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Health Surveillance



Health Surveillance can be defined in various ways. Classically it has been understood to comprise those strategies and methods to detect and assess systematically the adverse effects of work on the health of workers. It has however also been used to include systematic assessments of fitness for work, and/or of health status that is not directly related to occupation. 

Purposes of Health Surveillance

  1. Protection of health of the individual employee 
  2. Detection at an early stage any adverse health effects 
  3. Assisting in the evaluation of control measures 
  4. Data may be used for detection of hazards and assessment of risk 
  5. Other purposes: e.g. immune status assessment 

Criteria for conducting Health Surveillance

  1. There is an identifiable disease or other identifiable adverse health outcome
  2. The disease or health effect may be related to exposure
  3. There is a likelihood that the disease or health effect may occur
  4. There are valid techniques for detecting indications of the disease or health effects 

Health Surveillance Techniques should be: 

  • Sensitive 
  • Specific 
  • Easy to perform and interpret
  • Safe 
  • Non-invasive
  • Acceptable 

Examples of Health Surveillance

  • Biological monitoring 

  • e.g. 2.5-hexane di one (a metabolite of n-hexane) in urine COHb in workers exposed to methylene chloride. 


  • Biological effect monitoring 

  • e.g. Cholinesterase in blood of workers exposed to certain organophosphorus pesticides 


  • Enquiries, inspection or exam by a suitably qualified person 

  • e.g. an occupational health nurse administering a questionnaire for symptoms of asthma or rhinitis; or examining the hands for dermatitis 


  • Medical surveillance 

  • e.g. lung function measurement in workers exposed to substances known to cause occupational asthma

    Chest X-rays in workers exposed to respirable quartz 

  • Monitoring of sick absence -Review by Occupational Health for work-related trends in sick absence


Audiometer booth, and spirometerThe image shows an audiometer booth used for health surveillance for noise induced hearing loss, alongside a spirometer used for health surveillance for occupational asthma

This page deals with the classical definition of Health Surveillance in an occupational context, although you can find out elsewhere about screening.

Links to relevant guidelines and criteria documents can be found elsewhere on this website, especially by clicking here and looking by subject area or by using the search tool.

In the United Kingdom a substantial amount of valuable information on national health surveillance of occupational disease and work related illhealth is collected through the THOR network.

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