Is Health Surveillance a Legal Requirement?
When UK law requires health surveillance, which regulations apply, and what North East employers need to do to stay compliant.
Yes — in many workplaces health surveillance is a legal requirement. It is not required for every employee, but where workers are exposed to certain hazards that can cause ill health, and the risk remains after controls are in place, the law requires the employer to put health surveillance in place.
The general duty comes from the Management of Health and Safety at Work Regulations 1999 (regulation 6), which requires employers to provide health surveillance where their risk assessment shows it is appropriate. HSE guidance says it is needed when there is an identifiable disease or adverse health condition linked to the work, valid techniques exist to detect it, there is a reasonable likelihood it may occur, and surveillance is likely to benefit the employee.
Several regulations set specific requirements. The Control of Noise at Work Regulations 2005 require health surveillance (usually audiometry) where workers are regularly exposed above the upper exposure action value of 85 dB(A), or are at particular risk. The Control of Vibration at Work Regulations 2005 require surveillance for workers likely to be regularly exposed above the exposure action value for hand-arm vibration, or considered at risk — typically using the HSE tiered HAVS approach.
The Control of Substances Hazardous to Health Regulations 2002 (COSHH) require surveillance where workers are exposed to substances linked to an identifiable disease — for example respiratory sensitisers such as isocyanates, flour or wood dust (lung function / spirometry) and substances that cause dermatitis (skin checks). Some substances listed in COSHH Schedule 6 require medical surveillance by an HSE-appointed doctor. Separate statutory medical surveillance applies under the Control of Asbestos Regulations 2012, the Control of Lead at Work Regulations 2002 and the Ionising Radiations Regulations 2017.
In practice, health surveillance is most often legally required in construction, manufacturing, engineering, process industries, utilities and waste — sectors that make up a large part of the North East and Teesside economy. Groundworkers using breakers, welders, sprayers, joiners, bakery staff and plant operators are common examples.
Health surveillance is not the same as a general wellbeing check or a pre-employment medical. It must be linked to a specific hazard identified in your risk assessment, carried out at suitable intervals by a competent person, and supported by individual health records that employers must keep — for some COSHH exposures, for at least 40 years.
Employers must also act on the results. If surveillance finds early signs of ill health, you need to review your risk assessment and controls, consider the individual's fitness for their role, and follow the occupational health advice given. HSE can take enforcement action where surveillance is missing or not followed up.
How OH Workplace can help: our clinicians deliver audiometry, HAVS, spirometry, skin assessments and biological monitoring on-site across Newcastle, Gateshead, Sunderland, Durham, Northumberland and Teesside. Results, outcomes and recall dates are all available in OH One, our online client portal, so you can see who is due and evidence compliance at any time. This article is general guidance based on HSE publications — always check the latest HSE guidance for your specific hazards.