Many workers in many industries are exposed to things that can cause them harm.
Health monitoring is an organised process to assess people for early changes that could
be happening to them from those exposures and hopefully identify conditions at very
early stages before too much harm has occurred.
It also allows feedback of information to the employer, so they can perhaps introduce
better controls into the workplace to prevent any injuries in the first place.
The actual method of health monitoring can vary, depending on the nature of the hazard.
It may range from say hearing tests in one sphere, or it may involve a look at other
organ systems in the body.
Generally it will involve some form of medical history, also we like to know about the role
and what sorts of protections the person uses in their normal work.
We need to know a little bit about the likely symptoms that could be coming from the exposure.
Also in some cases it may be necessary to do some other testing and that could involve
specialised tests like spirometry, chest X-rays or even blood and urine tests.
A site should organise health monitoring when there's a significant risk of workers being
injured through an exposure to a hazardous substance.
Now that hazardous substance could appear in the schedule to the work, health and safety
regulation, or if it's not in that schedule then if it's a substance that has a known
harmful effect and there's a valid way of measuring for it, they should be having health
monitoring.
For workers exposed to silica they definitely have a prescribed schedule for health monitoring.
Workers exposed to silica will normally, once again, need a history.
You want to know their general health, you want to know their workplace exposure history,
you want to know what precautions are being taken.
Then because silica has its main effect on the lungs, that's where we tend to focus the
bulk of the assessment.
So normally you would have an examination of the respiratory tract and then we use some
specialised tests.
Now silica tends to cause inflammation and scarring in the airways and this can change
the way air flows through the lungs and also volumes.
So we use a test called spirometry, which measures airflow and volumes in the lungs.
Then with silica we also like the person to have a chest X-ray because that can help us
to detect the early changes of scarring in the lung.
The regulation actually says the employer must ensure the health monitoring is performed
by a medical practitioner with experience in health monitoring.
So ideally you should look for someone who works regularly in occupational medicine.
Now some GPs will have that experience, but many will not.
So it is one area where it is important to take some care with your choice.
In terms of payment, the legislation is quite clear; the employer must play all the costs
associated with the assessment.
The health monitoring report should have the workers' test results and it should explain
to them what the outcome was.
It should also tell them if there's a need for any further follow-up or testing and it
should also give an opinion on that worker's fitness for work and whether any forms of
remediation in the workplace are necessary.
The health monitoring report must be provided to the regulator when a worker has suffered
an injury, illness or disease as a result of the hazard that the health monitoring report
was prepared for.
These reports are a personal medical record, so they are confidential, they must be stored
confidentially and they can only be released with permission from the worker.
That said, the legislation does require some of the information to be released back to
the employer and the regulator.
You must keep the health monitoring report for a total of 30 years and in the case of
asbestos you must keep it for 40.
I'd just like to add that if you are exposing workers to hazardous substances like crystalline
silica, then it is your responsibility to find out whether they require health monitoring
and if you're not sure, then please ask.