Pre-employment Health Examinations: Evidence and Implications for Practice in Thailand

Krittin Nakaphadungrat; Supakorn Chansaengpetch; Narongpon  Dumavibhat; Tirathat  Virojskulchai; Nantapong  Chansaengpetch

doi:10.64960/srimedj.v41i4.271213

Authors

Krittin Nakaphadungrat Department of Community, Family and Occupational Medicine, Faculty of Medicine, Khon Kaen University, Mueang, Khon Kaen, Thailand 40002
Supakorn Chansaengpetch Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Pathum Wan, Bangkok, Thailand 10330
Narongpon Dumavibhat Siriraj Tuberculosis Comprehensive Center, Siriraj Hospital, Mahidol University, Bangkok Noi, Bangkok, Thailand 10700
Tirathat Virojskulchai Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok Noi, Bangkok, Thailand 10700
Nantapong Chansaengpetch Chakri Naruebodindra Medical Institute (CNMI), Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bang Phli District, Samut Prakan Province, Thailand 10540

DOI:

https://doi.org/10.64960/srimedj.v41i4.271213

Keywords:

occupational health, occupational injuries, employment, preventive health care, drug abuse screening

Abstract

Background and objective: Pre-employment health examinations are widely used, however, their effectiveness in preventing adverse occupational health outcomes remains in question. Therefore, this study aimed to examine the evidence on the effectiveness of pre-employment and pre-placement assessments and to consider their implications for practice, with particular reference to Thailand.

Methods: This study is a narrative review synthesizing evidence from studies identified through database searches (PubMed and Scopus), focusing on effectiveness, predictive value, and implications of pre-employment and pre-placement assessments.

Results: Overall, current evidence is insufficient to support a routine pre-employment examination in reducing occupational injury, illness, or sickness absence. Some evidence suggests that assessments focused on specific job risks may be more appropriate.

Conclusions: A targeted, risk-based approach is more appropriate than routine screening. In Thailand, a gap exists between policy and practice. Further research is required to support evidence-based occupational health policies.

References

Liss DT, Uchida T, Wilkes CL, Radakrishnan A, Linder JA. General health checks in adult primary care: a review. JAMA 2021;325(22):2294-306. doi:10.1001/jama.2021.6524.

Schaafsma FG, Mahmud N, Reneman MF, Fassier JB, Jungbauer FH. Pre-employment examinations for preventing injury, disease and sick leave in workers. Cochrane Database Syst Rev 2016;(1):CD008881. doi:10.1002/14651858.CD008881.pub2.

Alexander RW, Brennan JC, Maida AS, Walker RJ. The value of preplacement medical examinations for nonhazardous light duty work. J Occup Environ Med 1977;19(2):107–12. doi:10.1097/00043764-197702000-00001.

Madan I, Williams S. Is pre-employment health screening by questionnaire effective? Occup Med 2012;62(2):112–6. doi:10.1093/occmed/kqr208.

Cookson WO, Ryan G, MacDonald S, Musk AW. Atopy, non-allergic bronchial reactivity, and past history as determinants of work related symptoms in seasonal grain handlers. Br J Ind Med 1986;43(6):396–400. doi:10.1136/oem.43.6.396.

Talini D, Monteverdi A, Lastrucci L, Buonocore C, Carrara M, Pede FD, et al. One-year longitudinal study of young apprentices exposed to airway occupational sensitizers. Int Arch Occup Environ Health 2006;79(3):237–43. doi:10.1007/s00420-005-0040-0.

Pachman J. Evidence base for pre-employment medical screening. Bull World Health Organ 2009;87(7):529–34. doi:10.2471/BLT.08.052605.

Pidd K, Roche AM. How effective is drug testing as a workplace safety strategy? A systematic review of the evidence. Accid Anal Prev 2014;71:154–65. doi:10.1016/j.aap.2014.05.012.

Levine MR, Rennie WP. Pre-employment urine drug testing of hospital employees: Future questions and review of current literature. Occup Environ Med 2004;61(4):318–24. doi:10.1136/oem.2002.006163.

Zwerling C, Ryan J, Orav EJ. The efficacy of preemployment drug screening for marijuana and cocaine in predicting employment outcome. JAMA 1990;264(20):2639–43. doi:10.1001/jama.1990.03450200047029.

Thai Government Gazette. Ministerial regulation prescribing standards for health examinations of employees working with risk factors B.E. 2563 [Internet]. Bangkok: Thai Government Gazette; 2020 [cited Mar 26, 2026]. Available from: https://www.ratchakitcha.soc.go.th/DATA/PDF/2563/A/080/T_0030.PDF

Kongsin T. Fitness for work assessment of employees who receive pre-placement examination in a general hospital, Nakhon Ratchasima province. J R Thai Army Nurses 2023;24(2):335–44.