I cannot speak for other shops...only here.
It used to be when the coolant went from coolant to hmmm, that's not right. Skim the top add some fresh and hope for the best we knew it had to be changed. So out it came, cleaned the sump, machine recharged with a fresh batch and away we went for some time.
Then the formulation changed... and this became the every few months unless machine was used daily. This was about the time we got into CNC from the old conventional s.
The one then two CNC's were used daily, but coolant only lasted a couple months. Yes I was skimming and cleaning sump, staying on top of concentration. Just one day it didn't feel right, a bit of an off smell and it was time to change.
The search was on from that time...had to be a better coolant. It took a few years and a willingness to spend dumb money on what used to be cheap. Also a willingness to constantly clean out the machines to try a new. Some seemed ok at first, but stained material, others went rancid in weeks, some leached stuff from materials leaving clogged lines and filthy machines. Some didn't play nice with us operators...I was usually to first to break out. With each fail it was pull it from the machine, clean clean and recharge.
Finally found the one we are using and I only have one machine it turns sour in. I have cleaned that one from top to bottom and if its let to go even a tad low on concentration it goes rancid. Aside from that machine, keep it skimmed, pull crud from sump and concentration right it last for years.
So to answer your question...we change as needed. Luckily that is kinda rare these days, but if an odor is picked up we try to tackle it within a few days, when machine is between jobs and have several hours to clean and recharge.
It is cheaper to buy good stuff, stay on top of concentration, keep clean and skimmed then pull it out fill a big drum to have hauled off as hazardous waste, waste time cleaning and refilling. As to letting it go till ill health effects...no. I if I won;t put my hands in there or run the machine...nobody working under me will either. If it gets that bad...I am also the one pulling and cleaning as its the dirtiest nastiest job I won't let others do.