Confined Space Medicals



Does your business involve your employees working in confined spaces? Are you confident the individuals concerned are fit to carry out this kind of work? Have you checked they don’t have any medical conditions which – together with the risks of working in confined spaces – might put them at a greater risk of injury?

A confined space is defined as a space which is substantially enclosed (though not always entirely), where serious injury can occur from hazardous substances or conditions within the space or near to it. This could be as a result of a lack of oxygen, poisonous or flammable gas residues left in tanks, or conditions leading to a dangerous increase in body temperature.

People who work in confined spaces may need a medical to check their fitness for this type of work – and ensure they don’t have any medical conditions that may make them more likely to incur an injury when working in a confined environment.

How can Imperial Health at Work help?

Confined space medical clearance doesn’t have to be onerous. At Imperial, we can manage the entire process for you, by developing and implementing confined space medicals for your organisation. We’ll check your employees’ medical fitness and suitability for this kind of work – and assess and medically clear them for working in confined spaces. If you like, we can tailor the medicals to the specific needs of your organisation.

What does the Imperial medical consist of?

As part of our confined space medicals, we’ll:

  • evaluate each worker’s health declaration and thoroughly examine and assess their physical and mental health and wellbeing
  • look out for any physical problems, as well as check specifically for mental health fitness and claustrophobia
  • advise on how to support those employees whose health may pose difficulties for working in confined spaces.

In addition:

  • we can also give training and further support for managers and competent persons in charge of this work in your organisation
  • our assessment includes lung function testing (spirometry), which is an important step before any onsite check on ability to wear and use breathing apparatus.

What does it mean for your organisation?

A number of people are killed or seriously injured in the UK every year in confined spaces. These accidents occur across a wide range of industries, from those involving complex plant to simple storage vessels. 

To reduce the risk to your organisation, it is crucial you have an effective risk assessment process in place – to identify and assess the hazards and risks present in the confined space your employees are working in, and to determine the precautions to take.

In most cases, your assessment will need to consider:

  • the task
  • the working environment
  • the working materials and tools
  • arrangements for emergency rescue, and
  • the suitability of those carrying out the task.

Many organisations choose to outsource the final part of this assessment – checking the suitability of employees to do this work – to an experienced occupational health provider such as Imperial.

What does it mean for your employees?

Most employees who have one of our health checks will be able to continue working in confined spaces – as long as they have sufficient experience
of the work, have had appropriate training, and are medically fit.

Not all medical conditions will affect someone’s ability to work in confined spaces – and if a risk assessment highlights exceptional constraints, as a result of the physical layout, it may be less to do with someone’s fitness and more to do with checking they’re of a suitable build.

Whether your employees have health conditions or not, with Imperial’s confined space medicals in place, you and they can feel confident they are fit to work in confined spaces without undue risks to their health.


Some key points to be aware of:

  • Under domestic law (the Health and Safety at Work etc Act 1974), organisations are responsible for ensuring the safety of their employees and others. This responsibility is reinforced by regulations.
  • Under the Management of Health and Safety at Work Regulations
  • 1999, Regulation 3, organisations must carry out a suitable
  •  and sufficient assessment of the risks for all work activities
  • to decide what measures are necessary for safety.
  • If your assessment identifies risks of serious injury from work in 
  • confined spaces, then the Confined Spaces Regulations 1997 apply.
  • Some of the following law is also relevant because of the nature of the
  • work being carried out in a confined space, for example, where there
  • are risks from machinery, electricity or from hazardous substances:
  • The Control of Substances Hazardous to Health Regulations 2002 (as amended)
  • The Personal Protective Equipment at Work Regulations 1992 (as amended)
  • The Provision and Use of Work Equipment Regulations 1998
  • The Electricity at Work Regulations 1989
  • The Workplace (Health, Safety and Welfare) Regulations 1992.

More information

Simple and practical guidance from the Health and Safety Executive for
small firms on ‘Safe work in confined spaces’:

Information on the Confined Spaces Regulations 1997 (Approved Code
of practice, regulations and guidance, L101 HSE Books 1997 ISBN
0 7176 1405 0):

Information on working safely with solvents: