Health Surveillance is the ongoing monitoring of a worker to identify changes in their health status because of exposure to hazardous substances and stressors through their working environment. It involves experienced doctors monitoring the health of workers through medical examination to see if the exposure to hazardous substances or stressors at work are affecting their health. Some health monitoring may be required by law and a workplace risk assessment provides vital information to identify what monitoring is needed. Workers in many heavy industries (eg construction, mining, etc) are constantly exposed to hazardous substances. Long-term exposure to these substances can cause illness and even death.

Asbestos has been extensively used in building materials in Australia until the mid-1980s, causing workers that have long term exposure to the substance to develop asbestosis (Asbestos Safety and Eradication Agency, 2022). Although asbestos was primarily used in building materials, asbestos dust and fibres can easily become airborne when old building walls and ceilings are agitated. Workers may inhale the dust and fibres at their workplace if appropriate respiratory protection is not utilised. Since asbestos does not degrade, significant amounts of asbestos build up in the lung causing lung tissue scarring and shortness of breath over time when dust and fibres become lodged within the alveoli. Many years after exposure, workers are at risk of developing lung cancer or mesothelioma.

Coal, mineral mines, and quarry workers may inhale harmful levels of respirable (ultra-fine) dust at mines and quarries causing Mine Dust Lung Disease (MDLD) to develop over an extended period of time. Respirable dusts (including silica) are invisible and can pass through defences and directly enter into lung tissue causing irritation, later scarring, and finally replacing health tissue leading to a range of lung diseases including pneumoconiosis (coal workers’ pneumoconiosis or silicosis), chronic obstructive pulmonary disease (COPD), or lung cancer. It can also cause irritation to the eyes and skin. Adequate personal protective equipment and regular health monitoring requirements for these workers are regulated and helps to prevent, reduce and identify early onset of occupational diseases like MDLD.

Respirable crystalline silica (RCS) dusts, evident in much higher concentrations where workers are fabricating bench tops from stone, can lead to a range of respiratory diseases including silicosis. Symptoms of RCS exposure can include shortness of breath, cough and fatigue. For these workers, there is an increased risk of COPD, lung cancer, and kidney disease. A more rapidly progressive lung disease (accelerated silicosis) can occur after exposure to high concentrations of silica dust over a shorter period of time.

The process of implementing a health surveillance program involves identifying the hazards at each workplace, classifying the nature and severity of the risks, consideration of the degree of exposure, and the personal protective equipment. This may include conducting medical assessments for workers who have been identified as having a high exposure risk.

The primary benefit of a good health surveillance program is identifying workers who have or who are at risk of developing work-related illnesses over time. Other benefits include lowered rates of absenteeism and decreased long-term medical and liable cost. Finally, a health surveillance monitoring program can be implemented as part of a broader workplace employee health and wellness program.

Sonic HealthPlus’ Specialised Services Unit (SSU) has a dedicated team of health professionals that include occupational physicians and OP registrars ready to assist you. Building a long-term relationship with a dedicated health professional is an important link in ensuring the health and wellbeing of your workers into the future.   

Please see this link for a comprehensive list of substances that require health monitoring, and the contact details for our SSU team.

References

Asbestos Safety and Eradication Agency. (2021). About asbestos.

https://www.asbestossafety.gov.au/about-asbestos/about-asbestos  

Resources Safety & Health Queensland. (2022) What is MDLD? | Miners’ health matters

https://www.rshq.qld.gov.au/miners-health-matters/what-is-mdld

Dr Keith Adam
M.B., B.S., Fellow ACOM, Fellow AFOEM, RACPChief Medical Officer

Dr Keith Adam is a Senior Specialist Occupational Physician with Sonic HealthPlus and an Associate Professor of Occupational Medicine with the University of Queensland. Treating and rehabilitating injured workers since 1984, Dr Adam has extensive experience in determining what duties injured workers may be able to perform, and managing return to work programmes.

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Please note: Patients who attend for their medical assessment presenting with flu-like symptoms or have recently travelled from a COVID hotspot may be turned away.

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