Health surveillance

Activities to be carried out by employers in health surveillance



Occupational health monitoring includes the collection, analysis, interpretation and continued and systematic dissemination of data for prevention purposes. Surveillance is essential for the planning, implementation and evaluation of occupational safety and health programmes, the control of work-related disorders and injuries, as well as for the protection and promotion of workers' health. Such surveillance includes both monitoring the health of workers and that of the working environment.

The purpose of monitoring the health of working persons is to understand the impact that work has on their health, with the aim of improving working conditions.

To achieve this, in practice it must be carried out through longitudinal monitoring of the worker at risk and integrated into the plans and programmes for the prevention and improvement of condiciones de trabajo.

Royal Decree 843/2011, 17 June, laying down the basic criteria on the organisation of resources to develop the health activity of prevention services, provides, in Article 11, that the Ministry of Health, in coordination with the Autonomous communities, heard by scientific societies and social agents, shall develop and maintain up-to-date a basic and general Guide to the orientation of health surveillance activities for the prevention of occupational risks.

Let us see that other obligations should be taken into account by the employer in relation to Health Surveillance, indicated in the regulations for this purpose and contained in the Basic and General Guide to Health Guidance-Surveillance for the Prevention of Occupational Risks, the Ministry of Health, Consumer Health and Social Welfare:

  • Ensure the occupational risk assessment necessary for the proper monitoring of workers' health by the company's Occupational Risk Prevention Service.
  • Ensure workers regularly monitor their health Ensure workers regularly monitor their health
  • Order the implementation of the necessary preventive measures to prevent damage to the health of workers resulting from inadequate working conditions.
  • Bear the costs of monitoring the health of your workers.
  • Having the specialty of Work Medicine including it in your own (or joint) Prevention Service, or by going to a Third-party Prevention Service, to which you must contract all preventive health activities in accordance with the article 3 RD 843/2011, June 17.
  • To provide health services with prevention services, if their own, with the material resources appropriate to the functions to be performed.
  • Consult workers or their representatives, in advance, on the organization and development of the health surveillance programme.
  • Do not use health surveillance results for discriminatory purposes.
  • Ensure, promote and facilitate research on the relationship to occupational hazards in the event of harm to workers' health, whether from accidents, incidents, occupational diseases or non-traumatic pathologies caused or aggravated by work.
  • To encourage collective agreements and enterprise agreements To encourage collective agreements and enterprise agreements
  • Ensure that each job has identified whether medical examinations are mandatory or voluntary.
  • Consult prevention delegates regarding the decision to resort to outsourcing activities by their own prevention services.
  • Inform the temporary employmentundertaking prior to the conclusion of a contract for making available, the characteristics of the job to be carried out and the specific health monitoring measures to be taken in relation to those posts, specifying whether they are mandatory or voluntary for the worker, according to the regulations and their periodicity.
  • Collect the necessary information from the temporary work company, in cases where health monitoring measures are mandatory for the worker, to ensure that the worker made available has been deemed fit through a recognition of his health status for the performance of the services to be provided under the required conditions.
  • Facilitate the implementation in its companies of preventive and health promotion programmes referred to in Article 3 of DR 843/2011 of 17 June, assigned to the health service of the prevention service.
  • Provide labour and health authorities with the information needed to establish appropriate post-departmental health surveillance procedures.
  • Inform and consult workers' representatives on the content of worker-specific health protocols based on identified risks and selected health indicators to assess the effectiveness and effectiveness of prevention programmes.
  • Provide Prevention Delegates with specific medical protocols applied to workers based on the risks they are exposed to as a result of their activities.
  • Guide the worker in case of temporary suspension of the employment contract for risk in pregnancy and lactation, together with the Prevention Service.

Obligation to assess the effects of working conditions on workers' health

"Recognitions are mandatory where they are essential to assess the effects of working conditions on workers' health" (art. 22 LPRL).

Working condition means any characteristic of the worker who may have a significant influence on the generation of risks to the safety and health of the worker (art. 4 LPRL).

The study of working conditions defines three possible situations, based on their consequences on the safety and health of the worker:

Known and non-harmful effects. Under these conditions, there is no point in raising the obligation of health surveillance.

Known and potentially harmful effects (e.g. exposure to many chemical or biological agents). The worker should be informed that he or she is in likely harmful working conditions and health monitoring should be recommended as a possible health protection measure. But it is unethical to tolerate a worker's exposure to potentially harmful working conditions: it should be insisted that the prevalent preventive factor par excellence is the development of work under adequate conditions of hygiene and safety.

Little-known or unknown effects (e.g. exposure to electromagnetic fields). The possible effects of working conditions are not sufficiently evaluated. The worker should be informed of the situation and recommended for health monitoring.

In conclusion, one of the company's obligations in preventive matters is to ensure that workers at its service regularly monitor their health status based on the risks inherent in the work. Health surveillance is more than just medical examinations:

Proper health monitoring begins with initial medical examination, which should be prior to onboarding. In this exam, not only the medical protocols related to the workplace should be applied, but the parameters related to age, habits, etc... And from this moment on, a medical history should have been created that should accompany the worker throughout his working life.

It's transcendental.

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