Employer Guide
Is Health Surveillance a legal requirement?
The short answer: yes — if your risk assessment identifies certain exposures, whatever the size of your business. Here’s what the law actually requires, in plain English.
Where the duty comes from
Three sets of regulations create most Health Surveillance duties for UK employers:
- COSHH 2002 (Control of Substances Hazardous to Health) — surveillance where workers are exposed to substances linked to identifiable diseases: silica dust, welding fume, isocyanates, sensitising resins and cements, flour dust and many more.
- Control of Noise at Work Regulations 2005 — hearing checks (audiometry) where exposure regularly exceeds the upper exposure action values (85 dB daily or weekly average).
- Control of Vibration at Work Regulations 2005 — HAVS surveillance where workers are regularly exposed above the exposure action value (2.5 m/s² A(8)) from tools like breakers, grinders and chainsaws.
On top of these sit the statutory medical requirements — asbestos, lead and ionising radiation — where the law goes further and names who must do the medical: an HSE Appointed Doctor.
The test: does your risk assessment identify exposure?
Health Surveillance isn’t a blanket requirement for every workplace. The trigger is your risk assessment. If it shows workers are exposed to noise, vibration or hazardous substances at levels where harm is foreseeable, and there’s a valid way to detect early effects, surveillance is required. If your controls genuinely eliminate exposure, it may not be. This is exactly the judgement an Occupational Health provider should help you make; we routinely tell employers which roles don’t need surveillance.
What “suitable Health Surveillance” looks like
| Exposure | Surveillance | Typical frequency |
|---|---|---|
| Noise ≥ upper action values | Audiometry | Annual for 2 years, then 3-yearly |
| Hand-arm vibration | HAVS questionnaire & tiered assessment | Annual |
| Respiratory sensitisers & dusts | Spirometry & questionnaire | Typically annual |
| Skin sensitisers | Skin inspection | Annual + self-checks |
| Asbestos (licensable work) | Medical by HSE Appointed Doctor | Every 2 years |
| Lead (significant exposure) | Appointed Doctor + blood-lead monitoring | At least annual |
| Ionising radiation (classified persons) | Appointed Doctor health review | Annual |
What happens if you don’t comply
The HSE can serve improvement notices and prosecute; fines are means-based and can be substantial. Just as costly in practice: without surveillance records you have little defence against civil claims for noise-induced hearing loss, HAVS or occupational asthma — conditions that surface years after exposure. And increasingly, principal contractors simply won’t let subcontracted workers on site without current records.
Getting compliant
Start with your risk assessments, map exposed roles to the table above, and put recall dates against every worker. Or send us the risk assessments and we’ll do it for you — see our Health Surveillance service and how employer programmes work.
This guide is general information for employers in Great Britain, not legal advice. Reviewed by Dr Gillian Hawkley, Occupational Health Physician.