What are the main mandatory medical examinations?

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Employee medical monitoring has evolved significantly in recent years. We invite you to review the main medical examinations under the general and agricultural schemes.

Individual health monitoring

Two individual monitoring schemes are identified:

• enhanced individual monitoring for workers assigned to a position presenting particular risks to their health or safety, or to that of their colleagues or third parties working in the immediate work environment
• standard individual monitoring for other categories of workers.

1) Enhanced Individual Monitoring (EIM)

Positions requiring EIM are:

• firstly, positions exposing workers to:
  • asbestos;
  • lead concentration in the air exceeding 0.05 mg/m³ averaged over 8 hours or blood lead levels exceeding 200 µg/l of blood for men or 100 µg/l of blood for women;
  • carcinogenic, mutagenic, or reprotoxic agents of category 1A or 1B or carcinogenic processes listed in the decree of October 26, 2020;
  • pathogenic biological agents of groups 3 and 4;
  • ionizing radiation;
  • hyperbaric risk;
  • the risk of falling from a height during scaffolding assembly and disassembly operations;
• secondly, positions for which assignment is conditional on a specific professional aptitude examination. Example: workers with electrical authorization, workers holding an operating authorization.

If deemed necessary, the employer may supplement the list of positions presenting particular risks and requiring EIM. They must justify it in writing and seek the opinion of the occupational physician and the CSE.

Enhanced individual monitoring includes:

• a pre-employment medical examination;
• periodic medical examinations by the occupational health physician at intervals they define, not exceeding 4 years;
• medical visits conducted by a healthcare professional (associate physician, occupational medicine resident, or nurse) no later than 2 years after the examinations performed by the occupational health physician.

2) Standard individual monitoring

Standard individual monitoring is based on information and prevention visits (VIPs) that can be carried out by any healthcare professional from the occupational health service, namely, in addition to the occupational health physician, an associate physician, an occupational medicine resident, or a nurse.

The first VIP must take place within a maximum of 3 months from the effective start date of employment. Subsequent VIPs occur at intervals set by the occupational health physician, not exceeding 5 years.

3) Adapted individual monitoring (AIM)

Adaptation measures are provided for certain categories of workers.

These adaptations particularly concern night workers, pregnant women, young workers, workers with disabilities, ...

Other medical examinations

Mid-career examination

Workers are examined during the year they turn 45, or at a deadline defined by the sector. The objective is to assess the suitability between the job position and the employee's health status.

These medical examinations can be anticipated and organized jointly with another medical examination when the worker must be examined by the occupational health physician two years before the scheduled deadline.

Post-exposure examination

This visit concerns:

• workers benefiting from or having benefited from enhanced individual health monitoring (SIR);
• workers who were exposed to one or more of the following risks prior to the implementation of the enhanced individual monitoring system (i.e., before January 1, 2017, for the general scheme and before September 1, 2017, for the agricultural scheme):
  • asbestos;
  • lead concentration in the air exceeding 0.05 mg/m³ averaged over 8 hours, or a blood lead level exceeding 200 µg/l of blood for men or 100 µg/l of blood for women;
  • to carcinogenic, mutagenic, or reprotoxic agents of category 1A or 1B, or to carcinogenic processes listed in the order of October 26, 2020;
  • pathogenic biological agents of groups 3 and 4;
  • ionizing radiation;
  • hyperbaric risk;
  • the risk of falling from a height during scaffolding assembly and disassembly operations.

The employer must inform their occupational health and safety service as soon as they become aware of:

• the cessation of exposure of an employee to particular health or safety risks requiring enhanced individual monitoring (e.g., change of position or departure from the company of a person under SIR, modification of a position no longer exposing to a risk covered by SIR),
• the departure or retirement of an employee.

They must inform the worker concerned.

Note: If a worker believes they meet the conditions to benefit from this medical examination and has not been notified by the employer of this information being transmitted, they may, during the month preceding the cessation of exposure or their departure and up to six months after the cessation of exposure, request to benefit from this examination directly from their occupational health service.

The occupational health service verifies if the worker meets the conditions and organizes the examination when it deems them to be met.

Return-to-work medical examination

A return-to-work medical examination must be scheduled within 8 days of the employee's return to their position, in the following cases:

• after maternity leave;
• after an absence due to occupational disease ;
• after an absence of at least 30 days due to a work accident;
• after an absence of at least 60 days due to illness or a non-work-related accident.

Pre-return-to-work medical examination

To promote continued employment, employees on sick leave for more than 30 days may benefit from a pre-return-to-work medical examination.

Note: this examination is not initiated by the employer but by the employee, the treating physician, the health insurance medical services, or the occupational physician.

Medical examinations at the request of the employer and employee

In addition to these examinations, the employee or their employer may request a medical examination. Specifically, an employee may request a medical examination if they anticipate a risk of unsuitability for work, with the aim of initiating a process to maintain employment and receive personalized support.

Medical examinations at the request of the occupational physician

The occupational physician may perform or prescribe the necessary additional examinations:

• to determine the compatibility between the job position and the employee's health, particularly for screening conditions that could lead to a contraindication for that job position;
• for the detection of an occupational or work-related disease likely to result from the worker's professional activity;
• for the detection of diseases dangerous to the worker's professional environment.