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Pre Employment Medical Test
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Pre Employment Medical Test

Can your provide guidance in preparing Preemployment medical checkup for employees in construction, What type of Physical and Laboratry test to be carried out.
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Avatar_dr_m_tn
Hello,

There is a great deal of variability in best-practices for pre-placement medical examinations in the construction industry depending on many factors: type of construction work; location (geographic); anticipated work conditions (cold, warm, dry, etc); size of the employer.

PHYSICAL EXAMINATION:
- Full physical examination (including blood pressure, heart & lung examination, musculoskeletal examination, hernia evaluation, etc)
- Lift Test (usually done by a physical therapist)


LABORATORY TESTING to consider -
• Complete Blood Count
• Urine Routine & Microscopic
• Chest X-ray (CXR)
• Hepatitis B(Ag &Ab) & C Profile
• HIV
• VDRL
• Urine Drug Screening (cannabis, amphetamines, codeine,
benzodiazepines, opioids)
• Electrocardiogram

• Fasting Lipid Profile
• Fasting Blood Sugar
• HbA1C (diabetics only)

Other additional tests to consider for construction workers:
• Spirometry
• Audiometry (baseline hearing test)
• Urea,Electrolytes,Creatinine
• Blood Lead (e.g. workers involved in demolishing & repairing
old buildings
4 Comments
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144586_tn?1284669764
The most critical physical problem in construction is heavy lifting. At some time or other a construction worker will end up in a situation to carry a load that is too heavy or over terrain that precludes a "proper" carry. This is the kind of an task that can produce injury that is likely to be exacerbated and possibly end up in a workman's compensation claim. One of the screens should be to request a detailed verbal history that might suggest such an injury, and, although it is not normally done, a lumbar MRI to determine disc compression might be in order. Employees should be instructed in the proper manner of lifting, but in my experience a number of construction injuries are due to the fact that even if something is very heavy, there is a psychological block to asking for assistance. Similarly, other workers figure that "that's something a man should be able to lift" and will stand by and not provide assistance. Instructing a crew to always be cooperative and assist one another in lifting by supervisor helps.
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Avatar_dr_m_tn
Hello,

In the comment posted above, caregiver222 makes several important points regarding the usual physical demands that workers in the construction industry face in their jobs.

While I agree that worker education regarding lifting techniques, using assisted lifting equipment and "lift teams" are ideas to consider, MRI (magnetic resonance imaging) is rarely (if ever) used as a "screening" test in the pre-placement or pre-employment examination.

There are well documented clinical guidelines that guide medical providers in their decision-making process in determining when diagnostic imaging is indicated in patients or employees who present with lower back pain.

~•~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.
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144586_tn?1284669764
"Lift Teams", as suggest by Dr Parks are a great idea. Decades ago I worked in construction and th "standard" was for one man to carry an 80 pound sack of concrete in a union environment. There could be five guys standing around, but that 80 pound sack was considered a "man's load". I ended up supervising the crew and devised a stretcher so two men would transport one sack. It took a little longer, but that means only forty pounds plus ten or so for the stretcher. It was the same for a four by 12 sheet of 3/4 plywood. The "standard" was "one man carries one sheet". And we had to carry these sheets while walking over planks some distance above the ground.  I ended up relieved by the supervisor because we were "taking too long". D. Park is correct in stating that an MRI is never used. But the MRI is a rather recent invention, with few contraindications except expense. A good history should do just as well. Another test to think about would be depth perception and eyesight. There are various types of construction jobs but my work involved tall buildings and I was often suspended in a boatswain's chain by a rope and lowered on the side of the building to "point" the bricks. And we would often have to walk on high scaffolding and signal men lowering tools or objects and reach for them. I always had good depth perception, but we had a terrible non-fatal) accident when someone misjudged distances. It turned out the worker had only one good eye and as a result, non-existent depth perception. He came back to work, but was relagated to a "ground floor" job.
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Philip D Parks, MD, MPH, MOccH, F...Blank
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