Microscopic Haematuria at Pre-Employment Medical
Painless microscopic blood in urine on routine dipstick testing and fitness for work
Microscopic Haematuria (microhaematuria) is one of the commonest abnormalities found during routine checkups. It is always to be considered an abnormality although frequently it is a transient finding and, even if shown to be persistent, the cause of the bleeding may not be obvious even after detailed investigation.
Blood in the urine can originate either from the kidney tissue or anywhere along the urinary tract.
In Australia, approximately five percent of randomly chosen adults over 25 years of age have microscopic haematuria on the first urine dipstick test. This is confirmed by a second test (dipstick or microscopy) in 2.5 percent.
Transient microhaematuria may be caused by exercise, sexual intercourse, menstrual contamination or mild trauma. It can persist for some weeks after urinary tract infection.
Asymptomatic microhaematuria identified on routine dipstick testing during pre-employment medical assessments at OccuMED are referred to the family general practitioner for follow up, specifically repeat dipstick test and microscopy.
In general terms, without specific concern on history and examination findings, this finding poses very little risk in terms of the candidate's Fitness for Work (ability to undertake his/her job safely and effectively). This does not mean that further investigations are not required as there are potentially reversible serious and specific conditions that cause blood in the urine which pose limited risk to health if diagnosed and managed early.
It is therefore important for the patient to follow up with their general practitioner to repeat the urine test and map out a management strategy if required.
Dr. John Low
MBBS (UWA) Grad Dip OHS FAFOM
Occupational Physician
OccuMED Consulting
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