Occupational medicine: what is enhanced individual follow-up?

Enhanced individual monitoring (EIS) covers employees exposed to particular risks to their health and safety.

It shall include a medical examination of fitness for employment carried out by the occupational doctor, which shall replace the information and prevention visit (Vip).

This medical examination shall be repeated at least every 4 years. The occupational physician may choose a shorter periodicity for its renewal.

An intermediate visit shall be carried out by a healthcare professional at the latest 2 years after the visit with the occupational physician.

These medical examinations make it possible in particular to ensure that the employee is workstation-ready to which the employer intends to assign it.

They also make it possible to ascertain whether he is suffering from an illness which endangers other employees and to propose adjustments to the item or assignment to other positions.

Finally, they allowinform about the risks related to his workstation and the necessary medical follow-up and raising awareness about prevention to be implemented.

The SIR is set up in private companies, Epic: titleContentand Epa: titleContent employing staff under private law.

Employees at particular risk

These are employees assigned to a position exposing them to special risks following:

• Asbestos
• Lead according to occupational exposure values
• Agents that are carcinogenic or that may cause genetic mutations or impair reproductive function (agents RMC: titleContent)
• Ionizing radiation
• Biological agents of groups 3 and 4
• Hyperbaric
• Falling height during scaffolding assembly and disassembly operations

Employees assigned to a particular position

These are employees assigned to positions subject to specific aptitude test and in particular the following:

• Employees who have an employer's authorization to drive hazardous equipment (e.g. lifting machinery)
• Young people under 18 years of age on prohibited works which may require derogations
• Employees authorized by the employer to carry out operations on live electrical installations

Employees assigned to an employer-defined position

These are employees who may be affected by the list of posts presenting particular risks to their health and safety.

The employer complete this list, after obtaining the opinion of the occupational ESC: titleContent, consistent with the risk assessment and company card.

The employer must provide written justification for the inclusion of any position on the list.

This list shall be updated annually.

It shall be transmitted to the occupational health and prevention service and shall be made available to the prevention services of the social security bodies and the Dreets: titleContent.

The employer shall be exempt from organizing the medical examination for the suitability of a newly recruited employee if the following conditions are met:

• Same use and with equivalent exposure risks
• Occupational doctor in possession of the employee's last suitability opinion
• No employee's unfitness notice in the last 2 years
• No individual measures of transformation of the employee's work station or adjustment of his working time in the last 2 years

At the medical examination for medical fitness, a medical file on occupational health shall be drawn up by the occupational doctor.

After the medical examination of aptitude (initial as well as periodic), the occupational physician hands over a suitability opinion (or incapacity) to the employee.

The notice is attached to the employee's occupational health record.

If deemed necessary, the occupational doctor may propose to the employer individual measures such as transfer or conversion of post.

The employer shall take into consideration the proposals of the occupational doctor and, in the event of refusal, shall state its reasons.

Some employees are examined by the occupational physician in the following situations:

• Employees benefiting from or having benefited from enhanced individual monitoring of their health status during their career
• Employees who have been exposed to 1 or more of the particular risks prior to the implementation of the enhanced individual monitoring scheme

The employer shall request such a visit from the occupational health and prevention service to which he is a member. He shall immediately inform the employee thereof.

This visit shall take place under the following conditions:

• As soon as possible after the end of the exhibition of the employee at particular risk to his health or safety
• Before the employee's voluntary departure or retirement

An employee who considers that he can benefit from this visit and who has not been informed by his employer may request the organization directly from the occupational health and prevention service.

The employee shall request it during the month preceding the termination date of the risk exposure or during the month preceding his departure from the company.

This request must be made no later than 6 months after the end of the exposure.

The employee informs the employer of his approach.

This review establishes a summary balance sheet and one tracking exposures to 1 or more occupational risk factors to which the employee has been subject.

This assessment is based on the information contained in the employee's occupational health medical file, his statements and those of his successive employers.

The occupational doctor shall establish special medical surveillance if he finds that the employee has been exposed to dangerous risks, in particular chemical risks, during his career.

This post-exposure or post-occupational supervision of the employee is carried out in conjunction with the attending physician and the medical officer of the social security bodies.

It shall take into account the nature of the risk to which the employee has been exposed, the state of health and the age of the person concerned.

The occupational physician informs the employee of the steps to be taken to benefit from this follow-up.