Health assessment of forklift truck drivers

Not the sexiest subject to grace this blog but there appears to be a lot of confusion about health assessments for drivers of Fork Lift Trucks and other mobile plant.  I am often asked about it and the subject is often raised on OH discussion groups so it appears that not only are employers unsure, many of those advising the employers are not much wiser.  

The problem is this; there is no standard.   There is a standard if you drive large goods vehicles (LGVs) because apart from being bloody great things that can do some serious damage if driven recklessly, they are driven on the public road.  FLTs are driven on company premises and although a few are licensed, most never venture beyond the factory gates.

The Health and Safety Executive advise that you carry out a “suitable and sufficient risk assessment” of your mobile plant and that this should address the issue of health and potential ill health.  So what in practice does that mean and what should you do?

Well, it’s not for me to prescribe your risk assessment processes but most organisations that I work with and advise ensure that their FLT drivers have:

1)    A basic health assessment when they start (preferably before money is spent on training) that includes a health questionnaire, blood pressure, urine test, vision screen and assessment of musculoskeletal flexibility i.e. can the driver turn their head to look side to side and behind them.

2)    The health assessment repeated every 5 years.

3)    The health assessment repeated after any period of long term absence or serious illness.

4)    A signed declaration by the employee obliging them to inform the employer if there have been any changes to health that might affect the ability to drive.  For reasons of medical confidentiality, the employee does not have to disclose the details, just that there might be an issue.  It is then for the employer to obtain consent to take this up with the employee’s GP or occupational health service is there is one.

Even though the law does not require the above, arguably the spirit of the law does and an organisation could feel the heavy hand of the regulator if it wasn’t making some attempt to ensure that potential health risks amongst its FLT drivers were managed.  This process is also not overly burdensome and can be carried out with the assistance of a local occupational health service or the employee’s GP. 

Happier and healthier after a recession?

The picture is clear.  Most of the world is broke and hasn’t a penny to scratch its arse with.  The western world has been living beyond its means for 30 years and will bump along the bottom of the economic curve for another 10 years at least before the debts are paid off.  Whoever thought that living on such huge debt was a good idea anyway, be it personal, corporate or sovereign?  How did we blindly party our way into the current mess, thinking it was all rosy and would never end?  And what effect will this have on health?

The last 30 years have seen big reductions in musculoskeletal ill health, work related injury and disease, cancer and heart disease rates and many other improvements.  Correspondingly, the same period has seen a huge rise in mental ill health, particularly depression and anxiety (note to kids – during the next boom, become a shrink).  It seems that when we think we can have it all, we get rather stressed by the idea, don’t believe we should really have it, struggle to pay for it and are a lot happier when we have given most of it back. 

Only history and long term research will give the answer but I predict that once we have adapted to the “new normal” our expectation levels will be much lower and therefore more easily met.  Unrealistic expectation is the enemy of mental wellbeing in just the same way that Barbie doll figures and high fashion are the enemy of stable weight and sensible eating. 

The Irish are arguably one of the most put upon and downtrodden nations in history.  Their reaction to the Eurozone crisis has been to think “well, life’s always been a bit crap and we never had much before so it’s back to business as normal” They seem not too unhappy with the return of their particular status quo. Other parts of Europe on the other hand, well...  

Some sort of stability will return in the next couple of years even though there may be some big bumps along the way but once it has, we may find ourselves with a bit less but a lot happier  (note to kids – for the time being, get into waste management or something). 

Case study –  Parkinson’s Disease

One of my past cases involved Mr B who worked as a Hotel Porter and Cleaner.  He suffered from several health conditions; Parkinson’s Disease, Type 2 Diabetes and a heart condition,  He had undergone a heart bypass in 2005. All his conditions were managed with medication by his GP. At the time of the referral all the conditions appeared to be reasonably stable but his Parkinson’s affected his left arm and leg resulting in a slight tremor and weakness.  His ability to walk quickly was limited and he was also starting to have problems lifting significant weight.

On discussion Mr B stated that he was struggling with the role of Linen Porter on the two days that he did this due to the physical aspects of the role. He found the cleaning role easier to cope with on the other 3 days.

Our advice was that he would automatically be viewed as falling within the disability provisions of the Equality Act due to his Diabetes.  Also, his other conditions are likely to be regarded as having a long-term adverse effect on his ability to carry out normal day to day activities, were it not for his considerable amount of treatment.

Mr B was assessed on-site and the different aspects of his role were explored.   He was assessed as fit for the cleaning role of his job but advised against carrying out the role of Linen Porter as this was too physical for his current ability and there was a signficant risk of him having an accident if he carried on with these tasks. He was advised against lifting weights greater than 8 kilos. These adjustments were advised on a permanent basis, as his condition was not expected to improve.

Although this was a fundamental change to his role, his employer was able to rearrange the duties within the team and accommodate Mr B for the foreseeable future.  They kept him under review.  The case demonstrated that significant adjustments are achievable even though an employee’s health is deteriorating and starting to have an effect on daily living.  There will come a time when he is no longer able to fulfil other duties and his employment will become unsustainable. A tough business decision following further advice will then need to be taken but in the knowledge that the decision will be a fair one as the employer will have done all it reasonably can to maintain employment for as long as possible. 

Work place Flu Jabs - are they worth it?


I would be interested in views about whether flu jabs at work really are worth it.  Ten years ago as the National Occupational Health Manager for the Environment Agency, I was asked by the then Operations Director to cost this out.  It was as much a risk management exercise as cost saving exercise.  His view was that if the recent severe floods had happened at the same time as the previous year's flu outbreak, the organisation and much of the country would have been in the you know what. I looked at all the options including cost, time taken off to have the jabs, that those in high risk groups get it anyway from their GP, the percentage of those that might take time off due to a reaction, etc., and found that on a yearly basis the cost saving would be negligible.  On a risk management basis, bearing in mind that serious flooding only lasts for about 2 weeks (although does have a long tail) and the peak of a flu outbreak not much longer, the provision of an annual flu vaccination programme may have saved the organisation about once every 25 years. 


My view from talking to companies in the last 12 months is that Swine flu may have changed the game. Many have said they were caught out last year.  Where as seasonal flu, in their experience, tended to have a limited impact on the working age population - their employees - the impact of Swine flu on this group has been much greater.  The jury is still out.  Research has been done on the cost effectiveness of work place flu vaccination over the years but is of dubious quality and often carried out on behalf of those with a vested interest in selling it. If you have a view, I would like to hear it.  Were you caught out last year? Is this something you have been doing for years and believe you have reaped the benefits?  Please reply to the blog or email me on lindsey.hall@splitdimension.co.uk.  Thanks. 

Case studies for all

In order to turn this blog from a series of varied thoughts and ramblings into something that is more useful to readers, I am writing a series of case studies.  All are loosely based on real cases but confidentiality of the individual and employer is assured.   If there is an occupational health issue that you are wrestling with and you want some advice please DM via twitter or email me and I will blog a response. 

My first case study is about Mr H who is a painter and decorator for a large housing association.  Following receipt of the referral documentation, he was contacted by telephone.  He had undergone a left partial hip replacement in mid July 2011.  He assured me that he was recovering well and currently walking with one stick.  He had a fit note signing him off for 6 weeks and following this was expecting to have another for the same period after which he should be able to manage a phased return to work. 

Mr H had a similar operation to his right hip 8 years ago so knew what to expect in his recovery. He said he was recovering at a similar pace to last time.   He had no other major health problems.

Due to his requirement for this type of surgery on two occasions, his employer was  advised that he was highly likely to be regarded as disabled by an employment tribunal under the Equality Act 2010.

I then advised the following based on the information he provided.

1)    He was not fit for work at the time of our discussion.

2)    A 3-month recovery period for this type of operation is quite normal.

3)    I spoke to him again 2 weeks before his intended return to work.  He was fully mobile and walking without a stick.  He was driving but still feeling quite tired at times.

4)    A phased return was recommended starting on 4 hours per day during his first week back, 6 hours per day during the following week after which he should return to full hours.

He returned to work as planned and is fit for the full hours and duties of his role.

Let me know if you have an idea for the next one. 

Three reasons to look after your employees

My whole philosophy for providing occupational health services is based on 3 reasons why organisations should look after their employees, regardless of local culture or legal framework. I first wrote about this about 10 years ago on a Jiscmail OH discussion group and have seen it crop up a number of times since – not least in some of the documentation now provided by the Health and Safety Executive.  If you keep the following in mind when considering staff health, welfare, absence, productivity and culture, etc., you won’t go wrong.

1)    The moral reason. Since the days of 17^th Century Italian, Bernadino Ramazzini - one of the fathers of occupational health - work can sometimes make you ill or even prematurely end your life.  Employers and the 'State' have a moral and ethical duty to prevent this. This is well documented by various organisations around the world, particularly the International Labour Organisation.  Their website contains plenty of information on what countries should do about employee health and welfare, but that’s for the likes of me to read as you probably have better things to do.  All you need to know is that your employees go home a bit tired but with health and faculties intact.

2)    The legal reason.   Unfortunately, obeying Occupational health and Safety related legislation often comes with a reluctance; an "if we have to" sort of culture which is not always endearing. However, it is the law and not following it has risks and penalties for you, your employees and your business.  There’s plenty you need to do - probably too much. Occupational health Advisers are not legally required in the UK but the law requires much of organisations that is ours to do, almost by right. There is a place for us and we can help. 

3)    The business reason. If the law is a pain, think about the money.  Whether we like it or not, money makes the world go round more than ethics or law.  Organisations are in business to either make a profit or provide a service - or both.  Whatever they do, they rely on people to make them work efficiently who must be productive and be present.  Health interferes with both. Healthy, fit, well motivated employees who attend will be far better for business than unhealthy, unfit and poorly motivated employees who take time off.

Even if your moral code and legal radar are is wilting a little, investing wisely in the health of employees is surely of financial benefit. 

When is an absent or unwell employee fit to attend a meeting?

This is an occasional dilemma for both Human Resources and Occupational Health. Employers are often nervous of talking to an employee when they are off work. There is still the view, although it is becoming less common, that if they are unwell, they should be left at home to recover and not be troubled. More often than not though, the employee is wondering why no-one has bothered to call and feeling a bit isolated. 

The situation becomes more difficult if the employer is unsure about the reason for the employee absence or if there has been a grievance, stress or breakdown in communication. I’m sure you have all had experience of cases where an employee is off work with stress and blames this on the employer.  There may also be a disciplinary issue and the employer wants to talk to them informally about this or call a more formal hearing.  But, because the employee is signed off, there is concern as to whether they are fit enough to attend.  Well, if you can say “yes” to the following then yes they are and calling a meeting is a reasonable course of action. the criteria are:

1)    The employee understands the situation and possible employment implications

2)    They are able to follow proceedings

3)    They are able to defend themselves or instruct another person to do so

4)    They can understand the final verdict or outcome. 

Illness or absence needs to be taken seriously and managed professionally but should not be a barrier to running your business.