We investigated the status of the preplacement medical examination after the revision of the industrial safety and health law on Oct. 7, 2005 by the Ministry of Labor.

Preplacement medical certificates of 6,507 recruits issued by two hospitals in Busan, Kyeongnam Province from Jan. 1 to Dec. 31, 2006 were reviewed. Telephone interviews were performed to the recruits with disease and self-reported questionnaires were administrated to health and safety personnel from May 1 to Sep. 30, 2007.

Interviews were conducted with 185(56.1%) recruits with disease, 51(27.4%) of whom were rejected for employment due to the preplacement medical certificate. The questionnaire survey for the health and safety personnel revealed that 39(22.9%) personnel were unaware of the annulment of the preemployment medical examination. Eighty(48.8%) of the health and safety personnel answered that they performed a preplacement medical examination after employment, and 63(37.3%) made a practical application of the workers' placement. The recruits with chronic conditions were refused employment: 20 (11.8%) due to hypertension, 21(12.4%) diabetes mellitus and 22(13.0%) hyperlipidemia. The recruits with work-related diseases were also refused employments: 76(44.4%) due to lumbar spine abnormality and 75(43.8%) hearing loss.

Despite the annulment of the pre-employment medical examination, a preplacement medical examination was often used to discriminate among healthy and diseased recruits. Employers must respect the law for the point of time of the preplacement medical examination and the payment of cost. The government should publicize the revision of the objectives of the law. We suggest that health professionals elucidate the job fitness through the development of the assessment tools and maintain the confidentiality of recruits.