Occupational Health Surveillance Services

Audiometry Testing

The Legislation

The Control of Noise at Work Regulations 2005 (the Noise Regulations) came into force for all industry sectors in Great Britain on 6 April 2006 (except for the music and entertainment sectors where they came into force on 6 April 2008).
The aim of the Noise Regulations is to ensure that workers’ hearing is protected from excessive noise at their place of work, which could cause them to lose their hearing and/or to suffer from tinnitus (permanent ringing in the ears).
The Control of Noise at Work Regulations 2005 replace the Noise at Work Regulations 1989.

The Hearing Test

In advance of the hearing test the employee is required to complete our standardised questionnaire, this questionnaire documents the employee’s medical history and other exposures to noise.
The hearing test is done using industry standard audiometry equipment.
After performing the hearing test, any issues arising with an employee are brought to the attention of the company management and a referral service is offered.

Lung Function (Respiratory)

The Legislation

The Control of Substances Hazardous to Health (COSHH) Regulations 2002, require employers to control exposures to hazardous substances to protect employees’ health. Employers must assess the exposure (exposure means taking in chemicals by breathing in, by skin contact or by swallowing) and the risk that this exposure would cause undue health effects.

What Are Workplace Spirometry Tests?

Spirometry Tests (Lung Function Tests) aim to detect early damage to lung function from exposure to respiratory sensitizers and other substances that have the potential to cause serious ill health.

Substances that can cause Occupational Lung Disease

Substances that can cause Occupational Lung Disease, Chronic Obstructive Pulmonary Disease (COPD) or Occupational Asthma normally trigger a Health Surveillance requirement. Examples of such respiratory sensitizers are:

• Occupational Asthma
• Isocyanates
• Welding Fumes
• Dust and other Airborne Particulates (including Wood Dust)
• Paints / Adhesives/ Resins
• Glutaraldehyde
• Latex
• Soldering Flux
• Lung Disease / COPD
• Asbestos
• Silica Dust / Respirable Crystalline Silica (RCS)
• Ceramic Fibre

(This is not a complete list and you should refer to the latest COSHH regulations/assessments.)

Vision Testing

We incorporate vision testing into routine annual health surveillance where applicable. In most cases it is worthwhile carrying our vision testing to ensure that your employees eye sight is serving them well, and to help them remain safe on site.

We also carry out in depth vision testing, where we can test for left and right eye acuity, peripheral vision, and depth perception. Vision testing is one of the main tests that we carry out for those employees who driving is a main part of their duties such as forklift truck drivers.

Skin Assessments (Dermatology)

The Legislation

Control of Substances Hazardous to Health Regulations 2002

Personal Protective Equipment Regulations 1992

Occupational Dermatitis

Work-related skin problems are a very common occurrence, they can happen in most workplaces although they are more prevalent in certain high-risk jobs. They can be very costly, not just through the suffering individuals experience but to the employer as well. This is why skin assessment in the workplace can be an excellent strategy.

What are work-related skin problems?

Work-related skin problems are caused or made worse by exposure to or coming into contact with substances such as chemicals, and also by having wet hands for long periods while at work. The commonest sites are the hands and forearms and the severity can range from minor irritation to severe disabling painful conditions of the hands that prevent work and everyday activity. Sadly, without early detection of the problem, the skin can be affected for many years even after ceasing employment. The commonest problem is dermatitis, either irritant or allergic.

As an employer, what should you do about it?

Employers have a duty to assess the risk of skin problems developing in their workplace, putting controls in place to prevent problems, and arranging health surveillance if the risk cannot be eliminated. If you have staff who need to wash their hands regularly, need gloves to protect their hands, handle soaps, detergents or are in contact with chemicals, then you almost certainly should be providing regular health surveillance.

What dermatology screening provides

We undertake health surveillance using a questionnaire and skin (dermatology) examinations, looking predominantly at the hands and arms of your employees. This will identify any areas of concern relating to possible skin exposure and helps you meet your legal requirements under Regulations and assist in good skin health.

Confined Space Medical

The Legislation

• The Confined Space Regulations 1997 apply where the assessment identifies risks of serious injury.
• Wherever conceivable, companies should avoid carrying out tasks in confined spaces. Where this is not possible, you must assess the risks and plan how to control those risks.

What is a Confined Space?

A confined space is a place which is substantially enclosed (though not always entirely), and where serious injury can occur from hazardous substances or conditions within the space or nearby (e.g. lack of oxygen).

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.

Dangers of Working in a Confined Space Can Arise due to:

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

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

What is involved?

• Health questionnaire.
• Height, weight, BMI, 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 Questionnaire

Hand-Arm Vibration Syndrome Tier 1 – Tier 4

The Legislation

The Control of Hand Arm Vibration at Work Regulations 2005 (the Vibration Regulations), came into force on 6 July 2005 and aim to protect workers from risks to health from vibration.

What is Hand Arm Vibration?

Hand-Arm Vibration Syndrome (HAVS) is the medical term for symptoms caused by vibration damages that may occur in the fingers, hands and arms when working with vibrating tools or machinery. Vibration injuries are divided into three subgroups: neurological disorders, vascular and musculoskeletal.

HAVS can lead to adverse Health Effects

Multiple studies have shown that regular and frequent exposure to HAV can lead to permanent adverse health effects, which are most likely to occur when contact with a vibrating tool or work process is a regular and significant part of a person’s job.

Hand-arm vibration can cause a range of conditions collectively known as hand-arm vibration syndrome (HAVS), as well as specific diseases such as white finger or Raynaud’s syndrome, carpal tunnel syndrome and tendinitis. Vibration syndrome has adverse circulatory and neural effects in the fingers. The signs and symptoms include numbness, pain, and blanching (turning pale and ashen). Also known as vibration white finger, it has been estimated by the HSE that there are 288,000 sufferers in the UK.

It has 3 main symptoms:

• Sensory symptoms such as tingling and numbness in the fingers
• Poor circulation in the fingers
• Nerve (carpal tunnel syndrome), bone and joint damage.

In its early stages symptoms are minor, and soon wear off after the vibration stops. Control at these early stages prevents the onset of more severe symptoms which can cause disability, loss of employment.

Tools that can cause white finger

There are many different types of hand-held power tools and equipment which can place workers at increased risk of developing HAVS. Some of the more common ones are:

• Chainsaws
• Impulse Tools
• Ratchet Screwdrivers
• Concrete Breakers
• Cut-off Saws
• Hammer Drills
• Hand-held Grinders
• Impact Wrenches
• Jigsaws
• Pedestal Grinders
• Polishers
• Power Hammers
• Power Chisels
• Powered Lawn Mowers
• Powered Sanders
• Brush/Weed Cutters

HAVS Assessment

The Control of Vibration at Work Regulations introduces a detailed “Tier system” for HAVS assessments.

• Tier 1: An initial assessment before the employee starts work with vibrating tools.
• Tier 2: An annual assessment.

Anybody disclosing symptoms during Tier 1 or 2 reviews should then be subject to further more detailed assessment.

• Tier 3: A ‘qualified health professional’ administers a comprehensive and detailed questionnaire and carries out a range of clinical tests. Those with the appropriate symptoms and history progress to the next tier.
• Tier 4: This stage is when a formal diagnosis is made. It must be conducted by a suitably qualified Doctor. Any such formal diagnosis must be reported by the employer under RIDDOR 1995.