Health monitoring and exposure monitoring are an important part of ensuring the health of workers.

A business has the primary duty of care to ensure, so far as is reasonably practicable, both the health and safety of workers. This includes monitoring any conditions at the workplace that could put a worker’s health at risk. Businesses may also be required to monitor worker health or exposure in circumstances specified in health and safety regulations (for example, the Health and Safety at Work (Asbestos) Regulations(external link)).

Monitoring does not replace the need for a business to implement measures to manage any work-related risks to health and safety.

What is health monitoring?

Health monitoring involves testing a person to identify any changes in their health status because of exposure to certain health hazards arising from their work, such as noise or contaminants in the air like hazardous dusts, fumes or vapours. It is a way to check if a worker’s health is being harmed by the work they do, and aims to detect early signs of ill-health or disease.

Health monitoring can show if a business has in place effective risk management practices.  

Examples of health monitoring include:

  • spirometry testing to detect early changes in lung function

audiometric testing to detect early hearing loss. Health monitoring is not:

  • wellbeing checks (for example, cholesterol checks) or programmes (for example, promoting healthy living)
  • fitness-to-work examinations.

See the Health monitoring fact sheet for more information.

Because of the long period between exposure to a health hazard and harm occurring, a business should not rely solely on health monitoring. The combination of health monitoring along with exposure monitoring gives more insight into the effectiveness of controls in a workplace.

What is exposure monitoring?

Exposure monitoring involves measuring and evaluating workers’ exposure to a health hazard. It includes monitoring the conditions at the workplace, as well as biological monitoring of people at the workplace.

Exposure monitoring can be used to find out if workers are potentially being exposed to a hazard at harmful levels, or to detect whether the measures in place to control exposure to that hazard are working.

  • Exposure monitoring usually involves having workers wear personal monitoring equipment as they do their job. Examples of exposure monitoring include:monitoring the level of noise a worker is exposed to
  • monitoring the air a worker breathes to check how much of a substance they are inhaling
  • testing workers’ blood or urine for the presence of a harmful substance or the by-products of a substance. This is called biological exposure monitoring.

See the Exposure monitoring fact sheet for more information.

Taking part in monitoring

A business may require a worker to take part in health monitoring or exposure monitoring. The worker has a general duty to comply, as far as they are reasonably able to, with any reasonable instruction that allows the business to comply with the Health and Safety at Work Act 2015(external link) or its associated regulations. However, a worker must give informed consent before health monitoring or biological exposure monitoring is carried out as they are medical examinations. 

If a worker does not wish to provide biological samples, undergo a health test or provide the results of a health test to the business, the worker should discuss the matter with their manager or health and safety representative. The business may be able to consider other options, such as whether the worker could do different tasks that don’t expose them to the risk.

Ultimately, refusal to participate in health monitoring or exposure monitoring may give rise to an employment dispute. Similarly if the business and worker aren’t in a direct employment relationship, it could cause a contractual dispute.

In these situations, the parties involved should seek advice from an appropriate employment or legal adviser.