Dear Geoff - congratulations on such a succinct and helpful summary of HS issues - best wishes - Kate
>>> [log in to unmask] 19/06/03 05:27:34 >>>
You cannot transfer the same approach from Audiometry to Respiratory
Surveillance. The pathophysiology is different.
Noise causes 1/3 of damage immediately, 1/3 in next 3 months, and final 1/3
over 3 years - longer intervals are therefore logical in low risk
environments (see MS26). Initial annual Audiometry will identify those who
are more sensitive and need to remain on annual Audiometry (they may have
Temporary Threshold Shift). One easy method to identify these is to do all
initial Audiometry randomly during the shift/week, and then do repeat
pre-shift Audiometry in those with changes (48 hours away from noise).
If you are undertaking respiratory surveillance for sensitisers, then the
risk is higher on initial exposure, and then beds down to a constant rate -
the frequency depends upon the risk situation. MS25 has differing levels of
surveillance, ranging from self reporting of symptoms through to full lung
function (and some would say RAST/PRIST and skin testing). The interval of
Health Surveillance doesn't change, it is the method that can be scaled
back. I would recommend 6 weeks, 6 months, and then every 12 months (6
months in high risk situations such as Small Animal Allergy) see MS25.
If you are undertaking Respiratory surveillance for pnemoconiotic conditions
such as Silica exposure, then regular measurements of FEV1 and FVC (which
can be plotted over time), are essential to find the more sensitive workers.
I would recommend annually. Progression of restrictive defects identify who
should have Chest X-rays (NOT all of them - consider the risks from the
radiation exposure).
It is not just how often you do things, it is what you do - and most
importantly, what you do with the results. I have reviewed several Health
Surveillance programmes where previous OH (so called) Practitioners have
simply watched employees go deaf, and not recommended redeployment in cases
of Occupational Asthma - which then progress to permanent symptoms and
disability.
Dr Geoff Helliwell
MB ChB CIH FFOM MIOSH
Accredited Specialist in Occupational Medicine
www.wellwork.co.uk
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-----Original Message-----
From: Occupational Health mailing list
[mailto:[log in to unmask]]On Behalf Of Christmas Giuliana
Sent: 17 June 2003 15:41
To: [log in to unmask]
Subject: Re: Surveillence
Hi
Where i'm working the standard interval for audiometry is 3 yearly unless
there has been a Cat 4,3,2,1 in which case they're done annually.This
accounts for about 40% of my workforce and occurs because it is considered
that the consequences of further hearing loss would be particularly
detrimental to these people.
With regards,
Giuliana
-----Original Message-----
From: joan Twigger [mailto:[log in to unmask]]
Sent: 17 June 2003 15:05
To: [log in to unmask]
Subject: Surveillence
Advise please on best practise I have spoken to HSE who tell me that time
scale for any health surveillence is down to me based on risk assesment .
Audiomerty has been carried out for past 3 years annualy where no change is
apparent I want to go to 3 yearly testing all employees are wearing
protection following noise level recording.
Lung function tests are done following same pattern on all people wearing
respirators I want to do the same there.
I need to sell this to the business so would appreciate some key points.
Thanks in anticipation
Regards
Joan Twigger
Occupational Health Advisor
3M Healthcare Limited
Tel: 01509 613720
Fax: 01509 613065
e-mail [log in to unmask]
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