Occupational Health Services (OHS) in Luxembourg

1. General obligation to affiliate

Article L.312-1 requires every employer to organise or affiliate to an occupational health service to ensure the safety and health of employees in all work-related aspects. This obligation admits no exception based on company size: it applies from the first employee.

Beyond standard employees, the obligation also covers trainees, apprentices and certain jobseekers (Art. L.321-1).

2. Organisation by company size

The form of OHS organisation depends on headcount (Art. L.322-1):

The national occupational health service is a multisectoral public body (Art. L.323-1). It is the reference option for employers who do not reach the thresholds requiring an internal service and who do not wish to create a multi-employer service.

3. Missions of the occupational health service

OHS missions are essentially preventive (Art. L.322-2). They include in particular:

• identifying and assessing risks in the workplace;
• monitoring employee health and carrying out mandatory medical examinations;
• advising the employer and employees on hygiene, ergonomics and workstation design;
• organising first aid;
• cooperating with the staff delegation, particularly with the health and safety delegate (DSS) — see the staff representatives guide.

4. Pre-employment medical and resolutory condition

Timing of the pre-employment medical

The pre-employment medical examination is mandatory for every candidate. Its timing varies by post type (Art. L.326-1):

• for at-risk posts and night workers: the examination must be carried out before the employee starts work;
• for all other posts: the examination must take place within two months of hiring.

Resolutory condition when the medical follows hiring

When the pre-employment medical takes place after the start of work, the employment contract is entered into subject to a resolutory condition. An unfitness declaration issued by the occupational physician following this examination then results in the automatic termination of the contract by operation of law (Art. L.326-1).

5. Return to work after extended absence

The employer must notify the occupational physician when an employee returns to their post after an uninterrupted absence of more than six weeks due to illness or accident (Art. L.326-6).

This obligation enables the occupational physician to assess the employee's fitness to return to their previous post, identify any necessary adjustments and, where applicable, initiate a reclassification procedure if the employee can no longer perform their duties. See the professional reclassification guide.

6. Internal organisation and occupational physician qualifications

Every occupational health service must include at least one full-time occupational physician (Art. L.322-3). This physician must either be:

• a specialist in occupational medicine; or
• hold specific training of at least two years in this field (Art. L.325-1).

A single occupational physician may not be responsible for more than 5,000 employees. Beyond this threshold, a derogation from the Minister of Health is required (Art. L.322-3). This ceiling ensures sufficient individual monitoring capacity for each employee attached to the service.