Introduction to Health and Safety at Work

6.4.3
Assessing exposure and health 
surveillance
Some aspects of health exposure will need input from 
specialist or professional advisers, such as occupational 
health hygienists, nurses and doctors. However, consid-
erable progress can be made by taking straightforward 
measures such as:
➤
consulting the workforce on the design of workplaces
➤
talking to manufacturers and suppliers of substances 
and work equipment about minimizing exposure
What substances (products) do you use?
What are the health hazards (see R-phrases on
Safety Data Sheets and/or product label)?
Are you following the principles of good control practice? Or
Are your controls equivalent to those suggested by COSHH
Essentials? Or Can you demonstrate your controls are adequate?
Yes
No
Don't know
Maintain current
controls
Seek advice e.g. COSHH
Essentials or equivalent
Investigate improvements
(apply COSHH Essentials
guidance or equivalent)
Figure 6.6
Route map for adequate control for SMEs/non-experts.

---

Introduction to Health and Safety at Work
86
➤
enclosing machinery to cut down dust, fume and 
noise
➤
researching the use of less hazardous substances
➤
ensuring that employees are given appropriate infor-
mation and are trained in the safe handling of all 
the substances and materials to which they may be 
exposed.
To assess health risks and to make sure that control 
measures are working properly, it may be necessary, for 
example, to measure the concentration of substances 
in air to make sure that exposures remain within the 
assigned Workplace Exposure Limits (WELs). Sometimes 
health surveillance of workers who may be exposed will 
be needed. This will enable data to be collected to check 
control measures and for early detection of any adverse 
changes to health. Health surveillance procedures avail-
able include biological monitoring for bodily uptake of 
substances, examination for symptoms and medical 
surveillance – which may entail clinical examinations and 
physiological or psychological measurements by occu-
pationally qualifi ed registered medical practitioners. The 
procedure chosen should be suitable for the case con-
cerned. Sometimes a method of surveillance is specifi ed 
for a particular substance, for example, in the COSHH 
ACOP. Whenever surveillance is undertaken, a health 
record has to be kept for the person concerned.
Health surveillance should be supervised by a 
registered medical practitioner or, where appropriate, it 
should be done by a suitably qualifi ed person (e.g. an 
occupational nurse). In the case of inspections for easily 
detectable symptoms like chrome ulceration or early 
signs of dermatitis, health surveillance should be done 
by a suitably trained responsible person. If workers 
could be exposed to substances listed in Schedule 6 of 
the COSHH Regulations, medical surveillance, under the 
supervision of an HSE employment medical adviser or 
a doctor appointed by HSE, is required.