Programme 03 · Control of Substances Hazardous to Health 2002
Respiratory health surveillance
Occupational asthma is one of the few career-ending diseases that is almost entirely preventable, and the window for prevention is early. Respiratory surveillance under COSHH exists to find the change in someone's breathing before sensitisation becomes permanent.
Once a worker is sensitised, exposures far below any workplace limit can trigger a reaction. The duty is to detect the change early.
The duty
What COSHH requires
COSHH requires health surveillance where workers are exposed to a substance linked to an identifiable disease or adverse health effect, where there is a reasonable likelihood that the effect may occur under the particular conditions of the work, and where there is a valid technique for detecting it. Respiratory sensitisers meet all three tests, which is why respiratory surveillance is one of the most commonly owed and most commonly missed programmes.
Who is in scope
Common respiratory sensitisers at work
| Agent | Where it is found |
|---|---|
| Isocyanates | Two-pack paint spraying, vehicle refinishing, polyurethane foams and adhesives |
| Flour, grain and enzyme dust | Bakeries, food production, milling, animal feed |
| Wood dust | Joinery, sawmills, furniture manufacture, particularly hardwoods |
| Colophony and solder flux fume | Electronics assembly and soldering |
| Welding fume | All welding, including mild steel |
| Latex proteins | Healthcare, laboratories, food handling |
| Laboratory animal allergens | Research and animal facilities |
| Glutaraldehyde and other biocides | Endoscopy, disinfection, water treatment |
The programme
What the assessment involves
- Baseline before or shortly after exposure startsA respiratory questionnaire covering symptoms, smoking history, existing asthma or atopy, and prior occupational exposures, usually with lung function testing to establish the worker's own starting point.
- Routine screening questionnaireTypically annual, asking about cough, wheeze, chest tightness and breathlessness, and specifically whether symptoms improve on days away from work, the single most useful question in occupational respiratory screening.
- Lung function testingSpirometry at intervals set by the programme and the clinical picture, performed by a trained operator on calibrated equipment, and interpreted against the worker's baseline.
- Escalation on a positive screenSymptomatic workers route to a clinician for assessment rather than waiting for the next annual cycle, because in sensitisation, time matters.
When something is found
Occupational asthma is reportable
Occupational asthma diagnosed by a doctor is reportable under RIDDOR where the worker's work involves significant exposure to a known respiratory sensitiser. A confirmed case is also a signal about your controls: the regulations expect you to review the risk assessment and the control measures for the task, and to consider everyone else exposed to the same agent.
For the individual, the clinical advice usually turns on removing or substantially reducing exposure to the specific agent. That is a workplace decision as much as a clinical one, and it is easier to make early, when redeployment is a smaller change than it becomes later.
How Polarisk runs it
The programme, without the administration
The duty is mapped
Roles map to respiratory surveillance on the exposure criteria, so the list of who is owed an assessment is derived rather than remembered. Workers who need none are evidenced as such.
Each worker answers privately
A single-use link, bound to that person at issue and spent on use. Your organisation's own account is refused at the answers.
Protocol triages, a human judges
Responses are scored against the protocol and drafted for review. A registered clinician reads every case and signs under their own name and registration number.
The cycle runs itself
Due dates, reminders and lapse tracking are handled. You are told who has not answered, by name, while there is still time to act.
Evidence is generated
The audit pack comes from the live record: duty map, completion by site, certificate register and the sign-off trail behind each judgment.
Appointed-Doctor streams
Asbestos, lead, ionising radiation and compressed air require an HSE Appointed Doctor. We do not run those, and will say so rather than quote for them.
Questions
Common questions
Is RPE enough, or do we still need surveillance?
Respiratory protective equipment is a control measure, not a substitute for surveillance. COSHH places control and surveillance as separate duties, and surveillance is partly there to test whether your controls, including RPE, are actually working in practice. RPE also depends on correct selection, face-fit testing and consistent use, none of which can be assumed.
How often is spirometry needed?
A baseline at or near the start of exposure, then at intervals set by the programme and the clinical picture, with an annual symptom questionnaire in between. Frequency increases where symptoms appear, where exposure is high, or where the agent is a potent sensitiser. The interval is a clinical judgment informed by HSE guidance rather than a single fixed number.
Who can perform and interpret spirometry?
The test must be performed by someone trained in the technique, on calibrated equipment, because poor technique produces unreliable results that are worse than none. Interpretation against the worker's baseline and history is a clinical task. Polarisk records who performed and who interpreted each test, and both appear in the audit pack.
A worker has been diagnosed with occupational asthma. What now?
Act on the clinical advice about their exposure, which usually means removing or substantially reducing contact with the specific agent. Review the risk assessment and controls for that task, consider everyone else exposed to the same agent, and report it under RIDDOR where the criteria are met. Polarisk raises the review and reporting questions alongside the outcome.
We only weld occasionally. Does this apply?
Probably, and more than employers expect. HSE treats all welding fume, including mild steel fume, as carcinogenic, and expects effective control for indoor welding regardless of how long it lasts. Occasional welding by a small number of people is still exposure, and it is usually easier to bring those people into a surveillance programme than to argue the point at an inspection.
Start here
Find out what you owe before an inspector does
Four questions about your workforce and its exposures. You will get an estimate of the assessments owed each year, by programme, and where your current arrangement leaves a gap. No sign-up and no personal data.