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Health monitoring

Health monitoring is used to detect changes in a worker’s health because of exposure to certain substances.

Health monitoring may include:

  • consultation with a registered medical practitioner
  • a physical examination, for example skin checks or lung function (spirometry) test
  • clinical tests, for example urine or blood test
  • X-rays.

Health monitoring is not a substitute for using effective control measures to eliminate or minimise risks to health.

On this page

When to provide health monitoring

Hazardous chemicals for which health monitoring may be required includes:

  • asbestos
  • a scheduled chemical#, including lead (inorganic)
  • any other hazardous chemical for which there is a valid test method for detecting health effects or exposure.

# Scheduled chemical means a chemical listed in schedule 14 of the Work Health and Safety Regulation 2011.

Health monitoring must be provided if:

  • a worker is using, handling, generating or storing hazardous chemicals, and
  • the work is ongoing, and
  • there is a significant risk to the worker’s health because of exposure.
When is the risk significant?

As the level of risk depends on the frequency, duration and level of exposure, carrying out a risk assessment is the best way to decide if there is significant risk to health or not.

If risks are significant but not adequately controlled or there is uncertainty about the degree of risk, health monitoring is required. Any control measures already in place should also be reviewed and revised in this instance, to ensure the risk is eliminated or minimised so far as is reasonably practicable.

Consider what is known about the hazardous chemical and work process in working out if the control measures in place are adequate. For example, are the control measures mentioned in the safety data sheet or a relevant Code of Practice in place and working properly?

Use the following table as a guide to whether health monitoring may be required –

Level of exposure

Known control measures are in place

Not all known control measures are in place

Exposure is well below a level that could harm health*

cross

cross

Exposure is at a level that could harm health*

cross

Tick

Exposure to a chemical that is highly toxic

cross

Tick

It is reasonably foreseeable leaks or spills may occur

cross

Tick

Uncertain about the risk to health or level of exposure

Tick

Tick

* Where a workplace exposure standard (WES) for an airborne contaminant has been established, exposure over 50 percent of the WES indicates controls may not be adequate.

Air monitoring may be needed if the airborne concentration of a hazardous chemical is not certain or to find out if the control measures currently in place are keeping the level of airborne hazardous chemicals as low as reasonably practicable. You may need the advice of a competent person, such as an occupational hygienist, if you are unsure about the level of worker exposure.

Some hazardous chemicals may pose a risk through skin contact and therefore air monitoring alone may not be sufficient to determine the level of risk.

Read more about deciding if there is significant risk in the Health monitoring for exposure to hazardous chemicals – Guide for persons conducting a business or undertaking.

Frequency of health monitoring

Health monitoring usually includes baseline and periodic monitoring. Carry out health monitoring before a worker starts work with a hazardous chemical to establish a baseline from which changes can be detected. The frequency of ongoing monitoring varies with each hazardous chemical and the individuals who may be exposed, and should be decided in consultation with the supervising medical practitioner. Health monitoring is also recommended at the termination of work with a hazardous chemical.

The frequency of health monitoring for workers carrying out lead risk work is given in section 407 of the Work Health and Safety Regulation 2011.

Types of health monitoring

The table below lists the type of health monitoring that may be required for exposure to asbestos, scheduled chemicals or other chemicals for which there is a valid test method.

Other test methods may be used provided the test can detect health effects or biological levels from exposure to hazardous chemicals, and are equal to or better than those listed in the table.

If workers are at significant risk from exposure to hazardous chemicals that are not listed in the table below, seek specialist help from the supervising medical practitioner, an occupational physician or an occupational hygienist about whether valid test methods are available and if health monitoring should be provided.

Table of types of health monitoring

Hazardous chemical

Type of health monitoring

Health monitoring guidance

Acrylonitrile

  • Demographic, medical and occupational history
  • Records of personal exposure
  • Physical examination

Guide

Antimony

  • Demographic, medical and occupational history
  • Records of personal exposure
  • Physical examination with emphasis on the respiratory system and skin
  • Urinary antimony level

n/a

Arsenic (inorganic)

  • Demographic, medical and occupational history
  • Records of personal exposure
  • Physical examination with emphasis on the peripheral nervous system and skin
  • Urinary inorganic arsenic

Guide

Asbestos

  • Demographic, medical and occupational history
  • Records of personal exposure
  • Physical examination

Guide

Benzene

  • Demographic,   medical and occupational history
  • Records of   personal exposure
  • Physical examination
  • Baseline blood sample for haematological profile

Guide

Beryllium

  • Demographic,   medical and occupational history
  • Records of   personal exposure
  • Physical   examination with emphasis on respiratory and dermatological systems
  • Urinary   beryllium

n/a

Cadmium

  • Demographic,   medical and occupational history
  • Records of   personal exposure
  • Physical   examination with emphasis on the respiratory system
  • Standardised respiratory function tests including for   example, FEV1, FVC and FEV1/FVC
  • Urinary cadmium and β2-microglobulin
  • Health advice, including counselling on the effect of   smoking on cadmium exposure

Guide

Carbon disulphide

  • Demographic,   medical and occupational history
  • Physical   examination with emphasis on the respiratory system and skin
  • Urinary   2-thiothiazolidine-4-carboxylic acid level

n/a

Chromium (inorganic)

  • Demographic,   medical and occupational history
  • Physical   examination with emphasis on the respiratory system and skin
  • Weekly skin inspection of hands and forearms by a competent person

Guide

Cobalt

  • Demographic,   medical and occupational history
  • Physical   examination with emphasis on respiratory systems and skin Urinary cobalt   level

n/a

Creosote

  • Demographic,   medical and occupational history
  • Health   advice, including recognition of photosensitivity and skin changes
  • Physical   examination with emphasis on the neurological system and skin, noting any   abnormal lesions and evidence of skin sensitisation
  • Records of personal exposure, including photosensitivity

Guide

Crystalline silica (quartz)

  • Demographic,   medical and occupational history
  • Records of   personal exposure
  • Standardised   respiratory questionnaire to be completed
  • Standardised respiratory function test, for example, FEV1,   FVC and FEV1/FVC
  • Chest X-ray full size PA view

Guide

Cyclophosphamide

  • Demographic,   medical and occupational history
  • Urinary   cyclophosphamide

n/a

Ethyl benzene

  • Demographic,   medical and occupational history
  • Records of   personal exposure
  • Physical   examination
  • Baseline   blood sample for haematological profile
  • Urinary   mandelic acid

n/a

Fluoride

  • Demographic,   medical and occupational history
  • Urinary   fluoride level

Guide(PDF, 365.74 KB)

Form(PDF, 692.79 KB)

Isocyanates

  • Demographic,   medical and occupational history
  • Completion   of a standardised respiratory questionnaire
  • Physical   examination of the respiratory system and skin
  • Standardised   respiratory function tests, FEV1, FVC and FEV1/FVC

Guide

Lead (inorganic)

  • Demographic,   medical and occupational history
  • Physical   examination
  • Biological monitoring (blood lead)

Guide

Nickel

  • Demographic,   medical and occupational history
  • Physical   examination with emphasis on dermatological and respiratory systems
  • Urinary   nickel

n/a

Mercury (inorganic)

  • Demographic,   medical and occupational history
  • Physical   examination with emphasis on dermatological, gastrointestinal, neurological   and renal systems
  • Urinary   inorganic mercury

Guide

Methyl bromide

  • Demographic,   medical and occupational history
  • Physical   examination with emphasis on the nervous and respiratory systems and skin
  • Blood bromide levels

Guide(PDF, 465.33 KB)

Form(PDF, 640.21 KB)

4,4’-Methylene bis(2- chloroaniline) (MOCA)

  • Demographic,   medical and occupational history
  • Physical   examination
  • Urinary   total MOCA
  • Dipstick   analysis of urine for haematuria
  • Urine   cytology

Guide

Organophosphate pesticides

  • Demographic,   medical and occupational history including pattern of use
  • Physical   examination
  • Baseline   estimation of red cell and plasma cholinesterase activity levels by the   Ellman or equivalent method
  • Estimation   of red cell and plasma cholinesterase activity towards the end of the working   day on which organophosphate pesticides have been used

Guide

Pentachlorophenol (PCP)

  • Demographic,   medical and occupational history
  • Records of   personal exposure
  • Physical   examination with emphasis on the skin, noting any abnormal lesions or effects   of irritancy
  • Urinary   total pentachlorophenol
  • Dipstick   urinalysis for haematuria and proteinuria

Guide

Polycyclic aromatic hydrocarbons (PAH)

  • Demographic,   medical and occupational history
  • Physical   examination
  • Records of   personal exposure, including photosensitivity
  • Health   advice, including recognition of photosensitivity and skin changes

Guide

Styrene

  • Demographic,   medical and occupational history
  • Records of   personal exposure
  • Physical   examination
  • Baseline   blood sample for haematological profile
  • Urinary   mandelic acid

n/a

Thallium

  • Demographic,   medical and occupational history
  • Physical   examination
  • Urinary   thallium

Guide

Toluene

  • Demographic,   medical and occupational history
  • Records of   personal exposure
  • Physical   examination
  • Baseline   blood sample for haematological profile
  • Urinary   hippuric acid or o-cresol or
  • s-toluylmercapturic acid

n/a

Vinyl chloride

  • Demographic,   medical and occupational history
  • Physical   examination
  • Records of   personal exposure

Guide

Xylene

  • Demographic,   medical and occupational history
  • Records of   personal exposure
  • Physical   examination
  • Baseline   blood sample for haematological profile
  • Urinary toluic   acid

n/a

Payment of health monitoring expenses

If health monitoring is required the person conducting the business or undertaking who engages the worker must pay all the expenses related to the health monitoring including:

  • doctor’s fees
  • testing and analysis costs
  • travel costs
  • time off work to attend medical appointments for any testing.

Supervision of health monitoring

Health monitoring must be carried out by or under the supervision of a registered medical practitioner with experience in health monitoring. A medical practitioner may be a single practitioner in a medical practice, occupational physician who works for a specialist occupational health organisation or a provider of specialist services and testing in certain areas of health monitoring like respiratory screening and chest x-rays.

Workplaces may use any registered medical practitioner with experience in health monitoring. The registered medical practitioner should be adequately trained in the appropriate medical examinations and tests for the chemical in question.

Read about the minimum standard of competence for a medical practitioner to carry out health monitoring in the Health Monitoring for Exposure to Hazardous Chemicals Guide for Medical Practitioners.

Health monitoring reports

It is the duty of the workplace to take all reasonable steps to obtain a health monitoring report from the registered medical practitioner who carried out the health monitoring. The health monitoring report should only contain information relating to health monitoring for the hazardous chemical being used.

The Hazardous Chemicals Health Monitoring Report (PDF, 241.78 KB) may be used as the health monitoring report. Use the Lead Health Monitoring Report(PDF, 146.6 KB) if the health monitoring is related to lead (inorganic).

A copy of the health monitoring report must be provided to the worker.

The workplace should consider the results, recommendations and advice provided by the registered medical practitioner, and take appropriate action.

Keeping confidential health records

Health monitoring reports and any test results must be kept as a confidential record and must not be disclosed to another person without the worker’s written consent, except where the records are required to be given under theWork Health and Safety Act and Regulation.

Health monitoring records must be kept for at least 30 years after the record is made, even if the worker no longer works at the workplace.

Last updated
20 November 2017

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