What is HSG61?
HSG61 "Health Surveillance at Work" is the HSE's guidance on implementing health surveillance programmes in the workplace. Health surveillance means systematically watching for early signs of work-related ill health in employees exposed to certain health risks.
This guidance helps employers understand when health surveillance is legally required, what it should involve, and how to use the results to protect workers and improve workplace controls.
Who Needs This Document?
HSG61 is essential for employers and managers in workplaces where employees are exposed to:
- Hazardous substances (chemicals, dusts, fumes) covered by COSHH
- Noise above exposure action values
- Hand-arm vibration from powered tools
- Asbestos (current or historical exposure)
- Lead and other specific substances
- Compressed air (diving, tunnelling)
- Ionising radiation
It's also relevant for:
- Occupational health professionals
- HR managers responsible for employee health
- Safety representatives and committees
- Anyone conducting COSHH assessments
Key Topics Covered
When Health Surveillance is Required
Health surveillance is needed when:
- There is an identifiable disease or adverse health condition related to the work
- Valid techniques are available to detect the disease or condition
- There is a reasonable likelihood that the condition may occur
- Surveillance will benefit the employees being checked
It is not a general health check - it specifically targets work-related health effects.
Types of Health Surveillance
The guidance covers different levels of surveillance:
- Responsible person checks - Simple checks by a trained supervisor (e.g., skin inspections for dermatitis)
- Questionnaires - Symptom surveys administered by trained staff
- Clinical examinations - Examinations by qualified health professionals
- Biological monitoring - Testing blood, urine, or breath for substance exposure
- Biological effect monitoring - Testing for early biological changes
Legal Requirements
Various regulations require health surveillance:
- COSHH Regulations - For hazardous substances
- Control of Noise at Work Regulations - Hearing checks
- Control of Vibration at Work Regulations - HAVS screening
- Control of Lead at Work Regulations
- Control of Asbestos Regulations - For asbestos workers
- Ionising Radiations Regulations
Implementing Health Surveillance
The guidance covers practical implementation:
- Identifying who needs surveillance
- Choosing appropriate surveillance methods
- Frequency of health checks
- Record keeping requirements (40 years for some exposures)
- Using results to improve workplace controls
- Confidentiality and data protection
How This Applies to You
Step 1: Identify Health Risks
Review your risk assessments to identify work activities that could cause ill health:
- Do workers handle hazardous substances?
- Are they exposed to noise, vibration, or dust?
- Could they develop skin conditions, respiratory problems, or hearing loss?
Step 2: Determine if Surveillance is Needed
For each health risk, consider:
- Is there an identifiable work-related health condition?
- Can we detect it through valid techniques?
- Is it reasonably likely to occur given the exposure levels?
If all three apply, health surveillance is probably required.
Step 3: Choose Appropriate Methods
Match the surveillance to the risk:
| Hazard | Typical Surveillance |
|---|---|
| Skin sensitisers | Regular skin checks |
| Respiratory sensitisers | Lung function tests, questionnaires |
| Noise exposure | Audiometry (hearing tests) |
| Hand-arm vibration | HAVS questionnaires, Tier assessments |
| Lead | Blood lead monitoring |
Step 4: Arrange Competent Help
Depending on the level of surveillance needed:
- Train supervisors for simple checks
- Use qualified occupational health nurses or doctors for clinical surveillance
- Ensure laboratories are UKAS accredited for biological monitoring
Step 5: Act on Results
Health surveillance is only valuable if you act on findings:
- Investigate any adverse findings
- Review and improve workplace controls
- Consider restricting exposure for affected individuals
- Update risk assessments as needed
Related Guidance
- COSHH Regulations explained - When COSHH health surveillance applies
- Hand-arm vibration (INDG175) - HAVS surveillance requirements
- Workplace safety topic - General employer duties
- Managing for health and safety (HSG65) - Systematic safety management
- Risk assessment guide - Identifying health hazards
Official HSE document: HSG61 on HSE website