07/16/2009

Evidence base for pre-employment medical screening

The latest Bulletin of the World Health Organization oublishes a paper that
examines the evidence base for the use of pre-employment/pre-placement medical
examinations. The use of pre-employment examinations is often driven more by
cultural practices than evidence. There is a lack of evidence on their
effectiveness in preventing health-related occupational risks. Hypertension
screening is highlighted as a common pre-employment practice for which there is
no standardized criteria to use to determine fitness for work. There are
inherent problems in screening for psychiatric disorders and substance abuse as
well as potential for racial bias and other unintended negative effects. This
paper questions the economic case for this practice and also expresses concerns
about paternalism related to identified risk factors. Health assessments should
only be included when appropriate to the task environment and the general use
of pre-employment exams and drug screening should be eliminated. Generally, a
health assessment by questionnaire should suffice. Occupational health
providers should advise against the application of physical or mental standards
that are not relevant to fulfilment of the essential job functions. Consensus
development regarding best practice, as well as consideration for acquiring
outcome data related to pre-employment practice, is recommended.


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AplusA-online.de - Source: World Health Organization