Understanding Medical Surveillance: A Guide to Ensuring Employee Safety

Explore the role of medical surveillance, what it is, who needs it, and how it helps maintain employee health at the workplace.

a medical professional checking up on a worker for medical surveillance purposes

What is Medical Surveillance?

Medical surveillance is a program aimed at detecting and monitoring health conditions in individuals exposed to specific hazards in the workplace. It involves various assessment methods, including regular physical examinations and diagnostic tests to identify health issues early, prevent occupational diseases, target the root cause of the problem, and uphold the well-being of workers.


As industrialization continued to advance, the potential for exposure to occupational hazards also increased substantially. The Occupational Safety and Health Administration (OSHA), steered towards fostering a safe working environment, prescribes companies to establish a medical surveillance program to uphold standards for biological agents, dust exposure, noise, and chemical substances, to name a few.

  • Ensures worker health, safety, and morale – Keenly observing the working environment and regularly monitoring employee health provide valuable data to assess and control risks. The company nurtures a physically and mentally healthier workforce by prioritizing preventive measures and early intervention.
  • Improves productivity – Healthy employees are more enthusiastic about going to work. They are also more focused, enabling them to contribute more to the company.
  • Guarantees compliance – By adhering to OSHA medical surveillance standards, organizations don’t have to worry about higher insurance premiums, regulatory fines, medical compensation, or legal fees. On top of cost savings, compliant companies enhance their reputation among stakeholders, partners, and the general public.

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Key Aspects of an Effective Medical Surveillance Program

Medical surveillance in occupational health involves more than just scheduling regular health checks on the employees. Comprehensive and compliant programs require these components:

Hazard Identification and Risk Assessment

One of the most crucial components is knowing the occupational hazards, especially their severity and likelihood. The company’s health and safety team can better develop preventive measures and mitigation strategies:

  • Automate data collection and analysis to ensure accuracy for better decision-making.
  • Surveillance protocols should detail the types of health assessments, the frequency of the health checks, and the indicators to monitor.
  • Obtain feedback from stakeholders to better address health risks.

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Pre-Assignment and Periodic Medical Examinations

Before starting work involving exposure to a potential hazard, employees must undergo a pre-assignment test. The baseline data is then compared to the results of the periodic medical assessments. These are some of the required medical surveillance examples:

  • Complete medical history
  • Physical examination
  • Baseline laboratory tests

Biological Monitoring

Specific indicators are monitored and measured to detect early signs of effects resulting from the exposure. For biological hazards, specimens (e.g., blood and urine) are tested and compared with exposure indices. Regular physical checks are done to examine organ function (e.g., lung function tests for dust exposure and audiometric testing for noise-induced hearing loss).

As soon as the results are read, follow-up actions such as medical interventions and workplace adjustments should be recommended immediately.

Medical Examination Upon Resumption of Work

According to the Federal Employees’ Compensation Act (FECA), most claimants still opt to return to work after getting treatment for a work-related illness or injury. The company is responsible for ensuring workers are medically fit to resume their duties. Here are some must-dos:

  • Assess the worker’s recovery progress.
  • Evaluate ongoing health concerns, particularly those specific to the illness or injury.
  • Make adjustments to job duties or engineering controls on-site.

Medical Examination Upon Termination of Work

The organization should also be aware of the long-term impact of occupational exposure and the overall health status of the worker at the end of employment. The test is also a must-do in cases of resignation due to workplace injury or illness. It includes the following:

  • Comprehensive health evaluation
  • Exit interviews to discuss health issues
  • Documentation for future reference in case of delayed onset of occupational health problems

Recordkeeping and Confidentiality

Maintaining comprehensive and accurate records of health assessments and exposures is vital in medical surveillance. The company should also ensure that the employee information is kept private. Keep up with the best practices through the following:

Employee Education and Training

Informing and educating employees about health risks at the workplace and corresponding preventive measures is vital in any health and safety program. Health literacy in medical surveillance should include the following:

  • Extensive hazard information, including their effects and ways to control them
  • Medical surveillance protocols
  • Ongoing monitoring, data collection, and comprehensive analysis of health-related data
  • Use of electronic health records and other digital tools
  • The importance of cultural competence and sensitivity

FAQs About Medical Surveillance

According to OSHA, medical surveillance is required in industries where workers are exposed to hazardous substances, including the following:

  • Carcinogens, such as asbestos, benzene, and ionizing radiation
  • Blood pathogens, such as hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV)
  • Dust, such as mineral dusts, molds, and spores
  • Noise that exceeds 85 dBA for eight hours

Workers who use respirators and lasers should also undergo medical surveillance because long-term use is also harmful.

Aside from the pre-assignment, work resumption, and termination tests, periodic tests for medical surveillance greatly depend on the hazard identified and monitored at the workplace. To know more, check out OSHA’s medical screening and surveillance requirements.

Just like the frequency of testing, the standard requirements also depend on the hazard being monitored on-site. For example, Butadiene exams should include annual CBC and platelet count, liver, spleen, lymph nodes, and skin testing, and a written medical opinion to both employer and employee. On the other hand, Ethylene Oxide requires pulmonary, neurologic, and fertility testing with a written medical opinion from the employer.

OSHA’s medical screening and surveillance requirements guide is the best resource for this topic.

Yes. Medical surveillance is a systemic process of data collection over time, focusing on the entire workforce to detect and eliminate the underlying causes of health issues. Health screening focuses on individuals, mainly for early diagnosis and treatment. These two are interconnected since periodic health screening is one of the most important types of medical surveillance.

Eunice Arcilla Caburao
Article by

Eunice Arcilla Caburao

SafetyCulture Content Contributor
Eunice Caburao is a content contributor for SafetyCulture. A registered nurse, theater stage manager, Ultimate Frisbee athlete, and mother, she has written a wide range of topics for over a decade. Eunice draws upon her rich, multidisciplinary background to create informative articles about emerging topics on health, safety, and workplace efficiency.