We don't do exit (or pre).

We do annual checks for affected employees. And we know what exposures during a year are. We have never been questioned about an ex - employees health. If we were, we would take last annual check results and add exposure to get a sense of likely harm. Which would be virtually nil any way since the testng is showing exposures not causing any problems.

I have seen companies overseas do this as a matter of course and in that case, from a medical point of view, the purpose and benefit is questionable, especially if appropriate monitoring has already been performed. It may be different from a legal perspective.

Could be medically justified if role has involved an overseas posting to a tropical area where asymptomatic infections could be screened for although this is controversial.

Slightly different to your question, but an exit medical could be useful in specific cases where it is already known that significant illness, injury or exposure has occurred in the role. Purpose being to document current state of health, ensure that appropriate medical management/ education is in place.

If you'r doing pre and regular health monitoring then you should have an exit one, otherwise how do you know that subsequent changes against the baseline did not occur in that last year.

Organisations like Defence, Police and high risk industries that have pre-employment medicals normally carry out exit ones just to cross the T's and dot the i's.

Organisations that carry out pre-employment medicals do so to determine a baseline per worker, and to determine whether the worker's status meets the health fitness requirements for the role. The annual monitoring would be to check for any changes in that baseline that could possibly be a result of exposure to health related hazards within the workplace. Any changes noted enables the employer to address the issues and review the hazard controls.
So, a common practice I've seen around exit medicals for workers who are leaving the organisation is that if the annual screening was not conducted in the previous 6 months, then an exit medical will be done. However for workers that have been exposed to more significant risk environments - it would be a recommendation for them to undergo an exit medical examination, irrespective of whether a screening was done in the previous 6 month period. The employer can therefore demonstrate that they have been responsible in ensuring worker health.....

It depends on the type of working environment and what the workers are exposed to. I generally recommend pre-employment medical and annual monitoring thereafter. The exit medical should be done as part of a comprehensive health monitoring program

One aspect that may have been overlooked as to why you should complete exit medicals, and separate from whether pre or annual (which in some industry is mandatory) health monitoring has been undertaken or not is....... that you get your worker to declare the items below:

* Are you aware of any ill effects from any work you have done whilst working here? – Illnesses, injuries,
potential harmful exposures
* Was this injury/illness reported and recorded on an accident/incident form/database?
* Has this injury/illness been resolved? Please detail any on-going treatment
* Do you have an open injury case/claim?
* I agree to the contents of this record and confirm that it reflects a true record in regard to my past and
present occupational health.

This, to some degree anyway, indemnifies the Business from a worker claiming ACC (or other) benefits after they have left your employ. It is important to try to ensure they have no current injury or they have no undeclared injury as you maybe paying for their treatment through additional levies (ie your experience rating).

Now commenting on the responses re pre-employments.

* It is not always practical for some business to easily obtain pre-employment medicals, however some
GP's are providing this service.
* As minimal protection to the Business, completion of a pre-employ health questionnaire is essential.
* If no pre-emp med, the you can use the first annual medical as the baseline going forward (not ideal).
* WorkSafe is now (much more than OSH ever did) wanting to see evidence of annual health
monitoring espicially (but not only) around respiratory illness and noise induced hearing loss risks.

Certainly exit monitoring for those exposed to noise is essential, both for the person themselves and to establish the level of noise induced hearing loss (if any) when they left the company so as to mitigate future very expensive ACC claims. We have a policy to do that, but to be fair it's often overlooked.
As part of our health monitoring programme we do undertake pre-employment monitoring (there are different levels) which include establishing a baseline for hearing loss.

Our Health Monitoring Program covers before, during and after you leave our business.
Pre-medial covers off on potential health issues prior to being offered employment. Annual Health checks conducted to identify any changes in health while in our employment and Exit Medicals to ensure your health is healthy when you have left our business. For that i guess it touches on medical liability/ACC should an ex-employment suffer severe health issues later in life we as a business are able to confirm the health condition of ex-employees plus it gives the employee peace of mind also.

We currently only complete pre employment. I have looked into exit medicals, but in reality it is harder to achieve them. We complete medicals through their employment and this should give us their base line.

We do pre employment, health monitoring for high risk roles and exit interviews more so than medical unless employee has flagged as a concern / been injured wtc. These are done for all employees who serve over 6 months . Our HR team usually complete the exit Interviews and the Nurse will do exit medical.

I've given a LOT of thought to this and I cannot see that they CAN be particularly valid. I'm thinking particularly about lung capacity and hearing. HOW can any employer know what their employees are doing after hours? Consistently loud music? Concrete sanding, sanding oak furniture without a mask? HOW can anyone POSSIBLY know? And if no-one can know what is the point of in-house testing? There is surely not necessarily a lot of proof that hearing or lung damage can have occurred at work.

On the contrary there is a lot of validity in this testing , particularly hearing tests. First for the individual themselves whether its work related or not. And secondly while it may be difficult to establish work relatedness, for hearing there are questionnaires that the employer completes, the individual completes and the GP completes. ACC then pro-rata costs. This works pretty well in our experience and fairly establishes what is work related and what is not. If baseline testing was done at start of employment, and if the employer could clearly establish controls in place, then any loss would likely be after hours. So the value of this testing shouldn't be dismissed

That's why you can carry out exposure monitoring to measure the exposure levels of the hazard (noise, dust, vapours, etc) at the workplace as a means of assessing at-work exposures.

Thank you Mike. "For the individual themselves' - useful but not an employer's responsibility. Yup, I see that baseline plus controls would work. Thanks again.