Which tests are performed at pre-employment and periodic examinations is one of the most common questions. The legislation gives no single list for every occupation. The occupational physician sets the tests based on the nature of the work and the exposures in the risk assessment. This article summarises the key tests by exposure and the regulations behind them.
The general rule
Under Article 15 of Occupational Health and Safety Law No. 6331, employees are examined at hiring, on a change of job, on return to work when requested and at regular intervals. Work in the hazardous and very hazardous classes cannot begin without a report showing fitness for the job.
Periodic examination intervals are set in the regulation on occupational physicians and other health personnel. Examinations are repeated at least every five years in the low hazard class, every three years in the hazardous class and every year in the very hazardous class. For child, young and pregnant employees the interval is at most six months. The occupational physician may shorten these intervals.
Key tests by exposure
Dust
Under the Regulation on Dust Control, health surveillance for employees in dusty environments is recorded on the EK-2 form and its frequency is set by the occupational physician. Chest X-rays follow ILO standards. Chest X-ray and pulmonary function tests are key for silica, coal and mineral dust. In asbestos work, chest X-rays are repeated at intervals not exceeding two years.
Noise
Under the regulation on protecting employees from noise risks, hearing checks are carried out once the upper exposure action value of 85 dB(A) is exceeded. Above the lower exposure action value of 80 dB(A), audiometry can be performed based on the risk assessment.
Lead and heavy metals
The Regulation on Health and Safety Measures in Work with Chemical Substances sets the binding biological limit value for lead at 70 micrograms per 100 ml of blood. Medical surveillance is carried out when lead in air exceeds 0.075 mg/m³ or when an employee's blood lead exceeds 40 micrograms per 100 ml. Turkish legislation sets no binding biological limit values for other heavy metals.
Solvents and other chemicals
The same regulation ties biological monitoring to the risk assessment. For employees working with paint, thinner and adhesives, the occupational physician decides which urinary marker to monitor. In work with carcinogenic or mutagenic substances, biological monitoring is carried out where possible.
Biological agents
The Regulation on the Prevention of Risks from Exposure to Biological Agents lists work such as health services, laboratories, waste processing, sewage, agriculture, animal products and food factories. Health surveillance takes place before work starts and at regular intervals, and non-immune employees are offered vaccines for agents with an effective vaccine. Hepatitis serology and hepatitis B vaccination are common requests in the field.
Food and hygiene
A hygiene training certificate is mandatory in work such as food, hairdressing and accommodation. People with a contagious disease cannot work until a report documents their recovery. The scope and frequency of food handler screening are not fixed in the legislation and are set by the occupational physician.
Display screen work
Under the regulation on work with display screen equipment, the eyes of screen workers are examined before they start, at intervals set by the occupational physician and whenever visual problems arise.
Night work
Health surveillance of night shift employees is among the occupational physician's duties. For women employees working night shifts, a health report before starting and at regular intervals is regulated separately.
Work at height and drivers
There is no fixed test list for work at height in the legislation and the occupational physician sets the tests. In practice ECG, vision and blood tests are often requested. The health report for a driving licence is handled separately under the regulation on driver health requirements.
Short list
- Dust, chest X-ray and PFT, under the Regulation on Dust Control
- Noise, audiometry, under the noise regulation
- Lead, blood lead, under the chemicals regulation
- Solvents, urinary biological monitoring, under the chemicals regulation
- Biological agents, hepatitis serology and vaccination, under the biological agents regulation
- Display screens, eye examination, under the display screen regulation
- Under 18 and pregnant employees, a periodic examination at least every six months