The fitness for the job or activity: what the occupational physician should consider in the occupational examination

Abstract

Occupational Medicine has established itself as an interdisciplinary specialty dedicated to the protection and recovery of occupational health. In Brazil, its trajectory is marked by milestones such as Decree No. 1,313/1891, the PCMSO (Occupational Health Medical Control Program), and the National Policy on Workers' Health. This study aimed to reflect on the essential premises and technical criteria that occupational physicians should consider in assessing occupational fitness. This reflection is based on the author's experience and a manual review of the MEDLINE/PubMed database (2025), using specialized descriptors and evidence from the last decade. Technological transformations and labor precarization impose new challenges. The definition of fitness must surpass the classic care model, integrating anamnesis with task analysis and risk management. The complexity of the physician-worker relationship in the pre-employment examination is highlighted, where the fear of rejection can compromise the reliability of the information. It is concluded that the effectiveness of Occupational Health depends on a thorough assessment focused on human dignity. It is imperative to modernize legislation and strengthen specialized training to guarantee healthy environments and preserve health in the face of environmental risks.