Medical examination - Kunnskapsbasen
If you are exposed to hazardous substances at work, you might be offered a medical examination.
Norsk versjon - Helseundersøkelse
Your work and workplace should be organized to make sure you are not exposed to dangerous or harmful substances. The medical examination should prevent sickness and damage to your health, and uncover unfortunate consequences of your workplace.
The line leader must ensure that risk assessments are conducted, and, based on the risk assessments, ensure that students and employees who are exposed to anything dangerous receive the correct medical examination. Occupational Health Services helps the line leader in watching over and checking the employees’ and students’ health in relation to their work situation. Occupational Health Services may also help decide which employees and students need to receive medical examinations.
When should you have a medical examination?
A medical examination is a preventive measure, and must take place before you start working with one of the listed conditions or circumstances.
You are entitled, and sometimes obliged, to a medical examination if you are a new employee, and you shall work with one or more of the following conditions or circumstances. Later on, follow-up examinations can be necessary, if risk assessments determine that you are in danger of exposure to one or more of the following conditions or circumstances. Also, a follow-up examination may be necessary if there has been a discrepancy. The line leader must ensure that the necessary health exmainations are available for employees and students.
Conditions and circumstances that entitle you to a medical examination:
- Dangerous chemicals and gases: Chemicals that might be a safety and health hazard – e.g. chemicals that are carcinogenic, harmful to genes, toxic or corrosive, nano materials, lead, lead compounds and hazardous dust (e.g. wood dust, dust from animals,metal powder, smoke, dust from stones or sand, dry mortar and concrete). A medical examination might be necessary for anyone who synthesises, packs or handles waste from dangerous chemicals, or cleans equipment or spills from dangerous equipment. For more information, see the page on chemicals and gases. Working with chemicals that are carcinogenic or mutagenic, lead, lead compounds and wood dust may also require registration in the exposure index.
- Biological factors: Living and dead microorganisms, cell cultures, endoparasites and prions that can cause infections, allergies or toxicity when in contact with human beings. Biological factors may be found in natural or genetically modified forms. A medical examination might for instance be necessary for employees and students who work with human materials, in animal testing facilities, with wastewater or who have spent time in a room where work with biological factors occurs. For more information, see working with biological agents, working with human material and working with experimental animals. Working with biological factors may also require registration in the exposure index.
- Asbestos fibre and asbestos dust: Employees and students who may be or have been exposed asbestos fibres/asbestos dust while working for NTNU must undergo a medical examination (in accordance with the Regulations concerning the performance of work §4-11.). NTNU must keep an index of all employees and students who has had a medical examination due to exposure or possible exposure to asbestos fibres/asbestos dust. For more information: exposure index.
- Noise that can cause hearing damage: Employees who are exposed to noise above limit values (LEX, 8h = 80 dB eller LpC, peak =130 dB) must undergo a medical examination (specifically, a hearing examination). For more information, see noise.
- Radiation (ionizing radiation, artificial optical radiation and electromagnetic fields): A medical examination should be performed if you are exposed to radiation exceeding dose limits (see working with radiation sources), or if a risk assessment shows that your work may risk health. The medical examination should be performed before the dangerous work starts. For more information about ionising sources, optical sources and electromagnetic fields, see working with radiation sources and optical radiation sources and eye examinations. Working with ionising radiation may also require registration in the exposure index.
- Diving: Ahealth certificate is mandatory, according to §26-11 and §26-42 in the Regulation concerning the performance of work (in Norwegian).
- Mining or stone work: Mining, including testing, cleaning and securing. Loading and transport of blasted rock at the work site is included. NTNU must keep an index of employees and students who are exposed to hazardous substances during rock work.
You should be offered a medical examination if you:
- Work during the night.
- Are exposed to mechanical vibrations.
- Are exposed to noise below the limit values (LEX, 8h = 80 dB eller LpC, peak =130 dB)
- Ensure that a risk assessment is conducted before new experiments or tests are conducted.
- Inform Occupational Health Services if there is a need for a medical examination of a student or employee.
Employees and students
- During a medical examination: Bring a completed form for the examination. If you work with biological materials, you should also fill out the identification of vaccination status form. If you work with experimental animals, also bring either the form for the first-time examination of persons working with experimental animals, or the form for check-ups on persons working with experimental animals (both forms are in Norwegian).
- Go to your scheduled medical assessment.
- If the employer orders a medical examination, and the employee or student does not show up to the examination, it will be documented in the journal of the person concerned, kept by the Occupational Health Service. The employer will be notified.
The medical examination
- Occupational Health Services should examine the employee/student or give the employee/student an appointment with the occupational physician or occupational health nurse. They should also inform the employee/student of possible protective measures.
- Students on elementary courses who attend courses that imply working under conditions and circumstances that entitle them to a medical examination (laboratory courses or other kinds of practical training) may receive general information about health hazards and protective measures in a lecture.
- Professional history, previous exposure and other work-related illnesses will be made note of.
- The nature of the medical examination will depend on the type of exposure, e.g. hearing texts, spirometry, blood tests, eye examinations or chest X-rays.
- If the medical examination shows that work-related damage may have occur, the employee/student is to be referred to a specialist for additional evaluation.
- The medical examination should be repeated periodically, depending upon the nature and frequency of exposure. The need for examinations will be assessed by the Occupational Physician.
- If you work with human material and are at risk of infection with hepatitis B, you should be offered a hepatitis B vaccine.
- If you work with live animals and/or dirt, you will be offered a tetanus vaccine.
- If you work with waste water and/or sewage, in the par, as a cleaner or caretaker, you will be offered a vaccine for diphtheria, tetanus, polio and possibly Hepatitis A or Hepatitis B.
Additionally, employees who work with experimental animals should receive:
- Spirometry (a breathing test) and an allergy (blood) test for the experimental animals the employee works with.
- Vaccination for tetanus. The vaccine should be repeated every 10 years.
- Employees/students should be called in for follow-up meetings with an occupational health doctor or nurse, for spirometry and allergy tests after 6 months, one year and two years. If the student or employee develops allergy symptoms, he or she should have additional follow-up. Allergy symptoms include itchy skin and rashes, difficulties breathing, coughing and wheezing, sneezing and runny nose, itchy and watery eyes and red eyes.
- Any employee or student who leaves his or her job before two years have passed should be called in to a last medical examination before they stop working.
- Occupational exposure measurements should be made in laboratory animal divisions.
You will be notified personally of any findings in the medical examinations. Documentation of the medical examination is stored in the Occupational Health Services’ system for patient records. The information is only available to you and Occupational Health Services.
In the event that a number of medical examinations from the same unit show similar findings or problems, Occupational Health Services will provide a generalized notification to the unit. This also applies for preventive and risk reducing measures.
- First aid
- Medical examination form
- Vaccination status form
- Form first time medical examination if you work in animal units
- Form follow-up medical examination if you work in animal units
- Working with biological agents
- Working with experimental animals
- Working with human material
- Working with radiation sources
- Exposure index
- Biological agents
- HSE in animal units
- HSE process
- Chemicals and gases
- Laboratory and workshop handbook
- Report problems and discrepancies
- Risk assessments
- Safety data sheets
- Hazardous dust
- Hazardous noise
- Hot work
- The Working Environment Act (in Norwegian)
- Regulation of work with ionizing radiation (in Norwegian) – the Norwegian Labour Inspection Authority
- Regulation of work at wastewater treatment plants (in Norwegian) – the Norwegian Labour Inspection Authority
- Regulation regarding asbestos (in Norwegian) – the Norwegian Labour Inspection Authority
- Regulation of diving (in Norwegian) – the Norwegian Labour Inspection Authority
- Regulation of safety, health and working environment in rock work (in Norwegian) - the Norwegian Labour Inspection Authority
- Regulation of radiation protection and use of radiation (in Norwegian) - the Norwegian Radiation Protection Authority
- Regulation of welding, thermal cutting, thermal spraying, gouging, soldering and grinding (hot work) (in Norwegian) – the Norwegian Labour Inspection Authority
- The Personal Data Act (in Norwegian) - the Ministry of Justice and Public Security
- Law on medical records and processing of medical information (in Norwegian) - the Ministry of Health and Care Services
- Protection against exposure to biological factors (in Norwegian) – the Norwegian Labour Inspection Authority
- Protection against chemical exposure in the workplace (in Norwegian) – the Norwegian Labour Inspection Authority
- Protection against noise in the workplace (in Norwegian) – the Norwegian Labour Inspection Authority
- Personal protective equipment (in Norwegian) - the Norwegian Labour Inspector Authority
- Occupational Health Services
- Margunn Losnegard Karlsen, Corporate Nurse
- Bjørg Aadahl, Occupational Physician
- Find your safety representative
Approved by Director of HSE - December 7th 2012 - HMSR13E - ePhorte 2013/11305