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    What is health surveillance?

    Published on March 2nd, 2020 | by Sophie West

    One of the most common questions that we get is “what is health surveillance, and do I need to do it?” Health surveillance is a system of ongoing health checks. It allows for early identification of ill health and helps identify any corrective action needed.

    Health surveillance assesses the effectiveness of personal protective equipment (PPE) and is another element that helps to make sure that the workplace is free from anything that can cause detriment to mental or physical health, both in the immediate future and the long term.

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

    Health surveillance is important for:

    • Identifying ill-health effects at an initial stage, so employers can establish better controls to prevent them getting worse.
    • Providing data to help employers evaluate health risks
    • enabling employees to raise concerns about how work affects their health
    • highlighting lapses in workplace control measures, therefore providing invaluable feedback to the risk assessment
    • providing an opportunity to reinforce training and education of employees ( e.g. on the impact of health effects and the use of protective equipment)

    Your risk assessment should be treated to recognise any need for health surveillance.  You shouldn’t use health surveillance as a substitute for undertaking a risk assessment or using effective controls.

    Health surveillance can often be utilised to help detect what requirements need to be taken to control risks  or potential hazards that are effecting the employee. Seeing what premature signs of work-related ill health are identified, employers should take action to prevent additional harm and protect employees.

    Consider health surveillance if your employees are at risk from:

    • Hazardous substances solvents, dusts, fumes, chemicals, biological agents and other substances hazardous to health.
    • Asbestos, lead or work in compressed air or ionising radiation.
    • Physical agents such as noise, hand-arm vibration, whole body vibration, driving, working at heights or working in confined spaces.

    Control measures cannot always be dependable and trustworthy, regardless of suitable inspection and maintenance, so health surveillance can help make sure that any ill health effects are detected as early as possible.

    Can you afford not to implement health surveillance?

    Many SME business owners are concerned that this process will be too expensive and take a large chunk out of their operating budget, but in reality the failure to assess workplace hazards will cost them money rather than help them save. Just as you would never neglect to properly train your employees, or wouldn’t dream of skimping on the materials that you use in your industry – you should not disregard the importance of a healthy workplace on your bottom line.

    Do I need health surveillance?

    A health surveillance system can highlight hazards in your workplace that are not properly being controlled. In addition, they can recommend effective strategies that can help you to reduce these hazards.

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

    • If there is a specific ill-health cause which evidentially links to a workplace exposure.
    • it is probable that an ill-health impact may arise.
    • there are effective procedures and methods for identifying early signs of ill-health.
    • These practices do not cause/present a risk to employees.

    Remember – it’s the law, and ignoring this can result in hefty fines

    If you are not motivated by the benefits of implementing a health surveillance program, perhaps you should consider the repercussions of neglecting to pay attention to this issue. Recent case studies have profiled SMEs who have neglected the government’s HSE guidance and felt the full weight of monetary punishment – here is a case study of a Gloucester based firm that ignored the cause of an employee’s asthma and were fined 100,000 pounds (page 11).

    What sort of health surveillance do I need?

    Health surveillance could include employees themselves for signs or indications of ill health following a training session on what to look for and who to report symptoms to. For instance employees observing tenderness, inflammation and itching on their hands and arms, where they work with substances that can aggravate or cause harm to the skin.

    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 glucose, urine analysis and blood pressure
    • Physical tests – such as musculoskeletal function, height, weight and BMI.
    • Confidential health questionnaires which are industry specific and require a detailed recorded history.
    • Face fit testing – making sure they are the right fit for the individual.

    A responsible individual can be trained to make sure there are sufficient checks on a regular basis, such as skin examinations or signs of outbreaks and could be either a manager, line supervisor, or first aider. For more complex assessments, an occupational health nurse (OHA) or an occupational health doctor (OHP) can ask about any indications or problems around any issues, or can carry out periodic inspections.

    HSE can advise on what is needed for any specific industry and guidance, this will include advice on what certain jobs could require health surveillance and what is expected in response to this information.

    Fitness-to-work assessments

    In addition to monitoring any ill-health effects that could be related to work exposures, it is good practice to also ensure that staff do not have a health condition that could be detrimental to them working in particular roles. We can provide a fitness-to-work letter which can be produced by a professional within occupational health, for instance an Occupational Health Advisor. Where if any health conditions may cause difficulties when working at heights or in confined spaces or wearing respirators. Health conditions can also have harmful effects and can have dangerous implications on specific driving roles such as fork-lift trucks, cranes, lorry drivers and mobile elevated working platforms (MEWPS), even in secondary roles such as first aider and emergency responder. Using fitness to work letters and assessments implements good practice which can benefit and support helping to follow certain standards.

    What next?

    If a risk assessment indicates that you need to use health surveillance, you will need to put a program in place that looks at the highlighted risks involved. This could be from just to train employees to evaluate themselves for symptoms or signs of ill health. For more complex assessments, an occupational health technician/specialist can carry out questionnaire assessments and perform tests. If you would like anymore information on any of the information above or are considering health surveillance contact us today on  find out how the specialist team at Fusion could help you to implement a health surveillance program, contact us today on 01527 571615 or email are Occupation Health Technician at

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