Work at Height / Fall Hazard – Medical Fitness Examination

Example tasks and roles where this assessment is typically required:

• Work on overhead lines and catenary systems where continuous fall protection is not guaranteed during all movements.
• Mast/tower work (e.g., lighting masts, antenna installations, telecom towers, chimney stacks).
• Roof and facade work (installation and maintenance, including PV-related electrical work).
• Scaffold erection/inspection and work on elevated structures where temporary unsecured transitions occur.
• Use of rope access / work positioning techniques where individual health limitations may increase fall risk.
• Medical Examination – Checklist for the Physician
• Review of job requirements and hazard assessment (work positioning, transitions, rescue concept, expected physical load, environmental conditions).
• Initial short consultation (information and consent).

 

Medical Examination – Checklist for the Physician

• General medical examination (internal medicine).
• Musculoskeletal assessment (orthopedic focus: spine, large joints, grip strength; limitations relevant for climbing/positioning).
• Neurological evaluation (including seizure history; motor function; coordination).
• Balance and vestibular screening (history of vertigo, syncope, unexplained falls).
• Assessment of mental stability and stress tolerance (including fear of heights, panic risk).

 

Eye & Vision tests (safety-critical):

• Visual acuity (distance and, if relevant, near vision for safe movement and task execution).
• Visual field screening (as indicated for safe orientation and hazard perception).
• Optional: binocular vision/depth perception if required by the task profile.

 

Audiometry (hearing test) if relevant for communication and warning signal recognition:

• Pure tone audiometry (task-relevant frequencies).

 

Cardiovascular assessment:

• Resting ECG.
• Exercise stress test (ergometry) if indicated by age, workload, or cardiovascular risk factors.
• Blood pressure measurement and evaluation of orthostatic symptoms if reported.

 

Optional laboratory/urinalysis (as locally required/clinically indicated).

Clarification of any unclear findings (additional diagnostics if necessary).

Check for contraindications or major limitations (examples):

• Seizure disorders not reliably controlled, recurrent syncope, clinically relevant balance disorders.
• Severe uncontrolled cardiovascular disease, exertional chest pain, significant arrhythmias.
• Severe musculoskeletal impairment limiting safe climbing/positioning or rescue actions.
• Severe acrophobia/panic disorder that may compromise safe work at height.

Final medical judgment of fitness according to job requirements (fit / fit with restrictions / not fit).

Closing consultation with the employee (results, recommendations, follow-up if needed).

Issue of medical certificate / documentation according to the applicable framework.