Prepared By: Salah A. Skaik

A pre-placement or pre-employment examination is a medical assessment provided by a company.

The examination serves two functions:

to determine an applicant's ability to perform a specific job.

and to provide a baseline medical status against which to evaluate any occupational illnesses or injuries that might arise during employment.

It may include a physical examination, vision test, hearing test, pulmonary function test, electrocardiogram, chest X-ray, blood tests, urinalysis, and drug testing.

Job applicants may be required to be screened for drug and alcohol use prior to being hired.

Employees may be tested for drugs or alcohol in the workplace, where permitted by state law.

The physician must determine if the applicant can perform necessary job functions despite any medical condition he or she may have.

A company cannot, however, legally deny an applicant a job solely on the grounds of a diagnosis such as cancer or AIDS.

In addition, federal, state, and local laws prevent discrimination against people with disabilities.

The company can only deny the applicant employment if, in the opinion of the physician, the applicant is unable to perform the essential functions of the job

The existing research suggests that pre employment examinations are not even cost-effective in reducing a company’s potential financial liability

There also appears to be no added value for the pre-employment process regarding indirect costs.

Collings found no difference in future rates of absenteeism or productivity as a result of pre-employment examination findings

In a study performed for the International Labour Organization, it was noted that approximately 80% of drug testing worldwide occurred as part of a pre-employment process

pre-employment drug testing was performed by 98% of companies in the USA, while only 3% of companies did this in 1986.

One such analysis concluded that it cost a company US$ 77 000 to find one substance user during the pre-employment process

Globally 1.8 million people’s deaths every year are directly attributable to alcohol consumption

The National Institute of Health estimates that each drug abuser costs an employer approximately $ 7000 annually.

Therefore, a company like Steelcase would save $ 105,000 per year for every 100 employees hired by pre-screening applicants with hair analysis test.

In the United States, 77% of all illicit drug users are EMPLOYED! . That is more than 10 million workers

Substance abusers are 33% to 50% less productive than individuals who are not substance abusers.

Dollars spent on injury, fraud, indemnity, cost management, lost time, and rehabilitation.

◦ Average cost of back injury requiring surgery is $78,000.

◦ Average cost of same back injury under Jones Act is $750,000.

◦ Cumulative Trauma for one upper extremity can cost $55,000

What Are Ways of Reducing This Cost:

◦Drug Screen

◦Post-Offer Pre-Placement Physical Exam

There is very low quality evidence that pre-employment examinations that are specific to certain jobs or health problems could reduce occupational disease, injury, or sickness absence.

This supports the current policy to restrict pre-employment examinations to job specific examinations.

A study was undertaken at a large, multinational, industrial employer to determine if Pre-Employment Medical Screeningreduced the number of injuries and the resulting costs post

hire

The data for the study were gathered throughout the hiring process and tracked for 4 years.

CASE STUDY (Cont.)

The objective of the study was to determine whether or not the implementation of post offer screens would be a cost effective initiative to implement company wide,

and

to determine whether Pre-Employment Medical Screeningcould reduce the number of injuries and resultant suffering

The objective of the study

A group of 220 new hires participated in the study,

110 participated in Pre-Employment Medical Screening

and 110 did not

CASE STUDY (Cont.)

92 (83%) Of the screened group, passed the post offer screen and 18 (16%) did not. Only those passing the screen were placed in the jobs offered.

Individuals who did not meet the physical requirements of the job could retest for alternate jobs and potentially become employed in a position consistent with their functional capabilities.

CASE STUDY (Cont.)

The group that had post offer screens and, therefore, were known to have the physical capabilities to perform the jobs had only a 1% injury rate during the 4 years.

The group that did not have post offer screens experienced a 23% injury rate during the 4 years-a substantial difference in injury rates between the two groups.

CASE STUDY (Cont.)

Additionally,

the cost of injuries for the screened group was substantially less than those in the no screened group.

CASE STUDY (Cont.)

In this case, Pre-Employment Medical Screeningclearly positively impacted the number of occupational injuries and their resultant costs.

CASE STUDY (Cont.)

The findings of this case study are important to employers, employees, and occupational health professionals alike.

CASE STUDY (Cont.)

Employers must ensure the Health and Safety of their employees and the wider public who come into contact with their business.

the context of positions which could expose employees to injury , a pre-employment medical assessment plays a crucial part in the employer discharging its obligations under legislation and at common law to provide a safe workplace.

Conclusion