Health surveillance for hospital employees exposed to respiratory sensitizers.

Seventy-eight National Health Service occupational health departments were invited to take part in an audit of health surveillance for employees exposed to respiratory sensitising agents. Most of the departments had responsibility for workers using glutaraldehyde, formaldehyde, methyl methacrylate and X-ray processing chemicals, but the extent to which health surveillance was provided for these employees varied. Many departments had no written policies for surveillance, and the methods used were often unnecessarily labour intensive. Only a minority of departments had made arrangements for communicating the collective results of screening to employees, failure to do so indicating a breach of statutory duty. There were major discrepancies between departments in criteria for excluding employees from work with respiratory sensitising agents. Occupational physicians caring for hospital staff should discuss and establish guidelines for effective surveillance of people working with the commonly encountered sensitisers.