4.3 Biological monitoring Flashcards
Depending on the activities of an organisation, there are a number of roles that
would be involved with occupational health in the workplace, for example: 6
an occupational health physician
an occupational health nurse
a physiotherapist
a counsellor or psychologist
an occupational hygienist (Note: occupational hygiene, as discussed earlier, is a
different profession involving more proactive interventions, although hygienists
often work with occupational health practitioners)
an ergonomist.
Health surveillance is
the on-going assessment and/or medical examination of an
employee at regular intervals to determine the employees’ health state in the context
of exposure to occupational health hazards
The objectives of health surveillance are to: 3
Protect the health of individual employees by detecting as early as possible
adverse changes which may be caused by exposure to substances hazardous to
health
Help evaluate the measures taken to control exposure
Collect, keep up to date and use data and information for determining and
evaluating hazards to health.
Health surveillance is necessary under CoSHH Regulation 11 when: 6
An employee is exposed to one of the substances specified in Schedule 6
Is engaged in a process specified in Schedule 6
There is a reasonable likelihood that an identifiable disease or adverse health
effect will result from that exposure.
There is a disease or adverse health effect associated with the hazardous
substance in use, for example: asthma, dermatitis, cancer.
There is a reasonable likelihood that the disease or effect may occur under
the
particular working conditions.
There are valid techniques for detecting indications of the disease or the effect.
Health surveillance required
Systemic agents 2
Appropriate clinical or laboratory
investigations
Biological effect monitoring
Health surveillance required
Substances known to cause severe
dermatitis 1
Skin inspection by a responsible
person
Health surveillance required
Chrome solution, acid or compounds in:
Electrolytic plating or oxidation of metal
articles
Dyeing processes etc.
Liming and tanning of raw hides and skins
1
Skin inspection by a responsible
person
The benefits of health surveillance include: 4
Ensuring the early identification and treatment of an occupational disease.
Provision of statistics relating to the health of the workforce.
A feedback mechanism for risk assessments, to establish whether control
measures are effective.
Provision of evidence of due diligence and relevant information for defending
legal action.
Biological monitoring measurements reflect the total uptake of a chemical by an
individual by all routes. It is often used to complement….
personal air monitoring (which
measures inhalation of a chemical in the air in a person’s breathing zone).
Biological monitoring may be particularly useful in circumstances where there is
likely to be: 5
When there is significant absorption by non-respiratory routes, for example:
significant skin absorption and/or ingestion.
Where control of exposure depends on respiratory protective equipment.
Where there is a reasonably well-defined relationship between biological
monitoring and effect.
Where it gives information on accumulated dose and target organ body burden
that is related to toxicity.
When there is a specified guidance value against which a comparison might be
made (such as in EH40).
Practical difficulties that may be encountered during biological monitoring are that
biological monitoring is normally conducted on a voluntary basis, unless required by
statute, for example: lead. Consequently the informed consent of those involved
would have to be obtained and their concerns overcome. Other difficulties include: 6
The availability of suitable facilities or a location to carry out the monitoring
especially if this has to be done at the end of the shift.
The availability of specialists to carry out the monitoring, for example: if blood
samples are to be taken.
Maintaining the integrity of samples to avoid cross contamination and ensuring
there is no possibility of cross infection.
The fact that there are few guidance values available for comparison.
Exposure may be non-occupational.
The cost of carrying out biological monitoring is high.
In order to achieve an effective exposure assessment
it is essential that clear criteria are available for
interpreting the results of biological monitoring. For this
reason the HSE has established…
a system of non-
statutory Biological Monitoring Guidance Values
(BMGVs) to provide an authoritative guide to the
interpretation of biological monitoring results. The
BMGVs can be found in Table 2 (page 52) of the HSE
publication: EH40/2005 Workplace exposure limits.
BMGVs are set where: 3
they are likely to be of practical value
suitable monitoring methods exist
there are sufficient data available.
The type of data that is available will vary between substances and therefore the
route taken to deriving the BMGV will vary between substances. BMGVs are either
based on: 3
A relationship between biological concentrations and health effects
Between biological concentrations and exposure at the level of the WEL
Are based on data collected from a representative sample of workplaces correctly
applying the principles of good occupational hygiene practice.
Health guidance value (HGV)
HGVs are set at a level at which, from the scientific evidence available,….
there is no
indication that the substance being monitored is likely to be injurious to
health.
