Screening

Audiometry – Hearing Tests Hearing screening is regulated under the Control of Noise at Work Regulations 2005 Act, Employees exposed to a wide audio range require continued Health Surveillance. Noise Induced Hearing Loss (NIHL) is one of the most prevalent and irreversible industrial diseases, if it is left unchecked, it can prompt early retirement on ill-health grounds and costly Litigation claims. A baseline Audiogram is advisable with a follow up after one year (Year 1) and two year (Year 2) if these are both normal HSS normally advise a recall of either One or Two years depending on your own policy. Below are some examples of high noise exposures:

  • Construction
  • Demolition and Road Repair
  • Woodworking
  • Plastics Processing
  • Engineering
  • Textiles Manufacturing
  • General Fabrication
  • Forging, Fabrication, Pressing or Stamping
  • Paper or Board Making
  • Canning and Bottle Making
  • The Entertainments Industry

The following tools can cause noise induced hearing loss:

  • Hammering
  • Drop forging
  • Pneumatic Impact Tools
  • Drills
  • Chainsaws
  • Explosive Sources, Guns, Detonators or Cartridge Operated Tools

Lung Function Testing Lung function tests are recognised as one of the most efficient and accurate tests available to assess Lung Impairment. They are increasingly utilised by Occupational Health professionals and the Control of Substances Hazardous to Health (COSHH) Regulations 2002.
 Early knowledge of pre-existing problems can be vital enabling prompt remedial action and minimise future liability to any business. All employees who have been identified by your Risk Assessment as being exposed to respiratory irritants, sensitisers and nuisance dusts should be included in an ongoing Screening Programme with testing being completed on an Annual basis or in line with your own in-house policies. Substances responsible for most causes of occupational asthma:

  • Flour / Grain / Hay – Handling grain at docks, milling, malting, baking
  • Latex – Protective gloves for health care, motor vehicle repair, beauticians etc
  • Wood Dusts – Saw mills, woodworking
  • Electronic Soldering Flux – Electronic assembly and soldering
  • Laboratory Animals – Laboratory animal work exposure
  • Some Glues / Resins – Epoxy resins

Skin Surveillance Screening / Food Handling Occupational Skin Disease is important and a extremely common health problem. Repeated skin irritation or skin sensitisation can lead to Dermatitis and other skin conditions. If detected early enough and worker’s exposure to the trigger substances are reduced, Dermatitis may be cured or less severe. Left untreated it may become irreversible and even a small exposure may trigger a bad reaction. As well as a preventative measure HSS would also advise you to include this as part of your screening before commencement of employment Substances which may cause skin disease:

  • Epoxy Resins
  • Latex
  • Rubber Chemicals
  • Soaps and Cleaners
  • Metalworking Fluids
  • Cement
  • Wet Work
  • Enzymes
  • Wood

At risk occupations:

  • Construction Work
  • Health Service Work
  • Rubber Making
  • Printing
  • Paint Spraying
  • Fabricators
  • Food Handling
  • Agriculture
  • Horticulture
  • Electroplating
  • Cleaning
  • Hairdressing

Health Surveillance is required under the COSHH regulations 2002 though it is never an alternative to proper control of exposure. Hand and Arm Vibration Syndrome (HAVS) Screening Hand Arm Vibration is transmitted from a work activity into someone’s hands and arms. This occurs when:

  • Operating Hand Held Power Tools
  • Using Hand Guided Equipment, e.g. A Vibrating Compactors
  • Holding Materials Being Processed By A Machine

Regular and frequent exposure to Hand Arm Vibration can lead to permanent ill health. This is most likely if contact with a vibrating tool or work piece is a regular part of someone’s job. Occasional or low level exposure is unlikely to cause ill health and long term problems for any users if left unchecked. Hand Arm Vibration can cause a range of conditions called ‘Hand Arm Vibration (HAVS)’. The best known is vibration white finger (VWF), but vibration also links to specific diseases such as Carpal Tunnel Syndrome. For some people symptoms appear after only a few months of exposure but for others it may take years. The symptoms are likely to get worse with repeated exposure and can lead to permanent damage and disfigurement; they can severely limit the jobs that someone is able to do as well as affect family and social activities. Responsibilities for Employers: Where a works process is likely to pose a high risk of injury or illness consideration should be given to the possibility of discontinuing or replacing the process altogether, a thorough HAVS (hand arm vibration) Risk Assessment will aid this process and help you decide how to protect the health of employees exposed to vibration. Where it is impossible to eliminate the use of vibrating equipment a Hand Arm Vibration, Health Surveillance programmes should be in place. It is important to give appropriate information to employees and encourage their full co-operation. Occupational Health professionals (nurses and doctors) who are providing Hand Arm Vibration (HAVS) clinical assessment and overseeing the health surveillance programme will be able to assist employers to explain the serious nature of the Hand Arm Vibration disease and the importance of Health Surveillance. A tiered approach to Health Surveillance The testing process of Hand Arm Vibration (HAVS) is divided into 5 stages depending on the severity of damage caused by vibration. The first 2 stages of the (HAVS) screening process can be carried out by a suitably qualified Occupational Health Advisor. Referrals from Stage 3 are passed to accredited Occupational Health Physicians. Tier 1 – Initial or Baseline Assessment There should be an Initial Hand Arm Vibration (HAVS) Assessment for any new or existing employees before they begin exposure to hand arm vibration, this also provides an opportunity to educate workers about measures under their control that will help to reduce the risks from transmission of vibration. This initial assessment is completed by a questionnaire. As well as a preventative measure HSS would also advise you to include this as part of your screening before commencement of employment Tier 2 – Annual Screening Questionnaire The Hand Arm Vibration (HAVS) questionnaire should be repeated annually to form the routine Health Surveillance for those at risk but without symptoms suggestive of HAVS. If symptoms appear for the first time or progress workers should be encouraged to report them rather than wait for the next round of screening. Tier 3 – Assessment by qualified person This should normally follow Tier 2 if symptoms are reported by a suitable qualified Health professional. The main objective of HAVs Screening is good documentation by the Occupational Health provider. Tier 4 – Formal Diagnosis Formal diagnosis of Hand Arm Vibration (HAVS, vibration white finger) is made by the specialist and for certain actions i.e. reporting cases under RIDDOR 1995 and Fitness to Work recommendations. Tier 5 – Use of standardised tests (optional) In addition to clinical findings from Tiers 3 & 4, standardised tests can be conducted for a worker who has signs or symptoms of Hand Arm Vibration (HAVS). This tier is NOT required as part of routine Health Surveillance provision for a workforce exposed to Hand Arm Vibration (HAVS), though it is useful for studying the progression of the disease. Occupational Health Professionals experienced in the Clinical Assessment and diagnosis of Hand Arm Vibration (HAVS) undertake specialist training and should hold a recognised Occupational Health qualification in nursing and/or Medicine. They should also have undertaken the Faculty of Occupational Medicine’s approved ‘Training for Health Professionals’ for Hand Arm Vibration (HAV). Drug and Alcohol Screening Drug and Alcohol Testing is usually undertaken in three different circumstances:

  • At the Employment stage when first undertaking fitness testing for employees whose work roles involve high risk from the effects from drugs and alcohol such as Train Drivers, HGV Drivers or Workers in a High Risk Work Environment
  • Random testing of workers in the work roles as above to ensure safety is maintained. Usually a percentage of the relevant workforce is randomly assigned to testing on an Annual basis and this is undertaken without notice or in line with your own in-house polices
  • Cause testing is undertaken when there is high suspicion that an employee at work is under the influence of Drugs or Alcohol. Alcohol Breathalyser tests, Blood or Urine analysis are used for this purpose. There is a large variety of drugs which can be screened. The cost can be tailored to your company’s requirements, with all documentation passed on to the organisation

Osteoporosis Screening HSS provide Screening for Osteoporosis. Osteoporosis is a silent disease; you might not know you have it until you break a bone. Osteoporosis makes your bones weak and increases the risks of breaks and fractures, as many as half of all women and a quarter of men will suffer a fracture of some kind sometimes due to Osteoporosis. Osteoporosis can now be diagnosed prior to bones breaking, giving individuals the opportunity to take treatments and adopt lifestyle changes which will then reduce your overall risk of future fracture and breaks. Who should have the Scan?

  • People with poor diet, heavy smokers and those with above average alcohol intake
  • People who have already broken a bone
  • Those of petite structure / frame
  • People who are taking long term Oral Steroids
  • People suffering from Chronic Fatigue, PMS and HIV Infection
  • Women who have had their Menopause or Ovaries removed, before the age of 45
  • Women who have had a history of missed Menstrual Periods
  • Men with Low Testosterone Levels

There are many measures that may be taken to reduce the risks of Osteoporosis. The earlier measures are taken, the more likely you may be able to prevent the onset of Osteoporosis.

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