What is health surveillance?

Health surveillance is a system of ongoing health checks. These health checks may be required by law for employees who are exposed to noise or vibration, ionising radiation, solvents, fumes, dusts, biological agents and other substances hazardous to health, or work in compressed air.

The benefits to individuals

Health surveillance enables work-related health risks to be managed effectively.  It can help to reduce the incidence and severity of work-related ill health by:

  • Acting as a check on whether control measures for specific health risks are working;
  • Minimising the severity of individual cases of work-related ill health by earlier identification and better management;
  • Identifying and protecting individuals who may be more vulnerable and at increased risk from other health conditions;
  • Identifying where further action may be needed.

How do we identify where health surveillance is needed?

A suitable risk assessment should be used to identify any need for health surveillance. The risk assessment should identify who may be at risk of exposure, how they may be exposed to the hazard (e.g. by respiratory action, contact with skin, ingestion), and the nature of the residual health risk.

Where health risks are identified, these should be removed or controlled as far as possible first, and the residual risk should be assessed.

Health surveillance methods

Different types of checks will be required for different types of hazards. Assessments can be carried out by an Occupational Health Advisor who can ask about symptoms or carry out an examination or tests such as a lung function or hearing tests.

Health hazards and surveillance techniques


A number of substances can cause harm by respiratory and skin sensitisation typically causing asthma and dermatitis. Substances likely to cause sensitisation can be identified from chemical data sheets and Health & Safety Executive literature and can include: rosin-based solder flux fume, isocyanates, hardwood, softwood and wood composite dusts from wood machining and sanding, plant material and food stuffs, while metalworking fluids can grow bacteria and fungi which could cause dermatitis and asthma.

Respiratory health surveillance

Respiratory health surveillance consists of checking for signs and symptoms using a questionnaire and performing lung function tests. Health checks are undertaken by an Occupational Health Advisor and should be done before exposure and periodically afterwards.

Skin surveillance

This can be performed by the person monitoring themselves and reporting symptoms to a supervisor or manager. For this to be successful the people exposed need to understand why it is important, the symptoms of concern, and who to report symptoms to.


Exposure to high levels of noise can cause noise-induced hearing loss. The loss is in addition to the hearing loss most people experience as they get older.

People typically at risk are those working in entertainment and music, people using noisy power tools and machinery, and those working in environments where there is frequent impact noise from items being handled or dropped.

Health surveillance consists of questionnaires and testing of hearing function. The testing will not reverse the effects but would identify people at greater risk of further hearing loss. Hearing tests should be carried out before exposure at work and periodically while at work until exposure stops.

Hand-arm vibration

Hand-arm vibration is vibration transmitted into the hands and arms when using hand-held powered equipment or hand guided power tools and machines such as concrete breakers, hammer drills, chainsaws, hedge trimmers and powered mowers. Too much exposure can cause hand-arm vibration syndrome (HAVS) and carpal tunnel syndrome. HAVS affects the nerves, blood vessels, muscles and joints of the hand, wrist and arm.

Health surveillance consists of symptom questionnaires with referral for more detailed examination and testing where symptoms are identified. Health surveillance should be carried out before exposure to identify anyone at particular risk and periodically until exposure stops.

Advice on Health Surveillance can be provided by Alcumus, please speak to your health and safety consultant or contact our business support team on 01484 439930.