Risk assessment
Identify substances, processes, exposure groups and residual risk.
Programme design
Respiratory health surveillance is a process, not a test day.
Repeated, risk-led checks that connect employee health information with exposure control, clinical review and employer action.
Purpose
Detect change early and test whether controls are working.
HSE defines health surveillance as a scheme of repeated health checks used to identify ill health caused by work.
It is appropriate in defined circumstances: an identifiable disease or adverse effect can be linked to the exposure; it is reasonably likely under the conditions of work; a valid low-risk technique exists; and workers remain exposed despite controls.
Surveillance should only include workers who need it. It is not the same as a general wellbeing screen, diagnostic clinic or substitute for preventing exposure.
Programme anatomy
What a respiratory surveillance pathway may include.
Baseline
Record relevant symptoms and lung function before or soon after exposure begins, where appropriate.
Questionnaire
Ask consistently about respiratory symptoms and changes between scheduled checks.
Spirometry
Obtain technically acceptable, repeatable lung-function measurements when indicated.
Interpretation
Review results alongside symptoms, exposure history, quality and previous measurements.
Action
Inform the worker, advise the employer appropriately and review controls if concerns arise.
Records
Maintain the employer health record separately from confidential medical notes.
Recall
Repeat at the interval set by the protocol and competent clinical advice.
Between assessments
Symptoms should not wait for the next recall date.
Workers need a clear route to report respiratory symptoms or work-related patterns between scheduled reviews. The surveillance protocol should say who receives the report and what happens next.
Possible work-related patterns deserve prompt review.
Cough, wheeze, chest tightness or breathlessness that changes across shifts, days off or holidays may need occupational-health or clinical assessment. Severe breathing difficulty or other urgent symptoms need urgent medical help, not a website enquiry.
When surveillance flags concern
Close the loop.
Testing without interpretation and action is not an effective scheme.
- 01Inform and advise the worker
- 02Arrange appropriate clinical review
- 03Review the risk assessment and controls
- 04Consider similarly exposed workers
- 05Document outcomes and follow-up
Records
Keep the right information in the right place.
Employer health record
A legal record of surveillance outcome, work and exposure information, fitness relevant to the hazard, dates and recall. Under COSHH, relevant health records are kept for at least 40 years from the last entry.
Confidential medical record
Clinical notes, detailed results and personal health information held in medical confidence by the occupational-health professional. Employer access normally requires the worker’s written consent.
Employer enquiry
Request a tailored quote
Build a respiratory surveillance programme around the actual risk.
Share workforce numbers, sites, exposures and scheduling needs. Do not include employee health information.