Medical examination review for asbestos workers

A proposal to change the frequency of statutory health checks for licensed work from two years to three years, in line with the frequency for workers undertaking notifiable non-licensable work, was included in an HSE report earlier this year that looked into the effectiveness of CAR 2012.

The Post Implementation Review of the Control of Asbestos Regulations 2012, reviewed the extent to which the regulations have achieved their objectives and assesses the costs and benefits that might be attributed to them. Included in the report’s conclusions were a series of further clarifications that might be beneficial to CAR2012, and these included the frequency of medical examinations.

Regulation 22 of the Control of Asbestos Regulations 2012 (CAR), requires employers to arrange appropriate medical examinations for any employees who carry out licensable work or notifiable non-licensable work. It also sets out what health records employers must keep and how long.

Currently asbestos medical examinations should take place every two years by an HSE -appointed doctor for licensable work, but for notifiable non-licensed work (NNLW) the medicals should be conducted by a General Practitioner every three years.

At workshops carried out for the PIR, the HSE reported that there was some apparent confusion across all dutyholder groups as to why the frequency of medical examinations differed for licensable and notifiable non-licensed work.

There was a belief that working with asbestos carried the same risks irrespective of whether the work was licensable or notifiable non-licensed work, and therefore the frequency of medical examinations should be the same.

CAR 2012 implements the EU Directive 2009/148/EC which requires that ‘each worker’s state of health must be assessed’ licensed asbestos workers to by undertaking an initial medical examination, then at least once every 3 years during exposure.

CAR2012 therefore currently goes beyond the Directive and aligning the frequency of medicals to every 3 years would bring the Regulations into line with the Directive and remove any ambiguity relating to the required frequency of medical examinations.

In announcing its decision to explore this possibility, the HSE explained that medical examinations are designed to detect disease early and to allow removal from further harm. It says that this approach has limited value in relation to asbestos, as asbestos-related cancers have a latency effect and do not occur until many years after exposure.

The HSE says that independent expert medical advice confirms that reducing the frequency for licensed work and increasing the screening interval is unlikely to have an adverse effect on the risk of disease progression.

The less frequent need for medicals would also lower costs to business and would not lower standards of health protection of workers who carry out the most high risk work.

In the circumstances, the HSE says it will explore the health and safety impacts of any changes to the regulations, taking account medical, epidemiological, and scientific evidence, in consultation with stakeholders. The results of the evaluation will inform any proposals for changes to CAR 2012.