Importance of pre-employment medical exams & the annual physical exams for employees & employers

“He who has health, has hope, and he who has hope, has everything” Arabian Proverb

Our work environment today is really fast paced & competitive. Because of this, organizations have begun to put premium in ensuring the wellbeing & health of employees. Gone were the days that it was considered an unnecessary cost. Now, aside from the training & development of employees, healthcare is considered a good investment move that reaps intangible returns.

Having an over all view of the health & wellbeing of employees does not only minimize risk of workplace injuries and illnesses but also gives employees the sense of being comfortable & safe. This could not have been more pronounced than the previous pandemic, when health & safety protocols were helpful in mitigating the spread of the dreaded corona virus.

A former colleague told me how they found out about the sudden demise of her officemate, so young and full of potential, energetic and seemingly healthy who suddenly succumbed to a heart attack. Not only was it unexpected but also took time to sink in their workplace.

As an HR person, a crucial aspect of achieving a sense of security & assured well being of employees under our span & control would be making sure that we are compliant in the implementation of pre-employment medical exams (PEME) and annual physical exams (APE).

Assuming that the selection process & qualification of service providers (Hospitals, Laboratories or Diagnostic centers) is on a level playing field based on the requirements of both the company & the government, it should lessen the instances of unexpected death due to undiagnosed illness or prolonged diseases that could’ve been prevented or management if detected at early stages.

Book IV of the Labor Code of the Philippines outlines the rules governing health, safety and social welfare benefits. It also sets guidelines on fines and penalties. The document outlines the medical, dental, and occupational health and safety benefits that employers in the Philippines must provide to their employees, including requirements for first aid treatment, emergency medical services, qualifications of health personnel, and administration of safety and health standards.

The Pre-employment Medical Exams (PEME) is a critical step in the hiring process because it allows the employer to assess both the physical and mental health of potential employees. These exams are typically conducted by a medical professional, such as a doctor or nurse practitioner, and may include a range of
tests though have largely been outsourced to diagnostic & laboratories centers &/or hospitals.

Typically, the PEME includes physical examination, medical history, blood test, urinalysis, fecalysis, vision & hearing tests. Other specialized tests, such as drug screens, hepa screening & others as required by law are also conducted.

PEME results enables the company to identify any potential health risks or impairments that may impact an employee’s ability to perform the job safely and effectively. It gives them a certain level of confidence in assigning a new employee to the job they were hired for because the results of the Pre Employment Exams will determine if the employee is fit to work or not.

In some instances, there are employees that are assessed as fit to work but subject to certain limitations. Being helpful in deciding where the employee’s wellbeing & health is not at risk, the employer should always weigh not only of the qualifications, potential & health of the applicant as a whole.

In some instances though, the PEME results though may also be used as a basis to disqualify an applicant to be employed if the work itself poses a grave threat to an existing health condition putting not only the employee at risks bust also co employees. The employer though may defer onboarding of a hired applicant until he/she becomes fit to work, by allowing them to undergo treatment and recuperation.

In general companies specially those I’ve worked for, pay for pre-employment medical examinations. Though not obligated to do so, it will really on depend on the employer’s discretion, consideration & requirements. It can be simple doctor’s checkup plus the basic 5 or it may include extensive such as cardio pulmonary, drug tests, xrays etc.

The DOLE advisory 07-2020 states that pre-employment requirements for first- time jobseekers, should be free of charge. But the First Time Jobseekers Act or Republic Act (RA) No. 11261 is limited to one copy and one-time availment only. This means first time jobseekers may tap concerned government agencies for their PEME free of charge to which “private establishments are hereby enjoined to accept certified true copy from the issuing government authority of the pre- employment documents of the FTJ during the application process”. It also states that submission of original pre-employment requirements shall be required once the first time jobseeker is offered the job.

On the other hand, while the Labor Code shows the requirement for Annual Physical Examination (APE) for employees is not mandatory, it may be imposed depending on the industry, company policies, practice & procedures, or for specific job roles as part of the obligation of companies to ensure safe working conditions. Under the Occupational Safety and Health Standards (OSHS) of the Department of Labor and Employment (DOLE), certain industries, particularly those involving hazardous work, providing regular health assessments to employees is mandated.

The Annual physical exam (APE) is an important part of employee health and wellness programs of companies. The APE not only provide employees with a comprehensive health assessment, making them aware of any potential health issues early on, and employers get an over all view of their employees’ current state of health and wellbeing. It allows them to initiate programs that will help address potential causes of illness and mitigate if not eliminate risks related to work induced health issues.

During an APE duly qualified service providers should conduct a range of tests, including physical examination, Medical history review, Blood tests, Urine tests, Immunizations and vaccinations, other health risk assessments. The APE may also include evaluating your heart, lungs, abdomen, skin, eyes, ears,
nose, throat, and neurological function. Companies may require additional lab tests such as blood tests depending on age & work station may require complete blood count, lipid panel, blood glucose and urine tests (urinalysis).

Under the Occupational Safety and Health Standards (OSHS) of the Department of Labor and Employment (DOLE), certain industries, particularly those involving hazardous work, are required to provide regular health assessments to their employees not necessarily annual but at shorter intervals.

Manufacturing, the industry where I spent most of my career, is considered hazardous workplace. For instance, workers exposed to hazardous chemicals, extreme temperatures, or heavy physical labor must undergo periodic health checks to ensure that they are physically fit to perform their duties without
endangering themselves or others. Ambient & air quality tests, noise levels determination, air circulation flow among others may be required as well. Employers in these industries are mandated to ensure that such medical assessments are conducted regularly.

Based on Occupational Safety and Health Standards all examinations should be complete and thorough, be rendered free of charge to the employees, and include x-ray or special laboratory examinations when necessary due to the particular nature of the employment.

Though the APE can be conducted offsite, companies find it more economical & efficient to do it onsite so as not to hamper operations through their clinic/facility manned in partnership and/or in most instances in partnerships with duly accredited diagnostic/laboratories &/or medical institutions.

In some instances, forms of violations & inadequate implementation of the PEME or APE had led to substantial losses in terms of manhours and worst, loss of life.

Consider the following scenarios:

SCENARIO 1 Sudden Heart Attack

Mang Domingo was middle aged Facilities Maintenance technician. A father of two, he was also known to be able to down a good number bottles of his favorite beer with his friends during weekends. According to him, drinking with friends was his way to de stress and believes his three (3) times a week basketball game keeps him fit. Being a former high school varsity, we was a fixture during company inter department basketball tournaments.

In one of their games, he collapsed and died after just a few minutes later. He was only 40 years old.

SCENARIO 2 Lung Cancer

Manong Zosimo had worked for 30 years in the same company & had been a retired factory worker for five (5) years now. Being the only expert in a certain chemical washing process, he never changed process. He was constantly called out by the Health & Safety Officer for not being consistently compliant in the approved workplace safety procedures.

After experiencing constant dizziness and extreme weakness, he visited the provincial doctor for consultation. Results show that he had stage 4 lung cancer.

He died a few months later.

SCENARIO 3 Tuberculosis

Ate Perla was the nighshift cook for the company cafeteria. Her adobo, caldereta and menudo were a hit specially for employees doing graveyard. After the Annual Physical Exam (APE), a good number of employees were diagnosed with tubersculosis. Prior to this, their pre employment medical exams & their most recent Physical Check up never indicated such condition nor were there any signs .

Curiously, all infected employees were from the 3rd shift (10 pm – 6 am).

SCENARIO 4 Hearing Loss

Mr Nunez was assigned in the metal stamping area for five years until he realized that he wanted to apply his education as a Mechanical Technician on the job. Wanting to resign to work for a big mall, management, seeing his potential transferred him to Facilities Maintenance Engineering handling the diesel generator set & Boiler room. As a new supervisor, he was given a small office space right inside the generator room.

During meetings, many noticed that Nonito had a hard time understanding completely discussions and comprehending instructions.

When diagnosed by an Eye, Ear, Nose & Throat (EENT) Doctor he had irreversible hearing loss due to years workplace noise beyond acceptable decibels. Often times not wearing ear plugs or protection because they felt uncomfortable.

SCENARIO 5 Diabetis & Kidney Problems

Anissa was regularized on her third month of employment. One her seventh (7th ) month, the annual medical exams for regular employees was to take place.

The results of the Annual Physical Exams showed Anissa’s glucose tests showed very high level which never showed up in her pre employment exams.

When asked by the company doctor she ever experienced constant urge to urinate, blurring of vision, craved to eat all the time and had unexplained palpitations she said she noticed & felt that a year ago. Surprisingly, neither her PEME nor her APE results never indicated anything anomalies or alarming. One being just a few months ago.

Due to this condition, she is slowly losing her left eye sight and is set to undergo weekly kidney dialysis in the coming months.

In all the scenarios, the PEME & the APE tests results would’ve been red flags. Knowing better provides for both the employee & the employer peace of mind knowing that employees are fit for duty and can perform their job safely. The ability to undertake preventative measures to avoid serious health issues is also very important in addressing potential problems related to health. The early detection of potential health problems, reducing the risk of chronic diseases thereby reducing healthcare cost as well. The regular conduct of medical & physical exams can help employees maintain their physical and mental well being leading to improved productivity and reduced absenteeism.

For companies, it reduces the risk of workplace injuries and illnesses. Comply with relevant laws and regulations. Help reduce healthcare costs associated with treating preventable conditions. Improve employee productivity and reduce absenteeism.

The old saying that prevention is cure truly manifests its importance in all the stated scenarios. For the workplace, being aware of medical conditions and potential illnesses should be detected, diagnosed, tracked, managed & be managed only if the right & accurate information is acquired on a timely basis.

Lastly, it is always an important consideration in the scheme of things is that companies & HR should ensure is that they are getting reliable, accurate & timely information on the health & well being of its employees. That is why it is always important to make sure that companies partner with equally dedicated, reputable & reliable medical institutions &/or diagnostic centers that are both compliant to the requirements of the DOH, OHSAS and an audit done by the company’s health & safety committee based on their requirements and qualifications.

The health & safety of applicants & employees is the sole responsibility of medical professionals. HR & the Health & Safety Committee play a critical role as well. Any red flags should never be ignored at any point in time.

GOOD MORNING HARDWORKING PEOPLE!
For comments & suggestions, you may email author [email protected] & follow in Facebook Herrie Raymond Rivera.

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