Health surveillance

Introduction

Health Surveillance can be defined in various ways. Classically it has been understood to comprise those strategies and methods to detect and assess systematically the adverse effects of work on the health of workers. It has however also been used to include systematic assessments of fitness for work and/or of health status that is not directly related to occupation.

Purposes of health surveillance

  1. Protection of health of the individual employee
  2. Detection at an early stage any adverse health effects
  3. Assisting in the evaluation of control measures
  4. Data may be used for detection of hazards and assessment of risk
  5. Other purposes: e.g. immune status assessment

Criteria for conducting health surveillance

  1. There is an identifiable disease or other identifiable adverse health outcome
  2. The disease or health effect may be related to exposure
  3. There is a likelihood that the disease or health effect may occur
  4. There are valid techniques for detecting indications of the disease or health effects

Health surveillance techniques should be:

  • Sensitive
  • Specific
  • Easy to perform and interpret
  • Safe
  • Non-invasive
  • Acceptable

Examples of health surveillance

  • Biological monitoring
    e.g. 2.5-hexane di one (a metabolite of n-hexane) in urine COHb in workers exposed to methylene chloride.
  • Biological effect monitoring
    e.g. Cholinesterase in blood of workers exposed to certain organophosphorus pesticides
  • Enquiries, inspection or exam by a suitably qualified person
    e.g. an occupational health nurse administering a questionnaire for symptoms of asthma or rhinitis; or examining the hands for dermatitis
  • Medical surveillance
    e.g. lung function measurement in workers exposed to substances known to cause occupational asthma; Chest X-rays in workers exposed to respirable quartz
  • Monitoring of sick absence
    Review by Occupational Health for work-related trends in sick absence

This page deals with the classical definition of Health Surveillance in an occupational context, although you can find out elsewhere about Health Screening.