Workers’ health surveillance
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The employer is responsible for the health surveillance of workers who are exposed to risks. To do this, he must call on a prevention advisor/occupational physician who has competences defined in the legislation.
Every worker must be able to consult the prevention advisor/occupational physician in the context of a spontaneous consultation and has the right to a pre-reinstatement visit during the incapacity to work with the aim of finding a suitably adapted job.
Health surveillance is compulsory for security posts, vigilance posts, activities with a defined risk. This is the case, for example, of a worker exposed to dangerous chemicals such as asbestos during his work.
Workers in these categories are subject to compulsory medical examinations as part of the pre-assignment health assessment, periodic health assessment, extended health surveillance (after the end of exposure to chemical, physical or biological agents) and a return-to-work examination (after an absence of at least four weeks).
The purpose of these examinations is, among other things, to prevent workers from being employed on tasks for which they would not normally be able to bear the risks, to detect occupational diseases and work-related illnesses as early as possible, and to provide a basis for deciding whether a worker is fit for work at the time of the medical examination.
The employer must communicate the list of workers subject to compulsory health surveillance to the prevention advisor/occupational physician every year, so that they can be summoned to the medical examinations in time.
In addition, the prevention advisor-occupational physician is responsible for mandatory vaccinations necessary due to exposure to certain biological agents in the workplace and he supervises the organisation of first aid and emergency care. He declares occupational diseases that he finds to the occupational physician-inspector of the Directorate General of Supervision of Well-being at Work and to the physician-advisor of the Occupational Diseases Fund.
Some specific legislation requires the employer to take measures to ensure the health surveillance of workers engaged in particular activities, for example:
- Workers at risk of being exposed to carcinogens or mutagens (Title 1 of book VII), more info in French: Agents biologiques or Dutch: Biologische agentia;
- Workers exposed to dangerous biological agents (Title 1 of book VII) more info in French: Agents biologiques or Dutch: Biologische agentia;
- Workers exposed to asbestos (Title 1 of book VI), more info in French: Amiante et enleveurs d'amiante or Dutch: Asbest en asbestverwijderaars;
- Night workers and shift workers (Title 1 of book X), more info in French: Travail de nuit et travail posté or Dutch: Nachtarbeid en ploegenarbeid.
Implementation for the employer who employs posted workers in Belgium
If a worker is subject to health surveillance under this legislation, the employer must ensure that this health surveillance is carried out. If the worker employed in Belgium by a foreign employer has already undergone a health surveillance examination, for example in his country of origin, the examination does not have to be repeated in Belgium provided that the employer can demonstrate that this examination is equivalent to the one imposed in Belgium. The employer must be able to demonstrate this (e.g.: by means of health surveillance documents) whenever the Directorate General of Supervision of Well-being at Work requests it. As the rules that apply to health surveillance in Belgium are largely based on the European safety and health directives, these obligations will in many cases be similar to the health surveillance rules that apply in other EU Member States.
If the worker employed in Belgium by a foreign employer has not yet been subject to the health surveillance requirements, the worker must undergo the examinations. These examinations can be carried out by the employer's internal medical service (provided that it has such a service which is staffed with sufficiently competent personnel, such as a prevention advisor/occupational physician) or by a foreign external service (provided that the examinations are carried out in accordance with Belgian legislation on well-being), or by a Belgian external service.
More information on Workers' health surveillance on this website under the theme The well-being of workers.