Health Surveillance Testing is a legal requirement when employees are exposed to specific workplace risks—noise, respiratory hazards, harmful substances or tight-fitting respiratory protective equipment. Choosing the right tests means understanding which regulations apply to your operation, which employees need monitoring, and how often surveillance must be repeated.

This guide explains how to identify your duties, select appropriate health surveillance programmes, and arrange testing that meets HSE expectations.

When Is Health Surveillance Testing Required?

Health surveillance is not optional when your risk assessment shows:

• Employees exposed to noise at or above 85 dB(A) over a working day
• Work with substances listed in Schedule 6 of the COSHH regulations (isocyanates, vinyl chloride monomer, certain hardwoods)
• Exposure to respiratory sensitisers, skin sensitisers, carcinogens or substances causing occupational asthma
• Use of tight-fitting respiratory protective equipment (half-masks, full-face masks, filtering facepieces)
• Work with asbestos, lead, or compressed air (diving, caisson work)

If your COSHH or noise risk assessment identifies the need, you must arrange appropriate surveillance. The HSE can serve an improvement notice if you fail to comply, and continued failure can result in prosecution.

Types of Health Surveillance Testing

Audiometric Testing

Audiometric testing measures hearing ability to detect early signs of noise-induced hearing loss. It is required under the Control of Noise at Work Regulations when employees are exposed at or above the upper exposure action value (85 dB) or when a risk assessment identifies a hearing risk.

Testing must be carried out by a competent person and records kept for the duration of employment plus forty years. Baseline tests establish normal hearing, and periodic tests track any deterioration.

Lung Function Testing

Lung function testing (spirometry) is necessary when employees are exposed to respiratory hazards—dusts, fumes, gases, isocyanates, grain dust or other substances that can cause asthma, chronic obstructive pulmonary disease or other respiratory conditions.

Tests measure forced expiratory volume and vital capacity to detect early changes in lung function. Testing frequency depends on exposure level and the substance involved; initial baseline tests should be conducted before or shortly after exposure begins.

Skin Surveillance Testing

Skin surveillance is required when employees handle substances that can cause dermatitis, skin sensitisation or other occupational skin disease. Common triggers include wet work, oils, solvents, resins, chromates, nickel compounds and certain plants.

Surveillance typically involves regular skin inspections by a competent person and questioning employees about symptoms. Early detection allows intervention before severe dermatitis develops.

Face Fit Testing

Face fit testing is required whenever tight-fitting respiratory protective equipment is used. The test verifies that the specific make, model and size of mask achieves an adequate seal on the wearer’s face.

Testing must be repeated whenever the wearer changes mask type, experiences significant weight change, dental work or facial scarring, or at intervals recommended by the mask manufacturer (typically every two to three years). Without a valid fit test, the mask cannot be relied upon to provide the assigned protection factor.

How to Select a Health Surveillance Provider

When choosing a provider, consider:

• Competence: Technicians should hold recognised qualifications in audiometry, spirometry or fit testing. Ask about training records and professional memberships.
• Equipment: Audiometers, spirometers and fit-test equipment must be calibrated and maintained. Request calibration certificates.
• Location: On-site testing minimises disruption. Check whether the provider can visit your workplace or whether employees must travel.
• Record-keeping: The provider should supply clear reports, maintain confidential health records, and advise you when further action is needed.
• Follow-up: Ask how the provider handles abnormal results. Referral pathways to occupational health physicians should be in place.

Milne Safety delivers audiometric, lung function, skin surveillance and face fit testing at our Wymondham training centre or on your site across Norfolk. Our staff hold relevant competencies and use calibrated equipment to meet HSE standards.

How Often Should Health Surveillance Be Conducted?

Frequency depends on the hazard and the level of risk:

• Audiometry: Annual testing for employees exposed at or above 85 dB(A); more frequent testing if early signs of hearing loss are detected.
• Lung function: Baseline test before or within the first weeks of exposure, then periodic testing—typically annually or more often for high-risk substances.
• Skin surveillance: Frequency varies; some employers conduct inspections every few months, others rely on self-reporting and periodic formal checks.
• Face fit: At initial issue of RPE, when mask type changes, after significant facial changes, and at intervals recommended by the manufacturer.

Your risk assessment should specify the testing schedule. Document the rationale and review it whenever exposure conditions change.

What Happens If Health Surveillance Identifies a Problem?

When testing reveals early signs of occupational disease or an inadequate face fit:

• Review the risk assessment and control measures. Can exposure be reduced or eliminated?
• Refer the employee to an occupational health professional for further assessment.
• Consider redeployment or adjustment of duties if medical advice recommends it.
• Check whether other employees in similar roles are affected.
• Record the findings and actions taken in the health surveillance records.

Early detection is the purpose of surveillance. Act on results promptly to prevent progression to serious disease.

Common Questions About Health Surveillance Testing

Do I need health surveillance if my risk assessment shows low exposure?

Health surveillance is required when there is an identifiable disease or health effect related to the exposure, valid detection techniques exist, and there is a reasonable likelihood that the disease or effect may occur under the particular conditions of work. If exposure is genuinely negligible and the risk assessment supports that conclusion, surveillance may not be necessary—but document your reasoning clearly.

Can I conduct health surveillance in-house?

Simple skin surveillance and questionnaire-based checks can be carried out by a trained responsible person within your organisation. Audiometry, spirometry and face fit testing require specific training and calibrated equipment. Most employers arrange these services through a competent external provider.

How long must I keep health surveillance records?

At least five years for most substances. Forty years for asbestos, lead and certain COSHH Schedule 6 substances. Records are confidential and must be stored securely. Employees have the right to see their own records, and the HSE can request access during an inspection.

What happens if an employee refuses health surveillance?

Health surveillance is a legal requirement under COSHH and the Noise at Work Regulations when specified by a risk assessment. Refusal to participate can be treated as a disciplinary matter. Explain the purpose, address concerns, and document the refusal and any action taken.

Arrange Health Surveillance Testing in Norfolk

If your risk assessments identify a need for audiometric, lung function, skin or face fit testing, Milne Safety can deliver surveillance programmes at our Wymondham training centre or on your site across Norwich, Attleborough, Thetford and Dereham.

Call 01953 607093 to discuss your requirements, or visit our contact page to arrange a consultation. We will help you identify which tests are necessary, set appropriate testing intervals, and maintain compliant records.