If your employees are regularly exposed to hazards such as dust, chemicals, loud noise or vibrating tools, the law almost certainly requires you to carry out health surveillance. Despite this, many employers are either unaware of the obligation or unsure where to start. This guide covers the basics so you can work out whether health surveillance applies to your workforce and what you need to do about it.
What health surveillance actually means
Health surveillance is a programme of ongoing health checks designed to detect early signs of work related ill health. It is not the same as a general wellness check or a pre employment medical. The focus is specifically on hazards that your risk assessment has identified in the workplace. For example, if your staff use adhesives that contain isocyanates, health surveillance would include regular lung function tests. If they operate hand held vibrating equipment, it would include questionnaires and clinical assessments for hand arm vibration syndrome.
When is it a legal requirement?
Under the Control of Substances Hazardous to Health Regulations 2002 (COSHH), the Control of Noise at Work Regulations 2005 and the Control of Vibration at Work Regulations 2005, employers must provide health surveillance where the risk assessment shows that employees are exposed to specific hazards above defined thresholds. The Health and Safety Executive publishes guidance on which exposures trigger a surveillance requirement. In practice, this covers a wide range of industries including manufacturing, construction, printing, woodworking, motor vehicle repair and healthcare.
What does a health surveillance programme look like?
The exact checks depend on the hazard involved. Common examples include audiometry (hearing tests) for noise exposed workers, spirometry (lung function tests) for those exposed to respiratory sensitisers, skin checks for dermatitis in workers handling irritants, and HAVS assessments for vibration exposure. Appointments are usually scheduled annually, though the frequency may change based on clinical findings. A qualified occupational health professional carries out the assessments and provides a fitness certificate to the employer. The certificate confirms whether the employee is fit to continue in their role, without disclosing confidential medical details.
What employers often get wrong
One common mistake is treating health surveillance as a one off exercise rather than an ongoing programme. Another is relying on generic questionnaires without follow up clinical assessment where needed. Some employers also confuse health surveillance with sickness absence management or pre placement screening. These are related but separate activities. Getting the scope right from the outset saves time and avoids gaps in compliance.
How to get started
Start with your risk assessments. If they identify any of the hazards mentioned above, you likely need a health surveillance programme. An occupational health provider can help you design one that fits your workforce and your legal obligations. If you are not sure whether your current arrangements are adequate, a scoping conversation with a qualified provider is a sensible first step.