The COSHH ACoP (L5) contains a table which gives generic guidance on the types of substances and processes where health surveillance would probably be necessary, although this list is not exhaustive. The main points are summarised below.
Substances and processes where health surveillance is probably required include:
- Substances of recognised systemic toxicity (i.e. substances that can be breathed in, absorbed through the skin or swallowed and that affect parts of the body other than where they enter). Likely to occur under laboratory conditions where virulent toxins and biological investigations can take place. Health surveillance is likely to be lung function testing (vitalograph) and regular medicals by an occupational health professional.
- Substances known to cause occupational asthma. Likely to occur where irritant or toxic substances get into the atmosphere adjacent to the operator. Health surveillance is likely to be by lung function testing (vitalograph) and/or biological monitoring together with regular medicals by an occupational health professional.
- Substances known to cause severe dermatitis. Likely to occur with isocyanates, epoxy adhesives, solvent based glues, paints, inks and substances known to remove natural oils from the skin. Health surveillance in these circumstances would be a regular skin inspection by a trained, responsible person.
- Electrolytic plating or oxidation of metal articles by use of an electrolyte containing chromic acid or other chromium compounds. Plating and finishing shops are the most likely places where this might occur.
- Contact with chrome solutions in dyeing processes using dichromate of potassium or sodium.
Affected employees
Where an employee is found to have an adverse health effect or identifiable disease which a medical inspector, appointed doctor or other occupational health professional considers to be the result of exposure to a substance hazardous to health, you must arrange for the employee concerned to be interviewed and advised of the situation.
You must also consider, in association with an occupational health professional, as appropriate, whether:
- an affected employee should be transferred to a task where there is no exposure to the hazardous substance concerned;
- an affected employee, or other employees working in similar circumstances, should have further medical assessment; and/or
- facilities should be provided and what arrangements should be made for this.
In certain circumstances it may be appropriate for you to continue health surveillance of your employees (at least while they remain your employees) after exposure to a substance hazardous to health has ceased. The circumstances where this will benefit workers may be those where an adverse effect on health may be anticipated after a latent period and where it is believed that the effect can be reliably detected at a sufficiently early stage. Examples might include those substances which cause cancer of the urinary tract.
See also health surveillance and health screening