> Disclaimer: SiteKiln gives you plain-English information, not legal or health and safety advice. Always follow your site-specific risk assessments and talk to a qualified professional.
The short version
If your work exposes you to certain health risks -- like dust, noise, vibration, chemicals or other hazards -- your employer must provide appropriate health surveillance where it's needed, not just hope for the best.
Health surveillance means regular, targeted checks (hearing tests, lung function, skin checks, HAVS screening, etc.) to spot work-related health problems early so they can be dealt with before you're badly damaged.
Why it matters
Construction is not just about falls and crush injuries -- it's also about slow damage: dusted lungs, wrecked hearing, vibration-damaged hands, skin problems, stress, musculoskeletal issues.
HSE are putting more focus on health on construction sites (not just safety), and they expect to see proper health surveillance where the risks need it.
If you're on noisy, dusty, vibrating, chemical-heavy or physically punishing work and nobody has ever offered you any checks, there's a good chance they're not meeting their duties.
What the law actually says
The Management of Health and Safety at Work Regulations 1999 say:
Every employer must provide such health surveillance as is appropriate having regard to the risks identified in the risk assessment (regulation 6).
That's on top of any health surveillance required by specific regulations (like COSHH, Noise, Vibration, Asbestos, Lead, etc.).
HSE describe health surveillance as a system of ongoing health checks for workers exposed to certain risks, such as:
- Noise (risk of hearing damage).
- Vibration (risk of HAVS, CTS).
- Hazardous substances -- dust (silica, wood), fumes, chemicals (risk of lung disease, asthma, skin problems).
- Other risks where there's a known work-related disease and a valid way of spotting it early.
Health surveillance is legally required where all of these apply:
- There is a known health risk from a hazard in your work.
- Exposure still exists even after controls (e.g. PPE still needed).
- There are valid techniques to detect early signs of harm.
- It's reasonably likely the condition could occur given your exposure.
Construction ticks those boxes a lot -- particularly for dust, noise, HAV, and some chemicals.
Examples: when you should be getting health surveillance
In construction, health surveillance is often expected if you:
- Regularly use vibrating tools (breakers, rock drills, cut-off saws, grinders, compactors) -- HAVS screening and tiered HAVS medicals.
- Work in high noise for long periods (plant, cutting, drilling, powered tools) -- regular hearing tests (audiometry).
- Are regularly exposed to respirable dusts (silica from concrete/stone, wood dust, other hazardous dusts and fumes) -- lung function tests (spirometry) and respiratory health questionnaires.
- Work with sensitising chemicals (resins, adhesives, paints, some cements) -- skin checks/dermatology screening and respiratory surveillance for asthma.
- Do work with other specific hazards (lead, asbestos, certain biological agents) -- more specialised medicals required by those specific regs.
Health surveillance programmes usually include things like questionnaires, clinical checks, and tests (hearing, lung function, HAVS checks) at set intervals, recorded and followed up properly.
What you're entitled to -- in practice
If your job puts you in one of those risk groups and you're an employee (including many limb (b) workers in practice), you're entitled to:
- Health surveillance that matches the risk -- not nothing, and not a generic tick-box form.
- Surveillance paid for by the employer, not you personally.
- Proper explanation of why it's being done and what the results mean.
- Follow-up if issues are found -- adjustments to work, improved controls, referrals to occupational health doctors if needed.
For self-employed people genuinely in business on their own, the regs don't make another firm buy you health surveillance, but you still have duties to look after your own health -- and HSE still expect you to control these risks.
In reality, many micro-firms either pay for basic checks themselves, or piggy-back on a main contractor's occupational health provision on bigger jobs.
Health surveillance isn't disciplinary. If done properly, it's about catching issues early, adjusting the job and keeping you fit for work -- not finding reasons to get rid of you.
What to do if you're not getting any health checks
If you're regularly exposed to noise, vibration, dust or nasties and nobody's ever mentioned health surveillance:
Raise it
"We're on vibrating tools/noisy kit/dusty work all the time -- under the regs we should have some health surveillance. Can you tell me what's in place?"
Ask to see the risk assessment
If the risk assessment identifies significant noise, HAV, dust or chemical risks, but there's no mention of health surveillance, that's a gap.
Log your own health
Keep notes of any symptoms (hearing issues, hand numbness, breathing problems, skin rashes) and get them recorded with your GP early.
If they still do nothing
It's a pattern of not managing health risks and may be something to flag if HSE ever get involved, or to raise more formally if your health is affected.
For small firms, the practical next step is usually to speak to an occupational health provider and set up a basic programme for the people clearly at risk -- it doesn't have to be fancy to be compliant.
What to do next
- Ask your employer what health surveillance is in place for your team -- if the answer is "nothing", point them to HSE's guidance.
- If you're regularly on dusty, noisy or vibrating work, ask specifically about hearing tests, lung function checks and HAVS screening.
- Log any symptoms (hearing problems, breathing issues, hand numbness) with your GP so they're on your medical record.
- If you run your own small firm, contact an occupational health provider and set up a basic programme for anyone clearly at risk.
- Keep copies of all your health surveillance results -- they're yours to keep.
Sources
- Management of Health and Safety at Work Regulations 1999 -- regulation 6: health surveillance duty.
- Control of Substances Hazardous to Health Regulations 2002 (COSHH) -- health surveillance for hazardous substance exposure.
- Control of Noise at Work Regulations 2005 -- hearing surveillance duties.
- Control of Vibration at Work Regulations 2005 -- HAVS surveillance duties.
- HSE -- Health surveillance overview and construction-specific guidance.
Disclaimer
This guide is general information for small UK construction businesses and trades, not formal legal or medical advice.
SiteKiln is not a law firm and this page is not a substitute for getting advice on your specific situation.
Health and safety law and HSE guidance on health surveillance are updated from time to time, and whether you're legally entitled to specific checks will always depend on the exact risks in your work and your employment status.
If you think you should be on health surveillance but aren't, or you already have work-related health problems, get specific advice from a competent health and safety/occupational health professional, your GP and/or a solicitor before you make big decisions.
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