BOZP for healthcare — medical practices, pharmacies and social services

The risk assessment of a healthcare workplace must cover specific factors that do not occur in other sectors. Below are four categories that determine both the categorisation of work and the content of the BOZP documentation.

Every employer — even a practice with a single nurse — is obliged to ensure a health risk assessment and categorisation of work in cooperation with an occupational health service (§ 30 ods. 1 písm. b) of Act No. 355/2007 Coll.) and an occupational health service from the first employee (§ 30 and § 30aa). Work is classified into categories 1 to 4 under § 31 and Decree No. 448/2007 Coll.

Because of biological factors, physical load and night work, healthcare and care staff are generally classified in category 2 or higher. For category 2, the health risk assessment is repeated at least once every 24 months; for high-risk work in categories 3 and 4 at least once a year, and each year, as at 31 December, the employer prepares a report for the RÚVZ. The obligations also include keeping records of employees in categories 2 to 4 and preventive medical examinations in relation to work under § 30e.

Government Regulation No. 83/2013 Coll. on the protection of employees from risks related to exposure to biological factors at work is the basic regulation for medical practices, laboratories, pharmacies and social services facilities. Under § 4, the employer must determine the nature, degree and duration of exposure, assess the risk and adopt measures — the assessment is repeated regularly and whenever conditions change.

• Safe collection and disposal — sharp instruments are placed in marked puncture-resistant containers; the workplace must be equipped with means for the safe collection and disposal of waste.
• Prohibition of risky practices — recapping used needles is among the most frequent causes of injuries; it is replaced by safety-engineered devices and a correct disposal procedure.
• Vaccination — employees exposed to biological factors are provided with effective vaccination where available (in particular against hepatitis B).
• Procedure in the event of an injury — every sharps injury is treated, reported and registered as an occupational accident under § 17 of Act No. 124/2006 Coll.; this is followed by an assessment of the risk of infection and, where appropriate, post-exposure prophylaxis.

DSS (social services homes), homes for the elderly, specialised facilities and other operations under Act No. 448/2008 Coll. on social services have their own risk profile from a BOZP perspective: round-the-clock operation with night shifts, daily repositioning and transfers of immobile clients, biological factors during nursing procedures and a high mental workload for care workers and nurses.

• Handling clients — solve the lifting and transfer of clients with lifting and transfer aids and safe handling techniques under Government Regulation No. 281/2006 Coll.; the physical load on staff is the basis for the categorisation of work.
• Night shifts — night work (§ 98 of the Labour Code) is taken into account in the categorisation and in preventive medical examinations; the night shift must also be able to manage the evacuation of clients.
• Lone workers — a care worker on a night shift must not be left without communication; introduce a system for calling for help.
• Aggressive behaviour by clients — the risk of staff being assaulted is part of the risk assessment and of training; de-escalation procedures and calling for help belong in the BOZP documentation.

For a DSS it is crucial that the BOZP documentation is not copied over from an office environment — the risk assessment must speak about clients, repositioning, night shifts and evacuation, not about monitors and chairs. This is exactly the documentation we prepare for social services facilities as part of the external BOZP service.

The employer draws up operating rules for risk factors under § 30 ods. 1 písm. i) of Act No. 355/2007 Coll. — in healthcare, in particular for biological and chemical factors. The requirements for the operation of healthcare facilities from the point of view of health protection are laid down in Decree No. 553/2007 Coll.; for outpatient facilities, the minimum requirements under Decree No. 236/2025 Coll. also apply from 22 September 2025.

A related agenda is healthcare waste — sharp instruments, biologically contaminated and infectious waste of group 18 of the waste catalogue is collected, recorded and handed over under Act No. 79/2015 Coll. on waste. We can take over this agenda as part of our waste management service.

A legal entity and a natural person-entrepreneur fulfil fire-protection obligations under § 4 and § 5 of Act No. 314/2001 Coll. — from preventive fire inspections through documentation to employee training. The content of the documentation, including fire evacuation plans, is governed by Decree No. 121/2002 Coll. on fire prevention.

In in-patient healthcare facilities and social services facilities, fire protection is many times more demanding than in an ordinary operation: the evacuation plan must take account of immobile persons, and the staff — including the night shift — must genuinely be able to carry out the evacuation. Low night-time staffing is the most critical point of every plan; we therefore build OPP documentation and training on the facility's real capacities.

• Fire extinguishers — inspected at least once every 24 months under § 9 of Decree No. 347/2022 Coll., permanently accessible and marked.
• Escape routes and exits — permanently clear, marked and with functioning emergency lighting; in facilities with bed-bound clients, the width and passability for beds and wheelchairs is checked.
• Fire protection technician — the OPP documentation is kept and updated by a professionally competent person; employee training and the professional training of fire patrols are repeated at the statutory intervals.

Even a small medical practice operates reserved technical equipment (VTZ) that is subject to professional inspections and professional tests under Decree No. 508/2009 Coll. In healthcare and social services, these are most commonly the following groups:

• Pressure equipment — steam sterilisers and autoclaves, compressors of dental units and pressure vessels; the intervals of inspections and tests are set by the annex to Decree No. 508/2009 Coll.
• Gas equipment — medical gas distribution systems (oxygen, vacuum), gas boiler rooms and appliances.
• Electrical equipment — the electrical installations of surgeries and facilities, inspections under standards STN 33 1600 and STN 33 1610.
• Lifting equipment — lifts in polyclinics and facilities; stair lifts and vertical lifting platforms for persons with reduced mobility are lifting VTZ of group B (Annex No. 1 II. časť písm. i) of Decree No. 508/2009 Coll.) — in DSS they are often forgotten.
• Inspection technician and records — VTZ inspections are carried out by a person holding a valid certificate; inspection reports are part of the documentation checked by the Labour Inspectorate.

Every employee undergoes initial familiarisation with BOZP rules on starting work and refresher familiarisation at least once every three years under § 7 ods. 5 of Act No. 124/2006 Coll. Contracted instruction may be delivered only by a person holding an authorisation of the National Labour Inspectorate — Alpha Safety is authorised to carry out education and training.

Training must correspond to the real risks of the workplace: for nurses and care workers, client handling and sharp instruments; for cleaning staff, biological factors and chemical substances; for technical staff, VTZ and electrical equipment. Added to this is fire-protection training and evacuation drills. The employer also designates and prepares employees to provide first aid under § 8 of Act No. 124/2006 Coll.

Two supervisory authorities meet in healthcare and social services. The Labour Inspectorate checks BOZP and, under § 19 of Act No. 125/2006 Coll., may impose a fine of up to 100,000 euros; for an occupational accident with serious bodily harm at least 20,000 euros and for a fatal accident at least 33,000 euros. The Regional Public Health Authority checks health protection at work — categorisation, risk assessment reports, operating rules and the PZS — and under § 57 ods. 43 písm. a) of Act No. 355/2007 Coll. imposes fines from 150 to 20,000 euros, and up to double for a repeated breach.

Alpha Safety s.r.o. is an external provider of comprehensive safety services for medical practices, pharmacies, polyclinics and social services facilities throughout Slovakia. One partner, one responsibility — instead of four separate suppliers.

• BOZP — external safety service (BTS), risk assessment including biological factors and client handling, complete documentation tailored to healthcare operations.
• PZS — categorisation of work, risk assessment reports, surveillance over working conditions and coordination of preventive medical examinations (categories 1 and 2 on a contracted basis under § 30aa).
• OPP — fire-protection documentation, evacuation plans that take immobile persons into account, training and professional training of fire patrols.
• VTZ inspections — sterilisers, medical gases, electrical installations, lifts and lifting platforms.
• Training — initial and refresher familiarisation of staff, first aid, client handling and sharp instruments.
• Waste — records and management of group 18 healthcare waste.

In medical practices we most commonly find that BOZP and the PZS were last addressed when the practice opened — the current categorisation of work, the risk assessment report and a contracted occupational health service are all missing. In social services facilities the weakest point tends to be documentation copied over from an office environment, which says nothing about repositioning clients, night shifts or the evacuation of immobile persons.

Repeated findings from inspections: sharps containers replaced by PET bottles, missing records of needlestick injuries, a steriliser without a valid professional test and an evacuation plan that no one on the night shift can actually carry out. After the system is put in place — categorisation, operating rules, a realistic evacuation plan and regular training — our clients pass RÚVZ and Labour Inspectorate inspections without sanctions.