The Control of Substances Hazardous to Health Regulations and the Management of Health and Safety Regulations require employers to make an assessment of the risks that their employees are exposed to which may affect their health, including respiratory sensitisers and irritants. The risks should be controlled and monitored and, where appropriate, health surveillance should be undertaken. The decision to carry out health surveillance would stem from pinpointing potential health hazards during a risk assessment, and measurable health outcomes.

Occupational health surveillance is distinct from general health screening and health promotion. It involves watching out for early signs of work-related ill health in employees exposed to certain health risks. Such risks could be exposure to noise, vibration, ionising radiation, asbestos, lead, fumes, dusts, biological agents, solvents or any other substances that could be hazardous to health.

Health surveillance is necessary when:

  • there is an identifiable disease or adverse health effect associated with the exposure to the substance/s in the workplace, for example, dermatitis, cancer or asthma;
  • it is possible to detect the disease/adverse health effect;
  • the techniques for detecting the disease/adverse health effect pose no risk to employees.

The aim of occupational health surveillance is not only to carry out tests, questionnaires or examinations, but to interpret these results and take action to eliminate or control further risk where necessary. The findings can also provide some reassurance that control measures are effective.

Health surveillance may also involve employees self-checking for signs or symptoms of ill health associated with workplace risk. In this case, a training session should be carried out to ensure employees are looking out for the correct signs and symptoms, and know of the appropriate action to take should they detect these signs or symptoms.

Alternatively, a staff member could be trained to carry out such checks. For more complex assessments, an occupational health nurse or doctor can carry out examinations or ask about symptoms.

Statutory medical surveillance (that must be carried out by a doctor appointed by the HSE) is required to be part of the health surveillance /medical programme by law when certain high-hazard substances are present in the workplace. These substances include:

  • some forms of asbestos;
  • lead;
  • ionising radiation;
  • work within compressed air;
  • work with substances hazardous to health


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