BASIC Engineerin g Lt d.

Fitness For Dut y

(FFD)
Process

Updated: March 2015

BASIC FFD Process __Page 1/15

CONTENT Page No.

1.1 Purpose 03

1.2 Scope 03

1.3 Objective 03

2.0 Definition 03

3.0 Necessity of FFD Certification 05

4.0 Objectives of FFD Certification 05

5.0 Procedures for FFD Certification 05

5.1 Fitness for Duty Program Requirements 05

5.2 Pre-employment Medical Check-up 06

5.2.1 Fitness for duty exam 06

5.2.2 Medical tests required for FFD certification 07

5.2.3 Driver’s Medical 12

5.3 Periodic Fit for Duty Exam/ Frequency 13

5.4 Return to Work 13

6.0 Qualification of Medical Representative 13

7.0 Medical Clearance 15

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1.1 Purpose
The purpose of this Fitness for Duty (FFD) procedure is to ensure that BASIC
employees can safely perform the essential physical, psychological and cognitive
requirements of their job without risk to self, others or the environment. It will also
ensure that the employees are not impaired by drugs, alcohol or disabling medical
conditions.

1.2 Scope
The scope of this FFD procedure is limited to the following parameters which are entailed
in this document:
 Pre-employment
 Periodic evaluations
 Return to work

1.3 Objective
The Fitness for Duty is designed to ensure that the BASIC employees are fit to
perform the duties to which they are assigned while working with Clients and free from
communicable diseases.

2.0 Definition of FFD:

Fitness for Duty (FFD) refers to a state, whether physical, mental and emotional, which
enables an individual to perform an assigned task competently and safely. FFD is a major
safety considerations for organizations, especially those that operate in high “safety risk”
associated industries, such as: Mining, Aviation, oil & gas plant, Construction and
Transport.

An individual’s FFD may be adversely affected for a variety of reasons, including:

 Physical impairment
 Medical conditions
 Emotional state
 Fatigue
 Stress
 Alcohol
 Drugs

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 These cited areas of concern are noted by OHS professionals as potentially and
detrimentally impacting the competency levels of an employee’s workplace performance.
Consequently, the likelihood of accidents and general risk in the workplace is greatly
increased. To help circumvent incident, injury, accidents in the workplace, the FFD
stipulates that preliminary assessments prior to work duties commencing be routinely
conducted to ascertain whether an employee is safely capable of completing their duties.

A well-designed, ethical and consistently implemented FFD policy can exponentially

improve the risk management strategy and safety records of an organization. This is further
enhanced if a key component of a FFD policy stipulates the usage of a workplace drug
and alcohol testing program.

Therefore, to ensure our workplace is OHS compliant, a Fitness for Duty policy is a
standard OHS policy which is highly recommended for the majority of workplaces: this
policy is designed to provide an effective and early intervention checking system for
employees and contractors to assure their physical competence to complete their assigned
tasks safely and competently.

At times, employees may need support, information and recommendations with regards to
their suitability to perform their role after a non-work related incident. A non-work related
injury or illness does not arise out of the normal course of employment, however may have
the potential to impact on the health, safety and welfare of the employee or their colleagues.
A non-work related injury may also have the potential to inhibit the employee’s ability to
fulfill the full requirements of their roles and responsibilities.

Employers are required to make reasonable adjustments to allow staff to continue at work or
resume their duties within a reasonable time period; however this must be balanced with the
responsibilities associated with a range of legislative requirements including
o c c u p a t i o n a l , health, safety and welfare obligations.

Employees will often provide their employer with a Return to Work clearance letter from
their doctor or specialist, but sometimes their treating doctor is unaware of a specific job and
the demands required performing the job. This may cause problems for the employee upon
return to their job role.

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The Fitness for Duty assessment is tailored for the individual and will include:
 A 30 minute consultation with an Occupational Doctor with short report, or
 Long consultation (i.e. >30 minutes) with an Occupational Doctor with short report, or
 Additional comprehensive report.

The Fitness for Duty assessment may also include:

 Full functional capacity evaluation and fitness test, or
 Fitness test only.

3.0 Necessity of FFD Certification

To reduce the Health Risks, risks of injury or illness by evaluation of the personnel health
condition to determine their fitness to work.

Establish the principles for using of mitigation measures to prevent the employees from
developing occupational diseases.

To recognize any kind of physical, mental problem of employee that gives clear ideas to
Employer to engage such employee to specific task. Without medical evaluation, an
employee may act as a threat to the company and there is probability to create an incident
by him.

4.0 Objectives of FFD Certification

 To minimize health risk to employee and company liability.
 To maintain safety of co-workers.
 Concern for public interest or safety.
 Clarify poor job performance vs. a legitimate health issue.
 Observe health problems on the job (e.g. low blood sugar episodes;
seizures; falling asleep).

5.0 Procedures for FFD Certification

5.1 Fitness for Duty Program Requirements
We have a Fitness for Duty (FFD) program for medical evaluation of employees during
pre- employment, periodic and return to work evaluation of the existing employees. The
procedures of FFD program are described below:
1. All employees have to pass pre-employment FFD evaluation and are deemed fit for
duty prior to start of any work. BASIC ensures periodic medical check-up at
specified intervals and return to work evaluation after medical illness or injury for
its existing employees who work at construction site.
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 2. All medical tests are carried out by reliable & recognized medical clinics at
different geographical regions of Bangladesh.
3. A qualified medical representative is present at site for checking the test reports &
coordinate with Chevron Health and Medical Services for final fitness for duty
clearance.
4. All employees are instructed not to attend work site if traces of communicable
disease are noticed.

5.2 Pre-employment Medical Check-up

Pre-employment medical examinations are commonly included by employers in the
selection process of candidates for jobs and are usually conducted in the final stage of
the recruitment process.

Pre-Employment Medical Examinations are designed to assess the general fitness of

prospective employees as well as their susceptibility to any of the particular hazards they
are likely to encounter on the job. An integrated approach is implemented to ensure that
the principles of the provision of a safe and healthy work environment are followed. The
object of health assessment is to ensure that:

1. Prospective Employees have the physiological and psychological capabilities to

undertake the jobs without damage to themselves or those who work with them;
2. The work and the work environment will not adversely impact on the person's
health or any underlying medical condition;
3. The Employee's health status will not adversely affect the health of others;
4. Any change in health status, which may be the result of the job can be
identified in the future;

5.2.1 Fitness for duty exam:

BASIC uses this system to make sure the employees hired have the capacity to perform the
essential functions of their job.

It starts with a detailed assessment of each job’s requirements, which is translated into a
specific, customized testing protocol overseen by BASIC medical team. With this
combination of analysis & examination, the right person is chosen for the right job at the
right time.

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When it comes to the more complex task of assessing recently impaired worker, BASIC’S
medic, works with the employee with clinically objective manner determining the
employee’s ability to perform his essential job functions.

5.2.2 Medical tests required for FFD certification:

For FFD certification, various medical tests are carried out over an employee considering
the job type and nature. The following medical tests are quite natural to treat the
employee to be fit or unfit.
 Blood Test
 complete blood count (CBC)
 Serum electrolytes
 FSB & Lipid Profile
 Chest X-ray
 Electrocardiogram (ECG)
 Eye test
 Near-Far Vision
 Color vision & Visual field
 Depth Perception
 Hepatitis A
 HAV antibody (IgM)
 Hepatitis A Immunization
 Stool R/E with Ova & Parasites
 Drug & alcohol screening
 Exercise Tolerance Test (ETT)

Medical tests for Medical tests for food

Medical test for Expat/ Medical tests for
National/ Local Handlers, Caretaker, Office
Abroad Employee Drivers and operators
Employee Assistant, Cleaners
History and Physical History and Physical History and Physical
History and Physical
including Vitals , including Vitals , including Vitals ,
including Vitals , BMI,
BMI, Near Far vision BMI, Near Far vision BMI, Near Far vision
Near Far vision &
& Framingham & Framingham & Framingham
Framingham
Cardiovascular Risk Cardiovascular Risk Cardiovascular Risk
Cardiovascular Risk Score
Score Score Score
CBC (with ESR) CBC (with ESR) CBC (with ESR) CBC (with ESR)
Blood Chemistry Blood Chemistry Blood Chemistry Blood Chemistry (Fasting

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 (Fasting glucose, (Fasting glucose, (Fasting glucose, glucose, electrolytes, lipid
electrolytes, lipid electrolytes, lipid electrolytes, lipid profile)
profile) profile) profile)
TST(TB skin test) or
QuantiFERON
Chest X-ray PA View-
If clinically indicated
Chest X-ray PA View (history of Chest X-ray PA View Chest X-ray PA View
positive TB skin test
or QuantiFERON)
12 lead ECG 12 lead ECG 12 lead ECG 12 lead ECG
Comprehensive vision
tests (Near, far, color, Stool R/E with Ova &
D&A screening
depth perception, Parasites
visual field)
Hepatitis A screening
(HAV antibody IgM)

Blood (CBC) test

A complete blood count (CBC) is a blood test used to evaluate your overall health and
detect a wide range of disorders, including anemia, infection and leukemia.
A complete blood count test measures several components and features of your blood, including:
 Red blood cells, which carry oxygen
 White blood cells, which fight infection
 Hemoglobin, the oxygen-carrying protein in red blood cells
 Hematocrit, the proportion of red blood cells to the fluid component, or plasma,
in your blood
 Platelets, which help blood clotting
Abnormal increases or decreases in cell counts as revealed in a complete blood count may
indicate an underlying medical condition that calls for further evaluation.

Blood (Serum electrolytes) test

A blood test that measures the main electrolytes in the body—sodium, potassium,
chloride and bicarbonate (CO2)—can be used to evaluate symptoms of heart disease and
monitor the effectiveness of treatments for high blood pressure, heart failure and liver and
kidney disease.

The balance of sodium, potassium, chloride and bicarbonate in the blood is a good
indicator of how well the kidneys and heart are functioning. Knowing which electrolytes
are out of balance can help doctor determine a course of treatment.

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Blood (FSB & Lipid Profile) test
The fasting blood sugar test is also used to test the effectiveness of different medication or
dietary changes on people already diagnosed as diabetic.

The lipid profile is used as part of a cardiac risk assessment to help determine an
individual's risk of heart disease and to help make decisions about what treatment may be
best if there is borderline or high risk. The results of the lipid profile are considered
along with other known risk factors of heart disease to develop a plan of treatment and
follow-up. Depending on the results and other risk factors, treatment options may involve
lifestyle changes such as diet and exercise or lipid-lowering medications such as stations.

Chest X-ray
The chest x-ray is the most commonly performed diagnostic x-ray examination. A chest x-
ray produces images of the heart, lungs, airways, blood vessels and the bones of the spine
and chest. An x-ray (radiograph) is a noninvasive medical test that helps physicians
diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the
body to a small dose of ionizing radiation to produce pictures of the inside of the body.
X-rays are the oldest and most frequently used form of medical imaging.

A chest x-ray is typically the first imaging test used to help diagnose symptoms such as:
 Shortness of breath.
 A bad or persistent cough.
 Chest pain or injury.
 Fever.

Electrocardiogram (ECG)
Electrocardiography is the recording of the electrical activity of the heart. Traditionally this
is in the form of a transthoracic (across the thorax or chest) interpretation of the electrical
activity of the heart over a period of time, as detected by electrodes attached to the
surface of the skin and recorded or displayed by a device external to the body. The
recording produced by this noninvasive procedure is termed an electrocardiogram (ECG).
It is possible to record ECGs invasively using an implantable loop recorder.

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An ECG is used to measure the heart’s electrical conduction system. It picks up electrical
impulses generated by the polarization and depolarization of cardiac tissue and translates
into a waveform. The waveform is then used to measure the rate and regularity of
heartbeats, as well as the size and position of the chambers, the presence of any damage to
the heart, and the effects of drugs or devices used to regulate the heart, such as a
pacemaker.
Eye (Near-Far Vision) Exam
Vision tests check many different functions of the eye. Some of the tests measure our
ability to see details at near and far distances, check for gaps or defects in our field of
vision, and evaluate our ability to see different colors. Others may check how sensitive
we are to glare (brightness acuity), how well our eyes work together to provide depth
perception, and more. Vision tests are usually done along with exams and tests that check
the health of the eye.

Eye (Color vision & visual field) Exam

Under normal daylight (photopic) conditions, the smallest or least intense visible objects
are only seen in the central region of the visual field. In the periphery, objects must be
larger or more intense to be identified. A normal visual field extends approximately 100°
temporally (laterally), 60° nasally, 60° superiorly, and 70° inferiorly. A physiologic
scotoma (a blind spot) exists at 15° temporally where the optic nerve leaves the eye.
Definitive location varies slightly on an individual basis. The average blind spot is 7.5°
in diameter, vertically centered 1.5° below the horizontal meridian. For dim night
lighting (scotopic) conditions, the mid periphery is the most sensitive region of the visual
field.

Eye (Depth Perception) test

The term depth perception refers to our ability to determine distances between objects
and see the world in three dimensions. To do this accurately, one must have binocular
stereoscopic vision, or stereopsis. If someone lacks stereopsis, they are forced to rely on
other visual cues to gauge depth, and their depth perception will be less accurate.

Hepatitis A test
Hepatitis A (formerly known as infectious hepatitis) is an acute infectious disease of the
liver caused by the hepatitis A virus (HAV). Many cases have little or no symptoms
especially in the young. The time between infection and symptoms, in those who develop
them, is between two and six weeks. When there are symptoms they typically last
eight weeks and may include:

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Nausea, vomiting, diarrhea, yellow skin, fever, and abdominal pain. Around 10–15% of
people experience a recurrence of symptoms during the six months after the initial
infection. Acute liver failure may rarely occur with this being more common in the elderly.

Hepatitis A virus (HAV) test is a blood test that looks for proteins (antibodies) made by the
body in response to the virus that causes hepatitis A. These proteins will be present in
our blood if having a hepatitis A infection now or have had one in the past. It is important
to identify the type of hepatitis virus causing the infection to prevent it from spreading and
to start the proper treatment.

HAV infection is spread through food or water that has been contaminated by the feces
(stool) of an infected person.
 IgM anti-HAV antibodies mean a recent infection with hepatitis A virus. IgM
anti-HAV antibodies generally can be detected in the blood as early as 2 weeks
after the initial HAV infection. These antibodies disappear from the blood 3 to 12
months after the infection.

 IgG anti-HAV antibodies mean that already had a hepatitis A viral infection.
About 8 to 12 weeks after the initial infection with hepatitis A virus, IgG anti-
HAV antibodies appear and remain in the blood for lifelong protection
(immunity) against HAV.

Hepatitis A vaccine is available to prevent an HAV infection. If we have had this vaccine
and we have anti-HAV antibodies, this means the vaccination was effective.

Stool R/E with Ova & Parasites

A stool (feces) sample can provide valuable information about problems in the stomach,
intestines, rectum, or other parts of the gastrointestinal (GI) system.

In an Ova and parasites (O&P) exam, a technician views a sample of stool under a
microscope to look for parasites and their ova (eggs) or cysts, which are hard shells that
protect some parasites at a certain stage in their lifecycle. Without this type of testing, an
employer can never satisfy to deploy an employee into risky job.

Drug & alcohol screening:

Drug testing looks for traces of drugs in the body using samples of urine, breath, hair,
saliva, or sweat.

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Drug tests detect whether a person is under the influence of alcohol or whether he has taken
drugs recently. There are various methods of drug testing including urine, blood, breath,
hair, saliva and sweat.

Exercise Tolerance Test (ETT)

The physician will obtain valuable information about the condition of the person’s
cardiovascular system from the exercise tolerance test. The test is one of several diagnostic
tools that are available to help determine the presence or absence of heart disease. The
stress EKG also helps the doctor to determine the level of cardiovascular condition and
assess the safety of an exercise program.

5.2.3 Driver’s Medical:

Under the scheme, standards are set for various aspects of heavy vehicle operations
including fatigue management.

Drivers of trucks, public passenger vehicles and vehicles carrying dangerous goods must
meet higher medical standards because of the demands of their work, the extensive hours
spent on the road and the serious consequences likely to result from a crash.

There are various health conditions that can affect a commercial driver’s ability to drive
safely, for example:
 Blackouts or fainting
 Vision problems
 Heart disease
 Epilepsy
 Sleep disorders
 Diabetes
 Psychiatric disorders
 Neurological disorders
 Age-related declines

The basic fatigue management and advanced fatigue management standards require that
drivers undergo regular health assessments to make sure they meet the medical criteria
for commercial vehicle drivers contained in assessing fitness to drive, with a particular
focus on aspects such as sleep disorders, substance abuse etc. All BASIC drivers/operators
fitness shall be assessed every year and certified fit for drive/operate.

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5.3 Periodic Fit for Duty Exam/ Frequency
All employees including national, expat have to pass FFD examination after expiration of
recognized period. BASIC accordingly maintains the policy for ensuring proper fitness of
employees who work at site.
Frequency according to post/ status
Age limit National Expat Drivers & Operators
40 years and Below Every 2 years Annual Annual
Above 40 Annual Annual Annual

5.4 Return to Work

BASIC Employees shall be evaluated by medical tests when they return to work after the
following conditions:
 Serious physical condition
 Remarkable injury
 Medical intervention
 Over 5 days leave due to medical certification
Dedicated medical personnel shall conduct all the procedures & provide necessary
support to attain FFD certification to join the work. Without final FFD certification, no
employee will be allowed to work under BASIC.

6.0 Qualification of Medical Representative:

 He should have a Paramedic course certificate completing which is 01 year duration on
courses i.e. clinical medicine, pediatrics, surgery, gynecology and obstetrics, eye and ENT
related problems, and first aid and bandaging.
 Or he should have a LMAFP (Local Medical Assistant and Family Planning) which is 01
year long course. During such course, he should be educated on six different areas i.e.
pathology, anatomy, surgery, OB-GYN, pharmacology and medicine.
 Or he should have a Rural Medical Practitioner certificate which is 6 months long course.
During such course, he should be educated (for one month each) on six different areas i.e.
pathology, anatomy, surgery, OB-GYN, pharmacology and medicine.

The above mentioned 03 types of certificate holder are shortlisted for interview. In consideration of
experience, maturity, sincerity, we can recruit necessary Medical Representative against our
requirement.

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If employee returns from injury, BASIC Medical Representative shall assess fitness by the following format:

Fitness for Duty Certification

1. Employee / Patient Name

2. Date of Medical Examination

3. Please check the status of the employee’s release for duty

Full, unrestricted duty effective (date)
Modified duty effective (date) and next evaluation date
Not released for any type of duty. Next evaluation date will be
4. Physical Evaluation

Full Restriction Partial Restrictions (please specify) No Restrictions

Sedentary-Lifting 0 to 10 pounds
Light-Lifting 10 to 20 pounds
Moderate-Lifting 20 to 50 pounds
Heavy-Lifting 50 to 100 pounds
Pulling/Pushing, Carrying
Reaching or working above shoulder
Walking
Standing
Stooping
Kneeling
Repeated Bending
Climbing
Operating a vehicle
Finger Manipulation (operating)
Pain (frequency, degree, signs)

5. Behavioral Evaluation

Able to perform Other Considerations (please specify) Not Able to perform

Understanding
Remembering
Sustained concentration
Follow-through on instructions
Decision making
Receiving supervision
Relating to co-workers and students

6. Other Restrictions, Considerations, or Notes

I hereby certify that the facts in this document are true and correct.

Signature of Medical Representative

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7.0 Medical Clearance
 BASIC Medical Representative will review and make fitness for duty recommendation
 Medical Representative will forward it to Client’s Health and Medical team with
necessary medical test summary
 Client will review the test summary and also may request for further medical test
on consultation with the BASIC Medical Representative if the condition demands
 Client’s Health and Medical will send final approval/declination to BASIC’s
Medical Representative
 Finally, the final FFD report will be appeared in the following evaluation
categories: Fit for duty, Not fit for duty, Fit with Limitations, or Failed to comply
with requested evaluations

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