This information is only a guide. Fitness for work offshore will be determined by the OEUK-registered doctor.

Please get in touch if you require an OEUK-registered doctor advice in Bristol / South Wales.

This guide summarises the medical fitness requirements for working in the UK offshore energy sector (Oil, Gas, and Renewables), based on the OEUK Medical Guidelines (Issue 8, November 2025). These standards ensure medical safety when travelling by helicopter, working, and living in a remote environment.

Decision on fitness to work offshore

The decision is made by an OEUK-registered doctor, based on the OEUK guidelines. In complex cases, or where the medical standards are not clearly met, we may need to defer the certificate and:

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

Category 1 and 2 jobs

Offshore occupations are classified by employer risk assessments.

• Category 1 involves roles where sudden incapacitation causes risk to safety or life, e.g., crane operators, scaffolders or control room operators.
• Category 2 includes all other roles. Workers without an explicit classification default to Category 1.

Emergency Response Team (ERT)

Emergency Response Teams are responsible for firefighting and search and rescue. Due to vigorous physical demands, members undergo sequential risk assessment, including Medical Suitability, Aerobic Capacity (Chester Step Test), and Safety Risk Assessment.

Fit to Train (CA-EBS¹)

This medical assessment confirms fitness for the BOSIET²/ FOET³ course with in-water survival training. It is required before the first trip offshore and every 4 years. 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 may be fit to work offshore.

A Fitness to Train certificate is a separate document from your main OEUK certificate.

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

¹ CA-EBS: Compressed Air Emergency Breathing System

² BOSIET: Basic Offshore Safety Induction and Emergency Training

³ FOET: Further Offshore Emergency Training

Fit to Return Certificate

Operators postpone mobilisation following a medical evacuation or sickness absence until the worker is certified fit to return. Medical examiners review the specific absence cause and issue a certificate for full, onshore, or restricted duties.

Operator’s medical advisor

The operator’s medical advisor is usually a senior physician. In complex cases (e.g., anaphylaxis) or if you need certain medication (e.g., blood thinners), the OEUK examining doctor will need to seek authorisation from the operator’s medical advisor. (Additional costs apply)

Medical conditions and OEUK guidance on fitness to work offshore

Alcohol and Drug Misuse

Active drug or substance misuse or dependency is not compatible with offshore work. Employers’ D&A policy will likely apply.

Alcohol. Candidates with a history of alcohol misuse must demonstrate a significant period of stability (usually months) documented by normal blood tests before you can be certified, usually for a shorter period.

Illicit drugs. Drug testing is not undertaken at an OEUK medical. A positive drug test (random or for cause) will fall under the employer drug and alcohol policies.

A previous substance use disorder will require a significant period of abstinence and a supportive letter from a GP or a drug management programme.

‘Medical cannabis‘. This term refers to the prescription of UK-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, working together with your drug management programme and the GP. We can provide a management plan to help you return to work once you have engaged in treatment and demonstrated stability.

Allergies and Anaphylaxis

The OEUK doctor will require a GP letter to clarify the type of allergens, and the severity and frequency of anaphylaxis. If the risk is deemed acceptable, a restricted certificate can be considered, subject to the operator’s medical adviser’s authorisation. Workers with a history of anaphylaxis are permanently unfit to work on normally unmanned installations.

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

You are temporarily unfit for offshore work for at least 3 months, if you have had angina, a heart attack, stents (PCI) or bypass surgery (CABG).

After this event, you will need to be free from symptoms for at least 3 months, show good functional recovery, and well-controlled risk factors.

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.

Atrial Fibrillation (AF) and Cardiac Arrhythmias

Stable, asymptomatic Atrial Fibrillation is generally acceptable. However, the certificate will depend on a supportive cardiology letter, rate control, heart function (after an echocardiogram), and an anticoagulant treatment. Untreated or symptomatic arrhythmias preclude offshore work.

DVT and Pulmonary Embolism

The OEUK examining doctor will assess the risk of relapses and the need for anticoagulant medication (blood thinners). In low-risk cases, a conditional certificate can be considered, subject to the operator’s medical advisor.

Anxiety and depressive disorders, mild symptoms (‘common mental health problems’)

Fitness will be decided individually. It may depend on the identifiable cause, response to treatment and tolerance of treatment. Recurrent, moderate symptoms, poor response to treatment, sickness absence or admissions related to mental health, no clear cause and/or self-harm will likely preclude offshore work.

A shorter duration certificate can be considered in case of milder, stable symptoms in response to an identifiable stressor, and good response to treatment.

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 doses of medication, and you tolerate cold and exercise.

Asthma that causes frequent attacks and requires admissions to hospital or high doses of inhaled or oral steroids will preclude from working offshore until it is better controlled.

Musculoskeletal Problems

You may work offshore if the joint and muscle problems do not cause significant pain, impairment or require strong painkillers. You must have good mobility, range of movement, strength, balance, joint stability, and be able to don and wear a survival suit, climb stairs, move on gratings, and enter a survival craft. You must be able to escape independently in an emergency.

High Blood Pressure (Hypertension)

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

Acceptable: Readings under 140/90 are standard.

High: Blood pressure between 140/90 and 180/120 mmHg will require GP report and a shorter certificate, subject to the OEUK doctor’s discretion.

Very High: If your blood pressure is 180/120 or higher, you will not receive a certificate. You will have to see your GP for treatment. If you have symptoms call 999.

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.

Weight, BMI and Work Offshore (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 if you weigh 110-124 kg.

BMI 40-44.9: You must pass a minimum mobility test (walk 550 metres < 6 minutes without stopping) and can only work in a ‘Category 2’ job and will receive a time-restricted certificate. ‘Category 1’ job will require additional tests and authorisations.

BMI 45 or higher. A time-restricted certificate can be issued subject to the OEUK doctor’s assessment and:

• Minimum mobility test (as above)
• Employer’s risk assessment
• GP report to exclude additional medical problems
• Operator’s medical adviser’s authorisation.

Occupational health note: If your weight affects your certificate, we can offer lifestyle advice or support onshore working in a non-safety-critical role.

Cancer

Fitness is assessed individually. The OEUK doctor will consider the treatment phase, prognosis, treatment and immune status. Active chemotherapy or radiotherapy renders a worker temporarily unfit. The offshore certificate can be issued for workers with cancer in remission and stable health.

COPD (Lung Emphysema) or Similar Chronic Lung Conditions

COPD is confirmed using spirometry (lung function test). Requirements generally include FEV1 ≥60% and FVC ≥75% to ensure adequate lung reserve. A time-restricted certificate may be considered subject to clinical judgement of the OEUK doctor, depending on the history, e.g., smoking or frequent chest infections.

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. We recommend a dental check-up before your medical to avoid additional cost and delays.

Diabetes Treated with Insulin (‘Type 1’)

You will receive the Conditional Certificate of Fitness to Work Offshore, subject to the following conditions

• Supportive GP letter to confirm evidence of good self-management, full diabetes control for at least 6 months, and hypoglycaemia awareness.
• Operator’s medical adviser authorisation
• Your previous OEUK clinical notes

There are additional conditions for ‘Category 2’ jobs. Your insulin pump and subcutaneous monitoring device must be confirmed as intrinsically safe by the installation operator.

Diabetes Treated with Tablets (‘Type 2’)

Type 2 diabetes treated with diet or metformin is usually acceptable if your blood sugar is stable.

The OEUK doctor will require a letter from your GP and notes from your previous examination. If you have poorly controlled diabetes or additional risk factors (e.g., excessive weight or high blood pressure), the doctor will consider a deferred or time-restricted certificate.

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 onshore role if available.

Epilepsy

Active epilepsy is not compatible with a standard offshore certificate. The OEUK doctor will require a supportive letter from a neurologist and the operator’s medical advisor authorisation.

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.

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

Hearing

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

Occupational health note: As of 2025, an audiogram is no longer a part of a routine OEUK medical. The doctor may perform a practical ‘whisper test’ or an audiogram (hearing test) if there are doubts about the hearing.

Inflammatory Bowel Disease (Crohn’s, Ulcerative Colitis)

An active flare-up is incompatible with offshore work due to the high likelihood of a medical evacuation. However, certification can be considered in patients with documented clinical remission and stable course.

Kidney Stones

Kidney stones can relapse and cause sudden, incapacitating pain. The OEUK doctor will require a specialist report to establish the risk of recurrences of renal colic.

Occupational health note: If you are at risk of recurrent renal colic, we may support temporary on-shore duties.

Medications

You must declare all prescribed and over-the-counter medications during your medical. All medication will also be checked at the helipad.

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

Blood thinners (e.g., warfarin, apixaban, rivaroxaban) cause severe haemorrhage risk following an injury. Certification can be considered subject to proof of a stable dose (e.g., a stable INR for warfarin) and authorisation from the operator’s medical adviser.

CBD and THC-containing products are not permitted offshore.

Immunosuppressants (e.g., treatment of autoimmune conditions or post-transplant) cause significant infection risks in confined offshore environments. High-dose steroids or biologic therapies will require specialist endorsement and the operator’s medical adviser’s approval.

‘Over-the-counter‘ medications should not be required offshore. If you bring your own non-prescription medication or substance, it will be securely stored by the offshore medic.

Tranquilisers, hypnotics, sedatives (e.g., Zolpidem, diazepam, codeine, amitriptyline, pregabalin, promethazine, mirtazapine) cause impaired consciousness, alertness, dexterity, drowsiness, confusion and other effects. This medication is not compatible with a standard certificate of fitness. In exceptional cases, the OEUK doctor may consider seeking authorisation from the operator’s medical advisor.

Weight loss medication (e.g., GLP-1 receptor agonists: semaglutide, tirzepatide) can be used offshore if you can show a copy of prescription, you had your 2nd injection and suffer no significant side effects (e.g., nausea or hypoglycaemia).

The examinee must not increase the dose while offshore or in the week before mobilisation. A specific “weight-loss medication letter” is issued for the offshore medic. Standard certification is usually possible once these conditions are met.

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

Neurodiversity (Autism Spectrum Disorder and ADHD)

A certificate will usually be refused. Neurodiversity often affects interactions with others, thinking, and actions, and may cause substantial difficulties in the offshore environment.

For example, autism affects how a person interacts with colleagues and responds in unpredictable situations. In autism, difficulty reading social cues and anticipating others’ actions can create real risks in the confined, high-pressure offshore environment. In ADHD, reduced concentration and a tendency towards impulsive or risk-taking behaviour present similar concerns. Where the ADHD diagnosis is uncertain, stimulant medication would cause significant side effects and breach most operators’ substance misuse policies.

Additionally, for stimulant medication treatment, the operator’s medical adviser will require objective, measurable evidence of how functioning has changed before and after treatment. Self-reported improvement, or a clinician’s impression based on self-reporting, will not be sufficient.

In case of minimal symptoms, the OEUK doctor may consider fitness with clear evidence, gathered over a substantial period, of a good management in safety-critical employment, very similar to offshore work. In such cases, the OEUK certificate would be subject to the operator’s medical adviser authorisation and the availability of adjustments.

Pregnancy

Pregnant women may work offshore up to the 28th week if the 12- week ultrasound scan confirms low risk, and the employer undertakes mandatory risk assessment. Operator’s medical advisor authorisation is mandatory.

Psychiatric conditions

Psychiatric conditions (e.g., schizophrenia, bipolar disorder) or personality disorders (e.g., EUPD) are not compatible with offshore work.

In exceptional cases, the OEUK doctor may consider a restricted certificate subject to documented prolonged remission, good psychological resilience, a supportive letter from the psychiatrist to confirm very low risk of recurrence, tolerance of treatment and after the authorisation of the operator’s medical adviser.

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.

Stroke and TIA (Cerebrovascular Disease)

You will need to wait at least three months after a stroke or Transient Ischaemic Attack (TIA). Certification will require a documented satisfactory functional recovery, acceptable cardiovascular risk profile, and clearance from a neurologist or stroke physician.

You may receive a time-restricted certificate subject to these conditions and satisfactory examination.

Vision

Visual acuity of 6/60 (without glasses) is required for safe emergency evacuation.

Colour Blindness will require ‘trade testing’ by the employer if colour vision is required for work.

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

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Frequently Asked Questions about OEUK Medical Standards (Issue 8, November 2025)