It is advisable for a pre-employment, pre-placement and periodic medical to be undertaken on workers who are due to or work at heights and those who access/climb to heights. It is best industry practice to carry out a review of this assessment following significant sickness absence.
Periodic health assessments should be undertaken at agreed time scales; currently these are as follows:
- Age < 40 years - three yearly
- Age 41- 50 years - two yearly
- Age > 50 years - Annually
There are obvious hazards associated with work involving climbing structures and working at heights namely falling from a height. There are general principles to be borne in mind when assessing fitness for working at heights/access to heights:
Existing medical conditions may be aggravated by heights (e.g. neurological conditions resulting in dizziness)
- The effect of inclement weather
- The effect of medication
The assessment of fitness includes the Chester Step Test, which assess aerobic capacity.
An inadequate result (i.e. 'poor') will indicate that they are currently unable to perform any climbing, or working at heights activities.
They should be retested at three months. If on review they do not meet the required standard they will need to be referred back to their manager and possible referral to a physician.
Vision - Distance vision needs to be at least 6/12 in both eyes - aided or unaided. If this is less, then the individual is referred to an optician. Peripheral vision is also assessed.
If anyone is visually impaired (such as sight in only one eye) or has peripheral vision problems, as long as they had adjusted to dealing with this then they would not fail.
Pulse - This is assessed as an irregular, or rapid pulse may indicate and underlying condition. If a problem is suspected, then a referral is made to a physician.
Blood pressure - Individuals with raised blood pressures are referred to their physician for further assessment.
Height/Weight - BMI (body mass index) are checked. Obesity can indicate poor levels of fitness and in conjunction with their Chester Step Test results, could constitute a fail.
Skin is checked - No real reason to fail someone, unless the skin disorder was so bad on their hands they were not able to grip. This could constitute a fail for climbers.
Spirometry is performed - Anyone with moderate/severe debilitating airway disease could be excluded.
Musculoskeletal - Assessment examines if an individual has good mobility, power and strength. Where there are significant impairments to these, this could constitute a fail.
Urinalysis - Is done to ensure there are no signs of undiagnosed diabetes. The presence of diabetes does not constitute a fail in itself, but individuals require close monitoring.
We also test for Drugs and Alcohol
The purpose of the occupational health professional is to advise on fitness to work.
The final decision to employ or remove an individual from working at height/access to height sits with the employers.
Through the assessment process, it is often necessary to refer any identified problems to other health professionals - Physicians, Opticians etc - who can advise on specific conditions in relation to fitness for working at heights/climbing.
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