A SYSTEMATIC-APPROACH TO HEALTH SURVEILLANCE IN THE WORKPLACE

This paper reviews the range of health surveillance activities which c an be utilized in the workplace by occupational health professionals f or assessing fitness for work and contributing to the prevention of oc cupational illness and promotion of good health. The systematic approa ch described categorizes health surveillance procedures into occupatio nal or non-occupational, risk-based or unfocused, and as primary, seco ndary or tertiary preventive measures. Ail categories of health survei llance are currently being practised to some extent, but the type of s urveillance may not match the needs of the workplace in some situation s. In order to aid health professionals in deciding which procedures s hould be implemented, recommendations based on an assessment of health risks are made. The key proposal is to establish a minimum level of p eriodic health surveillance for all workers based on a targeted lifest yle health risk assessment and a structured health questionnaire. Addi tional procedures can then be added sequentially as appropriate to man age any health risks in the workplace. The role of the unfocused perio dic general medical examination is discussed in the context of the sys tematic approach and allows occupational professionals to critically a ppraise its usefulness.