A guide to “Médecine du Travail” in France

Occupational health is a global concept, concerned with the prevention and treatment of work-related injuries and illnesses.

However, each country has its own individual occupational health-related guidelines and procedures to adhere to.  In France, these are as follows.

What does occupational health mean in France?

French occupational health and prevention services (SPST) have the exclusive task of preventing damage to employees’ health as a result of their work. They therefore carry out various medical check-ups throughout an employee’s lifespan.

Such check-ups concern:

  • private companies, public industrial and commercial establishments (Epic) and public administrative establishments (Épa) employing staff under private law
  • employees with a permanent employment contract (CDI), a fixed-term employment contract (CDD), a temporary employment contract (temping) or a limited-term employment contract (apprenticeship contract).

Depending on the size of the company concerned, the occupational health and prevention service is provided by an internal health service within the company, or a nominated external health service.

Services are carried out by a multidisciplinary team, which includes occupational physicians, occupational risk prevention specialists, and nurses.

The role of the occupational physician

The occupational physician’s role is mainly preventive. The occupational physician conducts occupational health actions to preserve the health of workers throughout their career.

They monitor individual workers’ state of health according to their age, potential risks to their safety and health, and the perceived difficulty of their role.

They will also advise the employer, the workers and the staff representatives on the necessary measures concerning the following:

  • occupational risk
  • improving quality of life and working conditions
  • prevention of alcohol and drug use in the workplace
  • prevention of psychological or sexual harassment
  • exposure of employees to occupational risk factors
  • retaining workers in employment
  • vaccination and screening campaigns

Along with these suggestions and recommendations, the occupational physician will prepare an annual report to summarise their activities. This report is sent to the social and economic committee (CSE) and to the employer.

Medical check-ups

The occupational physician will usually have free access to the workplace, carrying out check-ups on their own initiative, at the request of the employer, or as advised by the social and economic committee (CSE).

There are several types of medical check-ups for employees:

Information and prevention check-up (VIP)

This check-up is carried out within a period not exceeding three months from the date of hiring or before hiring for minors and night workers.

At the end of the VIP, the health professional may, if they consider it necessary, refer the employee to the occupational physician. If the employee is recognised as a disabled worker or holder of a disability pension or a night worker, the VIP is carried out by the occupational physician directly.

For a night worker or an employee under 18 years of age, the check-up is carried out prior to their assignment. The occupational physician may request additional specialised examinations, which are paid for by the employer.

At the end of each VIP, the occupational physician or health professional issues an occupational health certificate to the employee and the employer. However, the occupational physician is not obliged to pass on detailed medical information about the employee to the employer.

Reinforced individual monitoring (SIR)

This monitoring concerns employees exposed to particular risks to their health and safety.

It includes a medical examination for fitness prior to recruitment, carried out by the occupational physician.  This replaces the information and prevention check-up (VIP) above.

This medical examination for fitness is renewed at least every four years, although the occupational physician may choose a shorter period for its renewal.

In particular, these medical examinations help to ensure that the employee is fit for the job they have been hired to do.

They also make it possible to check that the employee is not suffering from a condition that poses a danger to other employees, and/or to propose reasonable adjustments to the position, or potential re-assignment.

Pre-return to work check-up

Organised by the occupational physician, a pre-reinstatement medical check-up may be organised in the event of an absence of more than 30 days, as soon as the employee’s return to work is anticipated.

During this check-up, the occupational physician may recommend the following measures:

  • workplace adjustments and adaptations
  • recommendations for reclassification
  • organising professional training facilitate reclassification or professional reorientation

Return to work check-up

The return to work medical examination is only required for employees who are away from work due to a non-work-related accident or illness, following an absence of at least 60 days.

Carried out by the occupational physician, this check-up must take place within eight days of the employee resuming work.

The purpose of the return-to-work check-up is to:

  • ensure the employee is fit to return to work
  • check that the employee’s workstation (or, if applicable, the reclassification position to which he or she is assigned) is compatible with their state of health
  • examine any proposal for adaptation of the current role, or potential reclassification
  • issue, if necessary, a notice of unfitness for work

The return to work check-up takes place during working hours, with absence paid under the usual conditions.

If the return to work check-up cannot take place during working hours (e.g. in the case of night work), the time required for the medical examinations is then paid as usual working time.

What are the consequences of occupational health check-ups?

An occupational health medical file is compiled for each employee.

After each medical examination for fitness, the occupational physician issues a notice of either fitness or unfitness to the employee, which is then attached to their occupational health medical file.

If deemed necessary, the occupational physician may propose suitable measures to the employer, such as a transfer or a change of role.

As part of the reinforced individual monitoring, the occupational physician may also issue an opinion of fitness or unfitness to the employee and the employer.

The employer must takes the occupational physician’s proposals into consideration and, in the event of refusal, provide reasons.

For further information and guidance regarding occupational health procedure in France, please contact our experienced team at Viridian HR.




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