Is occupational health training mandatory for a nurse?

Yes, if you work in an occupational health and safety service. If you do not have it at the time of recruitment, your employer must enrol you within twelve months and cover the cost.

How many hours does occupational health nurse training last?

A minimum of 240 hours of theoretical teaching and 105 hours of professional practice placement. Partial or full exemptions are possible depending on your background.

Can an occupational health nurse declare an employee unfit for work?

No. Opinions based on medical considerations, including fitness and unfitness for work, are the sole responsibility of the occupational health physician.

What visits can an occupational health nurse carry out?

Under a written protocol from the occupational health physician, the nurse carries out in particular the information and prevention visit, as well as return-to-work and resumption visits.

Must a company employ a nurse?

Yes, from 200 employees in an industrial establishment and 500 employees in other establishments. Below these thresholds, a nurse is present if the occupational health physician and the works council request it.

Who organises specific occupational health training?

A university or other public higher education institution, or a certified training provider. It is they who validate the training.

Is the occupational health nurse bound by professional confidentiality?

Yes. The nurse respects professional confidentiality and the ethical rules of the profession, including in relation to the employer.

Occupational health nurse: roles, training, legal framework

In short

You must be a State-qualified nurse and complete specific occupational health training: at least 240 hours of theory and a 105-hour placement. If you have not done so, your employer must enrol you within twelve months of hiring and pay for it. You work in an occupational health and safety service.

Information and prevention visits, workplace activities, job retention: the occupational health nurse plays a central role in preventing occupational hazards. This guide presents the work settings, specific and delegated roles, the mandatory specific training and the framework set by the Labour Code.

What is an occupational health nurse?

It is a State-qualified nurse, or authorised to practise without limitation, who works within an occupational health and safety service (SPST). The Labour Code places them in the multidisciplinary occupational health team, alongside occupational physicians and occupational hazard prevention specialists (article L4622-8). The occupational physician leads and coordinates this team, or delegates this leadership.

This team pursues an objective set by law: to prevent any deterioration in the health of workers due to their work (article L4622-2).

Where does the occupational health nurse work?

In a multi-employer or autonomous service

Occupational health and safety services take two forms. The multi-employer service (SPSTI) brings together many member employers. The autonomous service is created by a company or group. According to INRS, membership in a SPSTI is mandatory below 500 employees; from 500 employees onwards, the employer may choose between an autonomous service and a SPSTI.

Directly in the establishment

The Labour Code requires the presence of nurses in certain establishments, depending on their size:

industrial establishments with 200 to 800 employees: at least one nurse, then one additional nurse per 600 employees beyond that (article R4623-32);
other establishments with 500 to 1,000 employees: at least one nurse, then one additional nurse per 1,000 employees beyond that;
below these thresholds: a nurse is present if the occupational physician and the social and economic committee request it. In case of employer disagreement, the labour inspector decides, after consulting the occupational health inspector (article R4623-33).

What are the roles of the occupational health nurse?

The nurse carries out their own roles, in compliance with the rules of competence in the Public Health Code, as well as roles delegated by the occupational physician (article R4623-30). In practice, they intervene on two fronts.

Individual monitoring of employees

Individual monitoring of health status is provided by the occupational physician and, under their authority, notably by the nurse (article L4624-1). INRS cites the visits the nurse carries out by protocol: information and prevention visit, pre-return visit, return visit.

Collective activities in the workplace

The nurse participates in workplace activities and information campaigns designed with the occupational physician: hazard awareness, health promotion, identification of at-risk situations. They are bound by professional confidentiality.

Prevention of occupational disengagement

Each service includes a multidisciplinary cell for the prevention of occupational disengagement (article L4622-8-1). It identifies employees at risk of losing their job for health reasons, proposes measures with the employer and employee, and works with Health Insurance and integration stakeholders. A member of the multidisciplinary team designated by the occupational physician may lead it.

How does an information and prevention visit take place?

Every worker receives an information and prevention visit within three months of starting their position (article R4624-10). Conducted by a health professional from the team, it aims to:

question the employee about their health status;
inform them of the risks of their position;
raise their awareness of prevention measures;
identify whether they should be referred to the occupational physician;
inform them of the arrangements for their monitoring and their right to a visit with the occupational physician at any time (article R4624-11).

What can the occupational physician delegate to the nurse?

The occupational physician may entrust to the nurse, by written protocol, a large part of the visits and examinations for individual monitoring (article R4623-14). Delegated roles are exercised under their responsibility, within the limits of the nurse's competence and, for delegations to the team, in line with the service project.

Point of caution: opinions based on medical considerations, such as fitness or unfitness opinions, remain the sole responsibility of the occupational physician. If in doubt during a visit, the nurse refers the employee to them.

What training is required to become an occupational health nurse?

Since the law of 2 August 2021 to strengthen occupational health prevention, the SPST nurse must have specific occupational health training (article L4623-10). The decree of 27 December 2022, applicable from 31 March 2023, sets its minimum content (article R4623-31-1):

at least 240 hours of theoretical teaching;
a professional practice placement in occupational health of 105 hours.

Training is provided and validated by a public establishment with scientific, cultural and professional status (a university, for example) or by a certified training organisation. The order of 30 January 2023 specifies its organisation, knowledge assessment and placement evaluation.

What competencies does this training develop?

The Labour Code sets out six areas (article R4623-31-2):

knowledge of the workplace and business environment;
occupational hazards, associated pathologies and their prevention;
collective health promotion action and support for employers;
individual monitoring of health status, including traceability of exposures and health surveillance;
prevention of occupational exclusion;
nursing practice within a multidisciplinary team and with external partners.

Useful to know: the training provider may take into account your previous training in occupational health and your experience to exempt you from all or part of the teaching or placement.

Who pays for the training and within what timeframe?

If you are recruited without this training, your employer must enrol you within twelve months of recruitment. For shorter-term contracts, enrolment must take place before the end of the contract. The cost is borne by the employer. The law also encourages your continuing professional development, and the tasks assigned to you take account of your additional qualifications (article L4623-10).

Your other obligations as a healthcare professional remain applicable, such as periodic certification and CPD.

Can an advanced practice nurse carry out the mid-career health check?

Yes. The mid-career medical check takes place during the calendar year in which the worker reaches 45 years of age, unless a different deadline is set by collective agreement (article L4624-2-2). It may be carried out by an advanced practice nurse working in occupational health. This nurse cannot propose workplace adjustments: they refer the employee to the occupational health physician if necessary.

This check verifies the suitability of the role to the employee's state of health, assesses the risk of occupational exclusion and raises awareness of the challenges of ageing at work.

What is the legal framework for the occupational health nurse?

Two codes apply simultaneously:

the Labour Code, which organises services, the multidisciplinary team, employee monitoring and specific training (articles L4622-1 et seq., R4623-29 et seq.);
the Public Health Code, which defines your competencies as a nurse and to which the Labour Code explicitly refers. These rules were reformed by the decree of 24 December 2025 on the activities and competencies of the nursing profession, adopted under the law of 27 June 2025.

Like any practising nurse, you must be registered with the Nursing Register, regardless of your employer.

Official sources

Frequently asked questions

Is occupational health training mandatory for a nurse?: Yes, if you work in an occupational health and safety service. If you do not have it at the time of recruitment, your employer must enrol you within twelve months and cover the cost.
How many hours does occupational health nurse training last?: A minimum of 240 hours of theoretical teaching and 105 hours of professional practice placement. Partial or full exemptions are possible depending on your background.
Can an occupational health nurse declare an employee unfit for work?: No. Opinions based on medical considerations, including fitness and unfitness for work, are the sole responsibility of the occupational health physician.
What visits can an occupational health nurse carry out?: Under a written protocol from the occupational health physician, the nurse carries out in particular the information and prevention visit, as well as return-to-work and resumption visits.
Must a company employ a nurse?: Yes, from 200 employees in an industrial establishment and 500 employees in other establishments. Below these thresholds, a nurse is present if the occupational health physician and the works council request it.
Who organises specific occupational health training?: A university or other public higher education institution, or a certified training provider. It is they who validate the training.
Is the occupational health nurse bound by professional confidentiality?: Yes. The nurse respects professional confidentiality and the ethical rules of the profession, including in relation to the employer.

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Occupational health nurse: roles, mandatory training and legal framework