ABSTRACT
There is much-perhaps too much-discussion of the term ‘surveillance’ and of its distinction from related terms such as (health) ‘screening’ or ‘health assessment’ (Wagner, 1996). The arguments may usefully be circumvented by the application of two principles:
• That the chief purpose of a workplace surveillance programme should be the primary prevention of occupational disease even if it is, in part, enacted through measures that are more properly described as secondary prevention
• That any workplace programme that includes ongoing health surveillance should always incorporate ongoing hazard surveillance in the same workplace
Together, these principles should form the basis of a programme that is focused, effective, fair and conducive to a ‘virtuous’ circle (Figure 15.1) akin to that of good clinical audit. The recognition that an occupational disease has occurred indicates that exposure controls have failed and that further investigation is required in order
to prevent future cases. Conversely, failure to adhere to these principles threatens to reduce workplace surveillance to simple ‘case nding’, and is probably responsible for much of the cynicism among employees, employers and even some occupational health practitioners, in which much surveillance is held.
