Annual Health Checks in Maharashtra Factories: New Rule 18-A Explained & Why Every Employer Should Adopt Yearly Health Screening for All Workers

Worker health is at the core of productivity, safety, and legal compliance. With the recent amendments to the Maharashtra Factories Rules, particularly the introduction of Rule 18-A, the requirements for occupational medical examinations have become clearer and stricter.

This blog simplifies the new provisions, explains what factory owners and safety managers must do, and highlights why conducting annual health checks for all employees — even beyond compliance — is one of the smartest decisions for any factory.

 1. What Is New Under Rule 18-A?
The amended Rule 18-A – Medical Examination of Workers now mandates

a) Mandatory Annual Medical Examination for:

• All workers engaged in hazardous processes (Rule 73-V / 73-W)

• All workers in dangerous operations (Rule 114)

• All workers aged 45 years and above, even if they are not exposed to hazards

This marks an important expansion. Earlier, only workers in hazardous areas required periodic medical surveillance. Now, every 45+ worker must undergo annual testing.

b) Who Can Conduct These Examinations?

• A Registered Medical Practitioner, or

• A Certifying Surgeon, or

• A Medical Officer under ESIC/ESIS

The medical officer must be competent to conduct occupational health assessments.

c) New Record Keeping Requirements

• Results must be recorded in Form 7-A

• Electronic submission is compulsory within the specified timeline

• Health Register (Form 7) must be updated and preserved

• Records must be retained for minimum 3 years

This digital transition aims to improve transparency and ensure timely reporting

2. What Factory Owners & HSE Managers Must Do (Step-by-Step Compliance Guide)

Step 1: Identify the covered workforce

Prepare a list of all employees, including their:

• Age

• Department

• Nature of work

• Hazard exposure

Flag employees who are:

• Above 45 years

• Working in hazardous processes or dangerous operations

Step 2: Appoint a qualified medical officer

Choose a:

• Certified Surgeon

• MBBS doctor with industrial health qualification (DIH/AFIH)

• ESIC/ESIS Medical Officer

Ensure documentation of credentials for audit.

Step 3: Schedule the annual medical examinations

Create a yearly calendar covering:

• All 45+ workers

• Hazardous workers (annual or six-monthly depending on hazard type)

Step 4: Provide infrastructure & support

Factories must ensure availability of:

• A clean examination room

• Basic equipment support

• Privacy for the workers

• Proper communication & employee consent

Step 5: Maintain proper records

• Update Form 7 (Health Register)

• Upload Form 7-A electronically within 7–15 days (as per the latest circular)

• Keep digital + hard copy records ready for inspections

Step 6: Follow up on abnormal findings

• Conduct repeat tests if required

• Reassign workers temporarily from hazardous exposure if unfit

Document all actions taken

3. Why Every Factory Should Conduct Annual Health Checks for ALL Employees — Even Beyond Compliance

Most factory owners focus only on compliance-driven checks. But in modern occupational health, proactive health screening is far more beneficial than reactive compliance.

Here’s why:

a) Lifestyle diseases are rising rapidly

Employees may not show symptoms early, but issues like:

• Hypertension

• Diabetes

• Heart disease

• Hearing loss

• Lung impairment

are widespread and often silent.

Annual checks help detect these conditions early and prevent costly medical emergencies.

b) Reduced absenteeism & fewer production disruptions

A medically fit workforce means:

• Lower sick leave

• Fewer accidents

• Higher productivity

Early diagnosis always costs less than long-term treatment.

c) Helps avoid workplace complications & liabilities

If an employee develops a health issue on-site and no periodic check was done, investigations become complicated.

With documented annual health reports, the factory can:

• Prove due diligence

• Prevent disputes

Avoid compensation-related challenges

d) Boosts morale and retention

A factory that invests in employee well-being creates:

• Higher trust

• Better engagement

A safer working environment

e) Supports ESG, CSR, and audit readiness

More organizations now demand cleanliness in:

• Worker welfare metrics

• Health monitoring

• Safety audits

Yearly health checks strengthen your compliance portfolio.

Recommended Approach: Full Workforce Annual Health Check-Up

Even though the law mandates checks only for:

• Workers above 45 years, and

• Hazard-exposed categories

It is highly recommended that factories conduct full annual health checks for every worker, every year, because:

Prevention is always cheaper than cure — and far easier than handling non-compliance notices, health-related disputes, or sudden medical incidents.

Factories that have adopted full annual screenings report:

• Better productivity

• Fewer health-related complaints

• Lower long-term medical expenses

• Improved workplace safety metrics

4. Suggested Test Profile for Annual Screening

A well-designed occupational health check typically includes:

• Clinical examination

• Height, weight, BMI, BP

• Vision & hearing tests

• CBC, Blood Sugar, Lipid Profile

• Kidney & Liver function tests

• Urine Routine

• Chest X-Ray (if exposure or symptoms)

• ECG (especially for 40+ age group)

• Spirometry (for dust/fume exposure)

Hazard-specific tests include:

• Audiometry (noise)

• Blood Lead Levels (lead exposure)

Lung function tests (dust, silica, welding fumes)

5. Final Thoughts

The new Rule 18-A brings clarity and discipline to occupational health compliance in Maharashtra. 
But factories must look beyond minimal compliance and adopt a proactive health culture.

• Compliance protects you legally.

• Annual checks for all workers protect your business.

Healthy employees mean:

• Safer shop floors

• Lower attrition

• Fewer accidents

• Higher productivity

• Stronger compliance credibilit