Changes to occupational health monitoring procedures in France

 

EMPLOYEES’ HEALTH MONITORING

 Since January 1st 2017, hiring medical examinations have been replaced by “informative and preventive visits”, except for employees with a job “at risk” who will benefit from an enhanced individual health monitoring. Furthermore, the involvement of the occupational physician is no longer systematically required. 

What changes from January 1st 2017

From now on, employees performing a job which does not present a specific health risk, should benefit from:

– An informative and preventive visit, which is conducted by a health professional (occupational physician, associate physician, occupational trainee or nurse) who will open a medical file for the employee. A monitoring certificate will then be issued and delivered to the employee and to the employer.

– Recurring health monitoring, which is conducted by the occupational physician and under his/her responsibility, by the associate physician, occupational trainee or nurse.

The aims of the informative and preventive visit

During the visit, the health professional should:

– question the employee about his/her health;

– inform the employee on potential risks to which he/she is subject to at work;

– educate the employee on ways of preventing health risks;

– identify whether or not the employee’s health will require a follow-up with the occupational physician; and

– inform on the modalities of health monitoring, and on the possibility he/she has to request at any time an additional visit with the occupational physician.

When is the visit not required

There is no requirement for an informative and preventive visit when the employee already attended such visit within five (5) years preceding the hiring, or within three (3) years for employees performing a job “at risk”, as long as the following conditions are fulfilled:

– The employee is expected to perform a job presenting similar health risks;

– The health professional owns the last monitoring certificate or the last certificate of medical aptitude; and

– The employee did not benefit from individual measures of work adjustment, accommodation or transformation or from working time adjustments based on age, physical or mental state of health; and no certficiate of medcial inaptitude was issued within the last five (5) years, or for employees performing a job “at risk” within the last three (3) years.

Frequency of health monitoring

In principle, the informative and preventive visit is conducted within three (3) months of the employee’s hiring date.

Then, the frequency of the employee’s health monitoring will depend on working conditions, on his/her health and age as well as on professional risks which the employee is subject to when performing the job. In principle, the monitoring should recur every five (5) years at maximum (instead of 2 years previously).

It has to be noted that employees working under a definite-term employment contract will benefit from a health monitoring with the same frequency which is applied to employees working under an indefinite-term employment contract.

Customized health monitoring

Following the informative and preventive visit, disabled workers, invalidity pensioners and night workers will benefit from a customized health monitoring which should recur at least every three (3) years. For disabled workers or invalidity pensioners, the visit will directly be conducted by the occupational physician who will recommend if necessary, any work adjustments or assignment to other positions.

At the time of the informative and preventive visit or at any time if they so wish, pregnant women, breastfeeding mothers or women who just gave birth, are directly seen by an occupational physician who will recommend if necessary, any work adjustments or assignment to other positions.

Employees with jobs “at risk”

Any employee performing a job which presents specific health and safety risks to himself/herself, to his/her work colleagues or to any third parties within the immediate work environment should benefit from an enhanced individual health monitoring.

Jobs considered “at risk” are notably those exposing the employees to asbestos, lead, carcinogens, mutagens and substances toxic to reproduction, biological agents, ionizing radiation, hyperbaric risks and to risks of falls during assembly and disassembly of scaffolding.

The enhanced individual health monitoring consists of a health ability assessment, which will be held by the occupational physician instead of the informative and preventive visit. This assessment should be conducted before hiring and renewed within four (4) years maximum. A certificate of medical  aptitude or inaptitude  will be issued in the employee’s medical file, and delivered to the employee and to the employer. In addition, an intermediate visit will be conducted by a health professional within two (2) years following the visit with the occupational physician.

Medical visit following an absence

This does not change, the requirement is still that the employee should attend a medical visit within eight (8) days following a maternity leave, an absence for occupational illness or an absence of at least thrirty (30) days caused by an accident whether or not it is occupational,  or a non occupational illness.

Request for additional visits

When anticipating a risk of medical inaptitude, the employee is entitled, at his request or at the request of the employer, to benefit from an additional visit, notably with the objective to maintain him/her in employement and to customize his/her occupational health monitoring. If need be, the occupational physician can also arrange a visit for any employee, and perform any additional examinations.

 

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