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Identifying ill health through health surveillance

Specific adverse exposures in the workplace and their related health effects can be identified and monitored through occupational health surveillance and screening, using:

  • medical health checks tailored to the exposures and conditions of the workplace
  • biological tests (including biomonitoring) for specific indicators of risk.

Health surveillance programmes should be set up only if they improve protection and prevention of risks and meet four criteria: need, relevance, scientific validity and effectiveness. They are normally organised by occupational health services. The International Commission on Occupational Health Code of Ethics specifies ethical criteria for health surveillance.

Some European directives and pieces of national legislation specify the content and the methodology of health surveillance for specific factors. Records have to be kept and workers should be informed of the results. However, as this information is confidential, the employer is informed only about workers’ aptitude to work and any measures to be taken in the workplace.

The requirements for making available monitoring and health surveillance data and the specific rules for record-keeping are also laid down in the directives. For example, the Carcinogens and Mutagens Directive specifies that records have to be kept for 40 years.