Occupational Health : Asbestos Medical

Exposure to asbestos can cause three main diseases:

• Asbestosis: irreversible scarring of the lungs;
• Lung cancer: increased incidence, particularly if you smoke;
• Mesothelioma: cancer of the lining of the lungs or stomach.

Important: All of these diseases have no cure – mesothelioma and lung cancer are fatal diseases. Typically, there can be a 15–60 years gap between first exposure and diagnosis.

Professions where workers may come into contact with asbestos

• Heating and ventilation engineers
• Carpenters and joiners
• Roofing contractors
• Plasterers
• Fire and burglar alarm installers
• Gas fitters
• General maintenance staff e.g. caretakers
• Cable layers
• Electricians
• Demolition workers
• Plumbers
• Painters and decorators
• Construction workers
• Shop fitters
• Computer installers
• Telecommunications engineers
• Building surveyors

Medical Surveillance

Medical surveillance should consist of initial and annual medical examinations. Both should include a specific examination of the chest and any laboratory tests or chest X-ray as the doctor may require. The purpose of medical surveillance is to: advise the employee on fitness for work with asbestos (with particular attention to the respiratory system); provide objective information to the employee on their current state of health (with particular attention to the respiratory system); alert workers to early signs of disease and advise on continued exposure; alert the employer to any particular problems which may require provision of a special respirator.

Initial medical examination
The first medical examination will be conducted by a physician, appointed by the Health and Safety Executive and will be no more than two years before beginning exposure to asbestos above the action level. It will include: a medical and occupational history; completion of a respiratory symptom questionnaire; physical examination with emphasis on the respiratory system;   measurement of lung function – at least FEV1, FVC.

A chest X-ray should only be part of the examination if deemed necessary by the physician. The employer must pay the costs of the chest X-ray and any other investigations the appointed doctor may require.

Certificate of examination (FODMS72A) and fitness for work
An employee may present with a history of pre-existing respiratory disease such as asthma, evidence of impaired lung function or radiological abnormality. The examining doctor can only advise employees about their health. The Regulations do not provide the option to issue certificates of unfitness to the employer and suspend employees from work with asbestos, as is possible with other statutory examinations. As a consequence; the certificate of examination does not constitute a fitness for work verdict for work with asbestos. Annual medical examinations are recommended thereafter.

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