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Employee evaluation/Medical

examination
Margaret K. Semakula

Content
Definition of Occupational Medical Examination
(ME)
Legal Framework for ME

Importance of ME
Types of ME
Process of ME

Definition
Medical examination is a procedure or test
carried out by a qualified Medical
Practitioner that seeks information about a
persons state of fitness in terms of physical
or mental health, to perform duties of a
given job.

Legal Framework for ME


Labour Laws Employment Act, cap 219 2006.
An Employee who wishes to enter into a
contract of service for any of the
employments specified in the schedule to this
Act shall first be examined by a medical
practitioner at the expense of the employer
and where practicable, a certificate showing
the results of the examination shall be issued
before the attestation of the contract.

Legal framework contd


Also provides for attestation of a work contract
provided the medical examination can be done
within 2 weeks.

Any employee who has been rejected after an


examination under this section as physically unfit
for the work contemplated by the proposed
contract shall be returned to the place of
engagement at the expense of the employer or
employers agent should the employee wish to
return.

Importance of ME
1. To identify prospective medical conditions that
are incompatible with the suggested occupation.
- e.g Respiratory conditions (Allergic rhinitis,
Sinusitis, Asthma, Chronic Obstructive Airway
disease, Bronchitis, Emphysema) Vs Tobacco
curing, Coffee processing, Mining Gold, Copper,
Tin, Limestone, Packaging Cement etc.
- E.g Mental illness or Hydrophobia, Height phobia
and Water rafting, Sky diving, Parachuting etc

Importance IV
2. To identify underlying medical conditions that
may be cause accidents at occupation.
- e.g Eye sight problems (Short sightedness &
driving,
- E.g Epilespsy & work at fires, water, driving e.t.c
- Mental disorders
- Physical disability & Climbing heights in
construction works

Importance III
3. To evaluate overall fitness and physical ability of
the prospective employee to perform the job
applied for.
4. To design programs for mitigating health problem
e.g fitness sessions (Physical exercise)/ controlling
conditions by regular treatment
- Degenerative disorders e.g spondylosis & heavy
weight lifting
- Chronic conditions e.g diabetes, HIV, Lung cancer

Importance IV
5. For surveillance of toxic waste products. Eg In 2006
alone, dumping of ~500 tons of petro-chemical
wastes in 15 sites in Abidjan, Cote dvoire, West
Africa, led to deaths of 8 people, & 90,000 more
seeking medical help. All was attributable to the
petro-chemical wastes (WHR, 2007).
1986 Chenorbyl disaster was the worst radionuclear accident in history in Soviet Union with
evacuation & resettlement of 336,000 people from
Soviet Union, Some Nordic countries, Eastern &
western Europe & parts of eastern North America.

Types Of Medical Examination


There are three main types of medical
examination.
1. Pre-employment
2. Routine/ Periodic
3. Mandatory

Pre-employment Medical Examination


Is done on any prospective employee for a
specified job. The prospective employee is not in
employment at the time of the examination.
Consists of a personal medical history, an
occupational history, a physical examination and
includes appropriate laboratory tests.
Such a pre-employment medical examination is
required prior to dangerous types of work.

Pre-employment ME

The dangerous types of work include;


Mining, Quarrying processes, Stone blasting
Taxidermy and hide processing
Wood preservation
Soldering and Electroplating
Textile and bleaching
Pesticide work e.g Fumigation and spraying
Welding and Smelting
Clothes dry cleaning
Radioactive substances e.g nuclear plants
Radio therapy e.g X-ray rooms e.t.c

Importance of Pre-employment ME
1. Baseline data on employees health
2. Creates job security
3. Creates a sense of job responsibility to the
employer
4. Enhances self confidence to the employee
5. Precursor for high productivity since a healthy
work force is recruited.
6. Mandatory by law.

Routine/ Periodic ME
Is a follow up of pre-employment examination.
Is done every after a specified period e.g (every
six months) depending on; the type of
occupational exposure, age of employees and
legal requirements.
Occupational exposures may include; Lasers,
carcinogens, infectious agents, radioactive
agents etc.

Importance of Periodic ME

Shows employee health status at the time compared


to the baseline.

Helps employer determine whether the employee


are still in good health to plan for transfers,
promotions, training e.t.c
Builds confidence of employees
Helps to monitor the health status of the general
working population.
Can help in identifying any un-anticipated exposure.

Periodic ME as Medical Surveillance


Employees that require medical surveillance
include workers exposed to;
- Asbestos,
- Lead,
- Noise,
- Lasers,
- Hazardous Waste And
- Other Biological Hazards.
- Radio nuclear and Toxic threats (WHR, 2007)

Mandatory Medical Examination


A type of medical examination that is a requirement (not
optional) from the employer due to specific reasons which may
include;
Unusual happening e.g. epistaxis etc
Noted occurrence of frequent accidents
Frequent absenteeism due to illness
Need to shift from one department to another with different
exposure.
Routine examination of equipment and un-usual hazardous
findings.

Importance of Mandatory ME
1. Creates information on use of protective wear/
devices/equipment.
2. Documentation of any new occupational hazard
discovered.
3. Screen out persons with un-anticipated exposure & use
of information for better monitoring methods.
4. Compensation of employees

Process Of Medical Examination


Official:
- Qualified physician, medical practitioner/ specialist
identified by Employer.
Inputs:
- Medical expert has details of Job description.
- Tools of work for medical assessment including
laboratory/ radiological services.
Assessment criterion:
- Is the person suitable/ fit for the proposed work

Process Of Medical Examination


Qualified persons criterion:
- Professional independence, Competence, Secrecy, Confidentiality,
Informed consent.
Areas for examination
- General Examination (Anaemia, Oedema, Lymphadenopathy,
Mental Status Examination)
- Specific/ Relevant Examination = Systemic e.g Cardiovascular
system, Respiratory system, Central Nervous System etc.
- Investigations e.g Laboratory & Radiology.

Process of ME
Final report is sent to the employer (Fit / Un-fit)
with reasons for the conclusion.
Reasons for this are based on the Medical
History, Examination, and Investigations.

REFERENCES
Labour Laws of The Republic of Uganda, 2000.
The Employment Act, Cap 219, pgs 4,697
4,724.
Davidsons, 2001. Principles and Practice of
Medicine, 17th Edition.
WHR, 2007. World Health Report , 2007. Towards
a safer future.
MUK MPH 8104 (2006), Introduction to
Occupational Health, Course Materials.