Working at height: how to prepare for the medical check

Why the checks are stricter

Work at height, whether on scaffolding, roofs, masts, structures or elevated areas from two metres up, carries different risks from ground-level work. If a worker faints, becomes dizzy or cannot see clearly while elevated, the consequences can be far more serious than a fall at ground level.

Pre-employment and periodic checks aim to identify the risks that could lead to a fall or serious accident, and to help the safety team plan appropriate controls.

What is usually tested

Requirements differ between employers, but common items include:

• History of conditions that risk fainting, such as heart disease, epilepsy, poorly controlled diabetes or severe dizziness
• Physical examination and blood pressure measurement by a doctor
• Electrocardiogram (EKG) when the doctor considers it appropriate
• Chest X-ray, plus vision and colour discrimination testing
• Hearing tests where noisy areas are also part of the job

Preparing for the day

If blood tests are included, fast for 8-10 hours; plain water is fine. Sleep well and avoid alcohol before the appointment, as both affect blood pressure and the electrocardiogram.

Bring the glasses or hearing aids you normally use so results reflect your real working ability, and tell the doctor about every medicine you take, particularly anything affecting blood pressure or heart rhythm.

How the results are used and when to retest

The result is a medical opinion on whether you are fit for work at height, with notes the safety team can use, such as reviewing protective equipment or adjusting rest schedules.

Surveillance programmes commonly require annual retesting, or retesting when job duties change or when age and medical conditions change. Check your employer's requirements before the visit.