Health Surveillance Flashcards
PEHS
Pre employment health screening Justifiable if: 1. The prospective employee requests it 2. Statutory Requirement 3. For safety critical roles 4. Where baseline tests are required for health surveillance
Equality Act on PEHS
Outlaws PEHS before job offer is made except in specific circumstances.
Any testing for PEHS
Prospective employees should be advised in advance in writing by HR of the pre-employment policy and in particular if any testing like drugs, alcohol, HEP B are to be done.
Night Workers
Under Working Time Regulations, all night workers are to be offered and initial and annual health assessment. They don’t have to accept.
Code of Practice
List of reasonable adjustments expected of all employers
Disabled employees are not entitled to more sick pay days unless reason for being off sick is employers failure to provide reasonable adjustments.
Safety critical role
Needs risk assessment under Management of Health and Safety at Work Act 1999
Access to Work Programme
Provides financial assistance towards extra costs of employing someone with a disability.
Run by DWP
Available to employed and self employed staff
Biological Monitoring
Aims to determine if someone has been exposed to a hazard.
Integrates exposures from all routes.
Measurement and assessment of chemicals or their metabolites in exposed workers. Breath, urine, blood, skin.
Can measure chemicals itself or metabolite
Biological Effect Monitoring
Measurement and assessment of early biological affect caused by absorption of chemicals in exposed workers
eg peak flow or lung function tests
Organic Lead
From skin. More toxic.
Measure ALA in urine.
OEL of 0.10
Only suspension value.
Inorganic Lead
Ingested
Measure FEP (free erythrocyte protoporphyrin in blood
OEL of 0.15
Has action and suspension value
EH40
Occupational exposure limits. Lists all chemicals and WELS
BMGV
Biological Monitoring Guidance Value
List available in HSE Publication
Non statutory except lead
Under this comes HGV and BGV
Environmental Monitoring (air)
Measurement of airborne substances
EH 42
Older HSE Guidance on monitoring strategies for toxic substances
HSG 173
New HSE Guidance on monitoring strategies for toxic substances
8 Steps to set up a health surveillance programme
- Define the purpose of the programme
- Appoint a competent person
- Define the monitoring strategy
- Consult with employees/representatives
- Discuss and agree with the individual employees
- Establish procedures for sample collection, storage, transportation, analysis and quality assurance
- Procedures for feedback, interpretation of results
- Acting on the results and evaluating the effectiveness of the programme
High Specificity
Needed for HS - true negative in a person who doesn’t have disease.
May get more false positives leading to redeployment but this is better than false negatives
Hierarchy of Controls and HS
HS is at the bottom
SEQHS
Safe Effective Quality Occupational Health Services
Voluntary UK national quality standard for occupational health services
Periodic Health Assessments
- Subject to legal duty - eg vision screening under DSE
2. Not subject to legal duty - best practices eg. annual health checks of fire, rescue crews.
Lead Action Level
If reached or exceeded the employer must carry out investigation, review control measures and take steps to reduced employees blood lead concentration
Only inorganic lead. Not organic lead.
Suspension Lead Level
Normally taken off work which exposes them to lead to prevent risk of lead poisoning.
Lead Surveillance
Legal requirement under control of lead at work regulations.
Can be done by blood or urine test
Can lead to dismissal - last resort
Different levels for those of child bearing age.
Monitoring Styrene
Monitor metabolite mandelic acid
Monitoring Benzene
Metabolite TTMA
G 402
New guidance on respiratory surveillance
MS 24
Guidance on skin surveillance
HGV
Health Guidance Value (comes under BMGV)
Set at a level where there is no evidence that substance being monitored is likely to be injurious to health.
Regularly exceeding HGV does indicate that control of exposure may not be adequate.
Employers need to look at ways to reduce exposure.
BGV
Benchmark guidance value (comes under BMGV)
Not health based. Practicable, achievable levels set at the 90th percentile of available biological monitoring results.
Does Health Surveillace measure risk?
Doesn’t assess level of risk
Audiometry Surveillance
Yearly for first 2 years, then every 3 years.
Asbestos Licensed Work
2 yearly health surveillance
Asbestos Non licensed work
3 yearly health surveillance.
