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10 February 2021
Occupational doctors' new tasks regarding COVID-19
Impact on occupational doctors' usual tasks
Occupational doctors can propose additional measures to employers
What does this mean for employers?
Checklist for employers
On 21 January 2021 a new royal decree was published in the Official Gazette which has temporarily extended occupational doctors' role in combating the COVID-19 pandemic in the workplace. Occupational doctors will be contact tracers in the workplace and in this context have been given the authority to:
This does not mean that employers can now have their workers tested on a large scale and systematically. Testing can happen only when the occupational doctor decides so and only for well-defined categories of worker (eg, high-risk contacts or when the occupational doctor deems testing necessary to combat an imminent outbreak in the company or for workers who must make a business trip abroad for which a negative test is required).
Occupational doctors must prioritise their new COVID-19-related tasks and will therefore be allowed to temporarily postpone their usual health surveillance tasks and to create a priority arrangement for those usual tasks in consultation with the employer. In addition, some consultations may take place by video or telephone.
The new tasks that occupational doctors have been temporarily entrusted with to combat COVID-19 in the workplace are as follows.
Tracking high-risk contacts within the company
Occupational doctors must identify the high-risk contacts of workers within the company in two specific situations – namely:
Providing quarantine certificates to workers whom they consider high-risk contacts
After identifying an infected worker's high-risk contacts, occupational doctors must issue a quarantine certificate to those workers. Subsequently, occupational doctors must inform the employer of such issuing and of the identity of the worker's high-risk contacts so that the employer can ensure that these workers do not come to the workplace during the period stated on their quarantine certificate.
If possible, workers who receive a quarantine certificate should perform their work from home (telework). However, if telework is impossible, workers are entitled to temporary unemployment allowances from the National Employment Office for the duration of the quarantine certificate.
Referring certain specific categories of worker for a COVID-19 test or conducting the test themselves
Occupational doctors can refer certain specific categories of worker to their personal doctor or to a test centre to conduct a COVID-19 test – namely:
However, the royal decree now explicitly states that occupational doctors can also conduct a COVID-19 test themselves or have it conducted by nursing staff under their responsibility for the categories of worker above if they consider this to be more appropriate. For example, this can be the case if:
Occupational doctors can either make a referral for or conduct both polymerase chain reaction tests and fast COVID-19 tests, depending on what is foreseen in the testing strategy of the competent authority.
Only workers who are physically present in the workplace can be referred or tested by the occupational doctor; this cannot happen for workers who are working from home.
During the COVID-19 pandemic, occupational doctors must prioritise these new COVID-19-related tasks over their other usual tasks regarding health surveillance.
Therefore, occupational doctors can temporarily postpone their usual tasks and create a priority arrangement for these tasks in consultation with the employer. In addition, some consultations may take place by video or telephone.
Only preliminary health assessments of applicants must always be carried out as a priority over other health surveillance examinations and always by means of a physical examination of the worker (ie, not by teleconsultation).
Employers must immediately inform the workers concerned and the health and safety committee (or, in its absence, the trade union delegation or, in the latter's absence, the workers themselves) of the measures taken concerning health surveillance (eg, that certain health assessments are being postponed) and the reasons for doing so. Employers must also inform the workers and the workers' representatives of the importance of cooperating with the occupational doctor within the framework of contact tracing and the quarantine arrangements.
If a number of infections have been detected, the occupational doctor may signal to the employer that additional prevention measures (eg, hygiene, ventilation and the organisation of work) are required to limit the spread of COVID-19 or prevent outbreaks.
In such a case, the employer, together with the competent prevention adviser (internal or external service), must review the risk analysis and consult with the health and safety committee (or, in its absence, the trade union delegation or, in the latter's absence, the workers themselves) as soon as possible and before taking the additional prevention measures.
Can employers now have their workers tested on a structural basis?
No, the royal decree clearly stipulates that it is by no means the intention that workers are to be tested systematically.
Employers cannot decide who should be tested and who should not be tested. The occupational doctor is the only person competent to make such a decision and they can decide so only for the specific worker categories listed above (eg, high-risk contacts or when testing is necessary to combat an imminent outbreak in the workplace or there are workers who must make a business trip abroad for which a negative test is required).
Can workers be obliged to take a test?
No, workers cannot be obliged to undergo a COVID-19 test as this affects their physical integrity.
What if workers refuse to take a test?
Since workers cannot be forced to take a test, they cannot be penalised by their employer for such a refusal.
However, if the occupational doctor considers that the worker in question is a high-risk contact, they could issue a quarantine certificate to this worker, even if the worker refuses to take a COVID-19-test.
The worker must then provide this certificate to their employer and the employer must ensure that the worker complies with the rules on permitted work during the quarantine. In concrete terms, this means that the employer can prohibit the worker from coming to the workplace during the quarantine.
If a worker refuses to be tested, the occupational doctor can also report a possible infection to the Sciensano database; if the worker violates their quarantine obligation, the occupational doctor can inform the regional infection control service of that fact.
Can employers direct occupational doctors to conduct a test on a worker?
No, the occupational doctor decides independently if and when they will subject a worker to a COVID-19 test.
When the employer knows that a worker is infected, they must report this to the occupational doctor as soon as possible so that the latter can contact the worker and check which of their high-risk contacts must be tested.
When a worker shows clear symptoms of illness (but has not yet tested positive), the employer must send them home and ask them to consult their personal doctor. If the worker refuses, the employer can notify the occupational doctor on the grounds that the physical condition of the worker undeniably increases the risks associated with the job (Article I.4-4, Section 2, point 2 of the Codex Wellbeing at Work). The occupational doctor then makes an independent assessment as to whether the worker should be subjected to a health assessment.
The new royal decree comes with several obligations for employers:
For further information on this topic please contact Esther Soetens or Annabel Coopman at ALTIUS by telephone (+32 2 426 1414) or email (email@example.com or firstname.lastname@example.org). The ALTIUS website can be accessed at www.altius.com.
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