If workers are regularly exposed to dust, chemicals, noise or vibration, you may have a legal duty to run health surveillance. This is not a general wellbeing MOT; it is a set of targeted checks linked to hazards in your risk assessments. Many employers are unsure where the line is drawn, so this page covers the basics.
What health surveillance actually means
Health surveillance is a planned series of health checks to detect early signs of work-related ill health in people exposed to particular hazards. It is not the same as a lifestyle screening or a standard pre-employment medical unless your assessment shows that is what you need. Examples: lung function testing where isocyanates are used; audiometry for noise-exposed staff; HAVS assessment for vibration exposure.
When is it a legal requirement?
COSHH 2002, the Control of Noise at Work Regulations 2005 and the Control of Vibration at Work Regulations 2005 require surveillance where risk assessments show exposure above relevant thresholds. HSE guidance lists which exposures typically trigger a programme. Sectors often affected include manufacturing, construction, printing, woodworking, motor repair and parts of healthcare.
What does a health surveillance programme look like?
Checks follow the hazard: audiometry for noise, spirometry for respiratory sensitisers, skin assessment for dermatitis risks, HAVS tiers for vibration. Frequency is often annual but may change with results. A competent occupational health clinician carries out the assessment and issues a fitness statement to the employer: fit or not fit for the role, without unnecessary clinical detail.
What employers often get wrong
Treating surveillance as a one-off tick-box, using questionnaires without clinical follow-up where required, or confusing it with absence management or pre-placement screening. Each has a different purpose; mixing them up wastes money and leaves gaps in compliance.
How to get started
Start from your risk assessments. If they flag regulated exposures, plan a programme with an occupational health provider. If you already have arrangements, an occasional review against HSE guidance and your current hazards is worthwhile.
