Pre-Employment Medicals: What to Expect, What's Tested, and How Long Until Results

Workplace Health Assessments: Setting the Baseline for Workplace Safety

What's something you can do before you even step on site that will help you and your colleagues avoid accidents and go home safely? It's a Pre-Employment Medical (PEM) assessment, and it's not just about vetting workers; it's about ensuring that they can perform in their roles safely and reliably.

Our role at 4CRisk is to work with employees and employers in complex and high-risk occupations to ensure that they're meeting their obligations and creating healthy, safe workplaces. As a part of this, we wanted to clarify why pre-employment medical assessments are so vital to both employees and employers, as well as what employees can expect before, during, and after their assessment.

1. The Essential Purpose: Why Pre-employment Medicals (PEMs) Matter

What's the point of Pre-employment medical assessments?

A pre-employment medical (PEM) assessment isn't just about ticking a box – it's a helpful tool for both employees and employers. Employers need PEMs to meet their Workplace Health and Safety obligations across many roles where work can be physically demanding or involve exposure to higher levels of risk. Industries like mining, manufacturing, transportation and construction tend to require pre-employment medical assessments. Emergency service workers and defence personnel are also generally required to have a pre-employment medical.

While an employee is at work, their employer is responsible for their wellbeing, and so it's their obligation to provide workers with the right conditions for them to do their roles safely. But a PEM is not just for an employer's sake – it can really help employees to manage their own health.

In plenty of cases, PEMs have highlighted health conditions that employees were not previously aware of, helping them manage their own wellbeing more effectively both at home and in the workplace.

For example, a PEM might identify a pre-existing injury that could be exacerbated by certain working conditions in your role. The results of the PEM can assist employees to be provided suitable accommodations in their roles, and identify where conditions are not optimally managed, allowing for treatment that might not have otherwise been prescribed.  .

2. What to Expect: The Step-by-Step Assessment Process

A pre-employment medical check can seem intimidating – but it doesn't need to be! We'll talk you through everything that's likely to occur during a test, and how individuals can prepare.

2.1. Before Your Appointment: Preparation is Key

Candidates will have to do some preparation beforehand, but it's nothing to stress about! Here's what you can expect:

Online Health Questionnaire: This is a pre-appointment, online form that will inform the pre-employment medical check. It's an opportunity to record any pre-existing medical conditions that a candidate has, or has had in the past. This questionnaire needs to be answered honestly and without omitting important information: if you're not sure if it's relevant, record it anyway.

What to bring: Candidates need to bring a valid photo ID (e.g. passport, license, Proof of Age Cards), as well as any hearing aids or visual aids they use – this includes prescription glasses and contact lenses. They should also bring a list of any current medications they take, including non-prescription medications.

What to wear: Candidates should wear loose and comfortable clothing, as well as enclosed footwear. Wearing something they can move in is especially important if a PEM is going to involve a functional assessment.

Things to avoid before the appointment: The medical tests will likely involve a hearing assessment (audiometry), so candidates should avoid loud noises for 16 hours before their appointment (e.g. musical concerts, unprotected exposure to loud machinery). They should also avoid alcohol, drugs, smoking, and caffeine prior to a functional assessment, as these things can impact performance.

2.2. The Standard Physical Screening Components

So, what happens when you arrive at a PEMs appointment? The assessor – whether it be a doctor or another qualified medical practitioner – will start by collecting some information related to the candidate's health.

Most – if not all – pre-employment medicals will involve collecting data around the following factors:

• Height and weight
• Blood pressure and pulse

• Vision testing 
• Urinalysis (testing for protein, sugar, and blood, to assess kidney function.)s)

2.3. The Doctor's Review (The Clinical Component)

The next part of the assessment will be with a doctor, who will take the candidate through the following steps:

• Review of the medical history questionnaire: This step involves discussing anything that was reported on the online questionnaire and checking that the candidate's health history and information are accurate and complete.
• Systemic Examinations: The doctor will conduct basic checks of the respiratory, cardiovascular, nervous, and musculoskeletal systems.
• Focus on High-Risk Indicators: The doctor will look for specific indicators relevant to the candidate's role, such as hernia checks for physically demanding roles, or signs of chronic respiratory disease for roles where there is a risk of exposure to airborne chemicals or particles.

3. Beyond the Basics: Essential Medical Testing for High-Risk Roles

What comes next in your assessment will depend on the type of role that the candidate is expected to perform. The following are examples of assessments tailored to specific roles:

3.1. Functional Capacity Assessments (FCA)

• What it measures: This type of assessment measures the candidate's ability to do certain physical tasks as demanded by their role. It can involve pushing, pulling, lifting, or bending – and is tailored specifically to the tasks in a specific role.
  What it might involve: Tests of cardiovascular fitness, manual skill handling, or strength testing, as well as dynamic posture assessments.
  Why it's important: It's crucial to check that workers who might need to do physical tasks in case of emergency or as a part of their role are able to perform them – this assessment ensures that they can do these things safely.

3.2. Legislative Health Monitoring and Surveillance

What it measures: These tests measure functioning in relation to specific hazards, including dust, asbestos, and noise.

What it might involve: Audiometry or hearing tests, or lung function tests to assess lung volume and flow rate.

Why it's important: It's important to check that a candidate doesn't have an existing sensitivity or health condition that might be exacerbated by a risk associated with their role – even if that risk will be controlled and appropriately managed. For instance, if you're in a role where there is a risk of exposure to respirable hazards like asbestos or silica dust, it's important to ensure you're not suffering from a lung condition that might increase the risk of exposure and to allow for adequate protections to be implemented by the employer. The assessment will also provide a valid baseline for future health monitoring to be compared to, to ensure any health effects of workplace exposures can be picked up and acted on early. 

3.3. Drug and AlcohoDrug and Alcohol Screening (DAS)

What it measures: Drug and alcohol testing measures for the presence of certain drugs in your saliva and urine, and breath alcohol concentration

What it might involve: Candidates will likely be asked to give a urine or saliva sample (or both), as well as having an alcohol breath test. Australian Standards (AS/NZS 4308:2008) require these samples to be given under supervised conditions, to ensure that the specimens aren't interfered with. These samples will usually be analysed 'on the spot', meaning that results will be available instantly. While these tests are highly accurate, if a candidate does present a positive test for either drugs or alcohol, they will have the opportunity to take a much more accurate test that will be confirmed via lab analysis. This protects workers from the possibility of false positives.

Why it's important: It almost goes without saying that drugs and alcohol can impair how someone functions in the workplace. For workers who manage safety risks as part of their everyday role, it's an essential pre-employment check.

Section 4: The Waiting Game: Results, Timelines, Privacy

4. 1. How long do pre-employment medical results take?

Waiting for any kind of test results can be nerve-racking, but thankfully, candidates should receive their assessment results within 24 to 48 hours in most cases. Sometimes, delays can occur if there are additional follow-up information required, or if an assessing doctor has to liaise with specialists or other practitioners, or even wait for the results of drug and alcohol testing. A delay in results doesn't necessarily signal a problem or a negative outcome: it is usually just a result of thorough checks and balances being made.

4.2. Understanding the Outcome (aka "the Fit Slip")

The result of a pre-employment medical testing will be delivered to the employer in a way that protects the individual's privacy, while still allowing them to make an informed safety decision. They will either receive a certificate saying that the employee is "Fit for Role" (sometimes referred to as a 'fit slip'), or a notice informing them that the employee is not fit for the role: they will not receive the candidate's detailed medical history. If the candidate is awarded a "Fit for Role" certificate, but the assessor determines that they might benefit from certain workplace accommodations, these can also be passed along to the employer.

Ultimately, the final decision around hiring for a role lies with the employer. 4cRisk can only provide a clinical recommendation, which your employer can use to inform their own decision.

Why it all matters: Partnering for a Safer Future

Pre-employment medical checks and occupational health assessments are a vital part of keeping your workplace safe and preventing workplace injuries. They're not just necessary for compliance; they're part of looking after yourself and your colleagues on-site.

If you're an employer, or an HR professional working in a high-risk industry, you can do better than generic compliance testing – 4cRisk offers specialised, highly tailored medical solutions that drive safer workplaces. With efficiency and care, we're here to help businesses and workers get home safely. Want to take the first step towards a safer workplace? We'd love to hear from you!

‍ Get in touch and we'll talk you through how your business could benefit.