Saf Health Work.  2014 Sep;5(3):165-167. 10.1016/

Developing a Best-Evidence Pre-employment Medical Examination: An Example from the Construction Industry

  • 1Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, The Netherlands.


The Dutch construction industry has introduced a compulsory preemployment medical examination (PE-ME). Best-evidence contents related to specific job demands are, however, lacking and need to be gathered. After the identification of job demands and health problems in the construction industry (systematic literature search and expert meeting), specific job demands and related requirements were defined and instruments proposed. Finally, a work ability assessment was linked to the instruments' outcomes, resulting in the modular character of the developed PE-ME. Twenty-two specific job demands for all Dutch construction jobs were identified, including kneeling/squatting, working under time pressure, and exposure to hazardous substances. The next step was proposing self-report questions, screening questionnaires, clinical tests, and/or performance-based tests, leading to a work ability judgment. "Lifting/carrying" is described as an example. The new modular PE-ME enables a job-specific assessment of work ability to be made for more than 100 jobs in the Dutch construction industry.


high-demand jobs; preemployment medical examination; specific job demands; specific job requirements
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