Cover Image
close this bookThe Organization of First Aid in the Workplace (ILO, 1999, 70 p.)
View the document(introduction...)
View the documentPreface
close this folder1. Why first aid and the organization of first aid?
View the document1.1. What is first aid?
View the document1.2. The need to prevent accidents
View the document1.3. If an accident occurs
View the document1.4. An organized approach to first aid
View the document2. What first aid must do
close this folder3. Responsibilities and participation
close this folder3.1. Responsibilities of the employer
View the document(introduction...)
View the document3.1.1. Equipment, supplies and facilities
View the document3.1.2. Human resources
View the document3.1.3. Other
View the document3.2. Workers’ participation
close this folder4. How first aid is organized
close this folder4.1. Variables to be considered in the assessment of first-aid requirements
View the document(introduction...)
View the document4.1.1. Type of work and associated risks
View the document4.1.2. Size and layout of the enterprise
View the document4.1.3. Other enterprise characteristics
View the document4.1.4. Availability of other health services
close this folder4.2. First aid in the context of the general organization of safety and health in the enterprise
View the document(introduction...)
View the document4.2.1. Occupational health services
View the document4.2.2. Safety and health committees and safety delegates
View the document4.2.3. The labour inspectorate
View the document4.2.4. Other institutions
close this folder4.3. First-aid personnel
View the document(introduction...)
View the document4.3.1. Functional tasks
View the document4.3.2. Type and number of first-aid personnel required
View the document4.3.3. Advice to, and supervision of, first-aid personnel
View the document4.4. The role of the occupational health physician or nurse
close this folder4.5. Equipment, supplies and facilities for first aid
View the document(introduction...)
View the document4.5.1. Rescue equipment
View the document4.5.2. First-aid boxes, first-aid kits and similar containers
View the document4.5.3. Specialized equipment and supplies
View the document4.5.4. The first-aid room
View the document4.5.5. Means for communicating the alert
View the document4.6. Planning for access to additional care
View the document4.7. Records
close this folder5. The training of first-aid personnel
View the document5.1. General considerations
close this folder5.2. Basic training
View the document(introduction...)
View the document5.2.1. General
View the document5.2.2. Delivery of first aid
View the document5.3. Advanced training
View the document5.4. Training material and institutions
View the document5.5. Certification
View the document6. Relation to other health-related services
close this folderAnnexes
close this folderAnnex I. Examples of first-aid legislation
View the document1. New Zealand
View the document2. United Kingdom
View the document3. Federal Republic of Germany
View the documentAnnex II. Be ready for emergencies1
View the documentAnnex III. Rescue equipment: An example
close this folderAnnex IV. First-aid boxes
View the document1. Belgium
View the document2. India
View the document3. New Zealand
View the document4. United Kingdom
View the documentAnnex V. Antidotes: Some useful examples
View the documentOccupational Safety and Health Series
View the documentBack cover

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 are present.

- 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.

New Zealand8

- 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. John’s Ambulance Association or the New Zealand Red Cross Society).

Summary overview

In summary, the following principles regarding the type and number of first-aid personnel may be established:

(a) Type

A distinction may be made in practice between two types of first-aid personnel:

- 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 unusual.

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).

(b) Number

- 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 enterprises (Belgium).

- 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 enterprise.

- 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 minutes).

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 enterprise.