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Occupational Medicine 1995;45:305-310
© 1995 Society of Occupational Medicine

research-article

A systematic approach to health surveillance in the workplace

J.G. Bell*, C. Bishop{dagger}, M. Gann{ddagger}, M.J. Gilbert§, W. Howe||,, C.T. Lamb, G. Leighton-davies**, N.I.P. McKie{ddagger}, I. Picton-Robinson{dagger}{dagger}, A.M. Prestage{ddagger}{ddagger}, C. Roythorne§§ and M. Turner¶¶

* Esso UK plc London, UK
{dagger} Caltex Services UK Ltd London, UK
{ddagger} Shell UK Ltd London, UK
§ British Gas plc London, UK
|| Conoco UK Ltd Warwick, UK
Mobil Oil Co Ltd Coryton, UK
** Gulf Oil Milton Haven, UK
{dagger}{dagger} Jaguar Cars Ltd Coventry, UK
{ddagger}{ddagger} Esso Petroleum Co Ltd Fawley, UK
§§ BP Oil UK Ltd London, UK
¶¶ City Medical Centre Ltd London, UK

This paper reviews the range of health surveillance activities which can be utilized in the workplace by occupational health professionals for assessing fitness for work and contributing to the prevention of occupational illness and promotion of good health. The systematic approach described categorizes health surveillance procedures into occupational or non-occupational, risk-based or unfocused, and as primary, secondary or tertiary preventive measures. All categories of health surveillance are currently being practised to some extent, but the type of surveillance may not match the needs of the workplace in some situations. In order to aid health professionals in deciding which procedures should be implemented, recommendations based on an assessment of health risks are made. The key proposal is to establish a minimum level of periodic health surveillance for all workers based on a targeted lifestyle health risk assessment and a structured health questionnaire. Additional procedures can then be added sequentially as appropriate to manage any health risks in the workplace. The role of the unfocused periodic general nedical examination is discussed in the context of the systematic approach and allows occupational professionals to critically appraise its usefulness.

Correspondence and reprint requests to: Dr W. Howe, Conoco UK Ltd, Warwick Technology Park, Gallows Hill, Warwick, CV34 6DB, UK


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