Keep a check – Health Surveillance and Risk Assessment Food and Drink Group Wednesday 6 September 2017

Julie Routledge – Occupational Health Manager Bit about me….

. Worked in Occupational Health for 24 years . PG Diploma and Specialist Practitioner in Occupational Health obtained from University of Surrey . Mostly manufacturing – Weetabix, Mars Petcare, Perkins Diesel Engines and currently Greencore . Set up 2 OH services . Health Surveillance and Fit for Purpose medicals from beginning What is Health Surveillance

• Health surveillance allows for early identification of ill health and helps identify any corrective action needed. • Health surveillance may be required by law if your employees are exposed to noise or vibration, solvents, fumes, dusts, biological agents and other substances hazardous to health, or work in compressed air.

Source: HSE accessed 21/8/2017 http://www.hse.gov.uk/health- surveillance/index.htm So what do we need to consider

Legislation for statutory requirements • Noise at work • Control of Substances Hazardous to Health • Manual Handling • Lead • Mercury • Asbestos • Vibration • Compressed Air • Radiation Fit for purpose screening

What else/Fit for Purpose? Not a legal requirement but considered best practice

• New starter Screening - baseline • Working Time Directives – Nightworker • Food Handlers • Drivers – Vocational and FLT etc • Working in Hot/Cold environments Health Risk Assessment

• 5 steps to risk assessment

• Identify the health hazard • Who is at risk from the health hazard • What are the current control methods – are they suitable to control the risk? • What more should be done – action plan, health checks etc • Monitor and review Occupational Health Assessment

Types of medicals • Statutory – COSHH (EH40) – Questionnaire, lung function, skin check – Noise – Questionnaire, audiometry – Lead – Biological Monitoring - blood tests – Mercury – Biological monitoring - blood/urine tests – Asbestos – X-ray, – Compressed Air – Questionnaire, lung function – Radiation – Questionnaire, lung, skin – Hand Arm Vibration – Questionnaire (Tier 1)

Fit for purpose – Drivers – Questionnaire Eye Test, – Food Handlers – skin check, symptoms, underlying condition – Extremes of Temperature - Questionnaire – Skin – Questionnaire, visual check – Nightworker - Questionnaire, – Musculoskeletal – Questionnaire, monitoring Where do we start Where do you start

• Know the site • Walk the area • Health and Safety – Review risk assessments • Carry out Health Hazard Matrix • Health Hazard Audits Where to start

Plan: Review risk assessments Do we have a health risk? Act: Decide who is going to carry out the health checks Do: Carry out a Determine who workplace audit requires the Health Health Risk Matrix Check Health Hazard Audit Complete screening and keep all records

Monitor results and Check: Current act if required controls are they suitable and sufficient? Recall - frequency Do I need to carry out health checks? Health Hazard Matrix

AREA______SUB AREA ______Assessed By______Date ______

Health Hazard Risk WRULD

Assessment Matrix -

WorkingHot/Cold in

ForkLift, LGV, HGV, -

Role/Task –

Noise Health to Hazardous Substance etc Truck Pallet field Light/Electromagnetic FoodHandling Welding Confined Space Driving VibratingTools Risk Musculoskeletal Equipment Screen Display Violet Ultra NightShift Risk Psychological Wholebody Vibration to asbestos, Lead, Exposure mercury WorkingHeight at LoneWorking Thermal BiologicalHazards Radiation Person Vulnerable

PRODUCTION OPERATIVE X X X X X X Health Hazard Audit

Section A: Area Assessment Summary

Factory Factory 1 Area High Care Line Sub area assessed: assessed: Ops Assessed by: Julie Routledge Shift times: 7 day a week manufacturing – 2200 to 16.30 Health hazard identified Control measures Medical Screening Intervention 1. Exposure to Noise Noise survey, Hearing protection zones, noise action Audiometry as a baseline on joining Greencore group looking to reduce noise levels at source and then every 2 years thereafter 2, Work related upper limb Suitable rest and recovery, rest breaks, manual Musculoskeletal Assessment disorders handling training, Risk assessment, rotation of tasks Working in a cold environment Wearing of layers of clothing, gloves provided, rest General Health Questionnaire periods, Occupational Health Assessment 3, Shift Work Redeployment opportunities to move to days if Night worker Assessment every 2 years requested 4. Demand of Role – keeping Management supervision, suitable rest and recovery None required monitor during medical up with line speed/production surveillance run 5. Exposure to food contact – Assess to Occupational Health, gloves are provided, Food Handlers medical every 2 years – skin risk of allergy, hand washing – soaps and detergents suitable for food manufacturing, check risk of dermatitis moisturiser provided

6. Quality Monitors – Taste Occupational Health Assessment Food Handlers medical every 2 years Panel – risk of food allergy

Are there any considerations to this area for vulnerable employees – including but not exclusive to pregnancy/young persons – Pregnancy risk assessment required to consider static standing, shift work and Only for Quality Monitors – Taste panel Comments: Rotation of tasks is key in reducing the impact of work related upper limb disorders

Overall Health Risk Rating Low Risk as long as control measures are observed Date 23 May 2017 Review Date May 2020 Health Hazard Audit

Occupational Health Health Hazard Assessment Section B: Health Hazard breakdown Do any of the following occupational health hazards exist? 1.Physical hazards Is there a risk of/from Yes/No Comments/current controls Working at height Vehicular/FLT Confined space Machinery/mechanical Vibration – use of power tools, whole body vibration Lone working

Noise Radiation Musculoskeletal Injury – WRULD Back Injury Ergonomics – is the area ergonomically designed?

Thermal hazards such as: heat (direct/radiated) humidity Cold/chill store Any other physical hazards? 2. Chemical hazards Do any of the following hazards Yes/No Comments/current controls – exist in this area? Dusts/powders Fumes Gases/vapour Aerosol/mists Liquids Cleaning agents Health Hazard Audit

3. Biological hazards Routine exposure to biohazards. If Yes/No Comments/current controls yes, list

4. Manual Handling/Ergonomic hazards Is there a risk from Manual Comments/current controls Handling or Ergonomics? Is the risk: LOW MEDIUM HIGH If the risk is med-high has a manual handling risk assessment been carried out? If Yes is it suitable and sufficient to control the risk? Comments:

5. Psychological hazards Do any psychological hazards Comments/current controls exist? If yes list Shift Work Lean crewing, future changes Are there any concerns for WRS? Additional comments: Signature Date

Health Hazard Audits

Overall Risk Assessment Rating Severity – 2 x Likelihood 1 = 2 Low risk

SEVERITY OF HEALTH EFFECT Taking into account what is Not severe Severe (off work for 3 days or Very severe (long term illness) known so far, how severe a more) health effect could working in Score 3 this area have on personnel? Score 1 Score 2

LIKELIHOOD OF OCCURANCE Having considered the control Unlikely Likely Highly likely measures, what is the likelihood of personnel developing a health risk? Score 1 Score 2 Score 3

RISK RATING = SEVERITY x LIKELIHOOD ENTER RISK RATING HERE: 2

Action: . A risk rating of 1 or 2 indicates that existing management arrangements are adequate and the risk is LOW

. A risk rating of 3 or 4 indicates that a review of current arrangements should take place and the risk is MEDIUM and changes made within 4 weeks

. A risk rating of 6 or 9 indicates that the current arrangements for health protection are inadequate and that urgent action should be taken to remedy the situation and the risk is HIGH Health Task sheet and surveillance programme

Health Risk Risk Who may require this Paperwork Medical Required Criteria/Standard Frequency Required New Starter LOW All employees General Health Baseline audio, spirometry, Refer to OHA if any underlying health Within 12 weeks of commencing Questionnaire skin assessment, Ishihara condition that may cause an impact employment. 4 weeks for all food Food Handler Plates on their ability to carry out their role handlers Questionnaire

Exposure to HIGH Engineers, Ultra Sonic Cutters, Audiometry Audiometry Refer to GP/OHA if CAT 3 At baseline then every 2 years. Noise Machine Minders, tray wash, porters, Questionnaire More frequent if results show dispatch or any employee where Any CAT 2 - Warning advise to wear vulnerability (CAT 2, CAT 3) noise levels are above 85 dB (A) hearing protection Annual for Engineers

Exposure to HIGH Hygiene, Engineers, Welders, Yard, Respiratory and Spirometry and skin Refer to OHA if Spirometry showing Welders and Dries/Spices - On Substances Diesel Tank, Dries Room Skin assessment restriction or obstruction or any commencing employment, at 12 Hazardous to Questionnaire symptoms of rhinitis (exc. hayfever) weeks, 24 weeks at 1 year then health annually thereafter. All others on commencing employment and annually thereafter

Food Handler LOW All employees who come into contact Food Handler Skin examination, nail check, Refer to OHA if any underlying health Every 2 years with unsealed/open food within low Questionnaire dental check. condition that may cause an impact or high care Check for respiratory or bowel on their ability to carry out their role, Assessment after travel or illness disorders or a danger to the product on return to work

Reach Trucks LOW Yard Workers, Dispatch, Goods In, Vocational Driver Blood pressure, vision test, Refer to OHA if vision acuity is < 6/7.5 Prior to becoming a driver and inc. FLT, Engineers, Unit E, Hygiene Questionnaire musculoskeletal assessment or monocular vision every 3 years thereafter. Counterbalance, of back and neck, whisper test Hypertensive – Diastolic >95 Cherry Pickers or audiometry Uncontrolled Diabetes Annual after 60 years of age etc. Medical history of cardiac, epilepsy, blackouts, faints or anything of Full assessment after any illness concern. that may affect driving Area Register

• Select the people that matches the plan

Date of CLOCK Food Date of next SURNAME FORENAMES NO. DEPT. Handler Skin MSK Noise Nights COSHH Medical medical Outcome Hygiene xxx Omer 67890 Op x x x x 01/01/2017 01/01/2018 Fit Hygiene xxx Abukar 35679 supervisor x x x 05/01/2017 05/01/2018 Fit Hygiene xxx Jeronimo 12345 Op x x x x x 02/05/2017 02/05/2018 baseline medical completed - fit Hygiene xxx Claudio 10484 Op x x x x 01/01/2017 01/01/2018 Fit Hygiene xxx Lawrence 10489 Op x x x x x 01/01/2017 01/01/2018 Fit Hygiene xxx Melwyn 10484 Op x x x x 01/01/2017 01/01/2018 Fit Hygiene xxx Francis 10442 Op x x x x x 01/01/2017 01/01/2018 Fit Hygiene xxx Justino 10480 Op x x x x 10/07/2017 10/07/2018 Fit Prioritising

• Safety critical • Sensitising Agents • Area of concern • Individual concern – e.g. poor hearing – carry out more frequent Trends & Data

• What is the surveillance programme saying? Don’t forget

• Adding New Starters • Removing Leavers • Fit slip • Change of position • New chemicals on site – is OH part of the COSHH assessment? Thanks for listening

Any Questions ?