Are pre-employment and periodic medical examinations required for workers in Kazakhstan?

Yes. Workers employed in heavy work, in work with harmful or dangerous conditions and in the other target groups listed by the Ministry of Health must pass a pre-employment medical examination and then a periodic examination once a year, at the employer's expense; workers in high-hazard jobs and drivers also need a pre-shift or pre-trip check before each shift. The examinations are carried out by licensed medical organisations under Order ҚР ДСМ-131/2020 of the Ministry of Health.

Short answer

• Legal basis: Labour Code Articles 181, 182 and 185; Code on Public Health and the Healthcare System (2020), Article 86; Order of the acting Minister of Health No. ҚР ДСМ-131/2020 of 15 October 2020 (target groups, rules and periodicity, and the list of harmful factors, jobs and work).
• Pre-employment: on hiring into a listed job, to confirm fitness; the worker discloses chronic diseases that are contraindications.
• Periodic: once a year for workers exposed to the listed harmful and dangerous factors.
• Pre-shift / pre-trip: within 1 hour before the shift for listed high-hazard jobs; within 30 minutes before and after a trip for drivers.
• Employer's duties: pay, release workers for examinations in working time with pay kept (Health Code Article 86), draw up the list of workers by 1 December each year, keep unfit or unexamined workers off the job, follow the medical recommendations.
• Penalty: 20, 30 or 120 monthly calculation indices (MCI) for small, medium and large businesses (Code of Administrative Offences, Article 93 part 2).

Who needs which examination

Article 185 of the Labour Code requires employers to organise, at their own cost, periodic examinations of workers in heavy work and in work with harmful or dangerous conditions, and pre-shift checks for workers in work of increased danger and with machines and mechanisms. The Ministry of Health order sets the details: an annex lists the harmful and dangerous production factors, the occupations and the types of work for which pre-employment and periodic examinations are required, and the examinations and specialists needed for each.

The employer also pays for examinations when a worker is transferred to work with different conditions or shows signs of an occupational disease (Article 182). Workers are obliged to attend (Article 181), and the employer may not admit anyone who has not been examined or has been found unfit.

How the annual cycle works

1. By 1 December the employer, together with the medical organisation that serves the company or the one the worker is registered with, prepares the list of workers to be examined, by factor and job.
2. The medical organisation forms a commission (therapist, surgeon, neurologist, ear-nose-throat specialist, ophthalmologist, dermatologist, gynaecologist, radiologist and others as needed) chaired by an occupational pathologist, and plans the tests for each factor.
3. Within 30 calendar days after the examinations, the chair issues a final act listing workers recommended for transfer, treatment, therapeutic nutrition or follow-up, and sends it to the employer and the territorial sanitary authority.
4. The employer carries out the recommendations, draws up an annual health improvement plan agreed with the sanitary authority, and sends workers with signs of occupational disease to a specialised occupational pathology centre.

Pre-shift checks need a heated room with water, sewerage and the equipment listed in the order, provided by the employer or the medical organisation, and a register of results. If the medical worker finds signs of alcohol, drugs or other psychoactive substances, the result is recorded and the worker is not passed as fit for the shift.

Is an occupational physician needed on site?

The Labour Code and the medical examination order do not require an in-house occupational physician. The examinations are done by licensed medical organisations, and a medical worker conducts pre-shift checks. This differs from Türkiye, where Law No. 6331 (Article 6) requires every employer to have a workplace physician (işyeri hekimi), employed in-house or provided by an external OSH service.

Common mistakes

• Examining only at hiring. Workers exposed to harmful factors need an examination every year.
• Letting workers pay. The employer bears the cost of mandatory examinations.
• Ignoring the final act. Transfer and treatment recommendations must be acted on and are checked by the sanitary authority.

Related on excodex

• Occupational safety and health in Kazakhstan: law, authorities and employer duties
• Must an employer in Kazakhstan appoint a safety professional or an occupational physician?
• Health surveillance: medical examinations and tests by exposure

Standards and further reading

• Labour Code of the Republic of Kazakhstan No. 414-V of 23 November 2015, Articles 181, 182 and 185: adilet.zan.kz
• Code of the Republic of Kazakhstan No. 360-VI of 7 July 2020 "On Public Health and the Healthcare System", Article 86 (medical examinations).
• Order of the acting Minister of Health No. ҚР ДСМ-131/2020 of 15 October 2020 on target groups, rules and periodicity of mandatory medical examinations (amended several times, last amendment seen 2 May 2024; check the current text): adilet.zan.kz
• Code of Administrative Offences No. 235-V of 5 July 2014, Article 93.

This article is general occupational safety and health information prepared by the excodex editorial team. It does not replace the applicable legislation, standards, manufacturers' instructions or the assessment of a competent OSH professional or occupational physician.