4.3.2. Type and number of first-aid personnel required
The type and number of first-aid personnel required in an
enterprise are determined by the variables previously discussed. Among them the
type of work and the associated risks, and the size and configuration of the
enterprise are the most important. The type of first-aid personnel
relates to the specific tasks which may be performed and, accordingly, to the
level of training, and depends primarily on the risks at work. The number
of first-aid personnel required is mainly dependent on the size and
configuration of the enterprise, but the potential risk at work and some other
factors will also be determinants.
National regulations for first aid vary in respect of both the
type and number of first-aid personnel required. In some countries the emphasis
is on the number of persons employed in the workplace. In other countries, the
overriding criteria are the potential risks at work. In yet others, both of
these factors are taken into account. In countries where occupational safety and
health is more advanced and the frequency of accidents is generally lower, more
attention is usually given to the type of first-aid personnel. In
countries where first aid is not regulated, emphasis is normally placed on
numbers of first-aid personnel. The following four examples are
indicative of the differences in approach used in determining the type and
number of first-aid personnel in different countries:
The United Kingdom5
- If the work involves relatively low hazards only, no
first-aid personnel are required unless there are 150 or more workers present at
work; in this case a ratio of one first-aider per 150 workers is considered
adequate. Even if fewer than 150 workers are at work, the employer should
nevertheless designate an appointed person at all times when workers
- Should the work involve higher risk, one first-aider will
normally be required when the number of workers at work is between 50 and 150.
If more than 150 workers are at work, one additional first-aider for every 150
will be required and, if the number of workers at work is less than 50, an
appointed person should be designated.
- If the potential risk is unusual or special, there will be a
need, in addition to the number of first-aid personnel already required under
the criteria set out above, for an additional type of person who will be trained
specifically in first aid in case of accidents arising from these unusual or
special hazards (the occupational first-aider).
- One first-aider is usually required for every 20
workers present at work. However, a full-time occupational health staff member
is required if there are special hazards and if the number of workers exceeds
500, or in the case of any enterprise where the number of workers at work is
1,000 or more.
- Some degree of flexibility is possible in accordance with
particular situations, or if other specific measures are taken to cope with the
immediate consequences of accidents at work.
Federal Republic of Germany7
- One first-aider is required if there are 20 or fewer
workers present at work.
- If more than 20 workers are present, the number of
first-aiders should be 5 per cent of those at work in case of offices or in
general trade, or 10 per cent in all other enterprises. Depending on other
measures which may have been taken by the enterprise to deal with emergencies
and accidents, these numbers may be revised.
- If work involves unusual or specific risks (for instance, if
hazardous substances are involved), a special type of first-aid personnel
needs to be provided and trained; no specific number is stipulated for such
personnel, i.e. the above-mentioned numbers apply.
- If more than 500 workers are present and if unusual or special
hazards exist (burns, poisonings, electrocution, impairment of vital functions
such as respiratory or cardiac arrest), specially trained full-time personnel
must be made available to deal with cases where a delay in arrival of no more
than 10 minutes may be allowable. This provision will apply in most cases of
larger construction sites where a number of enterprises often employ a workforce
of several hundred workers.
- If more than five workers are present, a person
employed at the enterprise is appointed and put in charge of the equipment,
supplies and facilities for first aid.
- If more than 50 persons are present, the person appointed must
be either a registered nurse or the holder of a certificate (issued by the St.
Johns Ambulance Association or the New Zealand Red Cross
In summary, the following principles regarding the type and
number of first-aid personnel may be established:
A distinction may be made in practice between two types of
- The basic-level first-aider,
who will receive basic training outlined in Chapter 5. This type of first-aid
personnel will qualify for appointment where the potential risk at work is low.
- The advanced-level first-aider, who will receive the
basic and advanced training outlined in Chapter 5, and will qualify for
appointment where the potential risk is higher, special or
First-aid personnel should be available in any
enterprise irrespective of its size. In the case of very small enterprises, and
if the potential risk at work is low, the designation of an appointed
person by the employer may suffice. The appointed person will
be informed about the equipment and supplies provided by the employer and their
location, and will be responsible for their maintenance. He or she will also be
made aware of all other arrangements for medical care if needed (i.e. the alert
and the referral to suitable medical facilities).
- One basic-level first-aider with basic training is often
considered sufficient if the number of workers present does not exceed a range
between 50 and 100, and if potential risks at work are low. In some countries
this number is 20.
- In the case of small enterprises, the presence of a
first-aider is always recommended, although this is not often made compulsory;
there are sometimes alter- natives such as the need to nominate a person in
charge of the first-aid box (careful custody and appropriate use) in all
- If the potential risks are higher, unusual or special,
advanced first-aiders (in numbers as given above) should be required, with
advanced training in respect of the specific needs established for the
- Larger enterprises with 500 or more workers present and where
the potential risks are higher, unusual or special, should, in addition, require
permanent occupational health staff (one for every 500) to back up the first-aid
personnel referred to above at relatively short notice (five to ten
The numbers set out above should be applied flexibly, depending
on the specific circumstances of the enterprise, the first-aid needs assessment
made by the employer and the level of safety in the