Protect

Asbestos is a known occupational health hazard. Working with asbestos is regulated by the Control of Asbestos Regulations 2012 (CAR); this places a duty of care on employers to maintain a health record for employees who are involved in licensed work with asbestos and make sure they are under medical surveillance by an appointed doctor or employment medical adviser. Self-employed individuals are also responsible and required to organise their own asbestos medical.

Licensed work includes work with the most dangerous form of asbestos, where asbestos fibres can be most easily released into the air, leading to a higher risk of worker exposure. Examples of this are work with asbestos coatings, most work with asbestos insulation and asbestos insulating board.

An asbestos medical, carried out by a HSE approved physician will check for respiratory conditions linked to asbestos exposure. This involves taking a medical and occupational history, examining the respiratory system and measuring lung function. A certificate is issued to confirm that medical surveillance under CAR has been carried out.

Medicals are required two yearly for licensed work.

Under the Ionising Radiations Regulations 2017 (IRR), classified persons require medical surveillance by an appointed doctor or employment medical adviser. The purpose of medical surveillance is to confirm that an individual is fit or continues to be fit for the intended work with ionising radiation.

Classified persons are defined as those exposed workers likely to receive an effective dose of radiation greater than 6mSv per year or an equivalent dose greater than 15mSv per year to the lens of the eye or greater than 150mSv to the skin and extremities.

Employers must also arrange for adequate medical surveillance for any employee who has received an overexposure.

It will be necessary for the appointed doctor to understand the work environment and tasks, obtain a full medical history and to review dose records. This will help to determine any examination that is required.

Reviews are required at least every 12 months. Reviews can be paper review but a face to face assessment is required at least once every five years.

Under the Control of Lead at Work Regulations 2002 (CLAW), employers must ensure employees are under medical surveillance by an appointed doctor or employment medical adviser where exposure to lead is, or is liable to be significant.

The initial medical assessment for inorganic lead exposure involves taking a medical and occupational history, doing a clinical examination and measuring blood lead.

Periodic medical assessments should be conducted at intervals of not more than 12 months and involve reviewing the records and history, clinical examination and measurement of blood lead. Women of reproductive age and young people should have blood lead assessed at least every 3 months.

Under the Control of Vibration at Work Regulations 2005, employers must provide health surveillance for employees who are likely to be regularly exposed to hand arm vibration above the exposure action value and for employees who have a diagnosis of Hand Arm Vibration Syndrome (HAVS).

The health surveillance programme includes:

• Tier 1 – Initial questionnaire, filled out by new employees or employees about to start working with vibrating tools.

• Tier 2 – An annual questionnaire for employees who remain exposed to hand arm vibration.

• Tier 3 – If an employee declares vibration-related symptoms on questionnaire, a Tier 3 assessment will be carried out by a HAVS qualified nurse. This includes taking a detailed history and physical tests that assess the vascular and the nervous system of the hands. The outcome of this assessment will help the nurse decide whether there is reason to believe that the symptoms could be due to HAVS. If so, the nurse will escalate this to a Tier 4 assessment and may recommend interim adjustment of exposure to vibration.

• Tier 4 – This assessment will be carried out by a HAVS qualified doctor. It consists of a detailed history, assessment of symptoms and signs of HAVS. Examination includes blood pressure, assessing the vascular system in the hands, sensation, grip strength and a test of manual dexterity. This is the stage where a formal diagnosis of HAVS or other conditions may be made. Furthermore, the doctor will advise on further surveillance and recommend limits to exposure.

The Working Time Regulations (1998) define night workers as staff who regularly work at least 3 hours during the night period (usually 11pm to 6am although exclusions apply).

By law, employers must offer night workers a free health assessment before they become a night worker, and a repeat assessment must be offered regularly.  The assessment is generally offered on an annual basis in the form of an annual questionnaire.

It is not a legal requirement for the employee to participate in the health assessment.

The term ‘Food handlers’ mainly refers to employees who directly touch open food as part of their work but may also include anyone who may touch food contact surfaces or other surfaces in rooms where open food is handled.

Pre-employment checks and periodic health assessments which can be in the form of a questionnaire, asking questions around the health of food handlers are seen as best practice within the industry, to avoid the spread of infection.

Further guidance can be found in The Food Standards Agency document “Fitness to work”.

Working in confined spaces is subject to the Management of Health and Safety at work Act (1999) and the Confined Spaces Regulations (1997) apply where the risk assessment identifies a risk of serious injury from work in a confined space.

Best practice would be for employees working in such area’s to have a comprehensive medical assessment to ensure they are fit and safe to work in such an environment.

Taxi drivers are generally required to meet the DVLA Group 2 higher medical standards for driving however the exact requirements are governed by the local authority.

The examination confirms that individuals are fit, healthy and able to drive a taxi or private hire vehicle and will be required to be periodically renewed.