Occupational health service (PZS): a complete guide

Health surveillance through PZS must be ensured by every employer from the first employee — regardless of the size of the company, the sector or the form of the employment relationship (including agreements on work performed outside an employment relationship). The employer's obligations in occupational health protection are imposed by § 30 ods. 1 of Act No. 355/2007 Coll. and are not tied to a minimum number of employees.

The obligations apply to a limited extent to self-employed persons as well. A natural person — entrepreneur who does not employ other natural persons and carries out hazardous work classified into the third or fourth category must, under § 30 ods. 6 of Act No. 355/2007 Coll., arrange a health-risk assessment, draw up a risk-assessment report and have their own fitness for work assessed. A similar arrangement applies under § 30 ods. 8 to a single-member limited liability company whose sole statutory representative is a natural person.

PZS is not merely a formal obligation — its purpose is to prevent real health damage caused by work. Every year in Slovakia hundreds of new occupational diseases are recorded that timely health surveillance and correct categorisation could have prevented or at least mitigated.

The number of newly recognised occupational diseases, after the pandemic peak in 2022 (525 cases), has settled at around 420–430 per year (2024: 423, 2023: 429). The highest number of cases occurs in industrial manufacturing, followed by healthcare and social assistance. This is precisely why risk assessment and regular health surveillance are the most effective — and least costly — form of prevention.

Behind each of these figures stands a real person whose health was damaged by work — and in most cases a company that bears responsibility for the occupational disease. An occupational disease means for the employer not only a moral but also a financial impact: compensation for damage, higher contributions and often an authority inspection. A well-functioning occupational health service helps to catch these cases before they develop into permanent health damage.

The core of the legal regulation is Act No. 355/2007 Coll. (in particular § 30 to § 30f and § 31), supplemented by implementing decrees and related regulations in the area of BOZP and social insurance. An overview of the key regulations:

The consolidated text of Act No. 355/2007 Coll. used on this page is effective from 1 January 2026 (with amendments incorporated). When citing specific deadlines and paragraphs we always link directly to zakonypreludi.sk so you can verify the wording.

The area of PZS is amended on an ongoing basis and some figures that are still circulating online are outdated — typically the claim that category 2 must be reported annually to the authority (abolished from 21 July 2020), or out-of-date penalty figures. On this page we work from the valid consolidated text and update the content whenever the regulation changes. For your own peace of mind, however, always verify the current wording directly in the collection of laws before making any important decision.

Categorisation classifies work according to the level and character of the factors of work and the working environment and the degree of health risk into four categories. The system is governed by § 31 of Act No. 355/2007 Coll.; the detailed criteria for individual factors (noise, vibrations, radiation, chemical, carcinogenic, mutagenic and reprotoxic factors, biological factors, physical and mental workload, heat and cold stress and others) are contained in Annex No. 1 to Decree of the Ministry of Health of the Slovak Republic No. 448/2007 Coll. The categorisation is not drawn up by the employer or the safety technician but by the occupational health service.

Hazardous work is work classified into the third and fourth category (§ 31 ods. 6 of Act No. 355/2007 Coll.). The classification of work into the third and fourth category — and equally its removal — is decided by the competent regional public health authority (RÚVZ) on a proposal from the employer or on its own initiative. Classification into the first and second category is determined by the employer in the risk-assessment report on the basis of a PZS proposal. Work classified into the fourth category is permitted only exceptionally and for up to one year (§ 31 ods. 5).

Correct classification has practical consequences for the company: from the category it follows whether periodic medical examinations are required and at what intervals, how often the risk assessment is repeated and what reports must be submitted to the authority. An underestimated category means unmet obligations and a risk of sanction; an overestimated category means unnecessary costs. This is precisely why categorisation is done by the occupational health service on the basis of a professional assessment, not an estimate by the employer.

Categorisation criteria are updated on an ongoing basis. Decree No. 123/2024 Coll. with effect from 1 June 2024 added reprotoxic factors to the categorisation criteria for chemical carcinogenic and mutagenic factors (transposing the relevant EU directive on the protection of workers). For work involving these factors, particular attention to risk assessment is therefore warranted.

Categorisation is based on the factors of work and the working environment — influences that act on an employee's health during work. Their complete list and criteria are contained in Annex No. 1 to Decree No. 448/2007 Coll. For risk assessment it is important to know which factors are present in the workplace and at what intensity. The main groups include:

• Noise — when limits are exceeded, noise-induced hearing loss threatens, one of the most common occupational diseases (criteria also in Government Regulation No. 115/2006 Coll.).
• Vibrations — transmitted to the hands or the whole body; they cause diseases of the blood vessels, nerves and bones (Government Regulation No. 416/2005 Coll.).
• Chemical factors including carcinogenic, mutagenic and reprotoxic substances — require a special assessment and examination regime.
• Biological factors — viruses, bacteria and other micro-organisms, primarily in healthcare and when working with people or animals (Government Regulation No. 83/2013 Coll.).
• Physical workload — prolonged, excessive and one-sided strain on the limbs and spine; this is the source of most occupational diseases.
• Mental workload — stress, monotony, time pressure and demands on attention, typical of administration and transport.
• Heat and cold stress, ionising and non-ionising radiation, increased air pressure and other physical factors depending on the character of the operation.

The intensity of factors often cannot be assessed 'by eye' — for several of them (noise, chemical factors) objective measurement is required. The results of measurement form the basis for classifying work into a category and for proposing measures. It is precisely for this reason that the health-risk assessment is a professional activity of the occupational health service, not an administrative act of the employer.

The employer's obligations in occupational health protection are listed in § 30 ods. 1 of Act No. 355/2007 Coll. In practice they can be arranged into six logical steps — from risk assessment to the annual report to the authority:

The most important output of the occupational health service is the risk-assessment report with a categorisation of work. It is a written document that the employer prepares in cooperation with PZS under § 30 ods. 1 písm. b) of Act No. 355/2007 Coll. It is precisely this document that, during an inspection by the regional public health authority, proves that the company has fulfilled its basic obligation — and its absence is the most common reason for a sanction.

The risk-assessment report typically contains identification of the factors of work and the working environment at individual workplaces, assessment of the health risk from exposure to those factors, classification of work into categories 1 to 4 and a proposal for measures to reduce or eliminate the risk. For hazardous factors it is accompanied by an operating procedure that sets out the rules for safe work with a specific factor (for example noise, chemical agents or biological factors).

The report is not a one-off document. It is updated whenever a change in working conditions that may affect the degree of risk occurs (new technology, new workplace, change of substances), and at the regular intervals for repeated assessment under § 30 ods. 1 písm. c) — for category 2 at least once every 24 months and for categories 3 and 4 at least once a year. An out-of-date report is as problematic during an inspection as having none at all.

The risk-assessment report also determines what it means for employees — which positions are subject to preventive medical examinations, what protective measures must be taken and which work will be classified as hazardous. In this sense the report is not merely 'a piece of paper for the authority' but a practical guide to how to organise safe and healthy work in your company. A well-drawn-up report saves time at every subsequent inspection and when a new employee joins.

The scope of surveillance depends on the work category, and that also determines the composition of the team that may carry it out. The minimum occupational health service team is made up under § 30a ods. 5 of Act No. 355/2007 Coll. of a doctor specialising in one of the fields of occupational medicine (occupational medicine, clinical occupational medicine and clinical toxicology, preventive occupational medicine and toxicology, or occupational health services) and a public health officer.

The head of the PZS team may, under § 30a ods. 6, only be a doctor with the stated specialisation, and only in one team. For non-hazardous work (categories 1 and 2), a public health officer or a doctor with the specified specialisation may also carry out surveillance of working conditions independently; for hazardous work (categories 3 and 4) the full team led by an occupational medicine doctor is required. The scope and content of PZS activities and the requirements for the professional competence of team members are governed in detail by Decree of the Ministry of Health of the Slovak Republic No. 208/2014 Coll.

It is precisely the professional competence of the team that is the reason why, since December 2017, the law does not permit safety technicians to carry out health surveillance — it is a healthcare activity that requires a doctor or a public health officer. A public health officer is a graduate of the public health study programme; an occupational medicine doctor holds an attestation in one of the fields focused on the impact of work on health. This division of competences ensures that the health-risk assessment and the fitness-for-work assessment are carried out by a person with appropriate healthcare training.

In carrying out its activities, PZS works in cooperation with the safety service (§ 30a ods. 9). Arranging PZS through a contractor does not, moreover, relieve the employer of their responsibility for occupational health protection — that always remains with the employer.

The scope and content of occupational health service activities are governed in detail by Decree of the Ministry of Health of the Slovak Republic No. 208/2014 Coll. Surveillance of working conditions is not a one-off inspection but a continuous professional activity. In practice it includes in particular:

• identification of health risks from physical, chemical, biological and other factors of work and the working environment,
• monitoring of exposure of employees to harmful factors (intensity, duration, frequency and combined effects),
• qualitative and quantitative assessment of health risks and evaluation of their impact on health,
• preparation of proposals for the classification of work into categories and the risk-assessment report with categorisation of work,
• advice on the working environment — layout, spatial and ergonomic solutions, ventilation, heating, lighting, sanitary and rest facilities and catering,
• participation in health protection and promotion programmes, employee education and the organisation of first aid,
• written notification to the employer when deficiencies or failures to fulfil obligations are found.

The outputs of surveillance of working conditions form the basis for preventive medical examinations and for decisions by the regional public health authority on the classification of hazardous work. This is precisely why it is important that surveillance is carried out by a professionally competent body — a public health officer or a PZS team with the relevant qualifications under Decree No. 208/2014 Coll.

Surveillance of working conditions is not conducted 'from a desk'. It typically includes a site visit, a discussion with the employer about technologies and substances used and, where justified, objective measurement of factors (noise, dust, chemical agents). The frequency and depth of surveillance corresponds to the degree of risk — for non-hazardous offices a basic assessment suffices; for hazardous workplaces it is an ongoing and detailed activity.

The employer may arrange health surveillance using their own employees or through a contractor. For contracted arrangements, what is decisive is which category the work falls into — the law distinguishes between two different regimes: registration in the list and authorisation.

In-house PZS — that is, health surveillance provided by the employer's own healthcare workers — is generally worthwhile only for large employers with a high number of hazardous jobs who are able to employ both an occupational medicine doctor and a public health officer. For the majority of small and medium-sized companies, contracted arrangement is significantly more efficient: you pay for actual services, there is no need to build your own team and the provider ensures the currency of professional competence.

For the employer this gives rise to a practical rule: when choosing a PZS contractor, verify in what regime they are registered and for which categories they may carry out surveillance. Both bodies registered in the list for categories 1 and 2 and holders of authorisation for categories 3 and 4 are published by the Public Health Authority of the Slovak Republic on its website. If your company has a combination of non-hazardous and hazardous work, the solution is typically cooperation between a contractor for categories 1 and 2 and a partner holding authorisation for hazardous categories.

The assessment of fitness for work is carried out on the basis of a health-risk assessment and the results of a preventive medical examination in relation to work (LPP). The types and grounds for LPP are governed by § 30e of Act No. 355/2007 Coll. LPP determines whether an employee is fit to perform a specific job with its specific risks — it does not therefore assess health in general, but in relation to the given work.

LPP for hazardous work (categories 3 and 4) is carried out by a doctor of the occupational health service with the relevant specialisation; for categories 1 and 2 it may also be carried out by a general practitioner who is not a PZS doctor. The costs of LPP are borne by the employer. For completeness: the annual periodicity for workers exposed to ionising radiation from category A sources arises from a special regulation (Act No. 87/2018 Coll.), not from § 30e.

The output of the examination is a medical report on fitness for work — not a health report with a diagnosis. The employer learns only the conclusion: whether the employee is fit for the given work, fit with a temporary restriction, or long-term unfit. This report is the basis for assigning the employee to work and protects both parties — the employee from work that would harm them, and the employer from liability for an overlooked health risk.

Data on employees' fitness for work is a special category of personal data (Art. 9 ods. 1 of Regulation (EU) 2016/679 — GDPR). Their processing within PZS is permissible on the basis of Art. 9 ods. 2 písm. h) GDPR (purposes of occupational medicine and the assessment of an employee's fitness for work), which is also reflected in § 16 ods. 2 písm. h) of Act No. 18/2018 Coll.

The key rule in practice: the employer receives only the medical report on fitness for work, not the employee's diagnosis. The conclusions of the report are established by § 30f ods. 2 of Act No. 355/2007 Coll.: the employee is either a) fit for work, b) fit for work with a temporary restriction, or c) long-term unfit for work. Specific health data is subject to the duty of confidentiality of healthcare workers under § 80 ods. 3 of Act No. 578/2004 Coll.; access to and disclosure of health documentation is governed by § 25 of Act No. 576/2004 Coll.

Medical reports on the fitness for work of employees who performed hazardous work are retained by the employer for 20 years from the end of the work (§ 30 ods. 1 písm. h)). The long period reflects the fact that some occupational diseases manifest themselves only years later.

The employer's PZS documentation includes in particular the risk-assessment report with a categorisation of work, operating procedures for individual hazardous factors, records of employees in categories 2, 3 and 4, medical reports on fitness for work and documents on annual reports submitted to RÚVZ. This documentation must be available for inspection in its current form — which is why it is useful to maintain it systematically and to monitor the deadlines for its updating.

The employer has several time-bound obligations to the regional public health authority. An overview of the most important ones:

• Annual report on categories 3 and 4 — to be compiled by 31 December and submitted to RÚVZ by 15 January of the following year (§ 30 ods. 1 písm. l) of Act No. 355/2007 Coll.).
• Proposal for the classification of work into category 3 or 4 — submitted by the employer; the classification decision is taken by RÚVZ (§ 31 ods. 6).
• Repeated risk assessment — category 2 at least once every 24 months, categories 3 and 4 at least once a year (§ 30 ods. 1 písm. c)).

These deadlines seem straightforward, but in practice they are the most common source of problems. The annual report on categories 3 and 4 by 15 January is easily overlooked because it falls right after the holidays; the repeated-assessment deadlines (24 months or 1 year respectively) roll on progressively for different workplaces and without records a company can quickly lose track. This is precisely why it is useful to maintain a PZS obligations calendar — or to entrust it to the provider who monitors the deadlines for you.

Compliance with obligations in occupational health protection is monitored by the regional public health authority in the form of state health supervision. During such supervision the authority checks in particular whether the company has a current risk-assessment report, whether it is observing the deadlines for repeated assessments and medical examinations, and whether it keeps the prescribed records. Failure to arrange a health-risk assessment and draw up a risk-assessment report in cooperation with PZS is an administrative offence under § 57 ods. 22 písm. b) of Act No. 355/2007 Coll.

For this offence the public health authority shall impose a fine of between €150 and €20,000 under § 57 ods. 43 písm. a) — the wording of the Act is mandatory ('shall impose'), not discretionary. For a repeated breach the fine may be increased up to double (§ 57 ods. 44). Proceedings for the imposition of a fine may be initiated within two years of the day on which the authority learned of the breach, but no later than three years from the day of the breach (§ 57 ods. 45); the fine is payable within 30 days of the decision becoming final (§ 57 ods. 46). Offences committed by natural persons who are not entrepreneurs are dealt with by § 56.

In addition to the fine, unaddressed PZS also has indirect consequences. If an occupational disease arises and it transpires that the employer failed to arrange health surveillance, a risk-assessment report or medical examinations, their liability for the damage and the risk of litigation increases. For hazardous work, without a valid risk-assessment report and a pre-placement examination, an employee may not be assigned to that work — the absence of PZS can thus directly disrupt operations.

BOZP and PZS are often confused, even though they are two separate obligations with different regulations and different supervisory authorities. In simple terms: BOZP protects against an accident 'here and now' (safety); PZS protects against the gradual damage to health and occupational diseases (health).

Both areas are preventive and complement each other — PZS and the safety service cooperate under § 30a ods. 9. Both obligations arise for the employer typically upon taking on the first employee. For more on occupational safety read the BOZP guide.

In practice these two agendas often overlap: the safety technician and the occupational health service exchange information about workplaces, the BOZP risk assessment follows from the PZS health-risk assessment and first-aid training is usually handled together with BOZP training. For a company it is therefore efficient to have both areas covered by a single contractor — there is no double administration and no risk of something 'falling between the cracks'.

Administrative work is also subject to PZS — it is typically classified as category 1 or 2. For these categories periodic medical examinations are not mandatory by law, but a risk-assessment report is always mandatory (§ 30 ods. 1 písm. b)). For office work, mental workload and work with visual display units are assessed in particular.

For homeworkers and teleworkers (§ 52 of the Labour Code, Act No. 311/2001 Coll.), the employer's responsibility for the health-risk assessment does not cease — it is simply adapted to the conditions of working from home. An employee working from home should also be included in the risk-assessment report and in health surveillance to the extent corresponding to their work category.

In practice this means assessing in particular the ergonomics of the home workstation (desk, chair, positioning of the visual display unit), lighting and mental workload associated with remote work. The employer does not have to physically inspect the employee's home, but should provide information and guidelines on the correct arrangement of the workstation and include teleworkers in its risk assessment. This helps to prevent in particular musculoskeletal and visual disorders, which are among the most common with prolonged office work.

• 'An office doesn't need PZS.' A risk-assessment report is mandatory even for categories 1 and 2 — that is, for administrative workplaces too.
• Still submitting category 2 reports. This obligation was abolished from 21 July 2020; only the annual report on categories 3 and 4 by 15 January remains.
• A missing or out-of-date risk-assessment report during a RÚVZ inspection — the most common reason for a sanction under § 57 ods. 22 písm. b).
• Confusing BOZP and PZS — the company has a safety technician and assumes that this also covers health surveillance. They are two separate obligations.
• A missed risk re-assessment — category 2 every 24 months, categories 3 and 4 every year (§ 30 ods. 1 písm. c)).
• Missing pre-placement medical examinations when starting hazardous work (categories 3 and 4).

From our experience: during a RÚVZ inspection what matters is whether you can present an up-to-date risk-assessment report and documents showing that the deadlines have been observed. This is precisely where companies most often fail — not because they are unaware of their obligations, but because no one is monitoring them systematically.

The second typical mistake is underestimating changes. The risk-assessment report drawn up when the company was founded remains unchanged for years, even though in the meantime new machinery, substances or workplaces have been added. Yet it is precisely a change in working conditions that under § 30 ods. 1 písm. c) triggers a new assessment. The third mistake is formality — the report exists, but does not correspond to the reality of the workplace, which an inspector quickly detects during a site visit.

The scope of the occupational health service — and thus its costs — is influenced by several factors. Without stating specific prices, the main ones are:

• number of employees and number of workplaces or operations,
• work categories — whether the work involves only categories 1 and 2, or also hazardous categories 3 and 4,
• the need to measure factors of work and the working environment (noise, chemical factors and the like),
• the number and type of preventive medical examinations,
• frequency of repeated risk assessment (24 months versus 1 year).

For predominantly non-hazardous operations (categories 1 and 2), contracted health surveillance is generally more cost-effective than building an in-house PZS team. The specific scope and a price quote will be prepared by the provider only after an initial assessment of working conditions.

For hazardous work (categories 3 and 4), the scope and costs increase — factor measurements, periodic medical examinations and more frequent risk assessments are added. However, the costs of health surveillance must be weighed against the alternative: a fine of between €150 and €20,000, liability for an occupational disease and a possible interruption of operations in hazardous work without a valid risk-assessment report. In this light, a properly configured PZS is more of an insurance policy than a cost.

The nature of work factors and typical categorisation differ significantly by industry. The following overview shows what to focus on in health surveillance in individual sectors.

Detailed criteria for individual factors are set by Annex No. 1 to Decree No. 448/2007 Coll., and for biological factors, noise and vibrations also Government Regulations No. 83/2013 Coll., No. 115/2006 Coll. and No. 416/2005 Coll. For work involving carcinogenic, mutagenic or reprotoxic factors, a special assessment and examination regime applies.

When choosing an occupational health service contractor, it is not just about price. Since it is a healthcare activity with statutory requirements on professional competence, it is worth checking several things before signing a contract.

• For which categories the provider may carry out surveillance — registration in the ÚVZ list suffices for categories 1 and 2; for hazardous categories 3 and 4 authorisation under § 30b is required.
• Whether the body is registered in the list / holds ÚVZ SR authorisation — both are published by the Public Health Authority of the Slovak Republic on its website.
• Whether they can cover your entire portfolio of work — a company with a combination of non-hazardous and hazardous work needs a provider that can cover the hazardous categories at least through a partner with authorisation.
• Whether they also offer follow-on services — coordination of medical examinations, first-aid training and integration with BOZP, so that you are not managing the agenda across multiple parties.
• How they handle updating — monitoring the deadlines for risk assessments and medical examinations is just as important as drawing up the documents in the first place.

A good PZS provider is not simply one who draws up a risk-assessment report, but one who guides the company through the entire cycle — from the initial assessment through ongoing surveillance to representing the company during a regional public health authority inspection. It is precisely continuity and monitoring of changes that distinguish a formal fulfilment of the obligation from genuine protection of employees' health.

The occupational health service is a statutory obligation of every employer from the first employee — including non-hazardous offices. For categories 1 and 2, a provider registered in the ÚVZ SR list suffices; for hazardous categories 3 and 4, ÚVZ authorisation and a team led by an occupational medicine doctor are required. The key to compliance is an up-to-date risk-assessment report, observed deadlines and documentation of health surveillance.

If you take just three things away from this entire guide, let them be these: PZS applies to every company from the first employee (not only hazardous work), the cornerstone is the risk-assessment report with a categorisation of work that must be kept up to date, and what is decisive is the distinction between registration in the list (categories 1 and 2) and ÚVZ authorisation (categories 3 and 4). Whoever has these three things in order need not fear a RÚVZ inspection.

If you are looking for a provider to take over health surveillance for categories 1 and 2 and provide advice on hazardous work, see the occupational health service from Alpha Safety. PZS is usually handled together with BOZP — under one roof and with one point of contact.