Occupational medicine, for whom?
Health surveillance of workers is governed by Book I, Title 4 of the Code on Well-being at Work. It is carried out by the prevention adviser-occupational physician and does not apply to all staff: only workers exposed to certain risks or holding a risk function are subject to it. The Code covers, among others:
- the safety function (driving machinery, using work equipment that could endanger others);
- the vigilance function (permanent monitoring of an installation);
- the defined-risk activity (exposure to physical, chemical or biological agents, manual handling, etc.).
Different medical examinations
Depending on the situation, surveillance takes the form of a prior health assessment (before assignment), periodic assessments, or a return-to-work examination after an absence. The occupational physician issues a fitness decision. A worker who refuses to undergo the mandatory examinations or vaccinations may be removed from the post concerned. Conversely, the employer may not impose health examinations other than those provided for by the regulations, in order to protect privacy.
Vaccination at work
Where the risk assessment shows that workers may be exposed to biological agents for which an effective vaccine exists, vaccination is offered to the workers concerned. For certain undertakings and categories of workers, some vaccinations are mandatory: they are listed in Annex VII.1-6 of the Code. The employer keeps an up-to-date nominative list of the workers subject to these vaccinations or tests (for example the tuberculin test).
Confidentiality and outcomes of the examination
The occupational physician gives the employer a decision on the worker's fitness for the post concerned, without disclosing the medical data covered by professional secrecy. Following the examination, they may recommend an adaptation of the workstation or additional preventive measures. Health data are protected: the employer may not require examinations other than those provided for, nor use surveillance for selection purposes. This surveillance is linked with the risk assessment, any vaccination and the organisation of first aid, forming a coherent prevention policy.
A preventive approach
Health surveillance and vaccination are part of a prevention logic: detecting a health risk early, adapting the post where necessary and protecting the work community. They are coordinated with the risk assessment and the organisation of first aid.
Informative article; the precise arrangements are a matter for your external prevention service and the legal texts.