This guide summarises the 2025/2026 medical fitness requirements for working in the UK offshore energy sector (Oil, Gas, and Renewables). These standards ensure you are safe to travel by helicopter and live in a remote environment.

This information is based on the OEUK Medical Guidelines (Issue 8, November 2025). However, it is a guideline only and does not replace a professional medical examination. Always consult an OEUK-registered doctor for advice specific to your situation.

Medical Decision Making

The OEUK-registered doctor makes the decision on medical fitness in accordance with industry guidelines. In complex cases, or where the medical standards are not clearly met, we may need to:

• Request a formal medical report from your GP or Specialist.
• Seek specific authorisation from the Operator’s Medical Advisor (OMA).

Medical conditions and OEUK guidance on fitness to work offshore

Alcohol and Drug Misuse

Offshore work requires strict sobriety. You cannot hold a certificate if you have an active substance misuse problem or dependency.

Alcohol: If you have a history of alcohol misuse, you must demonstrate a significant period of stability (usually months) before you can be certified.

Drugs: A positive drug test or a history of illegal drug use will prevent certification. You must be drug-free for a sustained period (often 12 months minimum) before reassessment. Return to work is only possible after documented abstinence and compliance with your employer’s substance misuse policy.

Medical cannabis: This term refers to the prescription of licensed medical products containing cannabis extracts. The recognised clinical indications in the UK include severe epilepsy, multiple sclerosis and cancer-chemotherapy. These indications and ‘off label’ prescriptions are not compatible with offshore work.

Occupational health note: If you are currently unfit due to misuse, we can support your rehabilitation. We can provide a management plan to help you return to work once you have engaged with treatment and proven your stability.

Angina and Heart Disease (Heart Attack, Stents, CABG)

If you have had recent angina, a heart attack, or procedures like stents or bypass surgery (CABG), you are temporarily unfit for offshore work.

You generally need a symptom-free period of at least 3 months, good functional recovery, and well-controlled risk factors before a standard certificate can be reconsidered.

You will need a report from your cardiologist confirming satisfactory recovery and an acceptable risk profile.

Occupational health note: We can coordinate your “Fit to Return” process. We can review your cardiology reports and conduct the necessary physical checks to get you back to work safely.

Anxiety and Depression

You can work offshore with mild anxiety or depression if you are stable and functioning well.

Medication: Most common antidepressants (SSRIs) are allowed if you have been stable on them for at least 4 weeks with no side effects (like drowsiness).

Severe Cases: If you have had recent thoughts of self-harm, hospital admission, personality disorder or psychosis, you will be temporarily unfit. You need a period of stability (often 6–12 months) before returning. You will require a supportive specialist report and an authorisation by the operator’s medical advisor.

Occupational health note: We understand that enduring mental health problems often fluctuate. If you are unfit for offshore duties, we can advise your employer on suitable onshore roles

Asthma

You can work offshore if your asthma is well-controlled without the high dose inhaled or oral medication. You should not have had a severe attack (requiring hospital admission) in the last 6 months. You must be able to tolerate cold and exercise without wheezing.

Cold air and exercise are common offshore. If these trigger your asthma, you may be unfit for safety reasons (e.g., wearing breathing apparatus).

Occupational health note: If you need to use an inhaler frequently, we may undertake spirometry and issue a shorter certificate (e.g., 6 months) to monitor your condition. Bring your inhalers to the medical.

Back Pain and Musculoskeletal Problems

Chronic back, neck, or joint pain is acceptable if you do not have impairment and can still climb stairs/ladders, move on gratings, and enter survival craft. You must be able to escape independently in an emergency. Severe pain or stiffness that limits your movement or agility or high doses of painkillers usually results in a restricted certificate or a finding of unfit.

Blood Pressure (Hypertension)

Uncontrolled high blood pressure is a major risk for stroke and heart attack. We check this at every medical.

Acceptable: Readings under 140/90 are standard.

High: Persistent readings above 140/90 require GP follow-up and shorter certificates (e.g., 1 year).

Very High: If your blood pressure is over 180/120, we cannot issue a certificate on the day. You must see your GP for treatment. If you have symptoms, you have to call 999 or be taken to A&E.

Occupational health note: If your blood pressure is high, we will give you a letter for your GP to facilitate your treatment, and we will offer a review once the blood pressure is controlled.

BMI and Weight (New 2025 Rules)

OEUK has introduced new rules to ensure you can travel safely by helicopter and escape in an emergency.

124 kg Limit: From 1 November 2026, you cannot travel by helicopter if you weigh more than 124kg (clothed). Until then, you may receive a shorter certificate.

BMI over 40: You must pass a mobility test (6-minute walk) to prove you can self-evacuate. You may also need a report from your GP checking for diabetes and heart risks.

Occupational health note: If your weight affects your certificate, we can offer lifestyle advice or issue a time-limited certificate to help you manage your progress before the 2026 deadline.

Cancer

During active treatment (chemotherapy or radiotherapy), you are usually unfit for offshore work due to side effects and infection risk.

After successful treatment and a period of remission, standard or time-limited certificates may be issued depending on the type of cancer and your follow-up plan.

Occupational health note: We can work with your oncologist to plan a safe return to lighter duties and the full scope of work once your treatment is complete, if there are no contraindications.

COPD (Lung Emphysema) or Similar Chronic Lung Conditions

COPD is assessed using spirometry (lung function tests). Requirements generally include an FEV1 ≥60% and FVC ≥75% to ensure you have adequate lung reserve.

Poor lung function or frequent chest infections often bar work on Normally Unmanned Installations (NUIs) and limit certificate duration.

Occupational health note: If you have COPD, we check your ability to breathe under exertion to ensure you can cope with emergency breathing systems (EBS).

Dental Health

Dental problems are a frequent cause of medical evacuation. Obvious decay, broken teeth, or gum disease must be treated before an OEUK certificate can be issued or renewed.

Occupational health note: We recommend a dental check-up before your medical to avoid delays.

Diabetes (Insulin Treated)

You cannot hold an unrestricted “Standard” certificate if you use insulin.

You may be able to work offshore if you have a “Conditional” certificate. This requires you to have good control, hypoglycaemia awareness, and to work only on platforms with a medic on board. The doctor must speak to the Operator’s Medical Advisor to get specific approval for you to travel.

Occupational health note: This is a complex area. Dr Palka has extensive experience managing insulin-dependent workers offshore and can guide you through the specific approvals required.

Diabetes (Treated with tablets or ‘Type 2’)

Type 2 diabetes treated with diet or metformin is usually acceptable if your blood sugar is stable. If you take tablets that can cause low blood sugar (e.g., sulphonylureas like Gliclazide or Repaglinide), you will need the Medical Adviser’s authorisation.

Occupational health note: Pending discussions, we can advise on a temporary redeployment to a non-safety-critical, on-shore role, if available.

Emergency Response Team (ERT)

ERT members must pass a higher-level medical, including spirometry and an aerobic capacity test (Chester Step Test). Conditions acceptable for general work (like significant asthma or insulin diabetes) will disqualify you from ERT duties.

Occupational health note: We offer the Chester Step Test as an add-on during your main medical.

Epilepsy

Active epilepsy is not compatible with a standard offshore certificate.

High Risk Roles: You generally need to be 10 years seizure-free and off medication.

Low Risk Roles: A minimum 6-month seizure-free period may be considered with neurologist support.

Occupational health note: We will need to contact your neurologist and obtain the Operators Medical Advisor’s authorisation.

Fit to Train (CA-EBS)

This assessment decides if you can do in-water training. Conditions like unstable asthma, COPD, previous pneumothorax (collapsed lung), or a significant ear or sinus problem may make you “Unfit” for in-water training, even if you are fit to work offshore.

Occupational health note: If you fail the Fit to Train, you may still undertake the ‘dry’ portion of the training.

Hearing

You must hear speech and alarms well enough to follow instructions. Hearing aid users can be certified if they can communicate adequately without the aid (in case it fails).

Occupational health note: We may perform a practical ‘whisper test’ or an audiogram (hearing test) if there are doubts about the hearing.

Kidney Stones

Kidney stones can cause sudden, incapacitating pain. If you have active stones that are likely to move, you are unfit.

Single Stone: You may be certified if specialist advice says the recurrence risk is low.

Recurrent: Frequent or high-risk stones often prevent certification.

Occupational health note: Please bring your most recent scan results if you have a history of stones.

Medications

Medicines labeled “May cause drowsiness” or with warnings about operating machinery usually make you unfit for safety-critical offshore work. This may apply to stronger painkillers, sleeping tablets, some allergy treatments and other medication.

You must declare all prescribed and over-the-counter medications during your medical.

Occupational health note: If medication is allowed offshore, you will receive a Medication Letter to show the offshore medic.

Neurodiversity (Autism Spectrum Disorder and ADHD)

Neurodiversity often affects interactions with others, thinking, and actions. You would need to submit a specialist report confirming a consistent lack of difficulties in an employment situation similar to offshore work over a substantial period. You will also require the Medical Advisor’s authorisation.

Sleep Apnoea

Untreated sleep apnoea with daytime sleepiness is not compatible with offshore safety.

If you use a CPAP machine and have data proving good control, you may be certified after a report from your specialist and the Operator Medical Adviser’s authorisation.

Occupational health note: You must bring compliance data from your CPAP machine to your medical to prove you are using it effectively.

Vision

You generally need at least 6/60 uncorrected vision for emergencies (to escape without glasses).

Colour Blindness: This may restrict you from specific roles (like electrician) but does not fail the medical entirely.

Occupational health note: We annotate your certificate so your employer can decide if your colour vision is safe for your specific role.

WorkAble Occupational Health

WorkAble Occupational Health provides OEUK medical examinations in Bristol and Chepstow.

We also offer “Fit to Return” assessments for workers recovering from illness or injury.

If you have any questions or wish to discuss further, please get in touch.

Please be aware that obtaining these reports and processing non-standard or restricted certificates requires significant additional administrative and medical time.