT WORK, INDG304

HEALTH SURVEILLANCE AT WORK, HSG61(3rd edition due April 2011)

Workplace Exposure Limits, EH40

OCC HEALTH SERVICE STANDARDS FOR ACCREDITATION

www.facoccmed.ac.uk/pubspol/pubs.jsp

OCC SAFETY& HEALTH CONSULTANTS REGISTER

www.oshcr.org

HAWKES ASSOCIATES

www.hawkesassociates.co.uk

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