Periodic Medical Examination Frequency and Tests

When is health surveillance carried out?

Art. 15 of Law No. 6331 on Occupational Health and Safety obliges the employer to place workers under health surveillance according to the risks they are exposed to. Under the Law, medical examinations are carried out in four situations:

1. On recruitment,
2. On a change of job,
3. On return to work after an occupational accident, an occupational disease or repeated absences for health reasons, if the worker requests it,
4. At regular intervals throughout employment, determined according to the nature of the worker and the work and the hazard class.

The change-of-job provision is often overlooked. A worker moving from the warehouse to the paint line is now exposed to solvent vapour, and an operator moving from the press to the welding section to welding fumes; a new exposure means a new examination and, if necessary, new tests. The cost of health surveillance and any additional cost arising from it is borne by the employer and may not be passed on to the worker (Art. 15/4).

How often is the periodic medical examination carried out?

The intervals are set in Art. 9 of the Regulation on the Duties, Powers, Responsibilities and Training of Workplace Physicians and Other Health Personnel:

These are maximum intervals. The Regulation expressly states that these periods are shortened where the workplace physician considers it necessary. The physician may shorten the interval on seeing high exposure, a finding that began at the previous examination, a chronic illness or a value approaching the limit in a workplace measurement. Workers who have completed the age of 15 but not yet reached 18 are defined in the Law as “young workers”; assess your interns and apprentices in this light too.

An example: for an operator who joined a metalworking factory in the hazardous class in March 2026, the periodic examination must take place by March 2029 at the latest. If the operator is exposed to noise above 85 dB(A), the physician may schedule hearing tests more frequently; a 17-year-old intern at the same factory, on the other hand, is examined at least every six months. So even within the same workplace, workers’ examination dates follow different rhythms and need to be tracked person by person.

Examination results are recorded in accordance with the Annex 2 Pre-employment/Periodic Examination Form appended to the Regulation and kept at the workplace. In a Bursa factory with hundreds of workers, planning examinations in batches by department or exposure group rather than spreading them by recruitment date both disrupts production less and ensures that tests are carried out consistently. You can use the OHS renewal calendar to track dates; if you are unsure of your class, see our hazard class guide.

Fitness-for-work report: who issues it, and who cannot start without one?

Art. 15/2 of the Law is clear: those who will work in jobs in the hazardous and very hazardous classes cannot start work without a medical report stating that they are fit for the work they will do. Since 2014 the text of the Law has used the word “jobs” instead of “workplaces”; what is decisive is the work the worker will actually do. A pre-employment examination is also mandatory in less hazardous work, but the ban on starting work without a report is expressly laid down for hazardous and very hazardous work.

In practice, the report should be issued with knowledge of the work the worker will do and the exposures in the risk assessment. A document titled “general medical report” that does not show which job it was issued for does not demonstrate the fitness of a press operator or an assembler working at height. If the physician considers that a worker is not fit for their previous job, they propose suitable work and submit it for the employer’s approval. The workplace physician also checks the validity of the reports of workers coming through a subcontractor or a temporary employment relationship.

Exposure-based tests: what is fixed in legislation and what is the physician’s decision

The answer to the question “which test for which worker?” usually lies not in a regulation article but in the risk assessment and the physician’s decision. The main exposures with express provisions in the legislation are noise and dust.

Noise. Under Art. 5 of the Noise Regulation, the lower exposure action value is 80 dB(A), the upper exposure action value 85 dB(A) and the exposure limit value 87 dB(A). Under Art. 13, if 85 dB(A) is exceeded, hearing tests must be arranged by the employer; if 80 dB(A) is exceeded and the risk assessment and measurement results indicate a health risk, a hearing test may be arranged.

Dust. Under Art. 11 of the Regulation on Dust Control, chest radiographs are taken to standards complying with the ILO International Classification of Radiographs of Pneumoconioses; the workplace physician determines their frequency.

Other tests. For tests such as pulmonary function tests, complete blood count, liver and kidney function tests, metal levels in blood or urine and eye examinations, the legislation sets no fixed frequency applying to all workers. The physician decides who has which test at what interval by looking at the risk assessment and workplace measurements.

In Bursa’s industrial profile this table has concrete counterparts: noise on automotive supplier press lines, dust in casting and grinding work, chemicals in textile dyehouses, wood dust and varnish in furniture workshops. A correct test plan first requires correct workplace measurements. We plan measurements and tests with authorised laboratories and health institutions, and record the results in both the health file and the risk assessment.

Special situations: vulnerable groups, return to work and suspected occupational disease

The periodic calendar is only one part of health surveillance. Art. 9 of the regulation governing the duties of the workplace physician also lists several situations that apply outside the calendar:

• Groups requiring special policies. For young, older, disabled, pregnant or breastfeeding workers, the physician carries out the necessary examinations and prepares a report for their placement in suitable work. When a pregnancy is reported, the worker’s duties, exposures and shift should be reassessed together with the physician.
• Return to work. After repeated absences for health reasons, a return-to-work examination is carried out if the worker requests it. If the physician considers that the worker is not fit for their previous job, they propose suitable work and submit it for the employer’s approval. On return after an occupational accident, this examination should be planned together with additional training.
• Link between absence and the workplace. If health-related absences may be linked to health hazards at the workplace, the physician may plan workplace measurements.
• Suspected occupational disease. If a worker is diagnosed with an occupational disease, the physician repeats the examinations of other workers in the same environment. Under Art. 14 of Law No. 6331, the workplace physician refers a case with a preliminary diagnosis of occupational disease to a health care provider authorised by the Social Security Institution (SGK); the employer in turn notifies SGK of an occupational disease reported to it within three working days of learning of it.
• Communicable diseases. The physician arranges the necessary examinations and tests relating to communicable diseases; this heading is particularly important in work with high hygiene sensitivity, such as food production.

What these situations have in common is that the business must pass on information in time for the physician to be able to decide. Long sick notes, pregnancy notifications, changes of duty and recurring complaints should flow regularly from HR to the physician.

Examination process and records

A well-functioning health surveillance cycle consists of the following steps:

1. Exposure list: Exposures for each task are drawn from the risk assessment and measurements.
2. Test protocol: The physician determines pre-employment and periodic tests by task group.
3. Examination and report: The Annex 2 form is completed and fitness for work is assessed.
4. Feedback: Findings are transferred, without identifying individuals, to the risk assessment and action plan; for example, if hearing loss is increasing in a department, noise controls are reviewed.
5. Calendar: The next examination date is recorded for each person.

The basic administrative fine for 2026 for failing to carry out health surveillance or obtain reports is 22,194 TL per worker. No hazard class increase is applied to this fine, which is multiplied by the number of workers, but the amount grows directly as the number of workers increases. For current amounts, see the OHS administrative fines tool.

Confidentiality and workers’ rights

To protect the private life and reputation of the worker examined, health information is kept confidential (Art. 15/5). The workplace physician and other health personnel are also obliged to keep the worker’s personal health file confidential. In practice this means that HR and production managers know the result “fit for work” or “fit with this restriction”; diagnosis and test details remain with the physician. Keep health files separate from personnel files with restricted access.

Workers’ rights are also clear: the cost of tests cannot be deducted from the worker, they can request an examination on return to work, and there is a route to object to the report. In our health surveillance and workplace physician services, we run the risk-based test plan, the examination calendar and the records on these principles.

Frequently Asked Questions

How often is the periodic medical examination carried out?

In less hazardous workplaces at least every 5 years, in hazardous workplaces every 3 years and in very hazardous workplaces every year. For child, young and pregnant workers this period is at most 6 months. The workplace physician shortens the intervals if they consider it necessary.

Can we obtain the pre-employment report from a family doctor for our less hazardous workplace?

Yes, if you are a less hazardous workplace with fewer than 50 workers: in addition to the workplace physician, reports may also be obtained from ÇASMER (occupational diseases hospitals), family doctors or other public health care providers. In other workplaces, reports are obtained from the workplace physician.

Are a chest X-ray and pulmonary function test mandatory for every worker?

No. Workers exposed to dust have a chest radiograph in line with the ILO classification. For pulmonary function tests and other tests, the legislation sets no fixed rule applying to everyone; the workplace physician decides according to the risk.

Which tests are carried out at the pre-employment examination?

The workplace physician determines pre-employment tests by looking at the exposures of the work the worker will do. A hearing test for someone who will work in a noisy department and a chest radiograph for a dusty department are typical examples. These initial results should not be skipped, as they are the reference point for later periodic tests.

Can we deduct the cost of tests from the worker’s salary?

No. The cost of health surveillance and any additional cost arising from it is borne by the employer and may not be passed on to the worker. The time spent on examinations and tests should also be treated as working time in planning.