30 years ago, the legislation on safety at work came into force. At first, only medium-sized and large companies were included in the prescribed occupational medical health care and safety measures. Since the mid 1990s, during national implementation of the EU guidelines on health and safety at work, this was extended even to small companies with just one employee. Prescribed health and safety measures, as experience in other EU states has shown, are met, however, with opposition. At the same time, from he point of view of the service provider, the health and safety measures cannot be carried out in small companies on the basis of a stipulated number of hours in a qualitatively acceptable form as regards the content and economic aspects. Therefore, a new concept for occupational medical health care and safety measures in small companies has been developed by the Employers’ Insurance Liability Associations. There are two possibilities: “standard care” and “alternative care”. For these models the (minimum) number of hours are no longer prescribed. Care is based on an evaluation of the risks. Both possibilities are subdivided into 3 risk groups: assignment to one of these groups is carried out by the Employers’ Insurance Liability Associations. The alternative care model, depending on the branch-specific circumstances, can be chosen for companies with a maximum of 50 employees. It is made up of motivation, information and training measures for the employer, in which occupational physicians and safety experts are to be included. In addition, the care relevant and necessary to the company should be carried out by occupational physicians and safety experts. Furthermore, mandatory consultation is defined which also requires the involvement of occupational physicians and safety experts. To guarantee the continuity of the care provided, quality control measures are installed. It the prerequisites are not fulfilled, the conditions for standard care must be observed. The model for standard care is for companies with up to 10 employees. It is defined as so-called “basic care” and supplementary “situation-related care”. As part of the basic care, which is repeated at regular intervals, the employer is helped to draw up or update the risk evaluation for the company. The expertise of occupational physicians and safety experts must be called upon. It is possible that the first examiner also covers the other area of competence, but the second examiner must be in a position, on the basis of the information provided, to be able to evaluate whether an additional inspection is necessary or whether the risk evaluation can be completed on the basis of records to save resources. As with the alternative care model, certain special situations are defined in which the occupational physician and safety expert must be called upon. This new concept of occupational medical care and safety measures in small companies is legally grounded in the also new, mutual accident prevention regulations “Betriebsärzte und Fachkräfte für Arbeitssicherheit” (BGV A2, ‘Occupational Physicians and Safety Experts’). It includes both occupational similarities and branch-specific areas for scope. Thus, the quality of care is similar, whatever Employers’ Insurance Liability Association the company belongs to. The quality control measures to be carried out will show to what extent corrections are necessary.
