Medical and health surveillance

13. Medical and health surveillance
13.1. General principles
13.1.1. Medical surveillance includes, where appropriate, pre-assignment and
periodical medical examinations. It also includes, where appropriate, medical
examinations upon resumption of work after a prolonged absence for health reasons,
and upon and after termination of work involving exposure to chemicals.
13.1.2. Medical surveillance, conducted by an approved medical practitioner,
should be used as part of overall health surveillance, in accordance with the objectives
and principles of the Occupational Health Services Recommendation, 1985 (No. 171).
Health surveillance should also include, where appropriate, simple techniques for the
early detection of effects on health. These could include examination and questioning
about health complaints.
13.1.3. Where necessary, the employer, or the institution competent under
national law and practice, should arrange, through a method which accords with
national law and practice, medical surveillance of workers:
(a) for the assessment of the health of workers in relation to risks caused by exposure
to chemicals;
(b) for the early diagnosis of work-related diseases and injuries caused by exposure to
hazardous chemicals;
(c) for the assessment of the workers’ ability to wear or use required respiratory or
other personal protective equipment.
13.1.4. In the case of exposure of workers to specific hazards, medical and health
surveillance should include, where appropriate, any examination and investigations
which may be necessary to detect exposure levels and early biological effects and
13.1.5. When a valid and generally accepted method of biological monitoring of
workers’ health exists for the early detection of the effects on health of exposure to
specific occupational risks, it may be used to identify workers who need a detailed
medical examination, subject to the individual worker’s consent.
13.1.6. Medical surveillance is necessary where:
(a) it is required by national law whenever workers are liable to be exposed to
chemicals hazardous to health; or
(b) the employer is advised by an occupational health service that it is necessary as
part of the protection of workers exposed to chemicals hazardous to health, given
special attention to pregnant and breastfeeding women and other susceptible
workers; or

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