Occupational medics: when they are mandatory – including on construction sites

In short: First aiders are not always enough. DGUV Vorschrift 1 requires at least one occupational medic from certain company sizes and hazard levels.

The thresholds

• more than 1,500 insured persons present at one site
• more than 250 insured persons present, if the nature, severity and number of accidents require it
• more than 100 insured persons present on a construction site – even if the employer uses subcontractors

First aiders or occupational medics?

First aiders provide initial measures. Occupational medics have much more extensive training, run the first aid room, treat more serious injuries until the emergency services arrive, and keep records.

In-house staff or service provider?

In-house staff are rarely worthwhile for shutdowns, plant outages and construction projects. A service provider supplies occupational medics for exactly the period in which the threshold is exceeded – including cover and equipment.

How to read the thresholds

Again, the insured persons present at a site are counted. For the middle threshold – more than 250 insured persons – the accident record matters: the nature, severity and number of accidents must require an occupational medic. This follows from the risk assessment and, if in doubt, from a conversation with the statutory accident insurer (BG). Conversely, the accident insurance provider may agree in individual cases that an occupational medic can be dispensed with if the chain of rescue is secured in another way.

Special case: construction sites

On construction sites, what counts is not the individual company but the number of insured persons working there at the same time. Employers who subcontract construction work must also count the subcontractors' employees. On larger construction projects, the threshold of 100 is therefore reached faster than many site managers assume – often already in the fit-out phase, when many trades work at the same time.

Training as an occupational medic

• Basic course: 63 teaching units
• Advanced course: 32 teaching units with an occupational focus
• Refresher training: regularly, at the latest every three years

Anyone who already has emergency medical services training – for example as a Rettungssanitäter (paramedic) or Notfallsanitäter (advanced paramedic) – can work as an occupational medic after completing the advanced course.

What comes with it: first aid room and equipment

A first aid room or comparable facility is required for more than 1,000 employees, for more than 100 employees with particular accident risks, and on construction sites with more than 50 employees. It must be easy to reach, including with a stretcher, and appropriately equipped. On construction sites this is usually a first aid container.

Day-to-day tasks

• Treating injuries and acute illnesses
• Looking after the first aid room and checking supplies and equipment
• Guiding the emergency services on site
• Documenting all first aid given
• Contributing to safety briefings and emergency drills

When a service provider is worthwhile

The obligation only applies as long as the threshold is exceeded. For shutdowns, plant outages and construction projects, that means weeks or months. Training and retaining your own staff for that period rarely pays off. A service provider supplies trained staff by the day or by the shift, arranges cover in case of illness and, on request, brings first aid containers and equipment.

We provide occupational medics for construction sites and industry in Berlin and Brandenburg. How many additional first aiders are needed is explained in the guide First aiders in the workplace.

Frequently asked questions

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