“The employer has a duty to take the necessary measures of occupational safety and health taking account of the circumstances which influence the safety and health of workers at work. … His aim in doing so shall be to improve the safety and health protection of the workers.”

In particular, occupational physicians are responsible for occupational health provision in the workplace. They are to be appointed by employers in accordance with the Occupational Safety Act (Arbeitssicherheitsgesetz, ASiG). Occupational health provision primarily has a preventive focus.

There are three important areas of occupational health prevention:

• occupational physicians’ support for risk assessments
• general (collective) occupational health advice as part of employee training
• individual education and advice as part of preventive occupational healthcare.

In Germany, the Occupational Medicine Committee (Ausschuss für Arbeitsmedizin, AfAMed) draws up the Occupational Medical Rules (Arbeitsmedizinische Regel, AMRs) and Occupational Medical Recommendations (arbeitsmedizinische Empfehlungen, AMEs) that specify the concrete duties of occupational physicians and are informed by the latest advances in knowledge about occupational medicine. Occupational Medical Rules are not legally binding, but permit a presumption of conformity. This means that, provided there is compliance with these technical rules, the employer is able to presume the fundamental requirements of the relevant acts and ordinances have been fulfilled. The principles of evidence-based medicine supply important methodological foundations for the drafting of AMRs and AMEs by AfAMed.

The Federal Institute for Occupational Safety and Health (Bundesanstalt für Arbeitsschutz and Arbeitsmedizin, BAuA) is responsible for the administration of AfAMed’s business. Information about the committee and all its decisions, rules, and opinions can be found on BAuA’s website. One of the Occupational Medical Rules is AMR 3.2, which defines the three above-mentioned areas of occupational health prevention.

One important element in the occupational health prevention measures implemented by organisations is preventive occupational healthcare. Preventive occupational healthcare is provided by the occupational physician responsible for supervising the workplace and is governed by the Ordinance on Preventive Occupational Health Care (Verordnung zur arbeitsmedizinischen Vorsorge, ArbMedVV). It involves assessing the individual interactions between employees’ work and their physical and mental health, diagnosing work-related health conditions at an early stage, and establishing whether the performance of particular activities entails increased risks to health.

Below the legislative level, this field is covered by Regulation 2 (Vorschrift 2) of the German Social Accident Insurance (Deutsche Gesetzliche Unfallversicherung, DGUV), which draws a distinction between basic supervision and organisation-specific supervision (for organisations > 10 employees). The nature and scope of supervision activities are determined for both occupational physicians and OSH professionals by the lists of tasks to be performed and services to be provided that are included in the regulation. According to these lists, the following tasks and services are essential to the functions carried out by occupational physicians:

• advice for the employer or company concerning the ASiG
• support for risk assessments
• support for workplace inspections and employee training
• occupational medical examinations for employees
• support for workplace health management and workplace return-to-work management, and
• support for bodies concerned with workplace occupational safety and health.

More-detailed information can be found on the pages linked to below.