DUS/General/TBT-DUS-004

Health Surveillance for Dust Exposure

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Health surveillance for dust-exposed workers detects early signs of lung disease before symptoms become permanent and disabling.
COSHH Regulation 11 requires health surveillance where workers are exposed to substances that cause identifiable diseases.
Construction dusts including silica, wood, and asbestos are classified as substances requiring health surveillance under COSHH.
Lung function testing using spirometry measures how well the lungs move air, detecting reduced capacity caused by dust damage.
A respiratory health questionnaire screens for symptoms including persistent cough, breathlessness, and wheezing.
Baseline surveillance must be carried out before first exposure so future tests can be compared against the worker's normal values.
Follow-up surveillance at regular intervals — typically annually — monitors for any decline in lung function over time.
A decline in lung function results triggers investigation into the worker's exposure, controls, and possible medical referral.
Workers must be informed of their results and any actions required to protect their health going forward.
Health surveillance records must be kept for 40 years due to the long latency period of dust-related lung diseases.

Early detection	Silicosis, COPD, and occupational asthma develop slowly — surveillance catches declining lung function before irreversible damage occurs.
Baseline comparison	Without a baseline test before exposure, there is no reference point to detect decline — the first test is the most important.
40-year latency	Dust diseases can appear decades after exposure ended — records kept for 40 years protect workers' rights to future compensation.

Don't

Complete a baseline lung function test before starting any dust-exposed work.
Attend all scheduled health surveillance appointments without fail.
Answer respiratory health questionnaires honestly — they screen for early symptoms.
Report any persistent cough, breathlessness, or wheezing to your supervisor.
Use the dust controls and RPE specified for your task to minimise exposure.
Know your lung function results and understand what they mean for your health.
Cooperate with any investigation triggered by a decline in your test results.
Keep a personal record of your surveillance dates and results for reference.
Tell your GP about your dust exposure history if you develop respiratory symptoms.
Encourage colleagues to attend their surveillance — it protects their future health.

DON'T start dust-exposed work without completing a baseline lung function test first.
DON'T miss or postpone scheduled health surveillance appointments.
DON'T provide inaccurate answers on the respiratory questionnaire — honesty detects problems.
DON'T ignore persistent respiratory symptoms — report them before they worsen.
DON'T skip dust controls because you feel fine — disease develops without symptoms.
DON'T accept results without understanding them — ask the nurse to explain.
DON'T refuse investigation if your results show declining lung function.
DON'T lose track of your surveillance history — it is your health record.
DON'T forget to inform your GP about occupational dust exposure during consultations.
DON'T discourage colleagues from attending surveillance — their lungs depend on it.

See also: Construction Dust Awareness | Respirable Crystalline Silica (RCS)

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