Health surveillance in the workplace refers to the health monitoring of employees where there is a risk to health from exposure to certain hazardous substances (listed in Schedule 5.3 of the OSH Regulations 1996) or other hazardous substances where suitable health checks are available. Health surveillance must be supervised by an Appointed Medical Practitioner. Health surveillance may include completion of a questionnaire, medical examination, blood or urine tests, lung function tests, chest x-rays, or other health tests relevant to the substance.
How to choose a suitable medical practitioner
Health surveillance must be supervised by an Appointed Medical Practitioner (AMP), appointed by the employer in consultation with employees. This should be a doctor with experience in health surveillance. As an example, any doctor who is a fellow of the Australian Faculty of Occupational and Environmental Medicine will have the necessary experience. A list of these practitioners can be found on The Royal Australasian College of Physicians’ website.
How can health surveillance protect employees in the workplace?
Health surveillance helps to identify possible excessive exposure to a hazardous substance before the person’s health is significantly affected, in order to prevent serious illness occurring. It enables feedback to the workplace for improvements to safe work practices.
Who should have health surveillance?
The employer should firstly undertake a risk assessment in the workplace in accordance with OSH Regulation 5.15. This will enable the employer to identify who in the workplace requires health surveillance. The employer should set up a health surveillance process for employees in consultation with an Appointed Medical Practitioner.
How often should health surveillance be undertaken?
The frequency of testing is determined by the type of the hazardous substance, the nature of the work, the exposure, previous health surveillance results and the presence of other risk factors. The Appointed Medical Practitioner will provide a recommendation on the frequency of health surveillance, with reference to the guidance provided in Health Monitoring For Exposure to Hazardous Chemicals – Guide for Medical Practitioners.
Who is responsible for arranging health surveillance?
The employer has the responsibility of providing health surveillance at no cost to their employees, and to appoint a medical practitioner to supervise health surveillance for their employees.
Who can be an Appointed Medical Practitioner?
Medical practitioners who wish to take on the role of Appointed Medical Practitioners (AMP) must:
- understand the principles of health surveillance;
- understand the toxicology of hazardous substances and have an awareness of current medical literature;
- comply with the OSH Regulations 1996; and
- exercise clinical judgement in advising employers and employees in relation to:
- frequency of testing,
- removal of employees from lead risk work,
- returning employees to work following removal,
- further clinical or medical investigations or management, and
- any need for remedial action in the workplace.
Medical practitioners who are considering conducting this work should contact WorkSafe’s occupational physician for further information, including an information pack by contacting the department on 1300 307 877 or emailling firstname.lastname@example.org.
What is the role of an Appointed Medical Practitioner (AMP)?
The AMP is appointed by the employer to supervise health surveillance in the workplace.
The AMP, in consultation with the employer, advises on an appropriate health surveillance program for the workplace taking into account the nature of the hazard and occupational exposure.
The program should be designed for the purpose of identifying those employees who are at risk of adverse health effects from occupational exposure to known hazardous chemical, biological and physical agents. The program will include the recommended frequency of biological monitoring, medical assessments, and workplace inspections as indicated.
The AMP is required to notify and explain the results to the employee. Where the results are of concern, the AMP is to counsel the employee, consider restrictions on or removal from occupational exposure, and liaise with the employer to investigate and implement effective workplace controls.
The AMP is responsible for notifying the results to WorkSafe on the appropriate WorkSafe Health Surveillance Notification Form. This should be done as soon as practicable. Should any results indicate risks of serious harm, the AMP may contact WorkSafe directly.
The AMP may recommend removal from further exposure to a hazardous substance on clinical grounds in order to prevent serious adverse health effects.
What happens if an employee has been removed from work exposure to a hazardous substance?
An AMP can recommend removal of the employee from further exposure to the hazardous substance. Often this would be on a temporary basis; however in some cases (eg severe sensitisation) it may be permanent. The employee is usually able to do other work.
There are specific criteria for removal from work in the OSH legislation for lead workers, e.g. blood lead level exceeding 20 µg/dL for female lead worker of reproductive capacity or exceeding 50 µg/dL for all other lead workers. The employee must undergo a medical examination by the AMP within 7 days of removal and may not return to lead work unless certified by the AMP. More information is available in the bulletin Removal from lead work – management of workers.
In October 2019 blood lead levels requiring workers removal from work will be reduced to 10 µg/dL for females and 30 µg/dL for males.
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