Medical surveillance is a process required in terms of several pieces of legislation to systematically detect and assess early signs of work related ill health. This is carried out in workplaces where workers are exposed to particular hazards.

The Occupational Health and Safety Act, (Act 85 of 1993) particularly, prescribes medical surveillance for employees who are exposed to noise, asbestos, certain chemicals, lead, biological agents, thermal stressors, etc.

Other forms of Health Surveillance are undertaken as good practice and may be conducted at the same time as Medical Surveillance.

An important objective of medical and health surveillance is the optimal placement of workers (fit for work) for example, those working at heights, transporting dangerous goods, working in confined spaces etc.

The use of substances such as alcohol or illicit drugs, or the misuse of prescription drugs is a reality.

Many aspects of the workplace require that the employee is alert and has accurate and quick reflexes. An impairment of these qualities has the potential to cause incidents and accidents and can interfere with the accuracy and efficiency of work.

Also, Section 2A of the General Safety Regulations in the Occupational Health and Safety Act, (Act 85 of 1993), deals with prescriptions regarding ”Intoxication” and states that employer shall not permit any person who is, or who appears to be, under the influence of intoxicating liquor or drugs, to enter or remain at a workplace.

Effects of substance abuse:

• The impact on an employee’s judgment, alertness, perception, motor coordination or emotional state will also impact on working safely or making safety sensitive decisions
• The after effects of substance use (hangover, withdrawal) can also affect job performance
• Absenteeism, illness, and/or reduced productivity is also an issue
• Preoccupation with obtaining and using substances while at work will interfere with attention and concentration
• An employee with a family member, friend or co-worker who abuses drugs or alcohol may suffer psychological or stress-related effects

Substance use and abuse is often considered an addiction or dependence. Use can be anywhere on the spectrum from recreational to frequent to problematic. As a result, there are varying impacts on lives and work. Gompo Occupational Health Services can conduct substance of abuse screening. This is strongly advised for employees who engage in safety or security critical tasks. Examples of those who should undergo substance abuse screening:

• Operators of self-propelled hazardous machinery, such as cars, trucks, forklifts, tractors, etc
• Workers in occupations in particularly hostile environments (Fire-fighters)
• Workers who are at high risk of injury from falling. Consider height plus risk of falling; ie. work at significant heights (>2m), for whom fall protection is required.  (suspended platforms, scaffolding, etc. – Consider too, awkward ergonomics (cat ladders, narrow ledges, etc)
• Employees in occupations with high security clearance (security, cash handling).
• Employees operating hand-held hazardous equipment. (grinding tools, power/chain saws, etc.)
• Employees working closely with highly hazardous stationary equipment. (lathes, saws, metal presses, etc.)
• Employees involved in high value processes
• Employees who use high value equipment
• Employees who work in confined spaces eg. Ovens, sewers, silo’s
• As determined/recommended by the OHMP