Health surveillance for hazardous substances

Actions required to ensure health surveillance is correctly undertaken for hazardous substances (as covered by COSHH)

The following provides guidance for those hazardous substances that are covered by the Control of Substances Hazardous to Health Regulations (COSHH). Guidance on other hazardous substances, that are covered by separate regulations, is available elsewhere. Specifically:

 

Work Place Activity or Hazard:

Working with substances which can cause Chronic Obstructive Pulmonary Disease (COPD):

  • Cadmium dust
  • Cadmium fumes
  • Grain and flour dust
  • Mineral dust
  • Organic dusts
  • Silica dust
  • Welding fumes

Health Surveillance requirements:

Health surveillance is necessary when:

  • there is a disease associated with the substance in use
  • it is possible to detect the disease or adverse change and reduce the risk of further harm
  • the conditions in the workplace make it likely that the disease will appear

Department Action:

(Guidance on how to establish if Health Surveillance requirements are met (as part of your risk assessment))

Where registration is required

Complete HS1 form and register with the University Occupational Health Service where after a suitable and sufficient risk assessment and implementation of control measures: There is still significant regular (and actual) exposure to silica dust; Or where there is significant regular (and actual) exposure and adequate control relies on personal protective equipment.  This would include where there is reason to believe exposure is approaching the Workplace Exposure Limit (not taking account of respiratory protective equipment).

COSHH Essentials e-tool and COSHH Essentials direct advice provides a way of assessing whether control measures are suitable and sufficient for certain tasks and processes

Referral to UOHS is also appropriate where there is reason to believe an individual may be at increased risk, including a previous diagnosis.

Where registration is not required

There is no need to complete HS1 form and register with the University Occupational Health Service where there no actual exposure or potential for exposure or there is only occasional & low/intermittent/well controlled exposure (not reliant on personal protective equipment).

Occupational Health Action:

(Following receipt of an appropriate registration form)

The employee may be enrolled onto a relevant health surveillance programme.

Further Information:

Please refer to your supervisor, departmental or divisional / area safety officer if you need further assistance in interpreting this information and how it relates to the work, and the risk assessment that is being undertaken.

Work Place Activity or Hazard:

Working with substances known to cause dermatitis (allergic or irritant) and urticaria

e.g. Alcohol, degreasers, solvents, metal working fluids, cutting oils and coolants, petroleum products, epoxy resins, latex, soaps/detergents/ cleaning products; cement, wet work, enzymes, wood dust, substances outlined below

Chemical Substance labelling:

H317: May cause an allergic skin reaction

And

H315: Causes skin irritation

 

Substances or occupations listed in HSE Guidance Note G403 Health surveillance for occupational dermatitis.

Substance is listed in HSE guidance on skin irritants and sensitisers  or HSE guidance on Urticaria.

Health Surveillance requirements:

Health surveillance is necessary when:

  • there is a disease associated with the substance in use (eg Asthma, Dermatitis, Cancers)
  • it is possible to detect the disease or adverse change and reduce the risk of further harm
  • the conditions in the workplace make it likely that the disease will appear

Department Action:

(Guidance on how to establish if Health Surveillance requirements are met (as part of your risk assessment))

Where registration is required

Complete HS1 form and register with the University Occupational Health Service (UOHS) where after a suitable and sufficient risk assessment and implementation of control measures:

a) There is regular exposure to the substance for example regular and immersive wet work with reliance on personal protective equipment to control the risk Or there is individual susceptibility/sensitivity (e.g. already sensitized or has dermatitis)

b) There is occasional or potential for actual exposure or a reliance on personal protective equipment as a means of achieving adequate control.

UOHS will provide an initial assessment, and decide on the appropriate level of health surveillance which may include regular skin checks (Skin checks for dermatitis poster (hse.gov.uk)) locally and/or via UOHS. To inform UOHS the department must provide information on the level and frequency of exposure in the HS1 form, i.e. whether the working exposure falls into the category a) or b) above.

Where registration is not required

There is no need to complete HS1 form and register with UOHS where there is no actual exposure or potential for exposure. For example where work does not involve direct contact, such as decanting, and appropriate personal protective equipment is worn as a precaution to protect against inadvertent splash.

Information instruction and training should include Skin checks for dermatitis poster (hse.gov.uk)

Occupational Health Action:

(Following receipt of an appropriate registration form)

Occupational Health will send the employee  the relevant skin health questionnaire

Enrolment onto the skin health surveillance programme may be necessary

Further Information:

Hazard phrases can be obtained from the substance safety data sheet, provided by the supplier.

Please refer to your supervisor, departmental or divisional / area safety officer if you need further assistance in interpreting this information and how it relates to the work, and the risk assessment that is being undertaken.

Work Place Activity or Hazard:

Working directly OR indirectly with Laboratory Animal Allergens (LAA)

Examples: Animals, insects, fish and birds

Health Surveillance requirements:

Health surveillance is necessary when:

  • there is a disease associated with the substance in use e.g. Asthma, Dermatitis, Cancers
  • it is possible to detect the disease or adverse change and reduce the risk of further harm
  • the conditions in the workplace make it likely that the disease will appear

Note: Exposure should always be adequately controlled which includes reducing exposure to a level as low as is reasonably practicable for respiratory sensitisers such as LAA.

 

Department Action:

(Guidance on how to establish if Health Surveillance requirements are met (as part of your risk assessment)

Staff

All staff who work with LAA must complete an HS1 form and be registered with the University Occupational Health Service (UOHS).

[Arrangements for students and visitors are outlined below].

  • UOHS will provide an initial health assessment, and decide on the appropriate level of health surveillance, which may include questionnaires and/or lung function tests and enhanced skin checking.
  • To inform UOHS the department must provide information on the level and frequency of exposure, specifically whether exposure to animal allergens is limited or infrequent, (for example for maintenance engineers), or regular and significant. Significant is considered to be handling/working with live animals for at least three hours a day on at least one day a week for at least two months). Please also specify if the member of staff is changing filters on animal air handling units on a regular basis. 

Note any respiratory protective (RPE) with a tight-fitting face piece must be face fit tested to the individual wearer. This must be arranged via the area or divisional safety officers.

Students and Visitors

Long-Term Exposure - Over 12 Weeks

Where the exposure activity for students last for over 12 weeks the individual must be registered with UOHS.

Long-term visitors for example visiting academics (over 12 weeks)  should follow departmental procedures and control measures. There will be a risk assessment covering LAA risks (shared with their employer). Their employer is responsible for their health surveillance arrangements and individual risk assessments. Departments may wish to confirm these arrangements are in place when authorising access.

Short-Term Exposure - Less than 12 Weeks

Where short-term exposure is significant

Students should be registered with UOHS where short term exposure is assessed as being significant using the General Worker Exposure Assessment for LAA table.

Visitors (including contractors) should follow departmental procedures and control measures. There will be a risk assessment covering LAA risks (shared with their employer). Their employer is responsible for their health surveillance arrangements and individual risk assessments. Departments may wish to confirm these arrangements are in place when authorising access.

Where exposure is not significant 

Where the exposure activity last for less than 12 weeks and exposure is assessed as not significant (low) then registration with UOHS is not necessary. However, a pre-exposure declaration should be administered locally. An example is provided here. The person responsible for the activity – course director/supervisor in the case of students or person responsible for the visitor is responsible for administering this in accordance with departmental procedures and with advice from the DSO. Individual risk assessments will need to be undertaken where the individual reports symptoms. This assessment may identify the need for additional precautions such as RPE or elimination of exposure depending on individual circumstances.

An example of exposure not considered significant would be intermittent observational work or handling activities. Further information on how to assess whether exposure is significant or not is provided in the General Worker Exposure Assessment for LAA table.

Occupational Health Action:

(Following receipt of an appropriate registration form)

Occupational Health will send the employee the relevant surveillance health questionnaire.

Enrolment on the Animal Allergy (AA) health surveillance programme may be necessary.

Further Information:

Please refer to your supervisor, departmental or divisional / area safety officer if you need further assistance in interpreting this information and how it relates to the work, and the risk assessment that is being undertaken.

 

Work Place Activity or Hazard:

Working with materials known to cause skin cancer

Skin carcinogens list of agents and industries  

Agents

Type of work

UV rays from the sun

Outdoor work

Coal tar and derivatives

Coal tar handling, coal gasification, coal tar distillation

Polycyctic aromatic hydrocarbons (PAHs)

Petroleum refining, coal tar distillation

Ionising radiation

Radiation-related work

Arsenic

Metal ore handling and smelting, pesticide manufacturing

Coke

Coke processing

Soot

Chimney cleaning

Health Surveillance requirements:

Health surveillance is necessary when:

  • there is a disease associated with the substance in use (e.g. Asthma, Dermatitis, Cancers)
  • it is possible to detect the disease or adverse change and reduce the risk of further harm
  • the conditions in the workplace make it likely that the disease will appear

Department Action:

(Guidance on how to establish if Health Surveillance requirements are met (as part of your risk assessment))

The only category relevant to university work is likely to be UV rays and ionising radiation (ionising radiation is dealt with in a separate section).

Referral to UOHS is unlikely to be required for outdoor work, as adequate control should be achieved following the advice:

HSE INDG147 Health Risks From Working in the Sun.

Instruction and training should include signs to look out for, such as a scaly patch of hard skin, a red lump or spot, an ulcer, a new mole, or a patch of skin which bleeds, oozes or has a crust.

Advice from UOHS is appropriately sought where an individual is identified at increased risk (for example previous history of skin cancer).

Occupational Health Action:

(Following receipt of an appropriate registration form)

The employee may be enrolled onto a relevant health surveillance programme.

 

Further Information:

Please refer to your supervisor, departmental or divisional/ area safety officer if you need further assistance in interpreting this information and how it relates to the work, and the risk assessment that is being undertaken.

 

Work Place Activity or Hazard:

Working with respiratory sensitisers (other than animal allergens)

Examples: isocyanates, glutaraldehyde, epoxy resins fumes, rosin-cored solder fume, latex, wood dust, flour dust, metal working fluids, welding fume (particularly stainless steel which contains chromium and nickel )  other asthmagens (respiratory sensitisers) as outlined below:

Chemical Substance labeling:

H334: May cause allergy or asthma symptoms or breathing difficulties if inhaled.

Any substance that has been assigned a “Sen” notation in the latest version of HSE publication EH40 Workplace Exposure Limits publication or the substance is on HSE list of substances that can cause occupational asthma.

Health Surveillance requirements:

Health surveillance is necessary when:

  • there is a disease associated with the substance in use (e.g. Asthma, Dermatitis, Cancers)
  • it is possible to detect the disease or adverse change and reduce the risk of further harm
  • the conditions in the workplace make it likely that the disease will appear

Department Action:

(Guidance on how to establish if Health Surveillance requirements are met (as part of your risk assessment))

Note exposure should always be adequately controlled which includes reducing exposure to a level as low as is reasonably practicable for respiratory sensitisers.

Where registration is required

Complete HS1 form and register with UOHS:

Where, after reducing exposure to as far as reasonably practicable:

  1. there is still regular and actual exposure to the substance, or the potential for high exposure or the individual has declared a known or suspected relevant medical condition e.g. a confirmed case of asthma
  2. there is only occasional (& low) exposure or potential exposure or where adequate control is reliant on respiratory protective equipment (RPE)*

* Note any respiratory protective (RPE) with a tight-fitting face piece must be face fit tested to the individual wearer. This must be arranged via the area or divisional safety officers.

UOHS will provide an initial health assessment, and decide on the appropriate level of health surveillance, which may include questionnaires (samplequest.PDF (hse.gov.uk) and/or lung function tests. To inform UOHS the department must provide information on the level and frequency of exposure on the HS1 form, i.e. whether the working exposure falls into the category a) or b) above.

Where registration is not required

There is no need to complete HS1 form and register with UOHS where there is no actual exposure or no potential for exposure:

For example where the substances is used in an enclosed system.

Occupational Health Action:

(Following receipt of an appropriate registration form)

UOHS will send the employee  the relevant respiratory health questionnaire

Enrolment onto the Respiratory health surveillance programme may be necessary

Further Information:

Please refer to your supervisor, departmental or divisional/ area safety officer if you need further assistance in interpreting this information and how it relates to the work, and the risk assessment that is being undertaken.

Work Place Activity or Hazard:

Working with substances which can cause pneumoconiosis (e.g. silica, coal, asbestos*)

For example silica occurs in dust from sand, concrete, masonry, rock, granite.

Note:  See separate guidance on Asbestos

Health Surveillance requirements:

Health surveillance is necessary when:

  • there is a disease associated with the substance in use
  • it is possible to detect the disease or adverse change and reduce the risk of further harm
  • the conditions in the workplace make it likely that the disease will appear

Department Action:

(Guidance on how to establish if Health Surveillance requirements are met (as part of your risk assessment))

Occupational exposure to coal and asbestos should not be relevant to members of the University.

There may be exposure to silica for example where dust from sand, concrete, masonry, rock and granite is created, such as during machining.  However, exposure in University activities is extremely unlikely to involve the exposures where health surveillance is required as identified in Health surveillance for those exposed to respirable crystalline silica (RCS) - Guidance for occupational health professionals (hse.gov.uk)

There is no need to complete a HS1 form and register with UOHS unless there is reason to believe an individual may be at increased risk, including a previous diagnosis.

 

Occupational Health Action:

(Following receipt of an appropriate registration form)

The employee may be enrolled onto a relevant health surveillance programme.

Further Information:
 

Please refer to your supervisor, departmental or divisional/ area safety officer if you need further assistance in interpreting this information and how it relates to the work, and the risk assessment that is being undertaken.

Work Place Activity or Hazard:

Working with toxic materials that have biological monitoring guidance values (such as mercury).

Substances that have been assigned a biological guidance value EH40/2005 Workplace exposure limits (hse.gov.uk) page 43 (Note: Please refer to the document to confirm the following list is up to date):

  • Butan-2-one
  • 2 Butuxyethanol
  • Carbon Monoxide
  • Chromium VI
  • Chlorobenzene
  • Cylohexanone
  • Dichloromethane
  • N.N-Dimethylacetamide
  • Glycerol trinitrate (Nitroglycerin)
  • Isocyanates (applies to HDI, IPDI,TDI and MDI)
  • Lindane (gBHC (ISO))
  • MbOCA (2.2’ dichloro-4.4’ metharylene dianline)
  • Mercury
  • 4-methylpenton-2-one
  • 4,4’ – methyrenedianline – (MDA)
  • Polycyctic aromatic hydrocarbons (PAHs)
  • Xylene, O-, M-, P-Or mixed isomers

Health Surveillance requirements:

Biological monitoring is a type of exposure assessment. It can be undertaken as a voluntary activity under certain specific circumstances, with consent and ethical considerations.

Department Action:

(Guidance on how to establish if Health Surveillance requirements are met (as part of your risk assessment))

A HS1 form should only be submitted where there is an agreed need for this following consultation with UOHS. Please email enquiries@uohs.ox.ac.uk.

It is appropriate to seek UOHS advice, where after a suitable and sufficient risk assessment and implementation of control measures, there is still significant regular (and actual) exposure to the substance. Significant residual exposure would include, for example where there is reason to believe exposure is approaching half of the Workplace Exposure Limit (WEL)* and there is potential for skin contact/a reliance on PPE as a means of achieving adequate control.

COSHH Essentials e-tool and COSHH Essentials direct advice also provides a way of assessing whether control measures are suitable and sufficient for certain tasks and processes.

*can be established by air monitoring or through an indicative draeger measurement/ grab sample (or similar), but not taking account of RPE.

Note any respiratory protective (RPE) with a tight-fitting face piece must be face fit tested to the individual wearer. This must be arranged via the area or divisional safety officer.

Note: A suitable and sufficient assessment should take account of all possible routes of routes of exposure i.e. inhalation (fume, vapour dust), skin absorption and ingestion.

Occupational Health Action:

(Following receipt of an appropriate registration form)

The employee may be enrolled onto a relevant health surveillance programme.

Further Information:

Please refer to your supervisor, departmental or divisional/ area safety officer if you need further assistance in interpreting this information and how it relates to the work, and the risk assessment that is being undertaken.

Work Place Activity or Hazard:

Substances used in specific process as requiring medical surveillance under Schedule 6 of COSHH Control of Substances Hazardous to Health Regulations

 

Substances for which medical surveillance is appropriate

Process

Vinyl chloride monomer (VCM)

In manufacture, production, reclamation, storage, discharge, transport, use or polymerisation

Nitro or amino derivatives of phenol and of benzene or its homologues

In the manufacture of nitro or amino derivatives of phenol and of benzene or its homologues and the making of explosives with the use of any of these substances

Potassium or sodium chromate or dichromate

In manufacture

Ortho-tolidine and its salts.  Dianisidine and its salts. Dichlorobenzidine and its salts

In manufacture, formation or use of these substances

Auramine. Magente

In manufacture

Carbon disulphide. Disulphur dichloride. Benzene, including benzol. Carbon tetrachloride. Trichlorethylene

Processes in which these substances are used, or given off a vapour, in the manufacture of indiarubber or of articles or goods made wholly or partially of indiarubber

Pitch

In manufacture of blocks of fuel consisting of coal, coal dust, coke or slurry with pitch as a binding substance

Health Surveillance requirements:

Medical surveillance, by a HSE Appointed Doctor, is required if an employee is exposed to a substance specified in Schedule 6 and is engaged in a process specified therein.

The health surveillance shall include medical surveillance under the supervision of a relevant doctor at intervals of not more than 12 months or at such shorter intervals as the relevant doctor may require.

Department Action:

(Guidance on how to establish if Health Surveillance requirements are met (as part of your risk assessment))

These are extremely unlikely to be relevant to the University environment and are included for completeness.

If there is exposure to workers to any of the substances in the table in column 1 and engaged in the associated process the individual must be registered with UOHS who will determine the appropriate health surveillance programme and advise on access to a HSE Appointed Doctor.

Occupational Health Action:

(Following receipt of an appropriate registration form)

Medical Surveillance must be undertaken by a HSE Appointed Doctor.

Further Information:

Please refer to your supervisor, departmental or divisional/ area safety officer if you need further assistance in interpreting this information and how it relates to the work, and the risk assessment that is being undertaken.

Work Place Activity or Hazard:

Other toxic materials that fulfil COSHH requirements  

Health Surveillance requirements:

Health surveillance is necessary when:

  • there is a disease associated with the substance in use
  • it is possible to detect the disease or adverse change and reduce the risk of further harm
  • the conditions in the workplace make it likely that the disease will appear

Department Action:

(Guidance on how to establish if Health Surveillance requirements are met (as part of your risk assessment))

If there are any other materials you are using or hazards you identify as fulfilling the criteria for health surveillance please discuss this with your supervisor, departmental or divisional/ area safety officer.

Occupational Health Action:

(Following receipt of an appropriate registration form)

The employee may be enrolled onto a relevant health surveillance programme.

Further Information:

Please refer to your supervisor, departmental or divisional/ area safety officer if you need further assistance in interpreting this information and how it relates to the work, and the risk assessment that is being undertaken.

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