17.0 Health monitoring

17.1 Introduction to health monitoring

Health monitoring looks for changes to your workers’ health that may be caused by what they are being exposed to at work.

This section offers guidance for persons conducting a business or undertaking (PCBUs) on how you can use information from health monitoring to help confirm that control measures are working effectively to minimise your workers’ exposure.

Health monitoring is not a control measure in itself. It does not replace the need for control measures to eliminate or minimise worker exposure to harm.

Examples of road and roadside worker health monitoring include:

carrying out hearing tests to check for hearing loss from being exposed to noise
testing lung function to check for any loss of function from inhalation of hazardous dusts, fumes, or chemicals
checking eyesight from being exposed to chemicals or ultraviolet (UV) radiation
checking for skin damage from being exposed to chemicals
skin cancer or mole screening from being exposed to UV
checking for nerve, muscle, or circulation damage from being exposed to vibration
checking on workers’ physical health for signs of discomfort, pain, or injury to muscles, ligaments, bones, tendons, blood vessels, and nerves, associated with manual tasks
checking on workers’ mental health - looking for signs of mental harm or stress resulting from their work
checking body temperature to look for hypothermia or hyperthermia.

Wellbeing programmes, pre-employment health screening, and fitness to work examinations are not health monitoring.

17.2 When should health monitoring be done?

The type of monitoring you should use depends on the kind of work you do. You will need to seek advice from a suitably qualified and experienced health and safety professional to see if monitoring is appropriate for you, and if so, what type and how often.

If relevant, you should carry out baseline monitoring at the beginning of a worker’s employment (to get baseline readings). Then regular (ongoing) monitoring should be carried out.

17.3 Who can carry out health monitoring?

Health monitoring should be carried out by suitably qualified, trained and experienced health practitioners with the knowledge, skills, training and experience to carry out the monitoring you need.

For example, an occupational health nurse could carry out initial health assessment (health screening) and subsequent routine regular testing.

If health issues are suspected, workers should be sent to a health practitioner who understands occupational health for a full medical assessment and formal diagnosis, and feedback to the PCBU. This could be an occupational physician or general practitioner (GP) with relevant experience.

For occupational health practitioners you could look here:

New Zealand Occupational Health Nurses’ Association(external link)

The HASANZ Register of verified workplace health and safety professionals(external link)

The Australian and New Zealand Society of Occupational Medicine Incorporated(external link)

17.4 Consent for health monitoring

Workers must give their written informed consent for biological exposure monitoring or health monitoring. This is a requirement of the Code of Health and Disability Services Consumers' Rights.

The Code of Health and Disability Services Consumers' Rights

Under the Code, workers have the right to:

be fully informed
make an informed choice and give informed consent.

Being ‘fully informed’ means workers must:

be given information about the health risks and/or consequences of the work
be given information about the proposed biological exposure monitoring or health monitoring, and
be told this information in a way they can understand.

Workers must be given the information that they would reasonably expect to receive, for example:

what options they have
what the risks are
what side effects and benefits of those options are
who will carry out the monitoring
who will have access to the results
how the results will be stored.

It is then up to workers to decide – they can say ‘no’ or change their mind at any time.

For further information:

The Code of Health and Disability Services Consumer Rights(external link)

Health monitoring cannot go ahead until the worker gives informed consent.

You should work together with any worker who is reluctant to take part in health monitoring to address their concerns. However, if the worker still does not want to comply, consider what alternative steps you could take to manage their health risks. For example, could the worker do different work that does not require monitoring?

A worker refusing to participate in monitoring does not excuse you of the responsibility to manage the risk in other ways. You could include health monitoring participation into employment agreements or contracts so workers will know about these requirements up-front before they take the job.

17.5 Worker privacy and health monitoring

Any personal information collected during health monitoring must be kept secure and confidential.

You must comply with the Privacy Act 2020(external link) if you are collecting, storing, using, or disclosing personal information (this is information about an identifiable person).

Any personal information must be stored securely, and access should be restricted to authorised people only.

17.6 Sharing monitoring results

Take care when sharing monitoring results. If the monitoring results contain personal information, you must comply with the requirements set out in the Privacy Act 2020(external link) for disclosing personal information.

Workers should be offered copies of their own monitoring results. PCBUs should also report back to all workers about how well they are managing all health risks.

WorkSafe can also ask for monitoring results.

17.7 Only use monitoring results to manage health risks

Under the Privacy Act, you can generally only use personal information for the purpose it was collected.

There is more information about this (and some specific exceptions) on the Privacy Commissioner’s website(external link)

The use of health monitoring results must comply with the Privacy Act.

17.8 If monitoring results shows a worker is at risk

The PCBU must take immediate action to eliminate or minimise the health risks to the worker.

You should urgently review and revise your control measures with help from a suitably qualified and experienced health and safety professional.
If immediate control measures cannot be put in place, work should stop until the environment is safe again.
Depending on the monitoring results, you could be advised to send your worker to a suitably qualified and experienced occupational health practitioner (for example, occupational nurse or occupational physician) for a medical assessment.
The workers’ PCBU should alert all other PCBUs in the contracting chain who may also have workers at risk (without compromising the privacy of the affected worker).