Factories Act medical examination checklist: tests, intervals and registers by hazard
The Factories Act, 1948 and each state's Factories Rules require employers running notified hazardous processes to have workers medically examined before employment and at fixed intervals afterwards, by a certifying surgeon, with the results entered in a statutory health register. The exact schedule of tests lives in the state rules (for example Schedule II of the Maharashtra Factories Rules or the corresponding schedule in Gujarat, Tamil Nadu, Karnataka or Haryana), so treat this page as the working checklist and confirm the state-specific schedule with your certifying surgeon. Last reviewed 30 September 2026.
Who this applies to
- Any factory carrying on a hazardous process listed in the First Schedule of the Act (29 industries, including chemicals, pharmaceuticals, foundries, paints, textiles processing, electroplating, batteries, rubber, glass and cement).
- Any process involving a substance listed in the state rules' schedule of dangerous operations (lead, benzene, chromium, manganese, mercury, silica, asbestos, pesticides, noise and others).
- Employers of contract labour at those processes: the principal employer is responsible for the examinations.
Checklist A: before the worker starts
Checklist B: while the worker is employed
Checklist C: the facility side
Tests and intervals by hazard
| Hazard / process | Baseline and periodic tests | Common interval (check state schedule) |
|---|---|---|
| Lead (batteries, paints, smelting, printing) | Blood lead level, haemoglobin, urine examination, clinical examination for lead effects | Blood lead every 6 months, or monthly biological monitoring where exposure is high |
| Benzene and organic solvents | Complete blood count, liver function, urine phenol or other metabolite, clinical examination | 6 months |
| Noise above 90 dB(A) | Audiometry (pure tone, both ears), otoscopy | Baseline, then 12 months; 6 months where exposure is high |
| Silica, coal and other dusts | Chest X-ray (ILO classification), spirometry (FVC, FEV1), clinical respiratory examination | Chest X-ray 12 months to 3 years by state; spirometry annually |
| Asbestos | Chest X-ray, spirometry, clinical examination, sputum where indicated | 12 months; long-term follow-up after exposure ends |
| Chromium, nickel, electroplating | Skin and nasal septum examination, urinary chromium where required, chest examination | 6 months |
| Mercury | Urine mercury, neurological and oral examination | 6 months |
| Manganese | Neurological examination, urine manganese | 6 months |
| Pesticides and organophosphates | Serum or RBC cholinesterase, clinical examination | Baseline, then per exposure season, often monthly during spraying |
| Isocyanates, paints, foam | Spirometry, skin examination, respiratory symptom questionnaire | 6 months |
| Heat process (foundry, glass, boilers) | Cardiovascular assessment, urinalysis, heat tolerance history | 12 months |
| Work at height, confined space, cranes | Vision, vertigo and balance screening, cardiovascular fitness, blood sugar, ECG for older workers | 12 months |
| Drivers and forklift operators | Vision including colour and night vision, hearing, blood pressure, blood sugar, substance screening where policy requires | 12 months |
| Food handlers (canteen) | Stool examination, skin and nail examination, vaccination status as per local rules | 12 months |
| Radiation (X-ray, gauges, sources) | Complete blood count, TLD badge record review, eye examination | 6 to 12 months, plus dosimetry as per AERB |
| Night shift (all processes) | General examination with blood pressure, blood sugar, sleep history | 12 months (recommended, not always statutory) |
Who can sign
Statutory examinations must be done by a certifying surgeon appointed by the state, or by a Factory Medical Officer holding the Associate Fellow of Industrial Health (AFIH) qualification where the state permits. A fitness certificate from a general practitioner without that status is a recurring audit finding.
The registers an inspector will ask for
- Health register (Form 7 or the state equivalent): worker, process, examination dates, findings, fitness, surgeon's signature.
- Accident and dangerous occurrence register with the notifications sent.
- First-aid register and the first-aider roster by shift.
- OHC OPD register and medicine stock register.
- Environmental monitoring records (noise, dust, chemical concentrations) where the process requires them.
Frequently asked questions
Is a pre-employment medical examination mandatory for all factory workers in India?
It is mandatory for workers joining a notified hazardous process or a dangerous operation listed in the state rules, and must be done by a certifying surgeon. For other roles it is the employer's choice, usually justified by the job (driving, height, food handling).
How often must factory workers be re-examined?
The interval is set per hazard by the state Factories Rules. Six months is common for lead, benzene and other listed chemicals; twelve months for noise and most other hazards; some exposures need monthly biological monitoring. Confirm the schedule with your certifying surgeon.
What is Form 7 in the Factories Act?
In Maharashtra and several other states, Form 7 is the health register in which the certifying surgeon records each statutory examination. The form number differs by state; the content is the same: worker, process, dates, findings, fitness and signature.
Can a company doctor do the statutory examination?
Only if that doctor is a certifying surgeon appointed under the Act or a Factory Medical Officer the state has approved, usually with the AFIH qualification. A regular clinic certificate does not satisfy the requirement.
What happens if a worker is found unfit?
The worker must be removed from the hazardous process, the restriction recorded in the health register, and a review date set. Alternative work outside the hazardous process is the usual route; take legal advice before any change to employment terms.
Plan My Health schedules statutory examinations by hazard and interval, digitises the health register and fitness certificates, and staffs occupational health centres. See occupational health centre automation and our guide to Factories Act medical examination requirements.