Hazardous Substance Health Monitoring
Health monitoring (or Health Surveillance) is the monitoring of a worker to identify changes in their health status because of exposure to hazardous chemicals or asbestos through their working environment. It involves experienced doctors examining and supervising the health monitoring of your workers to see if the exposure to hazardous chemicals or asbestos at work is affecting their health. If you are not sure and need to discuss your concerns or workplace exposure please contact our Specialist Team for assistance.
The Sonic HealthPlus Specialist Services Team are available to discuss any concerns or questions regarding workplace exposure.
Substances
- Overview
- Planning
- Substances
- Additional Risks
Overview
A person conducting a business or undertaking (PCBU) must ensure health monitoring is provided to a worker if the worker:
- is carrying out ongoing work using, handling, generating or storing hazardous chemicals, and there is a significant risk to the worker’s health because of exposure to a hazardous chemical listed in Schedule 14 to the WHS Regulations
- is carrying out ongoing work using, handling, generating or storing hazardous chemicals and there is a significant risk the worker will be exposed to hazardous chemicals other than those listed in Schedule 14 and either:
- valid techniques are available to detect the effect on the worker’s health, or
- a valid way of determining exposure is available and it is uncertain on reasonable grounds whether exposure has resulted in the biological exposure standard being exceeded
- commences or is conducting lead risk work, or
- is carrying out licensed asbestos removal or other asbestos related work.
![]({"file":"asbestos-removal.jpg","breakpoints":{"xs":{"width":400,"height":400,"mode":"crop","quality":80},"lg":{"width":800,"height":800,"mode":"crop","quality":80}}} "Asbestos Removal")
The PCBU has a duty to determine ‘significant risk’ and to decide if a program of health monitoring is necessary. Significant risk decisions are made taking into consideration the likelihood of exposure to a hazardous chemical in conjunction with the known health effects of the chemical. Consultation with a health monitoring doctor may be needed to determine if testing for exposure to the chemical being used is available to monitor potential effects on a worker’s health status.
The PCBU, in consultation with the health monitoring doctor, should consider instigating a health monitoring program for chemicals with severe known health effects, for example chemicals that are known, or are presumed to be, carcinogenic, mutagenic or toxic to human reproduction, respiratory or skin sensitisers or those with other known severe toxic effects.
The health monitoring doctor will choose the best way to monitor your worker’s health and may use more than one way to monitor your worker’s health. They will choose the best way by looking at:
- the regulatory requirements under the model WHS laws
- the type of chemical involved
- the way your worker is exposed
- the level of exposure
- if the work environment includes control methods or equipment to reduce the exposure, and
- if it is possible to use a proactive way to monitor adverse health effects.
Proactive health monitoring means monitoring your workers before they develop symptoms. This includes checking the level of a chemical or substance in your worker’s blood or urine. Proactive monitoring is preferable to monitoring symptoms after they have developed.
Planning a Health Monitoring Program
It is the responsibility of the PCBU to determine whether or not the risk to workers is significant and whether or not health monitoring is required. However, the PCBU may need to seek expert advice, for example from an Occupational Physician.
For chemicals listed in Schedule 14 to the WHS Regulations, a significant risk is considered to be one where a worker’s health is adversely affected by exposure to the hazardous chemical. For other hazardous chemicals, including lead and asbestos different tests for deciding health monitoring apply.
![]({"file":"hazardous-chemicals.jpg","breakpoints":{"xs":{"width":400,"height":400,"mode":"crop","quality":80},"lg":{"width":800,"height":800,"mode":"crop","quality":80}}} "Hazardous Chemicals")
In deciding if risk is significant, you should consider:
The nature and severity of the hazard for each hazardous chemical taking into account:
- the classification of the chemical according to the Globally Harmonized System of Classification and Labelling of Chemicals (GHS) for example irritant, sensitiser, carcinogen, acute toxicant
- the form of the chemical in workplace processes for example solid, granulated, dust, mist, fume, and
- the route of entry by which the chemical can adversely affect health for example inhalation, ingestion, skin contact and absorption
The degree of exposure to workers, taking account of:
- where in the workplace the chemicals are used, handled, stored or generated
- who could be exposed and at what levels or concentrations exposure could occur
- the quantities and concentrations (pure or dilute) of chemicals being used, handled, stored or generated
- standard work practices, procedures and control measures
- the way individual workers carry out their daily tasks
- whether existing control measures adequately control exposure, and
- how often and for how long exposure is likely to occur.
If you have determined there is significant risk, you can provide us with this information leading to this decision or if you are unable to determine the level of risk you can contact us to assist. We have a team of highly qualified specialist Occupational and Environmental Physicians and Senior Registrars with expertise in this field of medicine.
Substance which require Health Monitoring
The information below is taken from regulation 436 (asbestos) and Schedule 14 to the WHS Regulations.
Acrylonitrile
Arsenic (inorganic)
Asbestos
Benzene
Cadmium
Chromium (inorganic)
Creosote
Isocyanates
Lead (inorganic)
Mercury (inorganic)
4,4’-Methylene bis(2-chloroaniline) (MOCA)
Organophosphate pesticides
Pentachlorophenol (PCP)
Polycyclic aromatic hydrocarbons (PAH)
Silica, crystalline
Thallium
Vinyl chloride
Some hazardous chemicals which may require health monitoring:
Below are some examples of hazardous chemicals and testing methods which are not listed in schedule 14 of the WHS Regulations where you may wish to consider implementing a health monitoring program for your workers.
Antimony
Arsenic (inorganic) - Urinary inorganic arsenic by speciation (inorganic arsenic plus methylated metabolites)
Benzene - urinary S-phenylmercapturic acid (s-PMA)
Beryllium
Butanone (methyl ethyl ketone, MEK)
Carbon disulphide
Chromium (inorganic) - Urinary chromium
Cobalt
Creosote - Urinary 1-hydroxypyrene
Cyclophosphamide
Dichloromethane
Ethyl benzene
Fluorides (including soluble fluorides and aluminium fluoride)
Isocyanates - Urinary isocyanate metabolite
4-methylpentan-2-one (methyl isobutyl ketone) MIBK
Nickel
Organophosphate pesticides
Polycyclic aromatic hydrocarbons (PAH)
Styrene
Tetrachloroethylene (perchloroethylene)
Toluene
Trichloroethylene
Vinyl chloride - Annual liver function tests (AST, ALT, GGT, ALP, and bilirubin)
Uranium
Xylene
Additional Risks to Consider
Physical Effects Not Related to Health Monitoring to Schedule 14
Occupational Noise
Ionising Radiation
Occupational Noise
Work-related noise-induced hearing loss is a preventable but irreversible condition that affects many Australian workers.
Between 28–32% of the Australian workforce is likely to work in an environment where they are exposed to loud noise at work.
Noise-related injuries are most common in the manufacturing and construction industries with technicians and trades workers, machinery operators, drivers and labourers most exposed.
Learn more
Too much noise at work can lead to temporary or permanent hearing loss or tinnitus—ringing in the ears. Hearing damage can occur from extended exposure to noise or exposure to very loud impact or explosive sounds. Long term exposure to loud noise is the most common preventable cause of hearing loss.
If you have identified any noisy activities that may expose workers or others to hazardous noise, unless you can reduce the exposures to below the standard straight away, you should assess the risks by carrying out a noise assessment.
A noise assessment will help you:
- identify which workers are at risk of hearing loss
- determine what noise sources and processes are causing that risk
- identify if and what kind of noise control measures could be implemented
- check the effectiveness of existing control measures
Under the model WHS Regulations, a Person Conducting a Business or Undertaking (PCBU) must provide audiometric testing for a worker who is carrying out work if they are required to frequently use personal hearing protectors as a control measure for noise that exceeds the exposure standard.
- Audiometric testing must be provided within three months of a worker starting work that exposes them to a risk of work related noise-induced hearing loss.
Starting the audiometric testing before people are exposed to hazardous noise (such as new starters or those changing jobs) provides a baseline as a reference for future audiometric test results.
Regular follow-up tests must be carried out at least every two years. These should be carried out well into the work shift so that any temporary hearing loss can be identified.
Sonic HealthPlus can provide screening and occupational noise management assessments at baseline and every two years (or as indicated in your policy).
![]({"file":"uranium-ore.jpg","breakpoints":{"xs":{"width":400,"height":400,"mode":"crop","quality":80},"lg":{"width":800,"height":800,"mode":"crop","quality":80}}} "Uranium Ore")
Ionising Radiation
The system of radiation protection deals with exposure to radiation in three classes: occupational, medical and public.
Occupational exposures are incurred at work and principally as a result of working directly with radiation. Medical exposure is principally the exposure of patients as part of their medical diagnosis or treatment. Public exposure covers all other exposures arising from practices; that is, all exposures that are neither occupational nor medical.
Learn more
Occupational exposure associated with a practice includes all exposure to ionizing radiation which occurs at work. Exposure to radiation from natural sources is generally excluded from occupational exposure, except when the exposure is a direct consequence of a practice or is specifically identified by the appropriate authority as requiring control through the implementation of a program of radiation protection.
Such circumstances may arise, for example, in the mining and processing of radioactive ores, in the handling and storage of specified materials containing significant traces of natural radionuclides, in working in specified underground mines and caves, and in the operation of high-flying aircraft. Exposure to radon which occurs as a direct restricted consequence of a practice, such as in the case of uranium mining, should be treated as occupational exposure.
Except in the case of accidental exposure to high doses, no specific radiation-related medical examinations are normally required for persons who are occupationally exposed to ionizing radiation, as there are no diagnostic tests which yield information relevant to exposure at low doses. Where required, health monitoring should follow general occupational medical practice for determining fitness for work.
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