Occupational Health · Mandatory · Construction

Respiratory Health Surveillance Record

A health surveillance record for workers exposed to respiratory hazards including respirable crystalline silica, wood dust, welding fumes, and isocyanates. Documents baseline and periodic spirometry (FEV1/FVC), respiratory symptom questionnaires, and fitness outcomes. The silica WEL was reduced to 0.05 mg/m³ in 2020. Records must be retained for 40 years.

Last reviewed: 29 March 2026 — This guide reflects UK law as of this date. COSHH Regulations 2002 remains current with no amendments enacted as of 29 March 2026. Next scheduled review: 29 March 2027.

Legal basis	COSHH 2002 Reg 11
Key hazards	RCS (silica dust) — WEL 0.05 mg/m³. Wood dust — hardwood 1 mg/m³, softwood 5 mg/m³. Welding fume — all types now classified as carcinogenic per HSE. Isocyanates — spray foam, paints, coatings.
Spirometry	FEV1 (forced expiratory volume in 1 second) and FVC (forced vital capacity) — the primary lung function measurements
Record retention	40 years from date of last entry
Conditions	Silicosis, occupational asthma, COPD — all permanent and progressive once established

1. Respiratory Surveillance — The Lung Conditions That Cannot Be Undone

Silicosis, occupational asthma, and occupational COPD are permanent, progressive conditions that cannot be reversed once established. Respiratory health surveillance exists to detect early signs of lung damage — declining lung function, new respiratory symptoms, or sensitisation to workplace substances — before the damage becomes disabling or life-threatening.

A bricklayer cutting concrete blocks for 20 years without water suppression or adequate RPE is at extreme risk of silicosis. A joiner exposed to hardwood dust without LEV is at risk of nasal cancer and occupational asthma. A welder working without adequate ventilation is exposed to fumes now classified as carcinogenic by the HSE. In each case, respiratory health surveillance provides the early warning system that can trigger intervention before the condition becomes irreversible.

Baseline spirometry establishes the worker's lung function at the start of exposure. Periodic spirometry tracks changes over time. A decline in FEV1 or FVC, or a reduction in the FEV1/FVC ratio, may indicate developing obstructive or restrictive lung disease. The respiratory questionnaire captures symptoms — persistent cough, wheeze, breathlessness, chest tightness — that may indicate early occupational lung disease. Skin surveillance is also required where workers are exposed to substances that can cause both respiratory sensitisation and skin sensitisation, such as isocyanates and epoxy resins.

Silica dust — critically low WEL

The workplace exposure limit for respirable crystalline silica (RCS) was reduced to 0.05 mg/m³ in 2020. Cutting, grinding, or drilling concrete, brick, or stone without water suppression or local exhaust ventilation almost certainly exceeds this limit. FFP3 respiratory protective equipment is the minimum for RPE where exposure cannot be adequately controlled by other means.

2. Key Components

The following table sets out the key components that a respiratory health surveillance record must address. Each element supports the 40-year record obligation and provides the clinical evidence base for fitness for work decisions and RIDDOR reporting.

Component	Detail
Worker details	Full name, date of birth, NI number, employer, trade/role — sufficient to identify the individual across 40 years of records
Substance(s) exposed to	Specific hazardous substances the worker is exposed to — RCS (silica), wood dust (hardwood/softwood), welding fume, isocyanates, cement dust, or other respiratory sensitisers
Exposure assessment	Summary of exposure levels relative to WELs — from COSHH assessment, air monitoring data, or qualitative assessment of exposure likelihood and duration
Surveillance date	Date of each surveillance event — baseline and all periodic assessments must be dated and sequenced chronologically
Baseline spirometry	FEV1, FVC, and FEV1/FVC ratio at the start of exposure — establishes the reference point for detecting future decline
Periodic spirometry	FEV1, FVC, and FEV1/FVC ratio at each periodic assessment — compared against baseline to detect significant decline
Respiratory questionnaire	Worker's responses to standardised respiratory symptom questions — persistent cough, wheeze, breathlessness, chest tightness, sputum production, and any changes since last assessment
OH provider assessment	Occupational health provider's clinical assessment and fitness determination — fit, fit with restrictions, or unfit for continued exposure
Skin surveillance	Where the substance causes both respiratory and dermal sensitisation (e.g. isocyanates, epoxy resins) — skin inspection for dermatitis or sensitisation reactions
RIDDOR required?	Whether the case is reportable under RIDDOR 2013 — occupational asthma, silicosis, and other occupational lung diseases are reportable when confirmed by a doctor
Next surveillance	Date of the next scheduled surveillance — typically annually, or more frequently if declining function or new symptoms are detected
Records	40 years from date of last entry — spirometry results, questionnaire responses, and OH assessments must all be retained for the full period

3. Common Mistakes

Not conducting surveillance for all workers exposed to silica

Many employers limit respiratory surveillance to workers who operate disc cutters or breakers, overlooking labourers, banksmen, and other workers who are exposed to silica dust as bystanders in the same work area. Anyone who is regularly exposed to RCS above the action level must be included in the surveillance programme. Silica dust disperses across the work area and can affect workers who are not directly performing the cutting or grinding task.

Assuming RPE protects adequately without surveillance

Providing respiratory protective equipment (RPE) does not eliminate the need for health surveillance. RPE has a protection factor that depends on correct selection, fit testing, maintenance, and consistent use. Face fit testing confirms that the specific make and model of RPE fits the individual worker, but it does not guarantee real-world protection throughout a working shift. Health surveillance detects whether exposure controls, including RPE, are actually protecting the worker's lungs over time.

4. Frequently Asked Questions

What is the workplace exposure limit for respirable crystalline silica (RCS)?▾

The WEL for RCS is 0.05 mg/m³ as an 8-hour time-weighted average (TWA), reduced from 0.1 mg/m³ in 2020. This is an extremely low limit that is very difficult to achieve when cutting, grinding, or drilling concrete, brick, or stone without effective water suppression or local exhaust ventilation (LEV). For context, silica dust particles are invisible to the naked eye at the sizes that penetrate deep into the lungs. An FFP3 respirator is the minimum standard for RPE where exposure cannot be adequately controlled by other means, and face fit testing is mandatory for all tight-fitting RPE.

Generate your Respiratory Health Surveillance Record on Construction Suite

Construction Suite walks you through every required section with a guided Q&A — built to COSHH Regulations 2002 — and generates a professionally formatted document in minutes.

Get started free