How to set up an Occupational Health Centre (OHC) in an Indian factory

When does an OHC become mandatory?

The trigger is usually the combination of worker headcount and whether the plant runs a hazardous process listed in the First Schedule of the Factories Act. Most State Factories Rules require an ambulance room or OHC once 500 workers are employed, and a full-time Factory Medical Officer where hazardous processes are carried out.

Section 45 additionally requires a first-aid box for every 150 workers, with a trained first-aider available in every shift. Construction projects under the BOCW Act have their own first-aid and ambulance-van obligations linked to the number of workers on site.

• Up to 500 workers — first-aid boxes, trained first-aiders, medical retainer and referral tie-up
• 500+ workers — ambulance room / OHC, dressers, nursing staff and an ambulance van
• Hazardous process units — full-time OHC, AFIH-qualified physician, certifying surgeon liaison
• Construction and infra sites — mobile OHC or site clinic plus BLS ambulance on standby

OHC room and layout

State rules generally specify a minimum floor area, washable flooring, running water, adequate lighting and ventilation, and the OHC being located away from noise, dust and process emissions with barrier-free ambulance access.

• Consultation cabin with privacy and an examination couch
• Treatment and dressing area with a sluice and clinical waste segregation
• Observation bay with two beds and oxygen delivery points
• Pharmacy cabinet with a lockable scheduled-drug section
• Records desk with lockable storage for statutory health registers

Manpower: who staffs the OHC

The medical team must match headcount, shift pattern and hazard class. A single MBBS visiting for two hours a day rarely satisfies an inspectorate at a hazardous-process plant.

• Factory Medical Officer (MBBS) with fitness-certification authority
• AFIH-qualified physician — Associate Fellow of Industrial Health, expected wherever hazardous processes are run
• Staff nurses (GNM / B.Sc Nursing) registered with the State Nursing Council, deployed shift-wise
• Paramedics / EMTs trained in BLS and trauma first response
• Pharmacist for scheduled drug custody and dispensing records
• OHC Health Manager who owns rosters, registers, stock and monthly MIS

Equipment and medicines

Equipment is chosen against the site's exposure profile: audiometry where noise crosses 85 dB(A), spirometry for dust and fume exposure, and a defibrillator wherever response time to a hospital exceeds the golden hour.

Medicine stocking must respect the Drugs and Cosmetics Rules. Schedule H and H1 drugs can only be dispensed against a prescription by the registered medical officer, with the H1 register maintained for three years.

• Diagnostics — BP apparatus, glucometer, pulse oximeter, ECG, audiometer, spirometer, vision drum
• Emergency — defibrillator, oxygen cylinders with flowmeter, suction unit, Ambu bag, spine board, cervical collars
• Treatment — nebuliser, autoclave, dressing trolley, eyewash and emergency shower
• Pharmacy — statutory first-aid contents, life-saving drug tray, expiry-tracked cold chain

Records that an inspector will ask for

OHCs are judged on records as much as on equipment. Keep pre-employment, periodic and exit examination files, the Form 32/33 style health registers used in your state, audiometry and spirometry trend charts, injury and near-miss logs, drug registers and hospital referral notes.

Hospital tie-ups and referral pathway

Map the nearest hospitals by real travel time, not distance. Sign a written tie-up covering trauma, burns, ophthalmic and cardiac emergencies, and rehearse the pathway in drills so that ambulance, gate pass and receiving doctor all work in one call.

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