Workare

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 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.

What is a confined space?

A confined space is one which is both enclosed, or largely enclosed, and which also has a reasonably foreseeable risk to workers of fire, explosion, loss of consciousness, asphyxiation or drowning.

The space itself may be small and restrictive for the worker or it could be far larger such as a grain storage silo with hundreds of cubic metre capacity.

Legislation

• The Confined Spaces Regulations 1997 apply where the assessment identifies risks of serious injury from work in confined spaces

• Wherever possible, a company should avoid carrying out tasks in confined spaces. Where this is not possible, you must assess the risks of the particular confined space and plan how you will control those risks

Dangers can arise in confined spaces due to:

• Lack of oxygen
• The buildup of poisonous gas, fume or vapour
• Liquids and solids which can suddenly fill the space or release gas into it when disturbed
• Fire and explosions
• High dust levels
• Hot conditions

Working in confined spaces is subject to the Management of Health and Safety At Work Regulations 1999 and the Confined Spaces Regulations 1997. Risk assessment and safe systems of work are key in the management of these risks.

You should ensure that your workers are fit to work in these environments and are able to escape safely if they need to

Medical Assessment

It is not a legal requirement to have a confined spaces medical but it is good practice to have one if you or your staff are likely to be working in this environment.

What is involved?

• Health questionnaire including questions about psychological issues such as claustrophobia
• Height, weight, body mass index, waist and hip measurement
• Blood pressure
• Vision screening for near and distance
• Standard urine test for protein and sugar
• Lung function baseline
• Hearing test baseline
• Specific confined space related questions
• Sniff/ Smell test- to see if individual can distinguish different types of odours

Medical standards guidance for employers

Lift Trucks – Frequency of testing

It is good practice for all operators and potential operators to be screened for fitness before employment and again at regular intervals in middle age. Examination at age 40 and thereafter at five-yearly intervals up to age 65 is recommended. Operators over 65 should be screened annually.

Examination is also recommended in all cases after an accident or sickness absence of more than one month, or after a shorter period if it appears likely that the illness may affect fitness to operate. Should any operator or employer suspect or become aware of a condition which might affect ability to operate a lift truck, then examination should also take place.

It is recommended that any requirement for medical screening and/or examination should be agreed between employer and employee in advance under a contract of employment. Source HSE Guidance

Car Van drivers

The DVLA guidance on Fitness to drive applies and gives guidance to those driving Class 1 vehicles (cars) and Class 2 ( HGV/PSV ).

Application Of Medical Standards

• Always judge a person’s fitness for operating a vehicle individually
• Match the requirements of the driving task with the fitness and abilities of the driver
• For most work, a standard equivalent to Group 1 will be appropriate
• In some cases, however, a more stringent standard may be required such as Group 2 or Plant Operators Guidance

How often should you carry out a Driver Medical?

• All existing and potential workplace transport operators should be screened for fitness at employment and at five-yearly intervals from age 40 to 65 and  then annually over 65
• Group 2 licences are renewable five-yearly from age 45 by a doctor
• Group 2 after age 65 should have annual assessments for fitness by a doctor
• We recommend assessment after an absence of more than one month or after a shorter absence if it is likely that the illness has affected the worker’s fitness to operate workplace transport
• If a GP signs a worker off as fit to return to work, it may not be the same as fitness to operate workplace transport

Workare Driver Assessments

Fork Lift Truck Driver Medical – We follow the HSE Guidance

• Each person’s fitness for operating a lift truck should always be judged individually
• The underlying approach should be to match the requirements of the particular driving task with the fitness and abilities of the driver
• For most work a standard equivalent to that of the Group 1 entitlement will be appropriate
• In some cases, however, a more stringent standard may be required, for example …….demanding environment, working at night, or if large, heavy trucks are to be operated. In these instances some or all of the medical standards equivalent to that of Group 2 entitlement may be appropriate
• Every medical should however include a questionnaire, blood pressure check hearing check, vision check, agility check, heart conditions, nervous conditions, psychological issues and a urine test for sugar

Questions the employer should think about

Are you satisfied that your drivers are sufficiently fit and healthy to drive safely and not put themselves or others at risk?

• Do Class 2 HGV drivers have the appropriate licence in place?
• Do all your drivers have regular medicals to makes sure they are safe to drive?
• Do you remind your staff that there are minimum eyesight standards to meet if they are driving and how to do you ensure that they meet the standards?
• Have you told staff that they should not drive, or undertake other duties, while taking a course of medicine that might impair their judgement?

RUK Wind Turbine Medicals

What is involved in a Wind Turbine Medical?

• Completion of Health Questionnaire
• Consultation with a medical professional
• Urinalysis – routine urine test with immediate result
• BMI – measurement of height, weight and calculation of Body Mass Index
• Vision Test
• Pulse and Blood Pressure Measurement
• Lung Function Test (spirometry)
• Hearing Test
• Step Test
• Confined Space Medical Aspects
• Specialist Mobility/ Grip Test

This is a specialist medical and takes 2 hours.

If you have staff working at height where they could fall and injure themselves you need to ensure that they are fit medically to do their job. If your employees work with the following:

• Working platforms such as scaffolds, tower scaffolds, cherry pickers, scissor lifts and podium steps
• Work on a roof, piece of plant or equipment
• Using ladders or stepladders

It would be advisable to make sure that they are medically suitable for this work.

Working At Height Medical involves:

• Carry out a full base line medical
• Carry out extra tests that are working at height specific such as cardiovascular, and agility screening

We work to criteria set by National Guidelines.

What Is Biological Monitoring?

Biological monitoring involves analysis of breath, urine or blood samples collected from employees when there is a possiblility of substances being absorbed into the body.

What does your employer have to do?

Many jobs involve using chemicals which can harm your health if they are not properly handled. Under the Control of Substances Hazardous to Health Regulations 1994 (COSHH) your employer has to look for the risks to your health from chemicals in the workplace. Your employer must make sure that your exposure to chemicals is either prevented, or properly controlled. To do this he or she may need to measure your amount of chemical exposure.

How can chemicals enter your body?

• by breathing them in;
• by absorbing them through the skin; or
• by swallowing them. This can happen if your hands become contaminated at work and you do not wash them before eating, drinking or smoking

If you are exposed to chemicals in the job you do, the most common way of finding out how much you are exposed to is to measure how much of the chemical is present in the air you breathe in. However, this does not tell you how much of the chemical has actually entered your body. In particular, it does not measure how much has entered your body through the skin or by swallowing. This is why we sometimes recommend biological monitoring for certain chemicals.

Bow can the amount of chemicals absorbed into your body be measured?

Biological monitoring can be used to indicate how much of a chemical has entered your body. It involves measuring the chemical you are exposed to at work (or what it breaks down into) in a sample of your breath, urine or blood. Which of these three samples is used depends on how the chemical you are exposed to is processed by your body. Biological monitoring is often used together with air monitoring.

Biological monitoring is especially useful when:

• there is likely significant absorption through the skin; and
• control of your exposure depends on personal protective equipment and your employer needs to check it is protecting you. Courtesy of HSE web site

Through case management referrals from managers or HR we can advise on how those with health conditions and disability may be supported in their work. This assists employers to efficiently manage workforce health and well-being in work. We offer expert guidance to address employee health concerns, minimising absenteeism, and promoting a healthier, more productive workplace.

The Working Time Directive Regulations require employers to identify those employees who work long hours or shift patterns.

Under the Working Time Regulations 1998, employers are required to ensure that workers are fit for night work and must offer a free health assessment to anyone who is about to start working nights and to all night workers on a regular basis. Once identified, Workare can provide a comprehensive service for those who are entitled to a health screen. 

Long hours or shift/night working can have adverse effects on acute and chronic medical complaints.

What are the undesirable effects of shift work?

Research has shown that there can be undesirable consequences for those working shifts outside standard daytime hours, particularly those covering the night or with early morning starts.

For example, shift work may result in:

• Disruption of the internal body clock
• Fatigue
• Sleeping difficulties
• Disturbed appetite and digestion
• Reliance on sedatives and/or stimulants
• Social and domestic problems

Which in turn can affect performance, increase the likelihood of errors and accidents at work, and might have a negative effect on health.

Source: Managing shiftwork HSE Guidance ISBN 978 0 7176 6197 8

Night Worker Assessment health effects

As well as chronic fatigue, there is some evidence associating long-term exposure to shift work and the following ill health effects:

• Gastrointestinal problems such as indigestion
• Abdominal pain, constipation, chronic gastritis and peptic ulcers
• Cardiovascular problems such as hypertension, coronary heart disease
• Increased susceptibility to minor illnesses such as colds, flu and gastroenteritis

• Health questionnaire
• Clinical tests
• Counselling for employee
• Health record form for manager

Workare night worker assessments takes approximately 30 minutes per person.

Management will be provided with evidence that screening has taken place in order to satisfy the requirements of the Working Time Directive.

Good practice guidelines for shift design

• Plan an appropriate and varied workload
• Offer a choice of permanent or rotating shifts and try to avoid permanent night shifts
• Either rotate shifts every 2-3 days or every 3-4 weeks – otherwise adopt forward rotating shifts
• Avoid early morning starts and try to fit shift times in with the availability of public transport
• Limit shifts to 12 hours including overtime, or to 8 hours if they are night shifts and/or the work is demanding, monotonous, dangerous and/or safety critical
• Encourage workers to take regular breaks and allow some choice as to when they are taken
• Consider the needs of vulnerable workers, such as young or aging workers and new and expectant mothers
• Limit consecutive work days to a maximum of 5 – 7 days and restrict long shifts, night shifts and early morning shifts to 2-3 consecutive shifts
• Allow 2 nights full sleep when switching from day to night shifts and vice versa
• Build regular free weekends into the shift schedule

Source HSE web site