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Impacts of COVID-19 on Health Surveillance

Many of our clients took early action to reduce visits from external parties and as the public health advice has changed, we know that many businesses have taken the decision to comply with social distancing advice by closing their doors temporarily.  For some industries, social distancing measures can be enforced as far as possible whilst maintaining productivity and service delivery.  These industries could be those who are involved in food production, rail workers, and manufacturing; all key workers essential to ensure that those who are required to self-isolate or to treat those with ill health are able to do so without hindrance.  This is particularly important for those employers who have lost part of their workforce through those self-isolating due to symptoms which places an increased pressure on those still working through extended working hours or the requirement for higher productivity levels. 

HSE Guidance

The HSE have issued guidance for OH providers this week in stating face to face health surveillance is a non-essential activity and therefore should be postponed until a later date.  They are clear that the duty on employers remains and there are a number of areas of health surveillance where activities can continue remotely.  A proactive approach to workers health surveillance is likely to help keep the workforce healthy and able to deliver the support that is going to be essential to supporting the NHS and the public to cope with self-isolation and social distancing. 

The guidance from HSE is designed to a be a proportionate response that balances the current constraints on movement presented by the COVID-19 outbreak against the need to protect the health, safety and welfare of workers as laid out in health and safety legislation. 

Remote Health Surveillance

For health surveillance required under COSHH regulation 11, the assessment can be undertaken as a paper review.  A questionnaire for respiratory and skin symptoms can be administered and if no problems are identified, then a full assessment can be deferred for three months.  Those with current problems can be assessed further by telephone in the first instance.  There are options to perform assessments via remote camera that allows more in depth assessment.  Coronavirus symptoms can have some overlap with those that may be seen in irritation or sensitisation of the airways.  Cough and sore throat can certainly be seen in relation to work exposures, but this can be assessed once the risk of COVID-19 has passed and whether the symptoms persist.

COSHH Guidelines

With regard to Control of Noise at Work Regulations 2005, audiometry can be deferred for a period of three months.  where there is a problem, a review can be undertaken by telephone and then a judgement can be made on whether to see the worker face to face and, if so, how to do so safely.  In practice, it is unlikely that there will be any situations that impact on hearing health that are so urgent that they require face to face review in the absence of an audiometry repeat. 

With regard to and Control of Vibration at Work Regulations 2005, the usual tiered approach to health surveillance will apply to Vibration symptoms. Questionnaires can be administered remotely and where there is a problem, a review can be undertaken by telephone and then a judgement can be made on whether to see the worker face to face and, if so, how to do so safely.  In practice, up to tier 3 is likely to be possible via remote video if necessary. 

For medical surveillance under COSHH Schedule 6, ie radiation, compressed air, asbestos and lead, the appointed doctor can use discretion to determine the content of the review. Therefore, they can perform a telephone review and if there are no problems, schedule a full review three months later.  Specifically for asbestos, an appointed doctor can speak with the individual remotely to establish that the worker has no significant symptoms by using a respiratory symptom questionnaire.  Providing there are no problems, they can then issue a new asbestos certificate for three months.  Wherever there is a problem in the assessment that could affect safety, a judgement should be made on whether to need to see a worker face to face and how this can be completed safely. 

Antibody Tests

With the announcement of mass home testing for COVID-19 antibodies potentially being available in the next few days, this may help to identify those who are no longer at risk of symptoms as they have already developed resistance through early exposure to the virus.  If specificity and sensitivity can be confirmed as sufficiently high, this is likely to be a turning point for businesses in returning their workforce to full productivity. 

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