Occupational Health Checkup in Rome: When It's Required and How to Arrange It

In a nutshell

The occupational health checkup is a mandatory medical exam that employees must complete before starting work — but only when their role exposes them to specific risks listed under D.Lgs 81/2008 (Italy's main workplace-safety law). The exam is carried out by the Medico Competente (company-appointed occupational physician). The cost is always covered by the employer, never the employee.

At a glance

Cost	€50–150 per worker for a pre-employment exam (employer's expense). Annual contract with an occupational physician: €800–2,500.
Timeline	Pre-employment exam must happen before the employee starts. The appointment itself takes 30–60 minutes; the outcome is given on the spot or within 1–2 days.
Where in Rome	ASL (Azienda Sanitaria Locale — your local public-health authority) Roma 1 (Borgo S. Spirito 3), ASL Roma 2 (Via Filippo Meda 35), ASL Roma 3 (Via Casal Bernocchi 73) — or a private occupational physician.
Documents needed	Valid ID, Codice Fiscale (Italian tax ID), residence permit for non-EU workers, any prior medical records

When the exam is mandatory — and when it isn't

The fitness exam isn't required for everyone. It's only compulsory when the company's Documento di Valutazione dei Rischi (DVR — the statutory workplace risk-assessment document) identifies specific risks attached to that particular role.

The most common triggers are:

• Working at a screen for more than 20 hours a week (including remote work)
• Manual handling of heavy loads
• Exposure to noise at or above 80 dB
• Regular night-shift work
• Exposure to chemical, biological, or carcinogenic agents
• Vibration (hand-arm or whole-body, above threshold)
• Working at height on construction sites
• Driving company vehicles
• Roles in healthcare, construction, food service, cleaning, hair salons, or agriculture
• Workers aged 16–18: always mandatory
• Pregnant workers: a special unscheduled exam is required once the pregnancy is confirmed

By contrast, standard office work with no prolonged screen use and no other hazards does not require health surveillance. That said, any worker can request a checkup from the occupational physician at any time, even when it isn't compulsory.

Who is the Medico Competente and how is one appointed

The Medico Competente (MC — occupational physician) is not your family doctor. They hold a specialist qualification in occupational medicine (or an equivalent recognised discipline) and are registered on the national list maintained by the Ministry of Health.

The employer appoints them with a formal letter of engagement, names them in the DVR, and notifies INAIL (Italy's workplace-injury insurance institute). The MC can be a freelance professional, an in-house company doctor, or a specialist from a contracted clinic.

The MC's role goes well beyond appointments: they contribute to the company's risk assessment, inspect the workplace at least once a year, attend the mandatory annual health-and-safety meeting (required for companies with more than 15 employees), and maintain each worker's confidential health record.

How the pre-employment exam works

When you hire someone for a role that carries identified risks, you must arrange the exam before they start work — not on their first day, not after.

The process is straightforward:

1. You notify the MC of the new hire's name and the specific tasks they will perform.
2. The MC schedules the appointment (at a contracted clinic or on-site).
3. The exam includes a health history interview, a physical examination, and any additional tests the risk profile requires (audiometry, spirometry, blood tests, ECG, eye exam, etc.).
4. The MC issues a fitness verdict — one copy to the employer, one to the worker.

The employee should bring a valid ID, their Codice Fiscale, any relevant prior medical records, and — if non-EU — their residence permit.

Follow-up and unscheduled exams

The pre-employment checkup is just the first in a series. Health surveillance continues throughout employment:

Periodic exams: at intervals set by the MC in the health-and-safety protocol. Typical frequencies are annual (for screen workers over 50, or those exposed to elevated chemical agents), biennial (screen workers under 50, noise between 85–87 dB), or every five years (moderate noise, manual handling with no pre-existing conditions).

Return-to-work exam: mandatory after any continuous sick leave exceeding 60 days. The MC must clear the worker before they return to their role.

Role-change exam: required when a worker moves to a position with different risk factors from their previous one.

Worker-requested exam: a worker can request a checkup at any time if they believe their health is being affected by their job. The MC cannot refuse.

The fitness verdict: what the doctor can say

After the exam, the MC issues one of the following verdicts (art. 41 c. 6 D.Lgs 81/2008):

• Fit for the role, no restrictions
• Fit with conditions or limitations: for example, "fit provided corrective lenses are worn at all times" or "fit, maximum lifting load 15 kg." The employer is legally bound to comply with these conditions. Ignoring them exposes the company to fines and direct liability in the event of an injury.
• Temporarily unfit: the worker cannot perform the role for a set period (e.g. 30 days), after which they are re-examined.
• Permanently unfit: the employer must look for an alternative role compatible with the worker's health. If none is available, dismissal on objective grounds becomes possible.

Both the employer and the worker can appeal the verdict within 30 days of receiving it, by submitting a request to the Medical Commission at the territorially competent ASL. The appeal is free for the worker.

Mistakes to avoid

1. Letting the employee start before the exam. If the role requires health surveillance and the checkup hasn't happened, the employer faces a fine of €2,500–6,400 and bears direct liability for any resulting injury.
2. Sending the employee to their family doctor. A GP does not hold the MC qualification. Any certificate they issue has no legal standing for occupational health surveillance purposes.
3. Ignoring the MC's conditions. If the verdict states "fit, maximum uninterrupted screen time 4 hours" and the employee works 8 hours straight at a computer, the employer is in breach — and the consequences are serious.

Special cases

Remote workers: if an employee uses a computer at home for more than 20 hours a week, the health-surveillance obligation still applies. The MC can assess the workstation setup via a questionnaire or photos.

Agency (temp) workers: the pre-employment exam is the responsibility of the staffing agency, but the host company must provide full information about the specific risks involved.

Workers with disabilities: the exam must take the disability into account. The MC may prescribe workstation adaptations.

Non-EU foreign workers: the same rules apply as for all other employees. The fitness verdict may also be relevant for residence permit renewals tied to an employment contract.

Health records: the MC keeps a confidential health record for each worker. The worker can access it at any time and is entitled to a free copy when employment ends. Records are kept for 10 years in general, but for 40 years for workers exposed to carcinogens, mutagens, or asbestos.

Official sources

• Ministry of Labour — Health Surveillance
• INAIL — Occupational Medicine
• Ministry of Health — Work and Health
• Normattiva — D.Lgs 81/2008 art. 41
• National Labour Inspectorate — Workplace Safety

Legal references: D.Lgs 09/04/2008 n. 81 artt. 25, 38–42; DM 04/03/2009; D.Lgs 151/2001; D.Lgs 345/1999; D.Lgs 66/2003; DPR 309/1990 art. 125; Accordo Stato-Regioni 16/03/2006 e 18/09/2008.