External service for prevention and protection at work

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    Article 40 of the Act of 4 August 1996 on well-being of workers in the performance of their work provides for the creation of external services for prevention and protection at work. Within these external services, separate sections have been set up for the health supervision of workers.

    This ensures that the elements of risk analysis, risk management and health supervision can be dealt with in an integrated manner. The external service thus forms an entity in which all disciplines are represented.

    The separate sections responsible for health supervision are comprised of occupational physicians and keep separate accounts and reports of their health supervision activities and their preventive duties. The duties of the health supervision section therefore also have a preventive nature, which should be highlighted in the report. These sections can be approved by the Communities, as the Federal State cannot force them to do so.

    In addition, each external service must be approved. This approval is covered by Articles II.3-44 to II.3-51 of the Code on Well-being at Work.

    General principles

    In light of the foregoing, the following principles can be derived:

    • An external service for prevention and protection at work always includes a "health supervision" section.
    • An external service must in principle have at least two approvals. On the one hand, there is the general approval for the entire service by the federal government. On the other hand, the Communities retain the competence to approve the section responsible for health supervision.
    • With regard to the section responsible for health supervision, the Act contains a number of stricter requirements concerning accounting, reporting and management.

    For the external service as a whole, the management and organisational conditions are stipulated in title 3 of book II of the Code. The external service can be set up by employers, the State, Communities, Regions, public institutions, provinces or municipalities. It takes the legal form of a non-profit organisation. After consulting the monitoring commission, public bodies which are not in the form of a non-profit organisation can be approved. The sections that comprise the external service may not have legal personality.

    The external service applies a quality system that is certified according to the NBN-EN-ISO 9001 standard. In order to fulfil its duties, it must have a certificate issued by a certification body accredited for this purpose. The currently approved external services must have this certificate by 31 December 2006 at the latest. Services, which from 1 January 2003 are approved for the first time, must have this certificate within two years of operation. Where the certificate is withdrawn, not renewed or not issued, approval as an external service may be suspended or withdrawn.


    The external service has territorial jurisdiction for:

    • the entire Belgian territory;
    • one or more Communities;
    • an area to be determined.

    The external service has jurisdiction ratione materiae for:

    • a specific business segment;
    • different business sectors.

    The purpose of legal personality is to provide the appropriate framework for carrying out the duties of an external service and for the management of that service.

    The external service may not have any direct or indirect interest in the businesses or institutions in which it carries out duties. Only in this way can a sufficiently independent operation be guaranteed.

    The external service must have the necessary equipment, technical, scientific and financial means at his disposal so that it can always carry out his duties fully and efficiently.

    It keeps accounts and sets fees which are communicated to the Minister of Employment.


    The external service is required to enter into a contract with the employer, provided that the employer complies with the legislation and the provisions of the contract.

    This agreement mentions:

    • the duty or duties assigned to the service;
    • the nature, scope and minimum duration of the services to be provided to accomplish these duties;
    • the resources provided by the employer;
    • the method of working with the internal service;
    • relations with the Committee;
    • the terms for termination of the contract.

    The external service may not subcontract any duties.

    An advisory committee is established within the external service comprised of members representing the associated employers and members representing the workers of the contracting employers. This committee is responsible for giving opinions on various matters in order to contribute to the smooth running of the external service.

    Compulsory flat-rate contributions

    Each external service shall set the rates applicable to the affiliated employer for the duties it performs, which are set out in the contract with the employer. These rates respect the minimum rates imposed by regulation.

    For more information, see the following explanation: Rate regulation from 2016 onwards.

    Management of the service

    The person responsible for managing the service must:

    • be an expert in one of the disciplines that must be present in the external service;
    • have adequate professional and scientific experience;
    • have a permanent employment contract;
    • work full-time.

    This person has the following duties:

    • coordinate the sections;
    • ensure the operation and application of the principles of total quality management;
    • ensure that duties are carried out in partnership with the internal service;
    • write an annual report;
    • appoint a Prevention Advisor who, in consultation with the internal service, draws up a list of the duties to be carried out by the external service and prepares the contract to be entered into with the employer.


    The external service consists of two sections: a risk management section and a health supervision section. The risk management section is managed by an engineer with additional level I training. In this section, the disciplines occupational safety, occupational medicine, ergonomics, industrial hygiene and psychosocial aspects of work are represented. The health supervision section is managed by an occupational physician and includes the nursing and administrative staff necessary to carry out health supervision. The occupational safety and occupational medicine disciplines cannot be combined by one person.

    In addition, nurses, social workers and individuals who have undergone additional training at level II may also be employed in the external services. These persons carry out their activities under the responsibility of the Prevention Advisor they assist.


    It is always the same Prevention Advisor or the same team of Prevention Advisors who carries out the duties for the same employer.

    The names of the Prevention Advisors shall be sent to the committee by the employer and shall also be mentioned in a place easily accessible to the workers.

    For each intervention, the external service writes a report for the employer.