Medical screening and medical surveillance are two fundamental strategies for optimizing employee health. Although the terms are often used interchangeably, they are quite distinct concepts. Medical screening is, in essence, only one component of a comprehensive medical surveillance program. The fundamental purpose of screening is early diagnosis and treatment of the individual and thus has a clinical focus. The fundamental purpose of surveillance is to detect and eliminate the underlying causes such as hazards or exposures of any discovered trends and thus has a prevention focus. Both can contribute significantly to the success of worksite health and safety programs.

However, OSHA “medical surveillance” requirements are generally clinically focused (e.g.,medical and work histories, physical assessment, biological testing) with information obtained from the clinical processes used in the monitoring and analysis elements of medical surveillance.

Standards – Medical screening and surveillance are addressed in specific OSHA standards for general industry.

General Industry (29 CFR 1910)  For more detail, click on specific subpart or related information.
1910 Subpart H – Hazardous Materials1910.120, Hazardous waste operations and emergency response.
1910 Subpart I – Personal Protective Equipment1910.134, Respiratory protection.Related Information
1910 Subpart Z – Toxic and Hazardous Substances1910.1001, Asbestos. See Appendix H for information related to Medical Surveillance Guidelines for Asbestos Non-Mandatory.Related Information

State Standards

There are 29 OSHA-approved State Plans operating state-wide occupational safety and health programs. State Plans are required to have standards and enforcement programs that are at least as effective as OSHA’s and may have different or more stringent requirements.

Medical Screening

Medical screening is a method for detecting disease or body dysfunction before an individual would normally seek medical care. Screening tests are usually administered to individuals without current symptoms, but who may be at high risk for certain adverse health outcomes. The following references provide information about medical screening and clinical evaluation.

Clinical Evaluation

Medical Surveillance

Medical surveillance is the analysis of health information to look for problems that may be occurring in the workplace that require targeted prevention. Thus, surveillance serves as a feedback loop to the employer. Surveillance may be based on a single case or sentinel event, but more typically uses screening results from the group of employees being evaluated to look for abnormal trends in health status. Surveillance can also be conducted on a single employee over time. Review of group results helps to identify potential problem areas and the effectiveness of existing worksite preventive strategies. 

For detailed information, go to:  Medical Screening and Surveillance – Medical Surveillance | Occupational Safety and Health Administration (

Recordkeeping Requirements

For information on recording cases of work-related COVID-19 during the COVID-19 Pandemic, see OSHA’s COVID-19 Regulations page or OSHA’s COVID-19 page.

Many employers with more than 10 employees are required to keep a record of serious work-related injuries and illnesses. (Certain low-risk industries are exempted.) Minor injuries requiring first aid only do not need to be recorded.

This information helps employers, workers, and OSHA evaluate the safety of a workplace, understand industry hazards, and implement worker protections to reduce and eliminate hazards, preventing future workplace injuries and illnesses.

Maintaining and Posting Records

The records must be maintained at the worksite for at least five years. Each February through April, employers must post a summary of the injuries and illnesses recorded the previous year. Also, if requested, copies of the records must be provided to current and former employees, or their representatives.

Spencer-SHE has been providing Safety, Health, and Environmental Compliance Guidance since 1980.  Industries are consistently challenged with the ability to maintain organized and secure records for all their Safety, Health, and Environmental programs. To address these challenges, we are now providers of the records management software, MyMomentum™.  Records are organized in a central location and easily accessible, while always adhering to HIPAA regulations and respecting employee privacy .

Contact us here to help you to develop and maintain a safe and healthy workforce.