1. Health Surveillance Employer’s Responsibilities Mark Vickers Clinical Operations Director 14 th June 2016

2. Statutory Implications 2 According to the Health and Safety Executive (HSE); “Health surveillance allows for early identification of ill health and helps identify any corrective action needed. Health Surveillance may be required by law if your employees are exposed to noise or vibration, solvents, fumes, dusts, biological agents and other substances hazardous to health, or work in compressed air.”

3. Audiometry Surveillance 3 Control of Noise at Work Regulations 2005, guidance states, “If risk assessment indicates that there is a risk to health”. Regulation 9 (1) requires employers to provide suitable health surveillance where there is a risk from exposure to noise without taking account of the noise reduction provided by hearing protection. You should provide health surveillance to noise exposed employees who: Are exposed at or above the upper action value of 85dB(A) or peak sound pressure of 137dB(C) Have been identified as being at specific risk from exposure to noise levels at or above the lower action value of 80dB(A) or peak sound pressure of 135dB(C) HSE Recommendations for frequency: Baseline/Pre-employment Annually for first two years Three yearly (or more frequently if issues identified) Exit

4. 4 Respiratory surveillance is aimed at those workers at risk of developing work related asthma. HSE Recommendations for frequency: Baseline/pre- employment 3 months from first employment 6 months from first employment 1 year from first employment Annually Exit Respiratory Surveillance

5. 5 Where COSHH risk assessments and occupational hygiene reports have indicated actual/potential exposure to skin irritants or sensitisers, consult with the appropriate managers to obtain confirmation of the work areas and processes. HSE Recommendations for frequency: Baseline/Pre-employment 3 months after commencement of role Annually Exit Skin Surveillance

6. 6 Given the manual handling activities carried out in Warehouse and Dispatch areas consideration of musculoskeletal assessment is recommended to ensure no underlying conditions or injuries which may be further exacerbated by heir working role. HSE Recommendations for frequency: Baseline/Pre-employment Annually Prior to role change if from non –manual role to manual role. Musculoskeletal Assessment

7. 7 Exposure to vibration following use of hand held power drills. Regulation 7 of the Control of Vibration at Work Regulations 2005 requires employers to provide suitable health surveillance where the risk assessment indicates a risk to employees’ health or where an employee is likely to be exposed to the Exposure Action Value (EAV) 2.5m/s 2 A(8) HSE Recommendations for frequency: Tier 1: full baseline HAVS assessment should be undertaken for any new or existing employee before they begin exposure to vibration, which may also include agency staff. Tier 2: Following baseline assessment, routine annual screening should take place for all employees who are at risk but are asymptomatic as follows: Tier 3: At 24 months with a Face to Face Assessment with OHA Tier 4: If symptomatic consultation with competent OH Physician HAVS Assessment

8. 8 All DSE users should undertake self-assessment online with any issues raised to onsite DSE/HS assessor, more complex cases or significant issues could be considered for an Occupational Health review if required. HSE Recommendations for frequency: Baseline/Role Commencement Following any change in environment Following any reported change in health status affecting capacity DSE Assessment

9. 9 A confined space has two defining features. Firstly, it is a place which is substantially (though not always entirely) enclosed and secondly, there will be a reasonably foreseeable risk for serious injury from hazardous substances or condition within the space or nearby. Entry into a confined space is determined when a person’s head or upper body is within the boundary of the confined space; inserting an arm is not entry. HSE Recommendations for frequency: As part of placement screening When the employee is designated as someone who will need to work at heights Subsequent (periodic) assessments should be performed at intervals as agreed with the client Following any spell of sickness or development of condition Confined Space Regulations

10. 10 Working At Heights The Work at Height Regulations 2005 apply to all work at height where there is a risk of a fall liable to cause personal injury. They place duties on employers, the self-employed, and any person who controls the work of others (e.g. facilities managers or building owners who may contract others to work at height) to the extent they control the work. Working at heights may be defined specifically but not limited to: Climbing poles Using ladders Working from elevated platforms Climbing the stairs in chimney stacks Climbing and working on scaffolding HSE Recommendations for frequency: As part of placement screening When the employee is designated as someone who will need to work at heights Subsequent (periodic) assessments should be performed at intervals as agreed with the client Following any spell of sickness or development

11. 11 Fork-lift truck medical is a recommended requirement for all workplace transport drivers and FLT and ride on PPT operators within the site. HSE Recommendations for frequency: Baseline/Pre-employment Every 5 years from age 45 Annual assessment from age 65 Following absence of 1 month or reported significant change in health status FLT Assessment

12. 12 Night work is defined in these regulations as from 11pm to 6am whereas in Night Work and Shift Work Regulations the definitions of night time (period between midnight and 6am on the following day)and night worker (employee who normally works more than three hours during night time and at least 50% of total hours worked in a year is at night time) are taken from the Organisation of Working Time Act 1997. These definitions exclude many employees who work rotating shifts and it is recommended that a health assessment is made available to all workers who carry out shift work. The employee is asked to complete a short health questionnaire and return it to Occupational Health. If the employee answers yes to any of the questions in the short questionnaire, he/she is asked to complete a more detailed health assessment questionnaire and return it to Occupational Health for assessment. Night Worker / Working Time Directive