What are the main statutory medical check-ups?

Medical monitoring of employees has changed considerably in recent years. Here's an overview of the main medical check-ups under the general and agricultural schemes.

Individual health monitoring

There are two types of individual monitoring:

• reinforced individual monitoring for workers assigned to jobs presenting particular health or safety risks for themselves, their colleagues or third parties in the immediate working environment
• non-reinforced individual monitoring for other categories of workers.

1) Reinforced individual follow-up (SIR)

Positions requiring a CRS are :

• on the one hand, workstations exposing workers :
  • asbestos ;
  • an airborne lead concentration greater than 0.05 mg/m³ averaged over 8 hours or a blood lead level greater than 200 µg/l for men or 100 µg/l for women;
  • category 1A or 1B carcinogens, mutagens or agents toxic to reproduction, or to carcinogenic processes listed in the decree of October 26, 2020;
  • group 3 and 4 biological pathogens;
  • to ionizing radiation ;
  • hyperbaric risk ;
  • the risk of falling from a height during scaffolding assembly and dismantling operations;
• on the other hand, positions whose assignment is subject to a specific professional aptitude test. Example: workers with electrical clearance, workers with driving authorization.

If deemed necessary, the employer can add to the list of jobs presenting particular risks and requiring a CRS. This must be justified in writing, and the opinion of the occupational physician and the Works Council must be sought.

Enhanced individual support includes :

• a medical examination for fitness to work ;
• periodic medical examinations by the occupational physician at intervals defined by the latter, which may not exceed 4 years;
• medical check-ups carried out by a healthcare professional (medical assistant, occupational medicine intern or nurse) no later than 2 years after the examinations carried out by the occupational physician.

2) Non-reinforced individual follow-up

Non-reinforced individual monitoring is based on information and prevention visits (VIPs), which can be carried out by any health professional in the occupational health department, i.e. in addition to the occupational physician, an associate physician, an occupational medicine intern or a nurse.

The first VIP must take place within a maximum of 3 months of taking up the position. Subsequent VIPs take place at intervals set by the occupational physician, not exceeding 5 years.

3) Adapted individual follow-up (SIA)

Adaptation measures are provided for certain categories of workers.

In particular, these adaptations concern night workers, pregnant women, young workers, disabled workers, etc.

Other medical appointments

Mid-career tour

Workers are examined in the year in which they turn 45, or at a later date defined by the industry. The aim is to assess the suitability of the job for the employee's state of health.

These medical examinations can be brought forward and organized in conjunction with another medical examination when the worker is due to be examined by the occupational physician two years before the due date.

Post-exposure visit

This tour includes :

• workers who benefit or have 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 ;
  • an airborne lead concentration greater than 0.05 mg/m³ averaged over 8 hours or a blood lead level greater than 200 µg/l for men or 100 µg/l for women;
  • Category 1A or 1B carcinogens, mutagens or agents toxic to reproduction, or carcinogenic processes listed in the Order of October 26, 2020;
  • group 3 and 4 biological pathogens;
  • to ionizing radiation ;
  • hyperbaric risk ;
  • the risk of falling from heights during scaffolding assembly and dismantling operations.

Employers must inform their occupational health and safety department as soon as they become aware of the situation:

• the cessation of exposure of one of the company's workers to particular health or safety risks justifying reinforced individual monitoring (e.g.: change of position or departure from the company of a person on CRS, change of position no longer exposing the worker to a risk covered by the CRS),
• the departure or retirement of one of the company's employees.

He informs the worker concerned.

Note: If a worker considers that he qualifies for this medical check-up and has not been notified of this information by his employer, he may, during the month preceding the cessation of exposure or his departure, and up to six months after the cessation of exposure, request this check-up directly from his occupational health service.

The occupational health service checks whether the worker meets the conditions, and organizes the visit when it considers that they have been met.

Trade-in visit

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

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

Pre-resumption visit

In order to encourage employees to remain in work, those off work for more than 30 days are entitled to a pre-reinstatement visit.

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

Medical check-ups at the request of employer and employee

In addition to these visits, either the worker or his employer may request a medical examination. In particular, workers may request a medical examination when they anticipate a risk of unfitness, with the aim of initiating a job retention program and benefiting from personalized support.

Medical check-ups at the occupational physician's request

The occupational physician may carry out or prescribe any additional examinations required:

• determining the compatibility between the workstation and the worker's state of health, and in particular screening for conditions that may contraindicate the use of the workstation;
• the detection of an occupational disease or disease of an occupational nature likely to result from the worker's professional activity;
• screening for diseases that are dangerous for the worker's professional environment.