Showing posts with label COSHH. Show all posts
Showing posts with label COSHH. Show all posts

Wednesday, 21 November 2012

Advice on COSHH Training for small engineering workshops

There are a host of different hazards present in most engineering workshops, including: noise, hot surfaces, moving vehicles, moving parts of machinery, vibration, electricity, hazardous substances, etc.  When considering the risks from exposure to substances hazardous to health associated with engineering workshops, the range of substances may be daunting.  This article focuses on two hazardous substances commonly used in engineering workshops and demonstrates how the general management principles of COSHH may be applied. 

Elements to consider even before the training session

The training environment
COSHH training in the small engineering workshop may be carried out in a traditional training room environment.  Alternatively, if the numbers are relatively small, the training may be carried out in the workshop, using the existing workplace and the equipment therein as props for the training.  One of the problems with a workshop environment is that there tends to be a lot of background noise and so it may be necessary to: turn off equipment, turn off the air compressor and release the stored pressure in the air lines, turn off the local exhaust ventilation system(s), etc. 
 
Arrangements should be made for dealing with other distractions, such as deliveries, etc.

Consider the aim of the training course
When carrying out COSHH training for the smaller engineering workshop, the aim of the training is unlikely to be training in the COSHH regulation themselves, but is much more likely to be focussed on making workers aware of the health risks associated with the substances that they may be exposed to and on the control measures to be used to prevent (or control) that exposure. 

Consideration of the range of substances present
Before embarking on a COSHH risk assessment or on COSHH related training, it is important to determine what substances hazardous to health are present in the workshop.  Typical substances hazardous to health that may be found in an engineering workshop include:
             Oils and greases
             Spray lubricants (such as WD40)
             Metal working fluids
             Solvents (cleaning materials, thinners, etc.)
             Paints (containing solvents, pigments, lead, etc.)
             Isocyanates (in 2-pack polyurethane paints, etc.)
             Epoxy materials (adhesives)
             Welding and cutting fume (arc, gas and plasma)
             Soldering fumes
             Vapour phase degreasing materials
             Kerosene based degreasing materials
             Dusts (such as from processes like grinding, linishing and polishing)

A list (or inventory) should be made of all of the substances used, stored or generated in the workshop.

Information
Manufacturers’ (or suppliers’) safety data sheets are particularly useful for determining if a substance is hazardous to health. In fact, Regulation 12 of the COSHH Regulations states that relevant safety data sheets are amongst the pieces of information that must be made available to employees who are exposed to substances hazardous to health.  In order to carry out a suitable training session, the trainer must understand the hazards associated with the substances and this information may be found on the safety data sheet will provide this information. 

The HSE produces a wide range of informational literature that may be of direct benefit to small engineering companies and their COSHH issues.  These include a range of free leaflets (such as the INDG series) and priced publications (such as the HSG series).  Much of this information may also be downloaded (free of charge) from the internet.

It is recommended that useful information is made available to workers.  This may be contained in the COSHH risk assessment file or, more usefully, made available at the point of use (such as in local files on the shop floor or on notice boards).  Workers should be encouraged to access this information.

The application of the basic principles of COSHH to the management of health risks from exposure to hazardous substances

The Control of Substances Hazardous to Health Regulations 2002, as amended (COSHH) require that the health risks arising from exposure to substances hazardous to health are avoided where this is reasonably practicable or that they are controlled where it is not reasonably practicable to avoid them.  In order to comply with the principles of COSHH, the employer should:
     Assess the risks to health and decide what precautions are needed.
     Inform workers of the risks associated with exposure to substances hazardous to health and of the control measures to be used to ensure their health and safety.
     Prevent workers being exposed to substances hazardous to health or, where this is not reasonably practicable, ensure that such exposure is controlled adequately.
     Ensure that exposure control measures are followed at all times, and regularly checked and maintained, and that safety procedures are observed.
     Monitor workers exposure to substances hazardous to health and carry out appropriate health surveillance, where the COSHH assessment has shown this is necessary.
     Train workers in the use of control measures and the use of any personal protective equipment that may be required.
     Provide suitable welfare facilities, such as washing and areas to consume food away from the work place.

COSHH issues associated with exposure to metal working fluids

Introduction
The main health effects arising from exposure to metal working fluids (MWF) are to the skin and to the respiratory system.  These include: irritation of the skin, dermatitis oil acne and folliculitis; as well as: occupational asthma, bronchitis, irritation of the upper respiratory tract, breathing difficulties or, rarely, a serious lung disease called extrinsic allergic alveolitis.   Water based MWF support microbial growth and, hence, can lead to biological contamination of the MWF, increasing the risks of ill health arising from exposure.  Ill health effects may also be increased by chemical contamination of the MWF from: tramp oils, hydraulic fluids, polycyclic aromatic compounds (in neat oils) and nitrosamines (in water based oils). The (COSHH) risk assessment for the use of MWF should identify a range of simple control measures that can significantly reduce the risks of ill health developing. 

Health effects of exposure to metal working fluids

Respiratory ill health
Workers exposed to MWF mist and vapour are at risk of developing work-related asthma, bronchitis, irritation of the respiratory tract and breathing difficulties, as well as extrinsic allergic alveolitis (which can cause increasingly severe breathing difficulties in recurrent episodes, following repeated exposure). Exposure may also cause irritation to the eyes, nose and throat.

Inhalation of these biological contaminants (such as bacteria or toxins) can lead to irritation of the respiratory tract and flu-like symptoms, as well as aggravating existing asthma.

Skin problems
Dermatitis can be caused:
     by bacteria (or their toxic by-products) when they are present in the MWF in the sump;
     through contact with sensitising metal (such as chromium, nickel and cobalt), which can leach out from cutting tools, grinding wheels and substrates into MWF; and
     by contact with chemical additives, such as biocides and corrosion inhibitors.

The use of unrefined mineral oils may lead to skin cancer on affected skin, such as hands and the lower arms.  Prolonged exposure through wearing contaminated clothing and the habit of putting oily rags into overall pockets increases the risks of skin cancer and of scrotal cancer.  These risks are lessened by the use of highly refined oils, etc.

Routes for exposure to metal working fluids
MWF fluids are usually applied by continuous jet, by a spray or by a hand dispenser.  They can only cause health effects if they come into contact with the body.  The common routes for exposure are: 
     Inhalation of the mist generated during the machining operation.
     Direct contact (such as from splashes) with unprotected skin, particularly hands, forearms and heads.
     Entry into the body through direct contact with cuts, abrasions or other broken skin.
     Ingestion (arising from eating, drinking or smoking in work areas, or from poor personal hygiene). 

Control measures for working with metal working fluids
In general, the introduction and maintenance of simple control measures will significantly reduce the risks of ill health developing from exposure to MWF.

General control measures
     Ensure that the most appropriate MWF has been selected.
     Devise a safe system of work for working with metalworking fluids and instruct workers in this safe system of work.
     Ensure that suitable splash guards are provided, fitted and used appropriately.
     Minimise the production of MWF mist and vapour, such as by controlling the volume and rate of delivery of the MWF to the tool.
     Avoid the use of compressed air to remove excess metalworking fluids from machined parts, plant or equipment.

Extraction and ventilation
     Provide suitable extraction systems (such as local exhaust ventilation), where the need is identified in the (COSHH) risk assessment.
     Ensure that any enclosures or extraction systems provided to remove or control mist or vapour are used properly.
     Ensure that there is a time delay before opening the doors on (CNC) machine enclosures to ensure that all mist and vapour have been removed by the ventilation.
     Introduce regular monitoring (checks) of the equipment and arrange for any damaged or defective splash guards, extraction systems, etc. to be repaired.
     Ensure that the extraction system is checked and serviced regularly and that it is subject to statutory examination (by a competent person) at least once in every fourteen month period.
     Ensure that there is adequate general ventilation in the work area - open workroom doors and windows to improve natural ventilation, where appropriate.

 Avoiding skin contact and skin protection
     Introduce suitable measures to reduce the potential for contact with MWF .
     Reduce contact with wet work pieces and surfaces.
     Instruct workers not to put bare hands into fluid sumps and not to use oily rags to wipe them clean.
     Provide suitable personal protective equipment and ensure that it is worn as appropriate.  Suitable PPE may consist of gloves (or gauntlets), overalls, aprons, goggles or face shields.
     Instruct workers in the risks of contamination of the inside of gloves (with MWF) when putting them on or taking them off.

Sump fluid control
     Ensure that waste materials (especially unwanted food, drink, cigarette stubs) are not disposed of into the sump.
     Instruct workers to inform a supervisor if they observe any layers of scum or large amounts of tramp oil on top of the sump fluid, or if the sump fluid becomes dirty or smelly.
     Introduce and follow good working practices when mixing fluids, cleaning and topping up sumps etc.
     Monitor the levels of bacterial contamination using dip slides, or other means of measuring the level of bacterial activity.
     Consider a contract management service for the MWF (offered by some suppliers). 

Personal Hygiene
     Provide suitable hand washing facilities, including running hot and cold water, soap and towels.
     Provide, and encourage the use of, suitable pre-work barrier creams and after-work conditioning creams.  This barrier cream should be designed to provide a protective layer between the skin and the MWF, while the after-work conditioning cream is intended to replace the natural skin oils removed by washing and by contact with the MWF.
     Ensure that any cuts and abrasions are covered with a suitable waterproof dressing.
     Instruct workers in the need for high standards of personal hygiene.
     Instruct workers to wash regularly with soap and water to remove MWF from skin. Instruct workers to avoid using abrasive or solvent cleaners.
     Instruct workers to wash their hands thoroughly before eating, drinking or smoking.
     Store personal protective equipment in the changing facilities provided or another clean storage area.
     Ensure that a sufficient number of suitable overalls are provided and that they are changed regularly.
     Instruct workers not to put oily rags into their pockets.
     Provide a laundry service for dirty overalls and instruct workers not to take hem home for washing.
     Prohibit eating, drinking and smoking in areas where metalworking fluids are used.
 
Health Surveillance
     Appoint a responsible person to carry out health surveillance, as identified by the risk assessment.
     Carry out asthma health checks.
     Refer anyone affected by exposure to MWF to an occupational health professional.
     In the event of any ill health being identified, ensure that prompt action is taken to identify the likely cause and ensure it is prevented or adequately controlled.
     Keep workers informed of the collective findings of health surveillance.

COSHH issues associated with exposure to oils and greases

Introduction 
It is an inevitable consequence of many aspects of production and maintenance work that workers will come into contact with greases, oils and general lubricants.  Prolonged contact with these oils and greases can cause a range of skin problems, such as: rashes (e.g. oil acne), dermatitis and even skin cancer and testicular cancer.  Contact with hot lubricants, during servicing or maintenance, may also cause burns. 

Routes for exposure to oils and greases
Oils and greases may be used widely in the workshop.  They may be associated with the lubrication of the moving parts of machinery in the workshop, they may be associated with work being undertaken or may be contamination on surfaces (such as work benches, inspection pits, work pieces, etc.).  The common routes for exposure are:
     Inhalation of the mist generated during the machining operation or from the use of spray lubricants (such as WD40).
     Direct contact with unprotected skin, particularly the hands or indirect (but often prolonged contact) from oil contaminated clothing, such as overalls.  This may occur when fill or draining a lubrication system or reservoir.
     Entry into the body through direct contact with cuts, abrasions or other broken skin.
     Ingestion (arising from eating, drinking or smoking in work areas, or from poor personal hygiene). 

Hazards associated with oils and greases 

Skin rashes and dermatitis
‘Oil acne’ may be identified by the presence of blackheads, pimples and pustules on the skin.   The arms are the area most commonly affected (as these are the area most likely to come into contact with oils and greases), but any other part of the body may be effected if it comes into contact with oils or oil soaked clothing.  Oils may also remove the skin’s own naturally protective oils, leaving it dry.  This dry skin is liable to crack and is more susceptible to damage caused by cuts and abrasions.

Skin and testicular cancer
It has been established that contact with certain mineral oils may cause cancer in humans. The carcinogenic potential of oil products is usually, but not always, associated with the presence of polycyclic aromatic hydrocarbons.  Used oils (especially used engine oil) have been shown to have elevated polycyclic aromatic hydrocarbons levels.  Prolonged exposure to certain mineral oils, and especially to used engine oil, can lead to the development of warty swellings or sores on the skin, especially where contact is on the scrotum.  These warty swellings are slow to heal and may be cancerous.  It is recognised that prolonged skin contact with used engine oil can lead to skin cancer and testicular cancer (from putting oily rags into overall pockets).  Consequently, used engine oil is listed as a carcinogenic substance in Schedule 1 of the Control of Substances Hazardous to Health Regulations 2002 (COSHH).   

Other hazards
Hazards associated with slipping due to oil on the floor or with burns from hot oils are not considered in this article.

Control measures for working with oils and greases
The best control measures are those that avoid contact with oils (such as fully enclosed pumping systems in place of pouring systems for draining and filling operations), while others limit the amount of contact (such as hand washing after exposure).

Overalls
Workers potentially exposed to oils should be provided with a sufficient number of protective overalls.  It is usual for them to have at least three sets of overalls (one set to wear, one set being cleaned and at least one spare set), although some tasks may require more sets of overalls.  Suitable arrangements need to be made for the overalls to be cleaned.  It is recommended that overalls are dry cleaned in order to remove oils and greases.

Ideally, overalls should be supplied without (trouser) pockets, so that oily rags cannot be stuffed into the pockets - reducing the potential for prolonged skin (scrotal) contact.  Lack of pockets also reduces the risk of other injuries from the tools, etc. that may also otherwise be put into them.

Aprons
The use of (disposable) plastic aprons should be considered for certain operations where there is a risk of oil contamination of the overalls. 

Gloves
Appropriate gloves should be worn as a barrier to protect the hands from contact with oils and greases.  In many cases, disposable gloves are used, while in others, more robust longer use nitrile gloves are provided.  The type of gloves provided will be dictated by the level of protection required and the type of work being undertaken.  The thin, disposable gloves reduce skin contact with oil while allowing fine work to continue.

Suitable washing facilities
Decent washing facilities are necessary to remove oil from the skin.  These should include both hot and cold running water as well as suitable skin cleansers.  Suitable hand drying facilities should also be provided, such as paper towels.  The use of suitable conditioning creams after washing can help to counter the degreasing effects of the oil on the skin.  Skin must never be cleaned with solvents, etc.  So called “barrier creams” must not be relied on to protect the skin from exposure to oils.  They can, however, be a useful extra protection and can make it easier to wash oils off of the skin after exposure.

Use of tissue rolls in place of rags
It is recommended that, where appropriate, the use of rags for cleaning up is replaced by the use of suitable tissue wipes (usually supplied in a roll form).  Dispensers for these rolls may be wall mounted at suitable locations in the workshop.  This means that clean tissue is readily available for addressing small spills, cleaning tools, etc. and also that there is no temptation to keep rags (potentially oil contaminated) in overall pockets.

Draining and filling of lubrication systems, including those associated with vehicles
The drainage of used oil from lubrication systems offers significant risk of contact with the used oil.  These contact risks exist during the draining process, but also in subsequent handling of the drained oil, such as during transfer to a waste disposal holding vessel such as an oil drum or tank.  The risks may be reduced substantially by the use of a suitable oil collection vessel that later allows the waste oil to be pumped from the collection vessel to the waste oil storage vessel.  The collection vessel should be fitted with a wide funnel (for catching the oil) which should in turn be fitted with mesh to catch sump keys, bolts, oil filters, etc.

Storage and disposal of (waste) oil
Oil, including waste oil, should be stored in suitable, robust vessels inside a bunded storage area (with a bund capacity of at least 110% of the size of the largest storage vessel) pending collection for disposal by a licensed collector of such special waste. 

Health surveillance
As it is recognised that prolonged skin contact with mineral oils can lead to occupational dermatitis and, in some cases skin cancer, the employer should carry out routine skin inspections as a precautionary measure.  Employees should be encouraged to report sore, red or itching skin, whilst the responsible person should carry out regular, documented and recorded skin inspections of hands and forearms at monthly intervals.  Cases of suspected dermatitis should be referred to a doctor or occupational hygiene nurse for further investigation.  The results of health surveillance must be recorded and records must be retained for 40 years.

Information, instruction and training 
Employees who are potentially exposed to oils and greases must be made aware of the hazards associated with these materials and of the control measures to be used to protect their health.  Awareness can also be raised with suitable notices and leaflets that are available from the HSE.

Care with air-lines
Where compressed air is used to provide breathing air to air-fed masks, etc., care must be taken to ensure that the workers are not exposed to oil mists from the compressed air.  Suitable filters should be fitted and maintained and the quality of the air should be checked regularly.

Summary
Consideration needs to be given to the aims of the training course.  In many cases, the training needs to be focus on the nature of the hazard to which people will (or may) be exposed and on the measures that need to be used to avoid or control that hazard.  In the case of COSHH and its relevance to a small engineering workshop, it may be prudent to focus the training on examples that affect the workshop rather than on the intricacies and technicalities of the COSHH Regulations.  This may be achieved by training using examples that are directly relevant to the workshop.

 
For information on training and consulancy contact us through the website
 

 

Monday, 22 October 2012

A brief guide to Safety in the Warehouse

Many businesses have storage and warehouse facilities as an integral and important part of their operation.  These may be very busy places at all times (such as in a logistics operation) or they may be pretty quiet for many hours a day, but have periods of intense activity.  Warehouses are dangerous places and people do get hurt in them in several ways.  Many of the injuries suffered can be avoided by taking some simple steps; all derived from simple risk assessments. In this blog, I have asked two basic questions: "What types of accidents are associated with warehouse operations?" and "What can be done to avoid these accidents?" This blog does not seek to provide in depth answers, but to get the reader thinking. Contact me through the website for further information or assistance.

What types of accidents are associated with warehouse operations?

That depends on the operations carried out in the warehouse.  The main types of accidents in warehouses generally include:

  • Slips, trips and falls (on the same level)
  • Manual handling
  • Falls from height
  • Accidents involving vehicles moving in and around the warehouse
  • Being struck by moving or falling objects
However, other types of accident will occur in warehouses depends on the type of operations being carried out, such as:

  • Mechanical accidents involving the use of conveyor systems
  • Exposure to chemicals (from poorly stored items)
  • etc
What can be done to avoid these accidents?

Slips, trips and falls

  • Ensuring good standards of housekeeping – keep walkways clean. Clear and unobstructed
  • Ensure that spillages are cleaned up immediately that they occur or when they are noticed
  • Ensure that banding tapes, packaging materials and polythene, etc are not allowed to collect on the floors
  • Ensure that leaky roofs are repaired
  • Ensure that all staff are provided with (and wear) appropriate safety footwear
  • Ensure that the floors are maintained in good condition and that defects are repaired
Manual Handling

  • Arrange work such that the needs for manual handling are reduced (such as by the use of fork lift trucks, (powered)-pallet trucks, dock lifts, etc)
  • Ensure that the risks associated with all manual handling operations are assessed and minimised, giving consideration to:
    • the task
    • the load
    • the working environment
    • individual capability, and
    • other factors
  • Ensure that there are always a sufficient number of employees to deal safely with the loads that need to be handled
  • Arrange suitable training in manual handling for all warehouse staff (including temporary and agency workers)
Work at Height

  • Avoid the need to work at height were possible
  • Avoid climbing on the top of loads where possible
  • Provide suitable, practical protection to areas from which people may fall (such as loading bays, etc)
  • Provide suitable means of access  for any elevated work area, such as racking locations, etc
  • Arrange for all access equipment to be checked regularly by a competent person
  • Instruct workers not to use inappropriate or defective access equipment (avoid the use of the forks on a fork lift truck or the use of a pallet on the truck, etc)
  • Provide safe working platforms for accessing the back of vehicles (such as tankers or flat bed trucks) if accessed routinely
Vehicles

  • Manage the vehicles accessing the site – where possible, provide delivery drivers with relevant health and safety information about your site (times for deliveries, one-way system information, etc) before they arrive
  • Display suitable warning signs and notices
  • Consider have safety information available in different languages if regularly dealing with drivers from different countries
  • Provide clearly designated vehicle and pedestrian routes (where possible)
  • Ensure that areas are adequately illuminated
  • Provide warehouse staff with high visibility clothing
  • Control the reversing of vehicles (consider the use of CCTV systems on your own vehicles)
  • Provide workers with suitable and sufficient vehicle movement awareness training, banksman training, etc
  • Implement suitable controls for vehicles on site – such as warning signs, site speed limits, mirrors on “blind” corners and bends, etc
  • Ensure that all loads are safe before attempting to unload a vehicle
  • Ensure that all loads are secure before allowing a vehicle to leave site
  • Implement procedure to prevent vehicles from driving off prematurely (such as a key collection system or chocked wheel system).
  • Ensure that the use of fork lift trucks is restricted to trained and authorised users
  • Restrict access to the warehouse to authorised persons and display suitable notices to this effect
Falling Objects

  • Ensure that all loads stored at height (such as on racking) are secure
  • Avoid working under other people
  • Assess the safety of loads before attempting to unload a vehicle
  • Ensure that all racking systems are adequate for the loads that will be stored on them
  • Display the safe loading limit of all racking systems
  • Carryout regular inspections of the racking and of the goods stored on the racking
  • Check the condition of wooden pallets and do not reused damaged pallets
  • Arrange for loose items to be secured (such as by shrink wrapping) before storage
Mechanical Accidents
  • Ensure that all plant and equipment provided for use in the warehouse (such as shrink wrapping equipment, conveyor systems, etc) is suitable for the task and is in good condition
  • Arrange for all equipment to be checked and inspected regularly by a competent person to ensure that it remains in good condition, to ensure that all guards are in place and that all emergency stops and other safety features and controls work
  • Restrict the use of plant and equipment to authorised persons only
Exposure to chemicals
  • Ensure that all chemical packaging is in good condition
  • Ensure that appropriate PPE is provided
  • Ensure that suitable washing facilities and emergency arrangements are in place for washing and for emergency eye wash
  • Ensure that safety data sheet are available for all substances used and/or stored on site
  • Ensure that all chemical packaging display suitable warning symbols
Need some help? Contact us through the website

Health Surveillance

Introduction
It is a sad fact that eery year, many thousands of employees suffer or are made ill by the work that they do.  The harm may come from a range of occupation factors, such as:
  • Noise
    • Noise induced hearing loss (NIHL)
    • Tinnitus
  • Vibration
    • Hand-Arm Vibration Syndrome
  • Exposure to chemicals
    • Dermatitis
    • Skin sensitization
    • Reduced lung capacity
    • Occupational asthma
    • Respiratory sensitization
    • Poisoning (such as by lead)
The HSE estimates that between 1500 and 3000 people in Great Britain each year develop some form of occupational asthma. Many of these illnesses can be identified by the process of health surveillance.  In some cases, they can be identified before too much (irreversible) harm is done.  Health surveillance is about putting in place systematic, regular and appropriate procedures to detect early signs of work-related ill health among employees exposed to certain health risks; and allowing the employer to act on the results.

Health Surveillance and Risk Assessment
It is well established that employers must carry out risk assessments.  These assessments must be suitable and sufficient to identify how employers (and also non-employees) can be harmed and how that harm can be avoided or, if this is not reasonably practicable, minimised.  The Management of Health and Safety at Work Regulations 1999 (MHSW) create this duty in all work situations and other sets of Regulations enforce this requirement in certain circumstances.  Schedule 1 of MHSW details a hierarchy that the employer must follow when considering control measures (i.e. measures to avoid or reduce the harm that people may suffer).  Health Surveillance is at the bottom of this hierarchy.  The main reason for this is:

  • Health Surveillance does nothing to protect the employee from harm – it merely allows the employee to determine t he amount of harm of the level of exposure to harmful agents (chemicals, noise, vibration, etc.).
When Health Surveillance should be carried out and by whom
Health surveillance should be carried out when all of the following conditions are satisfied:
  • The work being carried out (or the environment in which the work is being carried out) is known to damage health in some particular way
  • There are valid and safe ways to detect the disease or condition – It is important to understand that health surveillance is only worthwhile in situation where it can reliably show that damage to health is starting to happen or that there is a likelihood of such damage occurring. It is also important to understand that a particular health surveillance technique is only useful if:
    • it provides accurate results,
    • it is safe, and
    • it is practical.
  • It is reasonably likely that damage to health may occur under the particular conditions at work?
  • Health surveillance is likely to benefit employees
Health surveillance should also be carried out when it is expressly required by legislation, such as where an employee is engaged in one of the processes listed in Schedule 6 of the Control of Substances Hazardous to Health Regulations 2002 (such as: manufacture involving exposure to vinyl chloride monomer (VCM), pitch, carbon disulphide, potassium or sodium dichromate, auramine, Magenta or several other identified substances) and is likely to receive significant exposure to the substance involved.
 
Procedure
By whom
Examples
Self Checks
The employee
Self checks are suitable for those employees exposed to hazards who have been properly trained in how to look for easily recognisable signs and symptoms of disease.  The employee should know who to go to if they find anything that causes them concern.
Basic (visual) checks for signs of disease
Responsible Person
 
 
Skin inspections where people work substances that can cause dermatitis, such as:
  • Detergents
  • metalworking fluids (MWF)
  • shampoos
 
Enquiries about
symptoms, inspection
and examination
 
Qualified person
 
An occupational health:
o   Checking for signs of asthma
o   Measuring lung function
Audiologist::
o   Measuring hearing
 
Clinical examinations
 
Should be carried out by or be supervised by a doctor.
 
Interpretation of results may also require a doctor.
In some cases this is a legal duty (for example for employees exposed to lead); in others the nature of the tests will require the expertise of a doctor to interpret the results and advise on their significance.
Examination by a doctor is also likely to be necessary where health surveillance by a responsible person or an occupational health nurse has identified possible work-related ill health that requires further investigation, diagnosis and treatment.
 
Biological monitoring
and biological effect
monitoring
 
In general, these should be carried out by or supervised by a doctor.
 
The samples may be taken by a suitably trained person.
Blood testing for:
  • lead
  • mercury
  • carbon monoxide
Urine testing for:
  • cadmium
  • fluoride
Urine testing for breakdown products of:
  • isocyanates
  • styrene
 

Responsible Person
Anyone trained to identify straightforward signs and symptoms caused by working with certain substances or processes.  A responsible person must not be expected to diagnose the possible cause of symptoms.  Managers, supervisors or first aiders could carry out these checks. An occupational health doctor or nurse should train these people to recognise signs or symptoms requiring further assessment and to know when and how to refer employees.

Qualified person
A qualified person usually means an occupational health nurse checking, for example, for signs of asthma.  It can also be someone with appropriate technical knowledge, for example an audiologist carrying out hearing tests or someone trained to conduct lung function tests.

Typical health surveillance for those working with substances that may cause dermatitis

Skin health surveillance should be considered in cases were workers:

  • Have the following occupations: construction work, health service work, rubber making, printing, paint spraying, agriculture, horticulture, electroplating, cleaning, catering, hairdressing, floristry
  • Are (potentially) exposed to any of the following substances: epoxy resins, latex, rubber chemicals, soaps and cleaners, metalworking fluids, cement, wet work, enzymes, corrosive chemicals, irritant chemicals, solvents and other similar organic liquids (such as paint thinners, etc.)
  • Are (potentially) exposed to any products that are labelled:
    • R43 ‘May cause sensitisation by skin contact’
    • R42/43 ‘May cause sensitisation by inhalation and skin contact’.
Typical forms that the skin health surveillance could take include:

  • Assessing the skin condition of workers as soon as possible after they start (and preferably within six weeks) a relevant job to provide a baseline.
  • Implementing regular testing at appropriate intervals (such as monthly, every few months or annually - as advised by an occupational health practitioner)
  • The regular testing could involve a suitable questionnaire and skin inspection (hands, forearms and, if these can be contaminated, lower legs) by a responsible person.
Typical health surveillance for those working with substances that may cause (occupational) asthma

Respiratory health surveillance should be considered in cases were workers:

  • Have the following occupations: bakers, food processors, beauty service providers, cleaners, painters, repairers (including electronics), welders and woodworkers (including forestry).
  • Are (potentially) exposed to any of the following substances: isocyanates (such as in two-pack spray paints), glutaraldehyde, wood dust (hard wood, soft wood, MDF, plywood, etc), latex (such as from powdered natural rubber latex gloves), flour dust, grain dust, rosin-cored solder fume, laboratory animals or glues and resins
  • Are (potentially) exposed to any products labelled:
    • R42 ‘May cause sensitisation by inhalation’ (may lead to asthma)
    • R42/43 ‘May cause sensitisation by inhalation and skin contact’; or
  • Have had a confirmed case of (occupational) asthma.
Typical forms that the respiratory health surveillance could take include:

  • Assessing the respiratory health of workers before they start a relevant job to provide a baseline.  This could be achieved by a combination of questionnaire and lung function assessment.
  • Implementing regular testing (again a combination of questionnaire and lung function assessment) at appropriate intervals (nominally annually or as advised by the health professional.
  • Arranging for the results to be explained to the worker by the health professional.
  • Arranging for the health professional to report to the employer on the fitness of the worker to work.
  • Interpreting the results of the health surveillance (in conjunction with the health professional) and identify whether there is any requirement to revise the risk assessment, and if so in what way.
  • Appointing a responsible person (supported by the health professional) to report any symptoms that occur between tests.
  • Setting up a simple system to keep and monitor attendance records to identify any patterns in sickness absence.
Making and keeping Health Surveillance Records
All health surveillance programmes should include the keeping of suitable records, including a health record for each individual. These are important as they provide:

  • An historical record of jobs involving exposure to substances or processes that require health surveillance;
  • A record of the outcome of previous health surveillance procedures
  • A demonstration (to enforcing authorities) that health surveillance has been carried out.
  • Useful information that may later provide a defence in the event of prosecution or civil proceedings.
The records should contain, as a minimum, the following information:

  • Full name
  • Gender
  • Date of birth
  • Employee’s address
  • NI Number
  • Date of start of current employment
  • Brief employment history (of jobs with exposure to hazardous substances, etc.)
  • Conclusions of health surveillance
Health surveillance records should be retained for a minimum period of 40 years (or should be passed to the HSE if the company ceases trading).  As with all personal data being held by a company, there are various data protection issues that must be considered.

Summary
Health surveillance is important as a means of demonstrating that the control measures put in place to protect workers from harm are effective.  Health surveillance is, however, ineffective as a control measure in its own right as it can only measure how much, or how little, harm has been done to an individual – it cannot protect them from that harm.  Health surveillance can be carried out in a number of different ways by different groups of people.  Whenever an organisation is considering the introduction of health surveillance, health professionals should be consulted to help to plan and design the service to be provided.  Health surveillance should be carried out at appropriate, regular intervals and suitable records of should be maintained of all health surveillance.