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.
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
- the work is ongoing
- 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* |
|
|
Exposure is at a level that could harm health* |
|
|
Exposure to a chemical that is highly toxic |
|
|
It is reasonably foreseeable leaks or spills may occur |
|
|
Uncertain about the risk to health or level of exposure |
|
|
* Where a workplace exposure standard (WES) for an airborne contaminant has been established, exposure over 50 per cent 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.
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.
Hazardous chemical | Type of health monitoring | Health monitoring guidance |
Acrylonitrile |
| |
Antimony |
| n/a |
Arsenic (inorganic) |
| |
Asbestos |
| |
Benzene |
| |
Beryllium |
| n/a |
Cadmium |
| |
Carbon disulphide |
| n/a |
Chromium (inorganic) |
| |
Cobalt |
| n/a |
Creosote |
| |
Crystalline silica (quartz) |
| |
Cyclophosphamide |
| n/a |
Ethyl benzene |
| n/a |
Fluoride |
| n/a |
Isocyanates |
| |
Lead (inorganic) |
| |
Nickel |
| n/a |
Mercury (inorganic) |
| |
Methyl bromide |
| Guide (PDF, 0.45 MB) Form (PDF, 0.63 MB) |
4,4'-Methylene bis(2- chloroaniline) (MOCA) |
| |
Organophosphate pesticides |
| |
Pentachlorophenol (PCP) |
| |
Polycyclic aromatic hydrocarbons (PAH) |
| |
Styrene |
| n/a |
Thallium |
| |
Toluene |
| n/a |
Vinyl chloride |
| |
Xylene |
| 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, 0.17 MB) may be used as the health monitoring report. Use the Lead Health Monitoring Report (PDF, 0.2 MB) if the health monitoring is related to lead (inorganic).
A copy of the health monitoring report must be provided to the:
- worker (at all times)
- regulator (Workplace Health and Safety Queensland) if the report contains
- any advice that test results indicate that the worker may have contracted a disease, injury or illness as a result of carrying out work with the hazardous chemical OR
- a recommendation that the person conducting the business or undertaking take remedial measures, including whether the worker can continue to carry out the work using, handling, generating or storing hazardous chemicals that triggered the requirement for health monitoring.
Submitting a report
Workplace Health and Safety Queensland
Occupational Health and Hygiene Unit
PO Box 820
LUTWYCHE QLD 4030
You must send WHSQ a copy of the health monitoring report even if WorkCover Queensland has been notified.
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 the Work 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.