Respiratory Surveillance

Our aim is to promote and maintain the health of all people at work.

Respiratory health surveillance is a programme of regular, periodic assessment and/or lung function testing, that is related to the substances that you use in your regular working environment. Health surveillance helps prevent asthma from developing by detecting the early signs of occupational respiratory disease at a stage where it can be reversed or its effects minimised. Health surveillance is never an alternative to the proper control of exposure. It is not the same as health screening or health promotion. Respiratory health surveillance is required for individuals who are exposed to substances and processes where occupational asthma is a known problem; or if you have a confirmed case of asthma your manager may present you to the Occupational Health Service (OHS) for periodic respiratory health surveillance. You will also be asked to complete a short questionnaire specifically asking questions about your health in relation to your respiratory system. (The questionnaire also refers to skin surveillance as this is usually undertaken alongside respiratory surveillance).

The questionnaire is and remains the primary consideration in any health assessment/surveillance.  For general lung surveillance, the main undertaking is completion of the questionnaire which is supplemented with lung function testing at certain intervals.  This is then assessed by qualified staff who are looking for symptoms and history; and these staff make clinical decisions about the need for referral to clinicians for their guidance and/or to monitoring including recall frequency, any need to undertake peak flow measurements, and/or further lung function testing.

Be assured that any information you include in this questionnaire is held within your clinical medical file in OHS. Information remains confidential and is not shared and it is not part of the CoSHH health record. The purpose of the questionnaire is to obtain your health history and symptoms to assess whether you have any health problems either past or current that may place you at risk in the workplace or affect your ability to undertake the duties of your role. OHS will make recommendations to the University to guide either your continued potential exposure, any restrictions during further investigation of your lung function and/or if you require any adjustments or modifications to your role as a result of this assessment. 

Your respiratory or breathing system includes the mouth, nose, lungs and the tubes that connect them. Occupational respiratory disease is a medical term used to describe diseases caused by, or made worse by, something you breathe in at work, e.g. wood dust, stone dust, poultry dust or fumes, animal dander. Difficulties in breathing and coughing, often painful, are just two of the symptoms that sufferers with lung diseases may have to deal with every day. It is important that if you do work in an area that contains respiratory sensitizers that you comply with all safety measures that are in place e.g. respiratory protective equipment (RPE).

If you are required to wear RPE in the form of a face mask you should contact the Health and Safety Department, via your manager to ensure that it has been appropriately face-fit tested for you. RPE is matched to the wearer and should not be shared with other colleagues. 

In the first instance speak to your line manager.  It is their responsibility to carry out suitable and sufficient risk assessments and present the names of affected employees to Occupational Health so that health surveillance can be carried out. They will make the assessment of whether you require to be put on a respiratory health surveillance programme and they will directly refer you to OHS by completing and returning Health Surveillance Request form to occupational.health@ed.ac.uk 

You will then receive notification of the details of your assessment and request to complete a Respiratory Surveillance Questionnaire.

As a general rule you will have an initial assessment (including spriometry) and a follow-up questionnaire only assessment at six and twelve weeks later. If there are no problems identified at these assessments you will then be notified of a scheduled recall if your hazard exposure risk remains the same as decided by your manager.

If, following your questionnaire assessment or spirometry problems are identified you will be contacted directly with your next appointment details.

There should never be an emphasis or reliance on health surveillance to protect health, and in particular lung function (spirometry) testing is never an alternative to the proper control of exposure. The purpose of the spirometry test in an occupational setting lung function testing is not diagnostic, it is only one part of the assessment if it is required, and the health history for individuals obtained through questionnaire and early notification of any symptom development is of far more importance.

If you are called for a lung function check it would be helpful if you could adhere to any guidance prior to attendance and bring:

• Your completed questionnaire (if not already submitted electronically) including; 
• a list of any potential respiratory sensitisers e.g. chemicals, animal products, you work with.
• a list of any medication that you are currently taking.

The Occupational Health Service is required to collect data regarding sex assigned at birth due to how this factor determines lung size, the impact of hormone therapy or pubertal blockade on longitudinal lung function is currently unknown so we are reliant on existing data. 

A lung function check (spirometry) is a physical test and will require a degree of effort from you. It involves deep breathing in and blowing out (exhaling) both in a relaxed and in a forced manner through the mouthpiece of the spirometer several times. If you have had any of the following within the last 6 months you should contact OHS to discuss whether your test should be postponed:

• Haemoptysis (vomiting blood) of unknown origin
• Recent myocardial infarction (heart attack) or pulmonary embolism
• Stroke
• Eye surgery in last 3 months
• Abdominal/thoracic surgery in the last 3 months
• Ear surgery or perforated eardrum in the last 3 months

If you take asthma medications please bring them with you for your test. If you smoke please try and refrain from smoking for at least four hours prior to the test. It is also advisable to avoid a large or heavy meal immediately before the test.

If you are concerned at all contact OHS to speak to a member of staff and they will rearrange your appointment if required.