The requirement for health surveillance / health monitoring is underpinned by the risk assessment required by applicable work health and safety legislation. The risk assessment is informed by (i) the nature of the hazard, and (ii) the exposure patterns. For example, even unpredictable rare exposure can carry a high-risk classification if the nature of the harm is severe. Premature death following asbestos fibre exposure is clearly indicative of a profound consequence, even though it may not occur until many years after the exposure.
The primary purpose of health monitoring is NOT to find a hazard-related disease or injury, BUT to
reinforce the gravity of the risk,
enable the worker to have a targeted conversation with the health professional about their individual risk,
reinforce the importance of compliance with safe systems of work,
identify baseline reference data, and to
collect and monitor specific serial data to detect the earliest possible changes suggesting a potential adverse health effect.
It is important to remember that incidental findings, health issues not directly related to the sentinel hazard, WILL BE DETECTED. Such findings MUST be managed confidentially and with the upmost respect to the nature of the treating doctor-patient relationship that supports the worker’s continuing care.
The primary purpose of health surveillance is to monitor and support worker’s health risks, arising from any cause, that might impact on their health and productivity. As the cost of the systems and procedures necessary to comply with compliance with statutory requirements and information privacy principles – absolutely necessary for health monitoring - are established and need to be applied as “standard practice”, there is a growing body of evidence demonstrating that the addition of health surveillance activity for the common community-associated health risks, converts the cost-of-compliance into a return-on-investment.
Confusion for any Organisation arises from
Knowing which legislation AND Australian Standards apply to your business, keeping in mind that the structure of the work health and safety legislation in each State of Territory imposes obligations beyond any prescribed minimum requirements
Safe Work Australia is an advisory body, not a regulator, and produces guidance material for all stakeholders
There is variability in the periodicity of each components of any health monitoring program – what should be done, and when, depends on the (i) assessed risk, and (ii) the risk appetite of the business.
For regulatory audits, the inspectorate applies the specific legislation applicable to their domain
The solution in brief:
The standard recommended periodicity is “annual”, however what is done annually depends on the risk stratification determined by KINNECT’s CLIENT, you, informed by our advice concerning your risk assessment.
KINNECT’s Consultant Physicians in Occupational and Environmental Medicine (OEP’s), support you by critically reviewing and advising on the health-risk and operational implications associated with your Risk Assessment. We partner with you to optimise compliance and operational performance. If you choose not to use this resource, our services are provided with the explicit assumption you have undertaken an adequate risk assessment.
Frequency of Risk Assessment review
Risk management decisions reflect business operational requirements and risk tolerance
A formal risk review is recommended every five years, or if a change to the work practices occur
Surveillance requirements
The issues to consider are:
The nature of the hazard
The pattern of exposure
What level respiratory protection is required (currently AS/NZS 1715:2009 and AS/NZS 1716:2012 complemented by the ISO 16900 series of Standards)
If the risk assessment determines that negative pressure respiratory protection with P2 filtering or above is required, then the minimum requirement (for lower risk roles) is annual fit-testing and fit-check training. Superimposed on this minimum requirement, triggered by meeting specific provisions within the relevant legislation is the need for either:
Respiratory Health Surveillance (moderate risk roles) (Fit testing, Respiratory Questionnaire, and spirometry)
Full Health Surveillance (higher risk roles) (Fit testing, Full medical assessment and spirometry
In all settings, if clinically significant features are found, more frequent spirometry, complex lung function testing, radiological investigations (Chest X-rays or HRCT) and respiratory physician assessments may be necessary to comply with National Guidance and statutory requirements.
Health monitoring requires compliance with both legislation and respiratory protection standards.
What must be considered?
The current Australian/New Zealand Standard AS/NZS 1715:2009 and 1716:2012 were last updated in 2009 and 2012 respectfully. These Standards describes the selection of respiratory protective devices and specifies performance and testing criteria.
The International Organization for Standardization (ISO) technical committees have produced a comprehensive range of respiratory protection standards. The full range of the ISO 16900 series of standards is approaching completion and as Australia participates in the development of these ISO standards, relevant components will be incorporated into future Australian Standards. ISO 16972 – ISO 16975 – covers selection and use.