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Global Occupational Health$
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Tee L. Guidotti

Print publication date: 2011

Print ISBN-13: 9780195380002

Published to Oxford Scholarship Online: May 2011

DOI: 10.1093/acprof:oso/9780195380002.001.0001

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Fitness to Work

Fitness to Work

(p.329) 17 Fitness to Work
Global Occupational Health

John W. F. Cowell

Oxford University Press

Fitness to work, as a concept, is a match between the capabilities of the worker and the work that the worker is being asked to do. The health provider who conducts a fitness-to-work evaluation needs to know the worker’s physical condition, mental capacity, skill level and any conditions that might place the worker at risk for injury or for injuring others. These capacities are then matched against the requirements of the job. The most common form of fitness-to-work evaluation is the preplacement, or preemployment evaluation, which are conducted when the worker is first hired or assigned to a new job. The preferred term, preplacement evaluation, implies that the decision to hire has already been made and the evaluation that is to be conducted is specific to the job assignment. Periodic health evaluations are a form of surveillance in which workers are examined at intervals, usually every year but sometimes less often, to determine whether they show early signs of an occupational illness. The purpose is to prevent more serious illness and to allow early treatment, if this is possible. Return-to-work evaluations are conducted when a worker has recovered from an injury and illness, whether work-related or not, and a determination must be made whether that worker can return to work safely. An adequate job description is the basis for all fitness-to-work evaluations and the health provider should ask the employer for a job description in writing. If health standards are known (such as strength, flexibility, good eyesight and good hearing) they should be spelled out in the job description. Only those health standards directly related to the job conditions and job performance should be considered. A worker’s general health is not a reason to deny them employment if they can do the work safely. The judgment of fitness to work is based on current capacity, not the worker’s medical history. The health care provider may make three judgments: fit to work, unfit to work and fit subject to accommodation or modification. The judgment is the only information that the health care provider should report to the employer.

Keywords:   fitness to work, preplacement evaluation, preemployment evaluation, periodic health surveillance, return to work, job description, health standard, functional capacity evaluation

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