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

Not as a general rule. Israeli law does not require a medical examination for every new worker, but agent-specific regulations require a pre-placement examination and periodic examinations by an authorised physician for workers exposed to noise, benzene, lead, certain metals and solvents, isocyanates, pesticides, ionising radiation and other harmful agents. Young people may be employed only after a medical examination and approval.

Short answer

• Exposure-based: each agent regulation sets who is examined, what tests and how often; the employer arranges the examination and the worker must attend.
• Who examines: an "authorised physician" (רופא מורשה), usually a specialist in occupational medicine, or an authorised medical service (district health office, health fund or approved institution).
• Noise: first examination within the month before starting work in harmful noise, then audiometry every year.
• Benzene: first examination within the month before starting, a repeat after three months, then every six months.
• Biological monitoring: toxicological tests only in approved laboratories, results kept at least 50 years.
• Young workers: under the Youth Employment Law 5713-1953 a young person may be employed only with a medical approval from the family doctor, plus an authorised physician's fitness approval and at least yearly re-examination for work that requires fitness checks; free of charge for the young person, parents and employer.
• Time: examination time counts as working time under the noise regulations and similar rules.

How the system works

Israel's health surveillance follows the exposure, not the job title. The Work Safety Ordinance allows regulations on occupational hygiene, and a family of "occupational hygiene and health of workers" regulations covers individual agents: lead, vinyl chloride and benzene (1983), harmful dust and noise (1984), arsenic and mercury (1985), certain halogenated and aromatic solvents, organophosphate and carbamate pesticides, isocyanates and certain metals (1990s), ionising radiation (1992) and lasers (2005). The Work Safety Regulations (Environmental and Biological Monitoring of Workers Exposed to Harmful Agents) 5771-2011 add that, wherever any law or a medical labour inspector requires occupational medical examinations, they may only be carried out by an authorised medical service, and that biological tests are done only in approved toxicology laboratories. Exposure measurements feed the medical side: the OSH Administration's national occupational hygiene laboratory checks environmental test reports and passes them to inspectors and authorised medical services, about 4,900 reports covering some 50,000 workers in 2023.

The examining physician decides fitness. Under the noise regulations, for example, the authorised medical service keeps a medical card with the physician's findings and issues a health booklet that the employer keeps while the worker is exposed; if the physician finds a worker unfit, the service must notify the regional labour inspector within 10 days, the inspector then warns the employer, and the employer must stop the exposure within a week. The worker must be told the results within a reasonable time.

Example intervals in agent regulations

A worker counts as "working in harmful noise" if the job is on the list in the regulations (for example quarrying, crushing, mechanical sawing, metalworking) or if measured exposure exceeds the permitted level and the worker works at least 200 hours a year in it.

Worked example

Example: A metal fabrication shop with 30 workers runs plate cutting and grinding. Noise measurements by an authorised laboratory show exposure above the permitted level at three workstations. The employer notifies the regional inspector in advance of work in harmful noise, sends the six exposed workers for a first examination with audiometry by an authorised medical service, fits engineering controls and supplies hearing protection, posts the required "harmful noise zone" sign, and books yearly audiometry. A 17-year-old apprentice also needs a medical approval before starting under the Youth Employment Law; where the work carries a special health risk, the Law's medical rules can extend to workers up to age 21.

Common mistakes

• Using a general practitioner for statutory examinations. Only an authorised physician or medical service may carry them out.
• Starting work before the examination. For noise and benzene the first examination must be done before exposure starts.
• Ignoring results. If a worker is found unfit, exposure must stop as instructed by the inspector.

Related on excodex

• Occupational safety and health in Israel: law, authorities and employer duties
• Must an employer in Israel appoint a safety professional or an occupational physician?
• Health surveillance in Türkiye: pre-employment and periodic examinations
• Benzene

Standards and further reading

• Work Safety Regulations (Occupational Hygiene and Health of Workers Exposed to Noise) 5744-1984 (תקנות הבטיחות בעבודה (גיהות תעסוקתית ובריאות העובדים ברעש), התשמ"ד-1984), as amended.
• Work Safety Regulations (Occupational Hygiene and Health of Workers Exposed to Benzene) 5744-1983.
• Work Safety Regulations (Environmental and Biological Monitoring of Workers Exposed to Harmful Agents) 5771-2011.
• Youth Employment Law 5713-1953 (חוק עבודת הנוער, התשי"ג-1953), chapter three (medical examinations).

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.