(1) An employer must establish and maintain a system of medical surveillance of employees if—
(a) the employer is registered as an asbestos contractor;
(b) in the opinion of an occupational medicine practitioner, after consideration of the results of the asbestos risk assessment carried out in terms of regulation 5(5)(d), it is reasonably likely that an asbestos-related disease may occur under the particular conditions of an employee’s work; or
(c) an occupational medicine practitioner recommends that the relevant employee should be under medical surveillance.
(2) In order to comply with subregulation (1), an employer must appoint an occupational medicine practitioner to document the system of medical surveillance of employees, including—
(a) consideration of—
(i) the risk of developing occupational asbestos-related diseases; and
(ii) medical fitness to work requirements, including fitness to wearing a respirator;
(b) an initial health evaluation before commencement of asbestos work, which comprises—
(i) an evaluation of the employee’s medical, occupational, exposure and social history;
(ii) an appropriate physical examination;
(iii) a chest radiograph; and (iv) any other additional medical examination, such as pulmonary function testing, which, in the opinion of the occupational medicine practitioner, is necessary to enable 27 such practitioner to perform an appropriate health evaluation;
(c) periodic health evaluations conducted, considering medical tests contemplated in subregulation (2)(b), at intervals determined by subregulations (2)(a) and 4(b);
(d) the duties of an occupational health practitioner, conducted under the direction of the appointed occupational medicine practitioner; and (e) making the documented system of medical surveillance available to the health and safety representative or health and safety committee, who is entitled to further clarification, if they so request.
(3) The appointed occupational medicine practitioner must notify the employer in writing of the outcomes of the health evaluation by issuing the certificate of medical surveillance, subject to the following:
(a) The information provided to the employer is limited to the presence of an occupational disease and the fitness of the employee to perform the inherent requirements of the job, and may not include confidential medical information;
(b) the employee is informed of the outcome of the health evaluation; and
(c) an employee is assessed to be temporarily medically unfit to perform work if there is a reasonable expectation that the employee’s health will improve, and that such employee will be able to return to work.
(4) An employer may not permit an employee who was certified by an occupational medicine practitioner as medically unfit to work in a regulated asbestos area: Provided that the employee may return to perform that work after being certified fit by an occupational medical practitioner, and after—
(a) being informed of the results of the exposure assessments; and
(b) being prescribed medical tests in the frequency they should be repeated based on the risks. 28
(5) The certificate of medical surveillance, as contemplated in subregulation (3)—
(a) must be provided by the employer to the employee upon termination of employment; and
(b) may be used for subsequent asbestos work for the full duration of its validity period.
(6) The employer must record, investigate and report the occupational disease contemplated in subregulation (3) (a) in compliance with section 25 of the Act and regulation 8 of the General Administrative Regulations, 2003.
(7) An employer must ensure that the employee provides written informed consent for inclusion in the medical surveillance programme, which forms part of the medical surveillance record.