The HSE has released new online guidance on Health Surveillance to make it easier for employers to understand what they need to do in order to make sure they are protecting their workers. Health surveillance is a system of ongoing health checks, usually used when employees are exposed to;

  • noise or vibration,
  • Ionising radiation
  • solvents, fumes or dusts, biological agents
  • asbestos, lead or when they are working in compressed air


It aims to identify early signs or symptoms of illnesses. It is estimated that previous exposure to harmful substances accounts for 12,000 deaths every year. Health surveillance is important because it can:

  • Detect ill-health at an early stage
  • Provide data to better evaluate risks
  • Enable employees to raise concerns
  • Highlight lapses in control measures
  • Reinforce training and education

The new guidance has been developed with industry, to provide clear and simple guidelines for employers. When reading the new guidance, it’s important not to confuse it with:

  • Monitoring health where effects from work are suspected but cannot be established
  • Having workplace wellbeing checks, like promoting health living
  • Fitness to work exams, e.g. fitness to dive, operate cranes or forklift trucks

What to do?

The place to start is with your risk assessments. Through this you should have identified what might go wrong in your workplace, and from this is you can judge if there is any risk remaining to your employees. Even with other controls in place, they may not always be totally reliable despite your best efforts. You need to remember that health surveillance is a particular legal requirement, if the following criteria are met:

  • There is an identifiable disease or adverse health effect, and evidence of a link with workplace exposure
  • It is likely that the disease or health effect may occur
  • There is a valid technique for detecting early signs, which does not pose a risk to employees.

In its simplest form health surveillance can involve training your employees to check themselves for signs and symptoms of the diseases or health effect; making sure they know what they’re looking for, and who to report it to should they find something. For more risky, or complicated situations it may be that you choose to train a responsible person to make basic, routine checks, or choose to employ an occupational health nurse or doctor to carry out these checks for you.

High-Hazard Substances

There are also a small number of high-hazard substances that the law requires that the health surveillance programme includes a programme of Statutory Medical Surveillance, which must be carried out by a HSE appointed doctor. These are:

The new guidance makes it clear that you should avoid blanket coverage for all employees, as it can provide misleading results and waste money. It is important to focus efforts on employees who are at risk.

And if you’re still not sure, you can always contact us.