Occupational Medicine Advance Access originally published online on November 26, 2007
Occupational Medicine 2008 58(1):46-51; doi:10.1093/occmed/kqm131
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Comparison of three methods of pre-employment medical evaluations
1 Occupational Medicine Department, Maccabi Healthcare Services, Holon, Israel
2 The Public Health School, Sackler Faculty of Medicine, Tel Aviv, Israel
3 Occupational Medicine Department, Maccabi Healthcare Services, Beer-Sheva, Israel
4 Maccabi Healthcare Services, Central Headquarter, Tel Aviv, Israel
5 The Dermatology Department, Hadassah Medical Center, Jerusalem, Israel
6 Occupational Medicine Department, Maccabi Healthcare Services, Netanya, Israel
Background Increasing efforts are being made to prevent sickness absence and to increase worker efficiency, including the use of costly pre-employment medical assessment of white-collar workers and labourers, excluding occupations for which medical supervision is required by law.
Aim To investigate whether filling out an occupational health questionnaire (OHQ) as pre-employment assessment was more efficient than previously used protocols which included a physical examination and laboratory tests performed for each applicant.
Methods Retrospective study comparing three groups of job applicants: Group A—applicants examined by an occupational physician (OP); Group B—applicants examined by a general practitioner (GP) whose medical records were subsequently evaluated by an OP and Group C—the applicant filled out an OHQ which was evaluated by an OP.
Results The study included 1940 pre-employment assessments divided into groups A (618), B (256) and C (1066). The restriction rate was 2.1, 1.2 and 2.3%, respectively. The lowest restriction rate (1.4%) was among applicants 29 years old and younger and the highest one (3.6%) among 50 years and older. The most frequent diagnoses among restricted applicants were musculoskeletal and circulatory diseases (15 and 12%, respectively).
Conclusions The restriction rate achieved by medical examinations either done by an OP (Group A) or by a GP (Group B) was the same as in OHQ (Group C). The use of a self-administered questionnaire evaluated by an OP is the preferred method of pre-employment evaluation for non-hazardous occupations.
Keywords Assessment; cost benefit; health examination; health services; occupational epidemiology; pre-employment
Correspondence to: Shlomo Moshe, Occupational Medicine Department, Maccabi Healthcare Services, 43 Geulim Street, Holon, Israel. Tel: +972 3 6530054/56/15; fax: +972 3 6521031; e-mail: moshe_sh{at}mac.org.il