Strengthened medical supervision in case of exposure to specific occupational hazards

When the employee is exposed to certain occupational risks, physical, chemical or biological, the medical supervision has to be strengthened. Until 2012, at least every 12 months, each employee undergo a medical examination with the occupational physician when he was exposed to one of this occupational hazards. Now, the medical examinations may be less common. Indeed, the number of occupational  physicians has reduced,it is difficult to find time for all the medical examinations.

Which employees are subjected to Strengthened medical supervision ?
Medical examinations when medical supervision is strenghtened

When the employee works at night, medical examination takes place every 6 months

 

  Which employees are subjected to Strengthened medical supervision ?

The French labor code,  article R 4624-18  defines the strengthened medical supervision :

1° The Minors (under 18)
2° The pregnant women

3° The employees exposed to the following hazards :

a) asbestos;
b) ionizing radiations
c) lead,
d) hyperbaric conditions,
e) noise,
f) vibrations,
g) biological agents groups 3 and 4,
h)CMR, Carcinogenic, mutagenic, reprotoxic category 1 and catégory 2.

4° The disabled workers

Which employees exposed to ionising radiations are concerned by strengthened medical supervision ?

Only A category  employees have a strengthened medical supervision, while B category employees have a simple medical supervision. But for the A category employees, the medical examination is necessary annual.

The French labor code,article R4451-84  clarifies this point.

The employer classifies the workers in category A if they may receive, in the usual working conditions, an effective dose greater than 6 mSv a year ( between 6 and 20 mSv a year) or an equivalent dose greater ( according to theFrench labor code article R 4451-13 which defines the annual limits of exhibition)

Which employees exposed to lead  are concerned by strengthened medical supervision ?

According to the French labor Code, article R. 4412-160  , medical supervision must be strenghtened in the following cases :

  • if the employees are exposed to a lead concentration in the air superior in 0,05 mg / m3 (weighted average according to time on a base of eight hours),
  • or if   blood lead is superior 200 µg /l of blood for men or 100 µg /l of  blood for women.

 

Which employees exposed to noise are concerned by strengthened medical supervision ?

According to the French labor Code article R. 4434-7 , medical supervision must be strenghtened  if  the employees are exposed to a daily level of exposure to noise of 85dB (A) or a peak acoustic pressure level of 137dB (C)

 

Which employees exposed to vibrations are concerned by strengthened medical supervision  ?

According to the French labor Code  R. 4443-2, medical supervision must be strenghtened if  the daily exposure( for 8 hours) is 2,5 m/s2 for vibrations transmitted to the hands and arms or 0,5 m / s2 for whole-body vibrations.

 

Which employees exposed to biological agents are concerned by strengthened medical supervision ?

Only employees exposed to biological agents  group 3 (hepatitis viruses , rabies virus, herpes virus, infectious agents of the tuberculosis, the brucellosis, etc) and biological agents group 4 ( Ebola virus) have a strenghtened medical supervision.

Which employees exposed to Carcinogenic, mutagenic, reprotoxic category  are concerned by strengthened medical supervision ?

Workers who are exposed to CMR, Carcinogenic, mutagenic, reprotoxic category 1 and catégory 2 have a strenghtened medical supervision : european   list of CMR  substances.

  Medical examinations when medical supervision is strenghtened

According to the French labor code,article R. 4624-18 :

when there is a strenghtened medical supervision, the pre-recruitment medical examination does take place before the employee starts working for the enterprise.

The periodical medical checks take place every 12 months or every 24 months : the occupational physician can decide to change the frequency of the medical examinations  in line with recommendations for good practices which are available for health at work.

Strenghtened medical supervision is called “Surveillance médicale renforcée” in French

Recommendations for good practices which are available in health at work in France :

 

When the employee works at night, medical examination takes place every 6 months

According to the French labor Code, Article L. 3122-42, when an employee works  during the  night, every 6 months, he meets the occupational physician for a medical examination.


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