Preemployment examinations: how useful?

An article in the March-April 1991 Journal of the American Board of Family Practice noted a lack of consensus among family physicians regarding preemployment testing of workers. Family physicians do not seem to adhere to any explicit or uniform criteria in performing these tests. Previous writers have suggested how these examinations might help both the employer and the worker. The Americans with Disabilities Act, which went into effect 26 July 1992, however, appears to make true preemployment examinations illegal.

A review of the Healthline (1975 to 1991) and the MEDLINE (1980 to 1991) data bases using the MeSH headings "physical examination," "personnel management," "occupational medicine," and "personnel selection" yielded 13 articles dealing with the benefit of preemployment examinations to employees or employers. No studies appeared under the text word "preplacement."

All of the published articles addressed the protection of the employer in some manner, but only three studies revealed any benefit to the employer or any protective value for the worker. The testing in these three investigations used detailed knowledge of the demands and duties of the job and, therefore, allowed for more task-specific examinations.

The paucity of evidence demonstrating the usefulness of preemployment examinations suggests the need for further research and the development of preemployment evaluations that would allow family physicians to examine employees in a consistently beneficial and more standardized manner.