SHE SC24 - Appendix 1

Health screening is when staff, in certain roles, are screened for any medical condition which could impact their ability to perform this role.

Health surveillance is performed when staff are working with known hazards to ensure these hazards are not impacting on their health.

All activities covered by either health screening and/or health surveillance must be accompanied by a documented risk assessment. As detailed in SHE Code 6: Risk Management, the risk assessment should consider control measures in a hierarchical order. This risk assessment should include health monitoring/surveillance as an additional control measure where control measures higher in the hierarchy may be insufficient to prevent harm to health, but health surveillance is not the primary control measure when working with the hazards detailed in the following tables. Health surveillance should be considered under ‘Administrative Controls’:

Most effective		1. Elimination (can exposure be avoided/removed? e.g. could equipment less noisy be purchased?)
		2. Substitution (can it be substituted for something less harmful? e.g. substance less toxic used?)
		3. Engineering Controls (e.g. adding an acoustic barrier or enclosure to reduce volume of gases, mists released, etc.)
		4. Administrative Controls (e.g. training, health surveillance)
Least effective		5. PPE (as outlined by Safety Data Sheets, manufacturer’s guidance etc.)

The risk assessment should be stored on Evotix Assure and health screening/surveillance recorded under the heading “Conclusion”.

When staff require multiple appointments for health screening/surveillance, the majority of staff will have their assessments completed in one visit.

Health Screening

It is important that staff in specific roles within STFC receive health screening. This will allow early diagnosis of any medical condition or implications of any medical treatment being received to be considered in relation to this role. The roles within STFC which require health screening, their recommended frequency and the assessments undertaken are:

Job role	Legislation and STFC SHE Code	Assessments undertaken	Frequency of assessment
Professional drivers	STFC SHE Code 8: Travel on Council Business	General health questionnaire Urine sample to test for diabetes or other underlying condition Whisper Test Vision Screening Musculoskeletal assessment Blood pressure and BMI	On commencement then every 2 years until age 50, thereafter annually.
Workplace transport operators, e.g. Fork Lift Truck (FLT) drivers, Mobile Elevated Work Platform (MEWP) operators, scissor lift operators, etc.	STFC SHE Code 4: Safety and the Safe use of Work Equipment	General health questionnaire Urine sample to test for diabetes or other underlying condition Whisper Test Vision Screening Musculoskeletal assessment Blood pressure and BMI	On commencement, every 2 years up to age 50 then annually thereafter.
Operators of cranes > 1 tonne	STFC SHE Code 26: Safe us eof Lifting Equipment and Lifting Accessories	General health questionnaire Urine sample to test for diabetes or other underlying condition Whisper Test Vision Screening Musculoskeletal assessment Blood pressure and BMI	On commencement then annually thereafter.
Working at height with no edge protection or fall arrest system in place. For example, e.g. use of ladders above average ceiling height (2.4m) with no fall arrest system in place, erecting scaffolding or mobile scaffold towers, etc. Note: This does not include working below average ceiling height (2.4m) from work platforms, stepladders or kick stools, etc.	STFC SHE Code 9: Working at Height. Working at Height Regulations 2005	General health questionnaire Urine sample to test for diabetes or other underlying condition Vision and hearing checks Musculoskeletal assessment Blood pressure and BMI Lung function test	On commencement, every 2 years up to age 50 then annually thereafter.
Confined space workers	STFC SHE Code 11: Work in Confined Spaces. Confined Spaces Regulations 1997	General health questionnaire Urine sample to test for diabetes or other underlying condition. Vision and hearing checks Musculoskeletal assessment Blood pressure and BMI Lung function test	On commencement, every 2 years up to age 50 then annually thereafter.
Night worker. All employees who undertake at least 3 hours of night work on a regular basis. All shift workers.	Working Time Directive and Working Time Regulations 1998. Employers are required to ensure workers are fit for night work and are required to offer a free health assessment on a regular basis.	General health questionnaire Urine sample to test for diabetes or other underlying condition Blood pressure	On commencement then annually thereafter.
Lone worker as defined in STFC SHE Code 1, together with a known pre-existing health condition, e.g. epilepsy, heart condition, diabetes, etc. which could affect their ability to work safely alone.	STFC SHE Code 1: Lone Working	General health questionnaire Urine sample to test for diabetes or other underlying condition Blood pressure	On commencement and then annually thereafter.
High altitude worker (Visiting or working at site located at or above 10,000ft (>3,000m))	STFC SHE Code 8: Travel on Council Business.	Currently under review	This must be booked with Occupational Health a minimum of 6 weeks prior to travel.
Underground worker Working more than 1km underground. Examples of current STFC relevance includes working in Boulby mine	Staff currently receive annual health surveillance from on-site Occupational Health service provided by the mine owners/operators.

Health Surveillance

Health surveillance may be required when working with certain hazards. Despite the risk assessment identifying control measures, with emphasis on the control hierarchy, where there is still potential for exposure a health surveillance programme may be required for the individual to monitor for any signs of emerging ill health so that prompt action can be taken.

Health surveillance is required if all the following criteria are met:

there is an identifiable disease/adverse health effect and evidence of a link with workplace exposure
it is likely the disease/health effect may occur
there are valid techniques for detecting early signs of the disease/health effect
these techniques do not pose a risk to employees

If you are unsure to the extent of your exposure to any substance detailed below, please contact SHE Group.

Hazard	Legislation and STFC Code	Potential health effect	Examples (not an exhaustive list)	Assessments undertaken	Frequency
Asbestos	All work with asbestos is carried out by specialist asbestos contractors – no surveillance requirement for STFC staff.
HAZARDOUS SUBSTANCES Biological agents Occupational activities which may expose staff to hazardous biological agents identified by the COSHH assessment, and hazard grouping.	Control of Substances Hazardous to Health (COSHH) Regulations, 2002 ACDP 4th Edition 2021 Genetically Modified Organisms (Contained Use) Regulations, 2014 ACGM Compendium of Guidance STFC SHE Code 16	Infection, depending on biological agent	Hazard Group 2 pathogens	Consult SHE Group	On commencement Annual review via questionnaire
		Infection, depending on viral agent	Bacteria, viruses, fungi (including yeasts and moulds) and internal human parasites Human blood or tissue culture (includes ancillary support staff) Exposure to viral agents in sewage (e.g. plumbers)	Consult SHE Group Possible Hepatitis vaccination plan	Prior to commencement Periodic boosters as required.
		Infection, depending on GMO and class	Class 1, 2 (or 3) GMOs	Consult SHE Group	Commencement Annual review via questionnaire.
HAZARDOUS SUBSTANCES Chemical agents – dusts, mists, fumes Anyone with any known sensitivity to specific substances or pre-existing relevant health condition such as asthma, COPD, dermatitis, etc. should receive this health surveillance. Note: The Safety Data Sheets and COSHH assessments should be used to identify any requirement for surveillance	COSHH 2002 COSHH Schedule 6 STFC SHE Code 37	Causing occupational dermatitis	Latex Adhesives Solvents	Health questionnaire Skin monitoring Lung function test	Commencement Thereafter annually
	COSHH 2002 COSHH Schedule 6 STFC SHE Code 37	Causing occupational asthma	Latex Isocyanates (e.g. some two-pack paints/adhesives) Wood dusts MDF Rosin-based solder flux fume (colophony)	Health questionnaire Skin monitoring Lung function test	Commencement Thereafter annually
HAZARDOUS SUBSTANCES Occupational Hygiene: Where environmental monitoring, e.g. air or swab samples indicates significant exposure	COSHH 2022 Control of Lead at Work Regulations 2022	Causing recognised systemic toxicity	Lead Mercury Arsenic	HSE appointed doctor for statutory lead medical surveillance Baseline medical examination and blood/urine sample (not later than 14 days after first exposure)	3, 6 or 12 months medical examination and blood/urine sample depending on level of exposure.
HAZARDOUS SUBSTANCES Carcinogenic, mutagenic, reprotoxic and teratogenic chemicals.	COSHH 2002	Adverse health effects with long latency periods	Carcinogens, mutagens, and substances hazardous to reproductive health (CMRs)	In practice valid tests and techniques do not exist but a health record is required for individuals working with these agents.	Health records detail the date work with the agent commences (and on terminates)
HAZARDOUS SUBSTANCES Exposure to animal aeroallergens	COSHH 2002	Causing sensitisation, in extreme cases occupational asthma	Animal secretions in saliva, blood, urine and on fur, dander and bedding (e.g. rodents and some insects)	Consult SHE Group Registration with OH	Initial health assessment Periodic questionnaires – frequency determined by OH
Hypoxic environments Occupational activities for everyone working in an environment of 12-15% oxygen levels. Working in an environment of 15-21% oxygen with any known pre-existing health conditions e.g. heart condition, which could affect their ability to work safely in an atmosphere with lower oxygen levels than normal air (21% oxygen).	Confined Spaces Regulations 1997 STFC SHE Code 11: Work in Confined Spaces	Hypoxia	Working in a sealed chamber where oxygen levels are lower than 21%	General health questionnaire Consultation with OH Physician when initially working in this type of environment Checks of the heart and lungs Urine sample to test for diabetes or other underlying condition	Annual
Ionising radiation Requirement for classified radiation workers to be in a programme of medical surveillance. Line managers notify Radiation Protection Adviser who will inform the Occupational Health Department before anyone begins work as a classified radiation worker	Ionising Radiation Regulations 2017 Approved Code of Practice (ACOP) and Guidance (L121) STFC SHE Code 29: Management of ionising radiation at work	Tissue effects and radiation induced cancers of blood, bone or tissues	Classified radiation workers	Undertaken by an HSE appointed doctor for statutory ionising radiation health surveillance Depends on nature of the work with ionising radiation, the results of dosimetric testing, sickness absence records and individual's state of health General health questionnaire	Prior to designation as a classified worker. Examination confirms fitness to become a classified radiation worker Periodic reviews at least annually or as required by dosimetric testing On cessation of work as required
Noise: Occupational activities which expose staff to upper action value, i.e. exceeding 85 dB(A). Occupational activities which expose staff to lower action value, i.e. between 80-85 dB(A). Staff with previously diagnosed hearing loss, injury to the ear, sensitivity to noise or an underlying health condition such as tinnitus, Meniere’s disease, etc	Control of Noise at Work Regulations 2005 STFC SHE Code 18: Control of noise at work	Noise induced hearing loss, tinnitus, hearing impairment	Working in machine workshops, computer data centres, etc.	Baseline audiometry	Exposed to Upper Action Level: Annually for the first two years and then at three-yearly intervals, although this may need to be more frequent if any problem with hearing is detected or where the risk of hearing damage is high. Exposed to lower action value: On commencement and on cessation of employment, although this may need to be more frequent if any problem with hearing is detected or where the risk of hearing damage is high. Those with pre-existing hearing damage or health condition: frequency will be determined after initial assessment by Occupational Health
Vibration: Occupational activities which expose staff to vibration exceeding 2.5 m/s. For example, using hand held vibrating tools ( grinders and jack hammers); chain saws or pneumatic drills	The Control of Vibration at Work Regulations 2005 STFC SHE Code 4: Safety and the safe use of work equipment	Vibration white finger, upper limb disorders, or Whole body vibration	Staff using hand held vibrating tools. Staff operating FLT or similar vehicle.	General health questionnaire Skin check	Annual

Further guidance can be found on the HSE website (link opens in a new window).

SC24 - Appendix 1
06 Dec 2010

Yes
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Health Screening and Surveillance for commonly encountered health hazards

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