guidance notes

Guidance Note 15 - Occupational health

Occupational health

Every year in Britain alone, more than two million people experience symptoms of ill-health believed to have been caused or made worse by work and around 33 million working days are lost to illness. Yet occupational ill health is preventable and many of these costs can be reduced by employers taking effective steps to control health risks at work.

Occupational health is concerned with the prevention, monitoring and treatment of work-related disease and ill-health. It covers a broad range of health-related issues, including:

  • Effect of work on health – both acute and chronic.
  • Prevention of occupational disease or its worsening, for example through health surveillance, ergonomics and good management systems.
  • Use of rehabilitation and recovery programme for those returning to work.
  • Help for disabled persons at work, for example, through provision of support or workplace adaptations.
  • Provision of advice on occupational aspects of ill-health with complex causation, such as stress.

Occupational health hazards

Health hazards can be:

  • Biological – exposure to bacteria and viruses can lead to transmission of disease to humans i.e. anthrax, hepatitis, Weil’s disease (leptospirosis).
  • Chemical – exposure to certain chemicals can cause various illnesses or conditions i.e. intoxication, allergy, asthma, cancer.
  • Musculoskeletal – conditions affecting the body which may arise from poor manual handling techniques, repetitive movements.
  • Physical – exposure to agents such as noise, vibration, extremes of temperature, radiation.
  • Psychosocial – affecting mental and physical health (stress). May be caused by excessive work pressures, bullying or racism, redeployment, redundancy.

The role of occupational health professionals involves identifying, monitoring, eliminating, preventing and managing the risks arising from these activities.

The costs of occupational ill-health

The costs of occupational ill-health to employers can be vast and encompass the following:

  • Loss of business and disrupted schedules.
  • Loss of skills and knowledge, through individuals leaving the workforce due to ill health.
  • Recruitment and training of replacement workers.
  • Rehabilitation and return to work arrangements.
  • Time spent investigating incidents.
  • Sick pay.
  • Increase in insurance payments.
  • Fines and compensation claims.

Benefits of occupational health services

  • The workforce is healthy.
  • Employees are protected while they are in work.
  • Gives an opportunity to provide more training in safety and healthier working practices i.e. use of PPE, manual handling etc.
  • Employees have the chance to raise any health concerns they may have in confidence.
  • Keeps sickness absence and its related costs at a minimum.
  • Checks how control measures are working and identifies areas where further action is required.

Occupational health services

The following activities fall within the scope of occupational health and safety:

  • Periodic medical examinations, including health surveillance – these may be due to statutory requirements, or where it is perceived that staff are exposed to specific hazards i.e. noise, HAVS or radiation (refer to separate Guidance Note on Health Surveillance).
  • Pre-employment assessments – range from self-completing questionnaires to full clinical examinations.
  • Sickness absence monitoring & post sickness absence review – recording and monitoring of employee sickness will help to identify and trends or patterns of sickness in the workplace.

Post Sickness-absence Review

Following long-term sickness absence, review may be conducted to see if individuals remain fit enough to carry out their current roles. This should provide the employee with the opportunity to discuss any continuing health concerns they may have. It may also highlight any further issues, such as a disability or sensitivity, that warrant a change in the workplace access arrangements, or exposure to specific individuals or levels of work pressure.

If the returning employee’s health indicates changes to the work environment, procedures or hours worked, it is beneficial to provide their work colleagues with awareness training or instruction.

Some employers provide staff with immunizations if they travel abroad in their job role. Foreign travel health requirements can vary, and so it is recommended that clinical advice be sought before travelling to exotic locations. Other immunizations with potential workrelated dimensions include TB, tetanus, hepatitis, rabies and influenza.

Many organisations now provide a confidential counselling service to staff, often via a permanent health insurance scheme.

Health Education
Information on diets, smoking, drugs, alcohol or sex education may be provided by occupational health services, in an effort to educate the workforce how to reduce the risk of ill-health.


Various occupational health providers offer special treatments to staff, such as physiotherapy, chiropody, reflexology or dentistry.

The principal aim of rehabilitation is to return staff who have suffered ill health, injury or the onset of disability to their original job or other productive work. Rehabilitation may involve changes to work practices, hours or the provision of specially adapted equipment, services or of the working environment itself.

Find an occupational health doctor or nurse

  • The NHS has a free advisory service for small businesses.
    Tel: 0800 077 88 442.
  • The Society of Occupational Medicine maintains a register of physician members, together with information on their likely availability.


  • Employers are required by law to protect employee health at work.
  • Sickness absence costs UK Plc more than £13billion each year.
  • As many as 80% of UK business currently provide no or insufficient occupational health.
  • The increasing trend for litigious action against employees has resulted in a wave of employment litigation adding to employer’s risk burden.
  • Healthy and effective workers are more productive.
  • Effective occupational health provision can save employers significant expense.

Further guidance