Workplace Medical Surveillance Programs

October 27, 2025 | On-site Work Safety

WorkCare has 40+ years of experience helping employers manage complex workplace medical surveillance requirements to reduce risk of exposure to health hazards, comply with applicable regulations, and protect employees from harm.

Medical surveillance programs are required in certain industries with health hazard exposure risks. Baseline and periodic physical exams are used to identify existing medical conditions that may increase a worker’s risk for injury or illness and exposure-related changes in health status over time. Surveillance trends provide insights for prevention strategies in regulated and non-regulated workplaces.

Why Workplace Medical Surveillance Matters

Millions of U.S. workers are exposed to workplace hazards that can potentially harm their health. Occupational Safety and Health Administration (OSHA) requires employers in certain industries to have comprehensive medical screening and surveillance programs. Timely scheduling of physical exams and laboratory tests, medical review by qualified providers, and secure document storage are essential aspects of these programs. Data collected through ongoing surveillance can be used to validate regulatory compliance, support proactive risk management interventions, and reduce legal liability exposure whether a surveillance program is mandatory or discretionary.

Key Benefits of Medical Surveillance Programs

Early identification: Symptoms of acute exposure to a hazardous substance or environmental condition may be clearly apparent, but many work-related medical complaints can go undetected without periodic medical surveillance. The earlier a medical condition is identified, the sooner appropriate care can be provided and preventive measures taken to prevent similar exposures.
Workforce retention: An employee with an underlying condition that increases their exposure risk or who experiences a work-related shift in health status may continue to work safely in the same or another job with appropriate care, protective measures, and in some cases, reasonable job accommodations as required by the Americans with Disabilities Act.
Cost containment: Medical surveillance programs produce measurable savings when employers comply with regulations and avoid citations. Corrective actions help lower medical treatment costs, workers’ compensation claims, and OSHA-recordable incident rates, reduce absence and lost productivity, and encourage employee retention. Objective findings can be used in legal and insurance defense matters to resolve disputes.

Medical Surveillance Program Components

A comprehensive program typically includes:

Exposure assessment: Identification of workplace hazards that may or may not be subject to medical surveillance requirements.
Baseline and periodic exams: Physicals based on exposure risks, e.g., noise, respirable particulates, biological agents, or toxic chemicals. (See Benzene Medical Surveillance for an example.)
Physician oversight: Occupational physician review of medical questionnaire and physician exam results, with follow-up when findings are outside of acceptable ranges.
Recordkeeping and reporting: Thorough documentation and secure electronic medical record storage to ensure regulatory compliance and safe operations. (See Managing Work-Related Medical Surveillance Exam Records.)
Trend analysis: Surveillance trend reports that inform job-specific and organizational intervention and prevention strategies.

How WorkCare Can Help

WorkCare has a 40+ year track record supporting employee health protections and compliance with medical surveillance requirements. Our Occupational Health Screening and Exposure Risk Assessment + Medical Monitoring teams design, administer, and manage cost-effective programs for employers in all types of industries based on existing hazards. This includes:

Assistance with timely scheduling of exams with qualified local providers
Occupational physician consultations, exam results review, and individual follow-up
Customized protocols that algin with applicable OSHA and industry standards
Electronic medical record storage and regulatory documentation management
Ergonomic injury surveillance to help reduce work-related musculoskeletal injuries
Biological exposure monitoring in laboratories and pharmaceutical manufacturing
Consultations to ensure readiness for on-site OSHA audits and record reviews

“I established WorkCare in 1984 as a consulting practice to help employers manage complex medical surveillance programs, ensure compliance, and provide measurable value through early injury and illness detection and prevention. With sound surveillance practices as our foundation, we have been able to expand our services in response to client needs across the occupational healthcare continuum.”
– Peter P. Greaney, M.D., WorkCare Founder and Chief Medical Officer

FAQs

Q: Which employees need to be included in a medical surveillance program?
A: OSHA requires surveillance for employees exposed to specific hazards above certain thresholds, such as noise, asbestos, lead, respirable crystalline silica, toxic chemicals, and biological agents.

Q: How often should medical surveillance exams be performed?
A: Frequency depends on exposure types and applicable regulations. Exams are commonly performed are part of the pre-placement process (baseline), annually, and upon termination or reassignment to another job.

Q: What does a typical exam include?
A: Job applicants and employees complete medical questionnaires that cover issues including occupational history, current health conditions and medical history, and personal behaviors such as smoking or drinking alcohol. WorkCare uses customized questionnaires that are reviewed by occupational physicians for outliers. For a sample OSHA questionnaire, refer to OSHA Safety and Health Regulations for Construction. Physical exams typically include vital signs, hearing and lung function tests, blood work, and other job-specific assessments.

Q: How are employee results managed?
A: Findings are documented in a standardized medical record and maintained in accordance with the Health Insurance Portability and Accountability Act and OSHA 1910.1020 recordkeeping requirements. The Genetic Information Nondiscrimination Act prohibits the collection of genetic information that may indicate predisposition for an injury or illness. Employers receive fitness-for-duty determinations and exposure trend summaries.

Next Steps

WorkCare can help your organization implement or enhance a compliant, cost-efficient medical surveillance program tailored to your industry and workforce risks. Contact us to learn how our occupational health experts can help you protect employee well-being, control costs, and strengthen regulatory compliance.

Incident Prevention + Wellness to empower a safer, healthier workforce

Injury Care at the onset of work-related injuries and illness

On-site Clinical Services for workplace hazard audits and physical exams

Consulting Medical Directors with training in toxicology and epidemiology

Physical Assessments + Exams for every stage of employment

Let’s Work Together

Ready to take your workforce health and safety to the next level?