The tests included in a pre-employment medical are determined by the IROJ (Inherent Requirements of the Job) for the specific role. There is no universal test list. A valid pre-employment medical test includes only those components that are directly traceable to a documented, genuine requirement of the role — and applies each component at the threshold appropriate to that demand.
Why a generic test list is not defensible
It is tempting to want a standard list of tests that applies to all new hires. It simplifies procurement, briefing HR, and scheduling clinics. But a generic test list applied uniformly is legally indefensible for employment decisions, and clinically unsound.
If an employer uses audiometry as a standard test for all new hires regardless of noise exposure, and then declines to hire a candidate on the basis of a pre-existing hearing loss that would have no bearing on an office-based role, that employer has collected health information they were not entitled to collect and used it in a way that exposes them to discrimination claims.
The IROJ solves this. By documenting the genuine inherent requirements of each role, the IROJ determines which tests are needed for that role — and at what thresholds. A heavy construction labourer IROJ will generate a very different test protocol than an accounts payable coordinator IROJ. The tests are calibrated to the demands, not applied uniformly to all human bodies entering an organisation.
Test-by-test breakdown
The following covers every commonly used pre-employment medical test — when it applies, what it measures, the relevant Australian standard, and record retention requirements.
Musculoskeletal screen
Applies to: Medium demand and above; all roles with specific physical requirements in IROJ
What it tests
Assesses joint range of motion, soft tissue condition, and functional movement patterns relevant to the documented IROJ demands. For the spine, upper limb, and lower limb — calibrated to the specific postures, movements, and load demands of the role.
Standard / method
Clinical examination by occupational health physician or nurse. No Australian Standard — clinical judgment calibrated to IROJ demand profile.
Record retention
7 years minimum; longer for roles with ongoing physical hazard exposure.
Functional capacity evaluation (FCE)
Applies to: Heavy and very heavy demand roles; roles with specific manual task requirements documented in IROJ
What it tests
Structured testing of the candidate's ability to perform the specific manual tasks in the IROJ — floor-to-bench lifting, carry distances, push/pull force generation, sustained posture tolerance, and repetitive movement endurance. Tests are calibrated to the documented IROJ demand category thresholds, not generic population norms.
Standard / method
WorkHab, Isernhagen, or equivalent validated FCE protocol calibrated to IROJ demand category (sedentary through very heavy per PDBF classification).
Record retention
7 years minimum.
Drug and alcohol test
Applies to: Safety-critical roles under employer D&A policy; mining, transport, construction under EA or principal contractor requirement; high-risk work licence roles
What it tests
Urine or oral fluid collection and analysis to detect the presence of specified substances (cannabis, opioids, amphetamines, cocaine, benzodiazepines, alcohol). Collection under chain of custody. Non-negative results confirmed by NATA-accredited laboratory with MRO review before outcome is reported.
Standard / method
AS 4308:2023 (urine collection and immunoassay) or AS 4760:2019 (oral fluid collection and analysis). Chain of custody end-to-end is mandatory for defensibility.
Record retention
7 years minimum; consult EA or site policy for specific retention requirements.
Audiometry (pure-tone audiogram)
Applies to: Roles with noise exposure at or above 85 dB LAeq (8-hour TWA); safety-critical communication roles with hearing requirements in IROJ
What it tests
Pure-tone air conduction audiometry across 500 Hz to 8,000 Hz. Establishes the pre-exposure hearing baseline for noise-exposed workers — mandatory before first hazardous noise exposure under WHS Regulations. Also assesses whether existing hearing is compatible with IROJ communication requirements for safety-critical roles.
Standard / method
AS 1269.4:2014 (occupational noise). Conducted by trained audiometrist or occupational health nurse with appropriate equipment.
Record retention
30 years after employment ceases for noise-exposed roles (WHS Regulations Schedule 14).
Vision assessment
Applies to: Vehicle and plant operators; safety-critical roles with specific IROJ vision requirements; healthcare roles with documented visual demand
What it tests
Snellen visual acuity (corrected and uncorrected where IROJ specifies), colour vision (Ishihara or anomaloscope where the role requires colour discrimination — electrical, transport, pathology), contrast sensitivity and depth perception where IROJ demands require it.
Standard / method
Calibrated to IROJ vision standard. Austroads standards for commercial vehicle drivers. Aviation medical standards for aviation roles. Clinical judgment for other safety-critical roles.
Record retention
7 years minimum.
Spirometry (lung function)
Applies to: Roles with respiratory hazard exposure (silica, asbestos, isocyanates, grain dust); roles requiring respirator use (SCBA, supplied-air)
What it tests
Measures FVC and FEV1. Establishes pre-exposure respiratory baseline for ongoing surveillance comparison. For respirator-use roles, assesses whether lung function is compatible with the increased work of breathing associated with respirator use.
Standard / method
ATS/ERS spirometry standards. NATA-accredited laboratory analysis. Baseline retained for comparison in periodic surveillance.
Record retention
30 years after employment ceases for Schedule 14 respiratory hazard roles.
Cardiovascular assessment
Applies to: FIFO and remote roles; emergency response functions; very heavy demand roles; roles with documented cardiovascular demand in IROJ
What it tests
Resting ECG, blood pressure measurement, and risk stratification. Submaximal exercise test (e.g., modified Bruce protocol) for roles with high cardiovascular demand. The purpose is to assess whether the candidate can sustain the cardiovascular demands documented in the IROJ — not to conduct a general cardiac screen.
Standard / method
AHA/ACC cardiovascular risk stratification. Exercise testing protocols appropriate to the demand level being assessed.
Record retention
7 years minimum; longer where ongoing surveillance is required.
Biological monitoring
Applies to: Roles with specific chemical hazard exposure under WHS Regulations Schedule 14 (lead, mercury, organophosphates, benzene)
What it tests
Blood or urine testing for biological indicators of chemical absorption. Provides the pre-exposure baseline for ongoing monitoring. Mandatory for Schedule 14 hazard exposures before commencement in exposed roles. Compared against biological exposure indices (BEIs) to identify above-normal pre-existing exposure.
Standard / method
WHS Regulations Schedule 14 specific requirements. AIOH Biological Monitoring guidance. NATA-accredited laboratory analysis.
Record retention
30 years after employment ceases for Schedule 14 hazard exposures.
Tests that should not be included in a standard pre-employment medical
As important as knowing what to include is knowing what not to include. The following tests are routinely requested by employers but are rarely justified in a pre-employment context and create legal exposure when used without traceable IROJ justification.
Full blood count and metabolic panel
Not a job-related assessment. Unless a specific Schedule 14 biological monitoring requirement applies, or a specific regulatory medical standard requires it, blood testing in a pre-employment screen is not justified and the results cannot be used in employment decisions.
Urinalysis (general)
Not a job-related assessment unless there is a specific exposure monitoring requirement. Not the same as a D&A urine screen — a general urinalysis reveals health information (glucose, protein, kidney function) that has no bearing on fitness for most roles and should not be collected without specific justification.
Psychological screening batteries (general)
Psychological assessment is among the most legally sensitive components of any pre-employment process. A generic psychological test not calibrated to specific, documented cognitive or decision-making demands in the IROJ creates substantial discrimination exposure. Psychological assessment is only justified where the IROJ documents specific cognitive or psychological demands of genuine safety significance.
Chest X-ray (routine)
Chest X-ray is only warranted for roles with documented respiratory hazard exposure — specifically asbestos — as part of a WHS Regulations Schedule 14 health surveillance program. A routine chest X-ray as a general health screen has no place in a pre-employment medical and exposes candidates to unnecessary ionising radiation.
BMI or weight assessment (as a determinant)
BMI or body weight alone has no place as a fitness criterion in a pre-employment medical. The relevant assessment is functional capacity against IROJ demands — which a candidate meets or does not regardless of BMI. Using BMI as a criterion creates both discrimination and clinical validity problems.
Frequently asked questions
What tests are included in a pre-employment medical?
The tests included in a pre-employment medical vary by role and are determined by the Inherent Requirements of the Job (IROJ). Common tests include: musculoskeletal screening, functional capacity evaluation calibrated to the IROJ physical demand category, vision testing, audiometry (for noise-exposed roles), drug and alcohol screen (AS 4308:2023 or AS 4760:2019 for policy-covered roles), spirometry (for respiratory-hazard roles), and cardiovascular assessment (ECG, blood pressure) for physically arduous or FIFO roles. A sedentary administrative role may include only a musculoskeletal screen and health declaration; a heavy mining role may include all of the above.
Is a drug and alcohol test always part of a pre-employment medical test?
No. A drug and alcohol (D&A) test is only required where the employer's D&A policy applies to the role, or where an enterprise agreement, principal contractor requirement, or regulatory standard mandates it. It is standard for safety-critical roles in mining, construction, transport, and utilities. It is not required for general office, retail, or administrative roles unless the employer's policy specifically covers them. Where D&A testing applies, it must follow AS 4308:2023 (urine) or AS 4760:2019 (oral fluid) end-to-end — including MRO-reviewed confirmation testing for non-negative results.
What blood tests are done in a pre-employment medical?
Blood tests are not a routine component of most pre-employment medical tests in Australia. They may be included for roles with specific biological exposure monitoring requirements (lead, mercury, organophosphates) under WHS Regulations Schedule 14, for healthcare roles where serology evidence of immunity is required (hepatitis B, varicella), or for roles with specific regulatory medical standards. A general blood count or metabolic panel is rarely justified in an IROJ-calibrated assessment and should not be included without a traceable link to a genuine role demand.
What is the purpose of audiometry in a pre-employment medical test?
Audiometry in a pre-employment medical serves two purposes. First, it establishes the pre-exposure baseline hearing profile — the reference point against which future audiograms will be compared to detect noise-induced hearing loss during employment. Under WHS regulations, employers must establish a baseline before the worker is first exposed to hazardous noise (at or above 85 dB LAeq). Second, for roles with safety-critical communication demands (emergency response, plant operations), the audiogram assesses whether existing hearing is compatible with those communication requirements as documented in the IROJ.
What is spirometry and when is it included in a pre-employment test?
Spirometry measures lung function — specifically forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). It is included in pre-employment medical tests for roles that expose workers to respiratory hazards: silica dust (mining, construction, quarrying), asbestos-containing materials (maintenance, demolition), isocyanates (automotive, manufacturing), grain or flour dust (agriculture, food processing), or other Schedule 14 respiratory hazards. It also applies to roles requiring the use of supplied-air breathing apparatus or SCBA, where baseline lung function affects fitness for respirator use.
Pre-Employment Screening — Complete Framework
Legal framework, IROJ calibration, and the five mistakes to avoid.
Pre-Employment Medical Check
Component-by-component guide to what a check involves.
Pre-Employment Functional Assessment
How functional capacity is measured against IROJ demands.
Pre-Employment Screening Service
OccuSpan's IROJ-calibrated PES platform.
OccuSpan PES Module
Right tests, right roles — calibrated from the IROJ
OccuSpan generates the test protocol for each role directly from its IROJ demand profile. No manual protocol assembly, no over-testing, no under-testing. AS 4308:2023 D&A chain of custody, audiometry baselines, and FCE results — all in one auditable record.
See the PES module