Primary prevention: acting before harm
Its purpose is to prevent injury or disease from developing. It includes eliminating a hazardous task, substituting a substance, reducing exposure or redesigning work organisation that creates overload. It is not limited to providing training.
Article 15 of Spain’s Occupational Risk Prevention Law (LPRL) requires risks to be avoided, tackled at source and work adapted to the person. This priority remains even where the company also provides health surveillance and healthcare.
Secondary prevention: detecting and acting early
It aims to identify health changes early and intervene to limit their progression. At work, this may include specific health surveillance where indicated by risks and applicable protocols. Detecting a health change should prompt review of exposure conditions and adoption of measures.
Not every environmental measurement is secondary prevention: measuring noise or contaminants may help eliminate or control exposure before harm. Classification depends on the intervention’s objective, not the instrument used.
Tertiary prevention: reducing consequences
It intervenes after harm has occurred to limit its consequences, support recovery and enable a return compatible with health. It may require rehabilitation, job adjustment, coordination of care and return-to-work follow-up.
Clinical activity belongs to competent healthcare professionals. Within the company, recommendations must become suitable working conditions, maintaining medical confidentiality and preventing the person’s return to exposure that caused or aggravated the problem.
The nuance in psychosocial intervention
In psychosocial risk management, the terms also distinguish organisational measures, support for exposed people and therapeutic care. The INSST prioritises prevention at source and explains that improving individuals’ ability to cope with stress is insufficient without addressing its sources.
For example, reorganising workloads and time has a different purpose from offering coping tools or psychological care. All three responses may be necessary, but a workshop does not correct inadequate staffing.
The relationship with the hierarchy of controls
Prevention levels organise objectives in relation to harm; the hierarchy of controls helps select measures addressing hazards and exposures. They are not three tiers equivalent to collective protection, PPE and medical care.
A useful programme identifies the problem, decides what can be eliminated or reduced and adds justified health interventions. Health surveillance provides information, but does not certify that a job is safe or replace its assessment.
Checking whether the programme is balanced
Record which factor each measure addresses, whom it protects, who implements it and how it will be reviewed. If every action involves detecting symptoms or treating cases, examine what changes are being made to the work itself.
Collective outcomes and implementation of adjustments must also be checked. An absence of sick leave does not by itself show that risk is controlled; it may coexist with exposure and unreported problems.
Hypothetical example: musculoskeletal discomfort
A warehouse identifies recurring discomfort during a picking task. It first redesigns working heights and provides handling aids to reduce load. Indicated health surveillance identifies needs for early intervention. For someone returning after injury, the task is temporarily adjusted and the return reviewed.
These actions complement one another. None justifies retaining a poorly designed operation on the assumption that examinations or rehabilitation will offset its effects.
