Health monitoring reports
The health monitoring doctor completes the health monitoring report in two sections:
- Section one: the health monitoring doctor must give you a copy of this part, and
- Section two: the health monitoring doctor keeps this section.
You must take all reasonable steps to get your copy of section one from the health monitoring doctor as soon as practicable after the health monitoring. You must get this section at regular intervals for workers on longer term or ongoing health monitoring programs.
Content of health monitoring report
The health monitoring doctor must put certain information in section one of the health monitoring report. To ensure you are meeting your duties, you must check it contains:
- the name and date of birth of your worker
- the name, registration number and signature of the health monitoring doctor
- name and address of the business or undertaking
- the date(s) of health monitoring
- any advice that your worker may have contracted an injury, illness or disease as a result of carrying out work that requires health monitoring
- any recommendation that you take remedial measures including whether your worker can continue to do the type of work, and
- whether your worker requires medical counselling or specialty medical advice about the injury, illness or disease.
- for health monitoring for hazardous chemicals specifically,
- test results that show whether or not your worker has been exposed to a hazardous chemical
- for health monitoring for lead specifically:
- the results of biological monitoring that indicate blood lead levels in your worker's body
- test results that show your worker has reached or exceeded the relevant blood lead level for your worker under regulation 415 of the model WHS Regulations
- the date of the blood sampling, and
- details of the pathology service used
Section one should also contain:
- the date of sampling if blood, urine or other samples are taken, and
- results of biological monitoring and other tests carried out.
Your copy of section one should only report information about the health monitoring program. It should not report health information other than what you need to know to help monitor your worker’s health. The report should not contain details of medical conditions provided to or diagnosed by the health monitoring doctor if these are not relevant to your worker’s job. If your worker has a pre-existing medical condition that may worsen the health effects of exposure to the hazardous chemicals at your workplace, the health monitoring doctor may bring this to your attention so you can put in place effective control measures. However, the health monitoring doctor will only share the details of pre-existing medical conditions if worker gives written permission to do so.
The health monitoring doctor should not include detailed results in section one of the health monitoring report. However, they should include a recommendation based on the results, for example biological exposure testing that shows early indication or diagnosis of injury, illness or disease related to the work that requires health monitoring, or other interpretation of X-ray or spirometry readings that lead to recommending you review workplace controls. If they include detailed health information about your worker in section one that is not required to be in the report, or information on your worker’s pre-existing medical conditions without permission, you should return the report marked as confidential to the health monitoring doctor, informing them of the error.
You will find more information on what is in a health monitoring report in Health monitoring guides for hazardous chemicals and the Health monitoring guide for registered medical practitioners.
Actioning a health monitoring report
Once the health monitoring doctor gives you the health monitoring report, you should consider the results, recommendations and advice provided.
As soon as practicable, you must provide a copy of the report to:
- your worker
- all other PCBUs who have a duty to provide health monitoring for your worker, and
- under certain circumstances, the WHS regulator.
The health monitoring doctor will provide recommendations in the health monitoring report about the health monitoring program for your worker that could include:
- whether it is a final health monitoring report
- details for a repeat appointment, for example:
- o a follow up assessment to confirm results, or
- o the next routine health monitoring appointment
- any counselling required
- an extra medical examination, or
- that your worker has been referred to a medical specialist.
The health monitoring doctor will also provide specific recommendations to you based on your worker’s health monitoring results that may include:
- your worker is fit for work with the hazardous chemical
- your worker is fit to resume work with the hazardous chemical
- biological monitoring results show unacceptably high exposure levels
- if you should review workplace control measures, and
- that your worker should be removed from work with the hazardous chemical.
Recommendations about a health monitoring program
You must consult with your worker and explain any recommended remedial measures you must take, for example removing them from work where they have been exposed. You should also consult your worker if you need to further monitor their health. Only your worker and the health monitoring doctor should discuss treatment.
Recommendations a doctor may give you
Removal of your worker from work with a hazardous chemical
If the health monitoring doctor recommends that you remove your worker from work, you should remove them from work with the hazardous chemical that triggered the need for health monitoring. For example, you should give your worker other work or another location where they won’t be exposed to the hazardous chemical. You should do this after consulting with your worker and the health monitoring doctor and ensure that your worker is not returned to work with the hazardous chemical until cleared to do so by the health monitoring doctor.
You should continue to provide workers who have been removed from work or transferred to other work with information about their health monitoring.
The health monitoring doctor will make recommendations in the health monitoring report if you should remove a worker from lead risk work.
You must remove a worker from lead risk work if recommended by the health monitoring doctor if:
- the biological monitoring of your worker shows your worker’s blood lead level is at or more than the blood lead removal level for that person:
- for females not of reproductive capacity and males – 30 µg/dL (1.45 µmol/L)
- for females of reproductive capacity – 10 µg/dL (0.48 µmol/L), or
- there is an indication a risk control measure has failed and, as a result, your worker’s blood lead level is likely to reach the relevant level for removal, as per the levels noted above.
A health monitoring doctor may also recommend you remove the worker from lead risk work if their blood lead level is still below the mandatory level but there is an indication your worker has health effects from exposure. If this recommendation is made you should remove your worker from lead risk work.
You must notify the WHS regulator as soon as possible if you remove a worker from carrying out lead risk work. You must arrange for your worker to be medically examined by a health monitoring doctor within seven days after the day your worker is removed.
If you expect your worker to return to carrying out lead risk work, you must monitor their health as often as the health monitoring doctor recommends. This will determine whether your worker’s blood lead level is low enough for your worker to return to carrying out lead risk work.
You must ensure your worker does not return to carrying out lead risk work until:
- your worker’s blood lead level is less than:
- for females not of reproductive capacity and males – 20 µg/dL (0.97 µmol/L), or
- for females of reproductive capacity – 5 µg/dL (0.24 µmol/L), and
- the health monitoring doctor is satisfied your worker is fit to return to carrying out lead risk work.
Review control measures in the workplace
You should, and in some cases must review, and revise if necessary, the control measures in the workplace. The health monitoring doctor will make this recommendation:
if test results show your worker has been exposed and has elevated levels of metabolites, or break-down products, of a hazardous chemical in their body
- in the case of lead, if test results show your worker has reached or exceeded the relevant blood lead removal level, or if they have otherwise been removed from carrying out lead risk work, or
- if test results show your worker may have contracted a disease, injury or illness as a result of working with the chemical that triggered health monitoring.
The health monitoring doctor may also recommend you take other actions including if your worker can continue to work with hazardous chemicals.
You should examine your work practices and procedures to see if tasks are being done correctly and if controls are not effective or being bypassed. If necessary, you should review and revise worker training programs.
You must regularly review and revise the control measures you have in place for hazardous chemicals. You will find more information on review of control measures in model Code of Practice: Managing risks of hazardous chemicals in the workplace.
Provide a copy of the health monitoring report to the WHS regulator
You must provide a copy of the health monitoring report to the WHS regulator if:
- the test results show your worker may have contracted an injury, illness or disease as a result of working with a chemical that triggered health monitoring
- the health monitoring doctor recommends you take remedial measures, including whether your worker can continue to carry out work or a review of control measures, or
- for lead risk work, the test results show your worker has reached a blood lead level at or above the relevant removal level.
Record keeping for health monitoring reports
You must identify workers’ health monitoring reports as a record for that worker. You must store these records confidentially and keep them separate from other information, for example records of non-health monitoring examinations.
You must keep health monitoring reports as confidential records and must not disclose them to another person without your worker’s written consent, except where you must provide the records under a law. For example, the model WHS Regulations require disclosure to any of the following:
- the WHS regulator
- another PCBU who has a duty to monitor the health of your worker, and
- a person who must keep the record confidential under a duty of professional confidentiality, for example another doctor.
You must keep health monitoring reports separate from normal workers’ records like payroll or human resources data, to prevent unauthorised people from seeing them.
To ensure you meet your confidentiality obligations, you must not use the health monitoring report for any purpose other than monitoring the health of your worker. Similarly, you must not use blood or tissue samples, X-rays, questionnaires or other materials taken for health monitoring for any other purpose.
How long to keep records
You must keep workers’ health monitoring records for hazardous chemicals and lead for at least 30 years after the record is made, even if the worker no longer works at your workplace.
You must keep asbestos health monitoring records for at least 40 years, even if the worker no longer works at your workplace, due to the long period of time it can take for asbestos-related disorders to develop.