Do you know your duties, as an employer, to people with epilepsy in the workplace? As Dr Lisa Bushby explains, “reasonable adjustments” are often very straightforward depending on the job and an understanding of what might trigger seizures.
Epilepsy is a condition that affects the brain and causes repeated seizures. In the UK, there are more than 600,000 people with epilepsy, with around 7 in every 10 of those being able to control their seizures with medication.
People with epilepsy are defined as disabled people for the purposes of the Equality Act 2010. The legal definition of a disabled person is someone “with a physical or mental impairment that has a substantial adverse impact” on their ability to carry out “normal” day-to-day activities. It must have lasted, or will last, at least 12 months.
Individual health and safety risk assessments
If someone has epilepsy, the employer must carry out an individual health and safety risk assessment to ensure that person can carry out their duties safely.
Some questions that should be discussed between the individual and the employer to assess the risk include the following.
What happens to you when you have a seizure?
Are your seizures controlled?
How often do you have seizures?
Do they happen at a particular time of day?
Do you have them when you are awake, asleep, or both?
Is there anything that makes your seizures more likely, such as lack of sleep, tiredness, stress, hormonal changes, flashing or flickering lights or patterns?
Do you get a warning before a seizure?
How long do your seizures last?
How do you feel afterwards?
How long does it take you to recover?
Do you need any first aid or specific care during or following a seizure?
Once the answers to these questions are known, the employer will be able to judge whether any “reasonable adjustments” are required.
Duty to make reasonable adjustments
It is illegal to treat a disabled employee less favourably than other employees or to disadvantage a person with a disability compared to those people who do not have that disability. Further, there is a requirement on employers to make reasonable adjustments where a disabled worker would be at a substantial disadvantage compared to non-disabled colleagues without the reasonable adjustment. It covers “provisions, criteria and practices”, “physical features” and “provision of auxiliary aids”. Once it has been established that the adjustment is reasonable, failure to comply is a breach of the law and cannot be justified.
What defines “reasonable” is:
whether the adjustment is effective in removing the obstacle
whether the adjustment is practical
the cost of the adjustment in relation to the resources of the organisation
the availability of financial support (such as Access to Work).
Some people with epilepsy will not need any adjustments in the workplace at all. This could be people who are completely seizure free, or people who will not come to any harm should they have a seizure at work.
Some people know that particular situations can “trigger” their seizures. Triggers can include being tired, stressed or anxious. Understanding triggers can be an effective route to identifying practical reasonable adjustments.
If someone’s seizures are triggered by tiredness, shift work could make them more tired and more likely to trigger seizures. This is because shift work can disturb the normal pattern of sleep. A reasonable adjustment may be to consider changing or reducing shift work, or changing working hours for this person.
The Health and Safety Executive offers the case study of a machine operator on shift work who developed epilepsy. Her employer was concerned that this might increase her risk of personal injury or put others at risk. The company involved the employee and, with her consent, her GP. They found the operative was more likely to have seizures if her sleep pattern was disrupted, so a move to day shifts gave her a regular work pattern and she was better able to manage her condition.
Up to 5% of people with epilepsy have photosensitive epilepsy where seizures are triggered by flashing or flickering lights, or by moving patterns. For most people with epilepsy, working with computers is not a problem as modern flatscreen computer screens do not flicker and so the screen itself is unlikely to trigger seizures. However, flashing images on the screen itself could be a photosensitive trigger for some people.
If an employee does have photosensitive epilepsy, it may be helpful to discuss this with them directly.
Time off work because of a disability, for example, to attend a medical appointment or to recover from a seizure, could be considered a reasonable adjustment. It might be recorded separately from time off for other reasons, such as sick leave for a cold.
If someone’s epilepsy is controlled they are unlikely to need more time off work than other employees. If they still have seizures, the need for time off work might depend on the type of seizures they have and the time they need to recover.
Reasonable adjustments for individual workers with epilepsy might include:
fixed hours rather than variable shifts
a change of work location, for example to be nearer home, or nearer support facilities
extra breaks to avoid becoming overtired
providing a mentor
providing extra time for training, if needed
having a clear routine and work schedule
having a personal workstation that is made as safe as possible for someone who is still having seizures
allowing additional time off for treatment/appointments, as part of a policy of disability leave
exchanging some work with colleagues, with their agreement.
There are some instances where adjustments fail to make a job safe for those with uncontrolled seizures, as work:
at unprotected heights (eg as a scaffolder)
near open water
with high voltage or open circuit electricity
on or near moving vehicles
with unguarded fires, ovens and hot plates.
First aid in the case of a seizure
First aid actions for a person experiencing an epileptic fit includes:
protecting the person from injury
cushioning their head
looking for an epilepsy identity card or identity jewellery
aiding breathing by gently placing them in the recovery position once the seizure has finished
staying with the person until recovery is complete.
Do not try to restrain the person or put anything in their mouth. Don’t try to move them unless they are in danger, give them anything to eat or drink until they are fully recovered or attempt to bring them round.
An ambulance should be called if it is the person's first seizure, the seizure continues for more than five minutes, one seizure follows another without the person regaining consciousness between seizures, the person is injured during the seizure, or it seems the person needs urgent medical attention.