Employers must organise occupational healthcare by law

Organising occupational healthcare is a legal obligation for employers. Summer workers are equally as entitled to preventive services as regular workers. 

Employers are free to expand their occupational healthcare beyond the statutory minimum by offering medical treatments and other healthcare services such as dental care, for example. These healthcare services are tax-exempt on the condition that the benefit is free of charge and available in equal measure to all workers and groups.  

The purpose of statutory preventive occupational healthcare is to: 

• prevent work-related diseases, illnesses, and injuries 
• promote a healthy work environment and working habits 
• improve the health, work ability, and functional ability of workers at different ages 
• develop the work community’s functioning. 

Kela reimburses employers for some of the costs of occupational healthcare. The costs and results of occupational healthcare are reviewed annually in industrial cooperation between the employer and the workers. The employer and the workers’ representative both sign the reimbursement application sent to Kela.  

Employers can choose how they organise occupational healthcare 

Employers may provide their own occupational healthcare services and medical treatments or procure them from the municipal provider or a private provider. 

The following information must be posted at the workplace: 

• who is the occupational health service provider 
• where the occupational health service is provided and what it includes 
• the names of occupational health nurses and physicians 
• the latest workplace health report produced by the occupational health service. 

The employers of agency workers also have the obligation to organise occupational healthcare. The occupational health service providers of the agency and its customer must cooperate to account for each worker’s current working conditions and the resulting need for healthcare services.  

Occupational healthcare is planned by the employer with the workers 

The planning and preparation of occupational healthcare is a cooperative process between the employer and their workers. The employer must provide the necessary information to the workers’ representatives in good time. 

The following are discussed every year in the occupational health and safety committee or with the occupational health and safety representative (if there is no committee):  

• content, extent, and general guidelines of occupational healthcare 
• occupational healthcare action plan 
• occupational healthcare implementation and impact assessment 
• content of voluntary medical care and healthcare services 
• worker suggestions for operational improvements 
• employer application to Kela for the reimbursement of costs resulting from occupational healthcare arrangements. 

Occupational healthcare planning is a cooperative process that also includes the occupational health service provider (occupational health physician and/or nurse). The employer must provide all necessary information that may affect the workers’ health to the occupational health service provider. This information includes but is not limited to the types of working hours, amount of overtime, age distribution, types of employment relationships, and all work-related information such as details of chemicals and machinery.  

The employer must also allow the occupational health service to access the workplace during business hours. 

Some occupational healthcare services may be organised as remote services. As a rule, workplace inspections carried out as part of a basic review or directed workplace surveys are made in person, however. 

The contract with the occupational health service provider must always be made in writing. If the employer also voluntarily pays for medical treatments, the examinations and treatments paid for by the employer (fully or partially) must be specified. 

Occupational healthcare content 

Occupational healthcare measures target individual workers, the work, working environment, work community, and the whole workforce. Their content is determined according to the workplace’s needs. 

For example, the following occupational healthcare is required by law: 

• workplace surveys 
• health examinations (pre-employment and health monitoring) 
• workplace health promotion (työkykyä ylläpitävä toiminta, tyky) 
• worker guidance on health hazards in the workplace 
• work ability monitoring, early support, and rehabilitation referrals  
• support for coping with work for partially disabled workers 
• referrals to treatment for substance abusers 
• working condition health impact and work community status monitoring (number of occupational illnesses and workplace accidents) 
• first aid readiness 
• post-crisis care (violence, serious workplace accidents, etc.). 

Workplace surveys 

Workplace surveys are the operational foundation of occupational healthcare. The survey includes the following:  

• chemical, biological, and physical exposure agents at the workplace 
• work-related physical, psychological, and social stress factors 
• work arrangements (working hours, employment relationships, overtime, etc.)  
• risk of accidents and violence. 

A written report is produced of the workplace survey and must be posted for viewing at the workplace. The survey is also used to prepare the health examination plan. 

The special features of the service sector such as agency work, part-time work, and temporary employment must be considered in occupational healthcare arrangements, especially for PAM members’ workplaces. In addition, working time arrangements that impact health such as shift work, night work, and adequate breaks must be considered. 

Pre-employment and other health examinations  

Health examinations are part of the preventive and promotive activities of the occupational health service. They are aimed at protecting the workers against work-related health risks, but also promote the workers’ health and recovery from work to maintain good work ability.  

In addition, health examinations are used in situations where an assessment of work ability or support is required. Goal-oriented health examinations are an important routine for occupational healthcare cooperation to support long-lasting working careers. 

If a health examination is carried out due to a specific risk of illness caused by work or work-related health requirements, a statement of fitness is always issued. For pre-employment and other voluntary health examinations carried out to assess health and evaluate and improve work ability, the issuing of statements is always negotiated by the occupational health service with the employer.  

These examinations do not assess the worker’s fitness for their duties but their current work ability in relation to the job. The agreed upon practice is included in the occupational healthcare action plan. 

Workers may not refuse health examinations required to assess their work ability. This especially concerns work that poses a particular risk of disease or illness. It must be noted that workers’ personal health data is always confidential, as is data that concerns a small group of workers. 

Factors posing a particular risk of illness  

A health examination is mandatory when a worker has duties that pose a particular risk of injury or illness, for example. A particular risk of illness may also be posed by the worker’s age, gender, physiological condition, night work, violence, or the use of new materials or methods.  

Workers should have a pre-placement health examination before they start working, but it may be postponed by up to a month from the first day of work. Periodic health examinations must be organised every one to three years. 

The factors posing a particular risk of illness present in PAM workplaces include, for example: 

• noise (restaurants and kitchens) 
• vibration of the hands (warehouses) 
• hot and cold work (restaurant kitchens, cold storage, ski resorts, property maintenance, and porters) 
• chemicals (cleaning and property maintenance) 
• asbestos (cleaning and property maintenance) 
• dust (cleaning, property maintenance, warehouses, and shops) 
• fungi, mould, and bacteria (cleaning, property maintenance, warehouses, shops, and restaurant kitchens) 
• night work (waiting staff, guards, and clerks) 
• violence and the threat of violence (shops, kiosks, restaurants, property maintenance, and guards). 

Health data processing and confidentiality 

Employers may only process personal data in the workplace when the data is directly necessary for the worker’s employment relationship. There can be no exceptions, even with the worker’s consent. Primarily, the data must be collected from the worker. 

Health data is classified as sensitive information. The data must be stored separately from any other personal data collected by the employer. In addition, the persons who process health data must be named or the duties that include the processing of health data must be specified. 

The occupational health service may only inform the employer of a worker’s fitness for their duties: fit, unfit, or partially fit with certain limitations. 

The only exception to confidentiality is work that involves a particular risk of illness on the condition that the conclusions of the health examination are related to occupational health and safety and occupational healthcare. Likewise, data may be released to the authorities for the supervision of occupational health and safety activities, as well as to another occupational health service provider if the worker transfers to another employer into a position with a similar risk of illness. 

Workers are entitled to their personal health data. All occupational healthcare must respect the patient’s rights and observe data protection legislation. 

Useful links 

• Occupational Health Care Act (pdf) (1383/2001) 
• Government Decree on the Principles of Good Occupational Health Care Practice, the Content of Occupational Health Care and the Qualifications of Professionals and Experts (pdf) (708/2013) 
• Government Decree on Medical Examinations in Work That Presents a Special Risk of Illness (1485/2001) 

See also 

• Occupational health and safety in the workplace – cooperation and collaboration 
• Workloads can be harmful 
• Early support helps maintain work ability