Introduction: Health surveillance ofworkers (HS) is a fundamental preventative strategy to implement health and safety protection and promotion in occupational settings. Fitness for work (FFW) is one of the major outcomes of HS. The relevant number of workers exposed to a variety of biological agents in various occupational settings, multiple transmission modes, underestimation of potential relevant adverse effects and work-related infectious diseases and injuries demand evidence- based, tailored and effective HS and FFW. Materials and Methods: Principles, criteria, methodologies and significance of HS and FFW are established by technical and scientific guidelines, international core documents and Code of Ethics, evidence-based scientific literature and specific legislation. HS and FFW are based on sound risk assessment procedures on a collective and individual basis. Results: HS is preferably performed by occupational physicians (OP) pre-assignment, periodically or on special request. Main objectives are: to evaluate general health and medical conditions of susceptibility/vulnerability of each worker; clinical and etiological diagnosis; epidemiological surveillance; counselling; FFW, sometimes with restrictions, aimed at protecting workers, third parties and sometimes the service provided. Besides medical examinations, questionnaires and laboratory tests are often necessary. Assessment of immunization status is of utmost relevance. Conclusions: HS and FFW benefit from a multidisciplinary approach based on good occupational health and medical practice. An OP’s proactive role is needed, especially in the current pandemic era.
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