Safety critical medicals are assessments designed to determine if a worker is physically and mentally capable of performing their job. When a role poses a significant health and safety risk to a worker and those around them, the position can be considered “safety critical” – think crane operators, train drivers or offshore rig workers. These jobs require not only technical skills but also the physical and mental resilience to respond to intense, unpredictable situations.
Why were safety critical medicals introduced?
Safety critical medicals were introduced in response to research that found construction workers had some of the poorest health, and highest accident/mortality rates of any industry. By proactively identifying health risks, safety critical medicals prevent accidents and create a safe working environment where everyone can feel confident in each other’s capabilities.
The purpose of safety critical fitness standards
Fitness standards serve as a benchmark, ensuring that individuals have the physical and cognitive ability required to meet the unique demands of their roles. These standards help reduce the likelihood of accidents, protect the integrity of an organisation and safeguard lives. They provide reassurance, not only to employers but also to employees, who know that they are being supported to perform at their best. At MOHS we publish our standards to bring clarity to our fitness decision making process and help workers understand the context in which these decisions are taken.
| Component | Fitness Standard | Recall |
| Skin | No work-related issues/rashes/dermatitis. | Annual |
| Respiratory | FVC and FEV1 should be 80% or above prediction. Repeat FVC or FEV1 less than 30ml difference. Symptoms may require referral to employees GP regardless of fitness decision. | Annual |
| HAVS 1&2 (if exposed) | No symptoms. Positive HAVS or CTS symptoms require Tier 3 review. A positive tier 3 outcome will require Tier 4 review with a physician. | Annual |
| Audio | Cat 1 or 2. Worse results may require adjustments and referral to the employee’s GP for investigation. Unilateral results do not usually affect fitness decisions. Cat 3 & 4 outcomes may require adjustments or a functional assessment. | Between1 & 3 years, depending on result |
| Blood Pressure | General work, less than 180/110 Heavy plant & HGV less than 180/100 | Up to 3 years. |
| Vision (Distance) | General work minimum 6/12 in one eye Heavy plant & HGV operation minimum 6/7.5 in one eye and 6/60 in the other | Up to 3 years. |
| Vision (Peripheral) | No deficits. Problems should be referred to optician | Up to 3 years. |
| Vision (Colour) | Ishihara test, normal result. Deficits may require adjustment or functional assessment. | Up to 3 years. |
| Vision (Near) | N6 both eyes. Deficits referred to optician but do not usually affect fitness decisions. | Up to 3 years. |
| Mental Health | Free from mental health issues that may affect concentration or decision making. Where there is a safety risk, employee’s fitness should be deferred, and they should be referred to their GP or a mental health practitioner for review. | Up to 3 years. |
| Urinalysis | No Anomalies – Positive results should be referred to employee’s GP. If signs of diabetes, consider symptoms and defer if risk of unconsciousness is evident. | Up to 3 years. |
| Musculoskeletal issues | Free from issues that might affect safety including climbing and safe vehicle operations | Up to 3 years. |
The decision making process
The process of deciding whether someone meets safety critical fitness standards goes beyond health metrics. Occupational health specialists look at how these metrics interact with the unique requirements of the job. For example, it’s not only important to determine whether a worker has good hearing, but whether their hearing is at a level suitable for a role where auditory cues are essential for safe operation. Detailed analysis helps determine if an individual is fit for the role in question or if additional measures, accommodations or even alternative responsibilities may be necessary.
Importance of periodic recertification
Health is dynamic, meaning that someone’s ability to meet safety standards can change over time. This is why regular reassessments are essential. Periodic recertification allows occupational health professionals to monitor any changes in a worker’s health that could affect their job performance. It also offers employees peace of mind, knowing that their health is being monitored and supported. Whether it’s adapting to age related changes, managing a new health condition, or recovering from an injury, recertification ensures that employees remain fit and ready to perform their jobs safely.
Final thoughts
Fitness standards for safety critical work are about much more than compliance. They represent a commitment to the health, safety and wellbeing of everyone at your organisation. Monitoring employee health not only reduces the risk of an incident, but also helps create a culture of trust and responsibility. At MOHS we conduct safety critical medicals for companies across the West Midlands. To learn more about how medicals can help your organisation, click the link below: