Health Monitoring for Respiratory Hazards
The requirements for health monitoring of respiratory hazards are underpinned by risk assessments which are required by applicable work health and safety legislation.
The risk assessment is informed by the nature of the hazard and the exposure patterns.
Even unpredictable, rare exposure can carry a high-risk classification if the nature of the harm is severe. For example, premature death following asbestos fibre exposure is clearly indicative of a profound consequence, even though it may not occur until many years after the exposure.
The primary purpose of health monitoring is not to find a hazard-related disease or injury, but to:
- Reinforce the gravity of the risk
- Enable workers to have a targeted conversation with a health professional about their individual risk
- Reinforce the importance of compliance with safe systems of work
- Identify baseline reference data
- Collect and monitor specific serial data to detect the earliest possible changes that could suggest a potential adverse health effect
It is important to remember that incidental findings – health issues not directly related to the particular hazard being assessed – will be detected. Such findings must be managed confidentially, while informing the worker’s treating Health Practitioner of the risk and ensuring the worker receives appropriate management.
What are the health monitoring requirements for respiratory hazards?
Health monitoring for respiratory hazards requires compliance with both legislation and respiratory protection standards.The issues to consider are:
- The nature of the hazard
- The pattern of exposure
- What level respiratory protection is required (currently AS/NZS 1715:2009 and AS/NZS 1716:2012 complemented by the ISO 16900 series of Standards)
If the risk assessment determines that negative pressure respiratory protection with P2 filtering or above is required, then the minimum requirement (for lower risk roles) is annual fit-testing and fit-check training.
In addition to this minimum requirement is the need for either:
- Moderate Risk Roles: Baseline Health Monitoring Assessment followed by Respiratory Health Monitoring Components at a frequency that reflects the risk.
- High Risk Roles: Baseline Health Monitoring Assessment followed by a full Health Assessment that incorporates Respiratory Health Monitoring components at a frequency that reflects the risk and the organisation’s risk tolerance.
In all settings, if clinically significant features are found, more frequent spirometry, complex lung function testing, radiological investigations (Chest X-rays or HRCT) and respiratory physician assessments may be necessary to comply with National Guidance[i] and statutory requirements[ii].
Additional items to consider:
- The current Australian/New Zealand Standard AS/NZS 1715:2009 and 1716:2012 were last updated in 2009 and 2012 respectfully. These Standards describes the selection of respiratory protective devices, the performance of such equipment on the individual using it and frequency of Respirator Fit Testing.
- The International Organization for Standardization (ISO) technical committees have produced a comprehensive range of respiratory protection standards. The full range of the ISO 16900 series of standards is approaching completion and as Australia participates in the development of these ISO standards, relevant components will be incorporated into future Australian Standards. ISO 16972 – ISO 16975 – covers selection and use.
[i] National Guidance for doctors assessing workers exposed to respirable crystalline silica dust (Feb 2022) https://www1.health.gov.au/internet/main/publishing.nsf/Content/ohp-dust-nat-guide-gp.htm
[ii] See for example https://www.rshq.qld.gov.au/__data/assets/pdf_file/0005/1278563/cmwhs-clinical-pathways-guideline.pdf
What do organisations need to know?
- It’s important to understand which legislation and Australian Standards apply to your business, keeping in mind that the respective legislation will often only detail the minimum health monitoring requirements. In some instances, additional standards and codes of practice must also be applied.
- Safe Work Australia is an advisory body, not a regulator. They provide guidance material only for all stakeholders.
- The frequency of certain components of a Health Monitoring Program may vary. For example, the frequency of blood lead testing is dependent on the results of the previous blood lead test. Blood lead testing may occur once yearly or at more frequent intervals (e.g. 4 weeks, 12 weeks, 6 months).
- The frequency of health monitoring requirements is not only dependent on the legislative requirements but also the assessed risk and the risk appetite of the business.
- For regulatory audits, the inspectorate applies the specific legislation applicable to their area of interest.
What is the recommended frequency of risk reviews for respiratory hazards?
A formal risk review is recommended every five years, or if a change to the work practices occur as defined by the respective legislation.
Should an organisation have a lower risk tolerance and wish to engage in Health Monitoring more frequently, they are able to do so and can engage with KINNECT’s Occupational Physicians to determine a best practice approach.
KINNECT’s solution
KINNECT’s Consultant Physicians in Occupational and Environmental Medicine (OEPs), support clients by critically reviewing and advising on the health-risk and operational implications associated with the risk assessment.
If you choose not to use this resource, our services are provided with the explicit assumption you have undertaken an adequate risk assessment.
The standard recommended periodicity for respiratory health monitoring is annual, however what occurs annually depends on the risk stratification informed by KINNECT’s advice, but ultimately determined by the client.
We hope you’ve found this helpful. If you still have questions about KINNECT’s health monitoring for respiratory hazards, feel free to contact our team on 1300 546 632 or chat with us via the live chat link.
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