Health and Safety
Executive / Commission
Musculoskeletal disorders
Health monitoring is an informal, non-statutory method of surveying your workforce for symptoms of ill health including low back pain. This type of occupational health management system can enable you as an employer to be aware of health problems and intervene to prevent their problems being caused or made worse by work activities. Another important role of health monitoring is to feedback into a system that reviews current control methods in place.
This guidance focuses on the risk of low back pain as the main health effect of concern for drivers and operators of mobile machinery at work (hereafter described as ‘drivers’
As part of an overall strategy for occupational health management, health surveillance may be appropriate to ensure control methods in place are working and to detect any incidence of ill health. However, at present it is not considered that any methods exist for the detection of changes in people’s backs which can reliably indicate the early onset of low back pain that are specifically related to workplace risk factors. Therefore no formal health surveillance programme can be required for specific causes of back pain, such as whole-body vibration (WBV), manual handling or posture.
Valuable information can be obtained from less precise measures than those provided for by a formal health surveillance approach, such as reporting, monitoring and investigation of symptoms. This is known as “health monitoring”. It is good practice to put in place this type of system to allow individuals to make early reports of low back pain. All workers at risk of back pain should be encouraged to report to their employer/ manager any symptoms that they may be suffering at any time.
There are specific regulations dealing with Manual Handling and whole-body vibration in the workplace. To ensure you are complying with your duties under these regulations you should refer to HSE guidance if manual handling or whole body vibration are risks in your workplace. There is also guidance available on how to deal with low back pain in the workplace these are available at:
Health monitoring enables you to check the effectiveness of any control measures by assessing the presence of relevant symptoms in your employees and using this information to inform the risk management process. Health monitoring does not lead to a diagnosis. However it allows information to be collected from your employees and when reviewed this may help to identify potential problems in the workplace.
Health monitoring will help you, as an employer, to take action to prevent back pain being caused or aggravated by work activities. It provides a means of obtaining early reports of back complaints which can be investigated and acted upon as appropriate e.g. revision of control methods.
Health monitoring could play an important part of your overall strategy to manage the risks of developing back pain in drivers in your workplace. A risk assessment will indicate whether or not you may have a problem with back pain in your drivers
Examples of situations where the risk to health of drivers may be considered high are:
You should also identify high risk groups. This will include pregnant workers. Young workers may be particularly susceptible to the risk factors for back pain and workers with previous back problems would also be considered to be at higher risk.
Those workers identified as being at higher risk of back pain in the workplace should be subject to health monitoring. All other workers should be encouraged to report any low back pain symptoms as soon as possible. It will be important to allay worker’s fears of reporting symptoms so that they may be helped in their work environment where possible. You should discuss this issue with worker and safety representatives to ensure cooperation.
A health monitoring regime for low back pain in drivers should involve a structured system for the self-reporting of symptoms. This system should allow the individual to describe the symptoms that they are suffering or have suffered in the recent past.
It is important to involve your employees and their representatives early on in the development of your health monitoring programme. This can overcome any problems with employees not reporting symptoms because they do not understand why the programme has been introduced and that it is in place to protect their health. Where trade unions are recognised, consult safety representatives in good time.
Where possible, any health monitoring should be under the responsibility of an occupational health professional. However, an employer can implement a simple annual questionnaire for all workers at risk of back pain without any other support.
An example of a simple questionnaire which you as an employer could use alone for the purpose of health monitoring is given in Table 1 [20kb]
. In most cases where significant symptoms of back pain are reported this will require further investigation by referral to a GP or occupational health professional. If in doubt about any aspect of a person’s health, the individual should be referred on for further advice from a health professional.
1. Use the information from health monitoring to check trends in back pain in your drivers
2. If you have a lot of drivers it may be worth analysing the data from each group separately; for example, do your fork lift drivers report more ill health than your tractor drivers?
3. If the data suggests your drivers (or groups of them) are reporting similar symptoms, investigate. Look for risk factors in the work, or evidence that control measures are not working as intended. It may be worth reviewing the risk assessment to help find out what the problem is, and decide on corrective action.