Putting the H back into Elf and Safety

Health as Part of the Risk Assessment

Health considerations at work (just like safety), are a part of the risk assessment (RA) process, yet rarely have I seen more than one or two health items on the best of them.

Ideally, all risk assessments are done early in any project or operation, with periodic reviews, and revisited if significant changes occur or required by legislation. You can do a high level (departmental or task-focused), or individual RA’s.

But how many of us consider the personal health of workers: the old/young, the pregnant, those with long-term health conditions and those with disabilities? Also, don’t forget minor health issues that affect work, such as, ear infections which provoke dizziness, and dangerous visual disturbances that accompany migraines. How does that fit into RA’s?

Do it Yourself Option

Preventing work-related ill-health rarely requires getting in specialists. Many companies just need signposting to the appropriate advice on common subjects such as ergonomic design, the substitution of materials and processes, dust extraction, adjusting equipment, and healthy lifestyle programmes. If the company is big enough then there may be a safety professional employed, where they take on the responsibility for managing health risks along with safety.

Identifying health risks is no different from safety risks except that the safety professional needs to adjust their thinking to consider how work may impact on health in the long-term. This article will give you the tools to consider aspects of health in a logical manner. It is a checklist or memory jogger for anyone involved in assessing and prioritising health risks as part of the process of making work safe.

Identify New or Existing Health Hazards

To start putting health in your risk assessment; think about the process of how you do your business. Are you aware of any substances, practices, or processes that have health risks? Is there a department with a high level of absence? Or complaints of health issues? Do workers avoid certain jobs? Questions like this, often ignored, maybe a genuine response to a job which affects health. Maybe there is a chemical or process that you believe is iffy. If so, or unsure, request information from manufacturers about the products. Maybe there are naturally occurring health hazards e.g., spores, radon and sunlight? Does the work involve asbestos, lead, compressed air, or ionising radiation? Is the work environment hot or cold and will that have an impact on workers? What sort of equipment is used?  Too much; I hear you say.

But, not all questions provoke workers to say yes or start complaining, which is what many are afraid of.

Increasing or Decreasing the Health Risk

When assessing the key factors of health damage; there are some basic scientific matters to understand. Consider:

  • Exposure time — the level of exposure for each group of workers. Some work for only a few minutes with a health hazard (emptying a bag of flour into a silo) which is unlikely to cause long-term health conditions, whereas others may work full-time in a noise hazard area, leading to industrial deafness, as it was called – now it’s ‘noise-induced hearing loss‘.
  • Level of exposure (dose)—engineers may have a higher levels of risk, due to their being called to ‘mend’ a broken machine or change contaminated equipment for the next batch; line workers are likely to have a much higher level of physical health risk than say supervisors or managers; who themselves are more likely to experience work-related stress.
  • Mode of exposure (e.g., direct contact, inhalation, injection, or ingestion); there are only four ways a substance can get into the body — consider how the harm occurs (e.g., ground workers may get needle-stick injuries from used needles found on construction sites)
  • Individual susceptibility and behaviours, e.g., nail-biting may ingest poisonous or harmful substances, smoking increases the risk of asbestosis and vibration white finger
  • Contact with hazard – how does the worker use a substance, e.g., in concrete there are many ways of applying: by hand, spraying, remote pumping. There are both health and safety issues here depending on the usage
  • Work environment— does the layout make the activity more hazardous (e.g., incorrect height and stacking, poor ventilation or lighting, confined space working)
  • Variables, such as different work rates and seasonal issues of wind, rain, and sun

Remember to review all workplace activity, including routine and non-routine tasks and emergency activities. Discuss health issues with the workers or workers’ representatives who have experience doing the job. Also, review operating procedures.

picture of a manager contemplating a health risk assessment
Checklist for health RA

To help, use this checklist for considering health hazards:

1. Geographical location

  • Temperature and climate (e.g., extreme heat or cold) and wide temperature variations
  • Altitude (e.g., low pressure of oxygen)
  • Humidity and air quality
  • Transport
  • Location in relation to available health services and facilities (distance and access)
  • Standard of health-care facilities
  • Competence of first aid or medical staff in relevant health issue
  • Security (e.g., stress, anxiety, violence)

2. Physical

  • Noise
  • Motion (e.g., sea sickness)
  • Vibration (e.g., hand-arm, whole body.) Obtain equipment with tags fitted that show noise and vibration level potential exposure
  • Pressure (e.g., vessels, diving)
  • Ionising and non-ionising radiation
  • Thermal work environments (e.g., foundry, food freezers)
  • Display screen equipment
  • Ergonomics: associated with mismatches between the task and capability (including man-machine interfaces, manual handling, repetitive movements). Also manual handling and repetitive tasks
  • Equipment may pose a risk to health, especially if the design is poor, used incorrectly, or malfunctions. Consider the condition of equipment, age, maintenance, calibration, training and method of use
  • Specific health hazards linked to the equipment (e.g., noise, vibration, radiation, heat, cold, and exhaust emissions)
  • Purchases of equipment (e.g., Buy Quiet campaign to reduce noise levels)

Measurement of physical and chemical hazards may require expert or technical assistance (e.g., vibration, dust levels). Are the results of measurements within legal, published, or industry-accepted limits?

3. Chemicals and Hazardous Substances

  • Poisons that accumulate in the body (e.g., heavy metals, lead)
  • Irritants (cause a local effect such as to skin, eyes, or lungs)
  • Sensitisers (cause skin and respiratory reactions, such as rash or asthma)
  • Acids and alkalies/caustic agents
  • Carcinogens

Look at safety data sheets (SSDs) closely for health information and Safety Data Sheets Health Risk Phrases

Request further information from the supplier regarding health concerns or ask for a site or process specific SDS for your workplace.

Review the most current information available from SDS, industry trade groups, governmental health and safety bodies, and current published occupational exposure limits and incorporate into the health and safety risk assessment. If in any doubt about the contents or the meaning of the SDS, contact the supplier for more information.

Having a vaccination at work
Vaccination protects against workplace health risks

4. Biological (usually covered in COSHH risk assessment)

  • Wildlife (animals including pets and guard dogs, reptiles, insects, plants)
  • Endemic/epidemic diseases (due to viruses, bacteria, fungi, parasites)
  • Occupational diseases (due to viruses, bacteria, fungi, parasites)
  • Contaminated food and drink (Hepatitis A)
  • Poor hygiene (catering, accommodation, toilet facilities, waste disposal)

See also: Controlling the Risk of Infections at Work with advice and guidance on pathogens and control measures from the HSE.

5. Psycho-social (usually covered in stress risk assessments)

  • Isolation (degree of access to social support)
  • Overcrowding and lack of privacy
  • Communication problems (business and family contacts for those working away from home for long periods)
  • Discrimination, bullying and harassment
  • Culture, local laws, religion, and language (e.g., comprehension and comfort level)
  • Job design (e.g., control, content, workload)
  • Job organisation (e.g., shift patterns, sleep deprivation, fatigue, jet lag)
  • Leisure and recreation opportunities
  • Substance abuse/dependence, alcohol use and addiction, and smoking
  • Beliefs and culture of an organisation

6. Individual Health (usually assessed by health professionals)

  • Health status—are there underlying health issues or in the case of psychological hazards, domestic and relationship pressures may affect an individual’s ability to handle workplace stress?
  • Beliefs/motivators
  • Demographics (e.g., age, sex, gender)
  • Learning ability (e.g., dyslexia, reading ability, understanding)
  • Prescription and over the counter medications that affect response rates and alertness
  • Personality (e.g., assertiveness, attitude to risk)
  • Physical condition (e.g., obese, fit)
  • Hobbies/lifestyle— damage from work hazards increase if workers have hobbies or habits that match work hazards e.g. going to discos, listening to loud music or rifle shooting significantly increases the risks of noise-induced hearing loss.
Health Risk Assessments
Health Risk Assessments


There are many types of health risks and just as many types of work. But use the generated list to divide the workplace into high, medium and low-risk areas which are likely to cause health issues. Further, prioritise action by counting numbers affected and the seriousness of the effect. The health RA works exactly the same way as the safety one. Now you have an action plan to tackle the issues and, a logical process of producing and defending it.


People are unique with hidden health issues that they may not even be aware of themselves. The consequences of a negative health exposure is not always instant – with sometimes fatal health effects developing over time.

One checklist could not encompass everything, it’s not supposed to – it’s here because we need to broaden our outlook. So, consider the issues above, and add control measures for health as well as safety in your RA. If you do, your health and safety risk assessments will live up to their title, earn their moniker and, more importantly, be instrumental in preventing ill-health and safety for workers and companies who rely on your expertise to keep them all safe and healthy.

First posted as an article on my LinkedIn page. September 2018

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