Health Surveillance and Safety-Critical Medicals during the Coronavirus (COVID-19) Pandemic

For all health surveillance, an adequate assessment of the worker should continue to take place (including specialist referral where required), with the provision of appropriate advice to the worker and employer. This guidance sets out options for conducting health surveillance remotely. Face to face assessments can be carried out if considered necessary, subject to a suitable and sufficient risk assessment to provide a COVID-secure environment, taking into account public health advice on coronavirus. The general principles set out in the guidance apply to both new workers and those undergoing periodic medicals.

Where local or national restrictions are implemented due to coronavirus, occupational health providers should discuss the delivery of health surveillance with an affected employer to establish an appropriate course of action.

Health surveillance using questionnaires

Where health surveillance is performed using questionnaires, they can be administered remotely.  For questionnaires requiring follow up, this can be by telephone, video or, if considered necessary, face to face assessment in a COVID-secure environment.

Respiratory health surveillance

Providing a current respiratory health questionnaire does not raise any concerns (for initial and review medicals) and previous lung function tests were normal (for review medicals), occupational health providers can defer spirometry for up to 12 months (including any previous deferral periods) and face to face assessment is not necessary.

Spirometry should be performed only when necessary, where it changes the assessment (such as a safety critical medical) or management of the worker (such as where there is clinical concern or known lung function abnormality). Where spirometry is considered necessary in these types of circumstances, the potential for aerosols containing coronavirus should be taken into account. It should be subject to a suitable and sufficient risk assessment and appropriate controls put in place, including the provision of suitable personal protective equipment (PPE). The reasons for performing spirometry should be documented.