Early intervention

Occupational cancer

Early intervention and immediate corrective action

This section discusses health surveillance, monitoring for symptoms that can help in early detection and some primary actions.

Helping an employee with cancer

Immediate medical advice

Review of occupational safety and health management system

Advice for employers

Health surveillance programme

Advice for employees

Getting more help

Many cancers can be prevented by reducing exposure to carcinogens. Some cancers  can be detected early in their development, treated and cured. Even with late-stage cancer, the pain can be reduced and the progression of the disease slowed. Early intervention is crucial to increasing the chances of surviving cancer, and this relies on early detection.

Helping an employee with cancer

Early intervention for all work-related ill health is a key aspect of ensuring the best outcome for both employee and employer. If someone has suspected occupational cancer, it's important to protect them from further exposure to carcinogens and other substances or tasks that could make their condition worse or adversely affect their treatment, while the causes of their symptoms are investigated.

Various symptoms can indicate cancer and it's important to get them checked out by a health practitioner. Detecting most cancers early means that treatment is more likely to be successful. Symptoms of cancer could include:

  • a lump anywhere on the body
  • changes to a mole
  • a cough that won’t go away
  • increasing breathlessness and wheezing
  • abnormal bleeding
  • a change in bowel movements
  • unexplained weight loss
  • persistent aches and pains
  • excessive tiredness (fatigue).

If cancer is diagnosed, exposure to carcinogens and other substances that could make the condition worse or affect the outcome of treatment  must be controlled. If controls are not sufficient or changes to the work process can't reduce exposure enough, then consider moving the employee to a different area or changing their duties.

Not all cancers are due to occupational factors, and employers need to consider whether an employee’s condition has been made worse by work or could make work difficult. There's a delay between exposure to carcinogens and the onset of cancer, so if an employee is diagnosed with an occupational cancer it might have been caused by an exposure some time in the past. However it's essential to review your existing measures to ensure exposure to carcinogens is adequately controlled.

Immediate medical advice

If an employee develops any symptoms, they should be put in touch with an occupational physician or nurse. If the employer doesn’t provide these facilitates, they should advise the employee to consult their GP. It’s important that the employee can provide information about their work and the substances they've worked with or been exposed to in current or previous jobs. The health practitioner needs this information to assess the cause of the cancer and begin appropriate treatment.

Employees can get advice from the NHS Choices and Macmillan Cancer Support websites on various types of cancers. Expert medical advice should be sought as soon as any symptoms are identified.

Review of occupational safety and health management system

If cancer-related symptoms are detected in the workforce, employers should review the systems they use to control exposure to known carcinogens and develop a protection programme if they don’t have one already. An occupational safety and health management system (OSHMS) should cover:

  • risk assessment
  • control measures
  • monitoring of exposure
  • health surveillance
  • education and training.

Further information on control of carcinogens can be found in the HSE's COSHH Approved Code of Practice. For more information, refer to the preventive action and early identification section.

The Peninsula Medical School’s literature review Avoiding long-term incapacity for work: Developing an early intervention in primary care provides an evidence base for early intervention in sickness absence. IOSH's produced a useful guide A healthy return: good practice guide to rehabilitating people at work.

Advice for employers

If employees have been diagnosed with a work-related illness it's important to investigate any potential exposure or breakdown in your controls to prevent further exposure.

You should also adopt a pragmatic approach when dealing with an employee with health problems. Remember occupational cancer can be caused by an exposure some years earlier so you might need to consider where the employee previously worked and what they did. You should:

  • recognise early signs of distress and low morale in the employee.
  • support the employee by listening to their health concerns in private.
  • liaise closely with the employee during their planned or unplanned absence from work.
  • seek competent help from a medical practitioner, human resources department etc
  • assist in return to work procedures
  • provide suitable and flexible work options and discuss these with the employee before making any decision
  • provide ongoing support to enable the employee to feel safe and productive. 

Health surveillance programme

A health surveillance programme involves obtaining information and watching out for early signs of work-related ill health in employees exposed to certain health risks. In the UK COSHH stipulates the requirement for defined health surveillance programmes when specific substances are used. It means putting in place certain procedures to achieve this, usually performed at least once a year and under the supervision of a health professional. These procedures can include:

  • initial health assessment
  • medical examination
  • self-examination
  • health questionnaire
  • exposure records
  • maintaining health records for employees.

Determine whether any of the substances or tasks your organisation is involved with require health surveillance.

The Health for Work Adviceline for small businesses helps you to quickly and effectively address the issue of employee ill health, minimise the impact of staff illness, and provide essential support to staff with physical or mental health issues. Healthy Working Lives Scotland and Healthy Working Wales also provide advice and support.
 
If a doctor confirms that an employee is suffering from an occupational cancer, you must report it to the HSE under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR)1995.

Advice for employees

If you’re suffering from cancer-related symptoms, you should tell your manager and/or safety representative immediately. You should also speak to your manager and/or safety representative if controls in your workplace aren’t working - for example if the respirators or gloves you wear are inappropriate for the work you do. It’s important that you go through a screening programme and attend health surveillance sessions if your employer asks you to.

Getting more help

The following organisations offer help and advice:

  • Health, Work and Well-being is a government-led scheme that provides advice to improve the health and wellbeing of working-age people
  • The Health for Work Adviceline for small Businesses is a free service to help you quickly and effectively address the issue of employee ill health, minimise the impact of staff illness, and provide essential support to staff with physical or mental health issues.
  • Healthy Working Lives Scotland has a free national advice line providing confidential advice and information on a wide range of workplace health issues, including health promotion; occupational safety and health; employability; and vocational rehabilitation.
  • NHS Health at Work offers a range of services to employers through a national network of over 100 NHS occupational health businesses.
  • ACAS provide a helpline for employers and employees who are involved in an employment dispute or are seeking information on employment rights and rules. The helpline provides clear, confidential, independent and impartial advice to assist the caller in resolving issues in the workplace.

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