Regulation 9 requires employers and self-employed workers to report cases of occupational cancer, and any disease or acute illness caused by an occupational exposure to a biological agent.

Occupational cancers

Cases of cancer must be reported where there is an established causal link between the type of cancer diagnosed, and the hazards to which the person has been exposed through work. These hazards include all known human carcinogens and mutagens, including ionizing radiation.

For example, the following diagnosed occupational cancers must be reported:

• mesothelioma or lung cancer in a person who is occupationally exposed to asbestos fibres
• cancer of the nasal cavity or sinuses in a person who is occupationally exposed to wood dust

Reports are only required when the person's work significantly increases the risk of developing the cancer. In some cases, the medical practitioner may indicate the significance of any work-related factors when communicating their diagnosis.

Cases of cancer are not reportable when they are not linked with work-related exposures to carcinogens or mutagens. As with other diseases, cancers are only reportable if the person's current job involves exposure to the relevant hazard.

Biological agents

All diseases and any acute illness needing medical treatment must be reported when it is attributable to a work-related exposure to a biological agent. The term biological agent is defined in the Control of Substances Hazardous to Health Regulations 2002 (COSHH) and means a micro-organism, cell culture, or human endoparasite which may cause infection, allergy, toxicity or other hazard to human health. Work with hazardous biological agents is subject to specific provisions under COSHH.

Work-related exposures to biological agents may take place as a result of:

• An identifiable event, such as the accidental breakage of a laboratory flask, accidental injury with a contaminated syringe needle or an animal bite
• Unidentified events, where workers are exposed to the agent without their knowledge (eg where a worker is exposed to legionella bacteria while conducting routine maintenance on a hot water service system)

A report should be made whenever there is reasonable evidence suggesting that a work-related exposure was the likely cause of the disease. The doctor may indicate the significance of any work-related factors when communicating their diagnosis.

Minor infections common in the community such as colds, bronchitis or stomach upsets cannot generally be attributed to work-related exposures to biological agents, and so are generally not reportable. However, where there is reasonable evidence of a work-related cause, such as inadvertent contact with the infectious agent during laboratory work, you should make a report.

Acute illnesses requiring medical attention must be reported when they result from a work-related exposure to a biological agent, including its toxins or any infected material.