Medical testing strategy

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What is meant by medical testing?

In occupational health, a legal definition of a medical test includes “any test, question, inquiry or other means designed to ascertain, or which has the effect of enabling the employer to ascertain, whether an employee has any medical condition”. (Employment Equity Act, 55 of 1998). In practice, it includes verbal enquiry, physical examination, or special investigations (such as laboratory tests, radiology, audiometry, spirometry, etc).

Why is medical testing done?

The 3 main reasons for medical testing are:

  • Medical Screening for early occupational disease
  • Medical Screening for certifying medical fitness to work
  • Wellness Screening

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OH Specialist
“Medical screening for early occupational disease”, which refers to medicals aimed at identifying early adverse effects of workplace hazard exposure, so as to trigger corrective measures to avoid progression to florid occupational disease, incapacity, or disability.

This is a legal requirement for employees exposed to hazardous chemical agents, including silica and other dusts (Regulations for Hazardous Chemical Agents, 2021), asbestos (Asbestos Abatement Regulations, 2020), lead (Lead Regulations, 2001), noise (Noise Exposure Regulations, 2024), physical agents such as heat, cold, vibration and radiation (Physical Agents Regulations, 2024), hazardous biological agents (Regulations for Hazardous Biological Agents, 2022), and ergonomic risks (Ergonomics Regulations, 2019).
OH Specialist
“Medical screening for certifying medical fitness to work”, which refers to medicals aimed at identifying medical impairments adversely impacting the safety or work performance of employees, so as to trigger corrective measures to avoid critical operator error.

This is a legal requirement for employees performing safety sensitive work, such as certain vocational drivers, construction workers, operators of lifting equipment, pilots of planes, trains, and seagoing vessels, etc. The Noise Exposure Regulations, 2024 and the Physical Agents Regulations, 2024 now also provide for certification of medical fitness, in addition to medical screening for early occupational disease.
OH Specialist
“Wellness screening”, which refers to medicals aimed at identifying employees’ personal health risks, so as to trigger corrective measures to avoid progression to chronic disease, incapacity or disability.

This is not a legal requirement, but contributes significantly to the employer’s overall sustainability strategy. It also builds resilience against wider public health threats, as the COVID-19 pandemic showed.

Medical screening versus medical surveillance

The new regulations under the Occupational Health and Safety Act draw an important distinction between medical screening and medical surveillance. These are the Noise Exposure Regulations, 2024, the Physical Agents Regulations, 2024 and the draft Regulations for Hazardous Chemical Agents, 2024. In essence, they require an employer to establish, implement and maintain a documented system of medical surveillance, overseen by an occupational medicine practitioner, wherever medical screening has been determined to be necessary (see, for example, regulation 8(10) of the Physical Agents Regulations).

The Act defines medical surveillance as:

“a planned programme or periodic examination (which may include clinical examinations, biological monitoring or medical tests) of employees by an occupational health practitioner or, in prescribed cases, by an occupational medicine practitioner”.

Put simply, medical surveillance is a planned programme of risk-based medical screening, together with the systematic analysis of the outcomes data, aimed at preventing occupational disease. Screening individual employees is not enough on its own: the results must be recorded, analysed and acted on.

This is what Synergee is built for. As an occupational health management system, Synergee gives employers the documented system of medical surveillance the regulations now require:

  • written procedures
  • risk-based screening protocols linked to each job’s exposures (through OREPs)
  • practical clinical and administrative tools
  • data tools that turn screening results into outcome reports
Find out more about Synergee →

Where does medical testing fit into the overall strategy?

The following graphic illustrates flow of a typical occupational health process, from risk assessment to medical outcomes – and then the interactions between medical outcomes and the integrated wellness services.

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OH Specialist

How I can help with your medical testing strategy

  1. You tell me what type of medical testing you need (screening for early occupational disease, fitness certification, or wellness screening).
  2. If you are not sure, describe the situation and we can discuss the type of medical testing I think you should consider.
  3. I can review your medical testing strategy and identify gaps: errors of commission (unnecessary tests) or omission (missing or incorrect tests). I can also check that the people doing the testing are appropriately registered.
  4. I can help you set up the documented system of medical surveillance the new regulations require, using Synergee.
  5. I, or a colleague in my network, can conduct all or part of your medical testing, and provide you with the outputs (eg certificates of fitness) plus a report.

Contact me

Location

Cape Town, South Africa

Phone

+27 82 553 0316

Email

greg.kew@ohspecialist.com

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