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Health monitoring is the monitoring of a worker to identify changes in their health status because of exposure to certain substances. It involves a health monitoring doctor examining and monitoring the health of your workers to see if the exposure to hazardous chemicals at work is affecting their health.

You must ensure that health monitoring is carried out or supervised by an appropriate health monitoring doctor (see the Health monitoring guide for registered medical practitioners for more information about what experience your health monitoring doctor should have). If your workers have health monitoring regularly it is called a ‘health monitoring program’

The health monitoring doctor will choose the best way to monitor your worker’s health and may use more than one way to monitor your worker’s health. They will choose the best way by looking at:

  • the regulatory requirements under the model WHS laws
  • the type of chemical involved
  • the way your worker is exposed
  • the level of exposure
  • if the work environment includes control methods or equipment to reduce the exposure, and
  • if it is possible to use a proactive way to monitor adverse health effects.

Proactive health monitoring means monitoring your workers before they develop symptoms. This includes checking the level of a chemical or substance in your worker’s blood or urine. Proactive monitoring is preferable to monitoring symptoms after they have developed such as markers of liver injury or changes in the blood cells of your worker. 

Sometimes a worker is exposed to chemicals outside of the workplace, through food or water, and this information can also be captured during a worker’s health monitoring program. This information can help the health monitoring doctor to better understand and help manage your worker’s health monitoring program. You can read more about confounding effects and effects that are difficult to understand in the individual Health monitoring guides for hazardous chemicals.

You must never use health monitoring instead of implementing effective control measures. However, you can use it to see:

  • how effective your control measures are, or
  • whether you should apply new or more effective control measures.

A health monitoring program is only effective if you:

  • act on the results of health monitoring that show early signs of, or a trend towards potential injury, illness or disease
  • know when you should refer workers for health monitoring, and
  • know how you should use the results of health monitoring to minimise risks to health and safety.

The health monitoring doctor will monitor your worker’s health in different ways to assess exposure and the impact this has on their health. These are further discussed below.


The health monitoring doctor or other qualified person (such as an occupational nurse) can interview your worker and ask questions about:

  • symptoms related to exposure
  • previous occupational history, and
  • medical history or lifestyle, for example dietary, smoking and drinking habits.

An interview may include your worker answering simple questions about their work, their personal hygiene at work or where they eat and drink at the workplace.

The health monitoring doctor will use the answers to assess your worker’s current or previous exposure to hazardous chemicals.


Counselling is where the health monitoring doctor educates your worker about the effect of their lifestyle on symptoms of workplace exposure, for example workers who smoke or bite their nails should be counselled on the risk of lead ingestion.
The health monitoring doctor might also discuss how exposure to certain chemicals can have an effect on reproduction, pregnancy and breastfed children.

Medical examination

The health monitoring doctor may use standard techniques to measure early or long term health effects, and they may do this regularly. They might check your worker’s skin, eyes or hearing and collect baseline information to measure any future changes against.

Monitoring biological exposure

The health monitoring doctor may check the levels of a hazardous chemical or its metabolites (breakdown products) in:

  • body tissues
  • body fluids like urine or blood, or
  • the exhaled breath of an exposed worker.

Monitoring biological effects

The health monitoring doctor may look at early biological effects, before your worker’s health is harmed, for example by:

  • blood tests
  • monitoring your worker’s liver or kidney function, or
  • measuring the reduction of cholinesterase activity levels.

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