Comparison of three methods of pre-employment medical evaluations.
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.


OBJECTIVE
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.
Occupational Medicine Department, Maccabi Healthcare Services, Holon, Israel. moshe_sh@mac.org.il
Shlomo
S
Moshe
Michal
M
Shilo
Yaron
Y
Yagev
Doron
D
Levy
Dan
D
Slodownik
Gabriel
G
Chodick
Michael
M
Levin
D000328:Adult; D003362:Cost-Benefit Analysis / Q000191:economics; D004651:Employment / Q000458:organization & administration; D004812:Epidemiologic Methods; D006304:Health Status; D006801:Humans; D007586:Job Application; D008487:Medical History Taking / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D009786:Occupational Health Services / Q000379:methods* / Q000592:standards; D009787:Occupational Medicine / Q000191:economics; D010808:Physical Examination / Q000191:economics* / Q000379:methods