In the second of two extracts from the textbook Contemporary Occupational Health Nursing, Susanna Everton discusses the legal underpinning of health surveillance and the range of professionals involved.
The Control of Substances Hazardous to Health (COSHH) Regulations 2002 state that: "If an employee is exposed to a substance specified in sch.6 and is engaged in a process specified therein, the health surveillance required under paragraph (1) shall include medical surveillance under the supervision of a relevant doctor at intervals of not more than 12 months or at such shorter intervals as the relevant doctor may require."
Other legislation where medical surveillance is stipulated includes:
- Asbestos at Work 2002: "Each employee who is exposed to asbestos is under adequate medical surveillance by a relevant doctor."
- Lead at Work 2002: "Every employer shall ensure that each of his employees who is or is liable to be exposed to lead is under suitable medical surveillance by a relevant doctor."
- Ionising Radiation 1999: '"The employer shall ensure that each of his employees to whom this regulation relates is under adequate medical surveillance by an appointed doctor or employment medical adviser for the purpose of determining the fitness of each employee for the work with ionising radiation which he is to carry out."
The appointed doctor - in practice, usually an occupational physician - will conduct a baseline examination and then regular clinical examinations of at-risk individuals and carry out any tests that may be required to ascertain their health, which may include blood and urine tests for lead levels.
The doctor must then decide on the fitness of the individual to continue working in the exposed environment and certify any entry on the health record.
Each regulation where medical surveillance is required gives detailed information on the full remit of the doctor, particularly regarding health records, asbestos licences and the Health and Safety Executive (HSE).
The doctor will also be involved in advising the employer on the future employment of an individual who is found to have an identifiable disease in alternative work.
The COSHH Regulation stipulates: "Where an employee is subject to medical surveillance in accordance with paragraph 5 and a relevant doctor has certified by an entry