Annual Health Checkups (Kenko Shindan)

The legal basis for annual health checks

Japan’s Industrial Safety and Health Act (労働安全衛生法, Rōdō Anzen Eisei Hō) requires every employer to conduct annual health examinations for employees. This is not a recommendation — it is a legal mandate enforceable by the Labor Standards Inspection Office. Employers who fail to conduct examinations can be penalized.

The requirement applies to all employees regardless of nationality. Foreign residents employed in Japan have the same right to an annual health check as Japanese employees, and the same obligation to participate when the employer arranges it.

What the standard examination covers

The standard annual health examination (定期健康診断, teiki kenkō shindan) includes a core set of measurements and tests prescribed by MHLW:

• Physical measurements: height, weight, BMI, abdominal circumference (screening for metabolic syndrome)
• Blood pressure: measured sitting; hypertension screening
• Visual acuity and hearing: standard screening tests
• Chest imaging: chest X-ray (primarily tuberculosis and lung disease screening)
• Electrocardiogram: for employees aged 35, 40, and above; some employers include it at all ages
• Blood tests: complete blood count; liver enzyme panel (AST, ALT, gamma-GTP); lipids (total cholesterol, LDL, HDL, triglycerides); blood glucose (fasting or HbA1c); kidney function markers (creatinine)
• Urinalysis: glucose and protein
• Medical interview: review of symptoms, lifestyle factors, and any health concerns

Results are provided to each employee. The employer receives aggregated data and, for individuals with findings requiring intervention, a form from the examining physician with recommendations on any work adjustments (就業上の措置に関する意見書).

The specific health examination (metabo kenshin)

For NHI or shakai hoken enrollees aged 40–74, there is a separate but related examination called the specific health examination (特定健康診査, tokutei kenkō shinsa) — commonly called metabo kenshin (メタボ健診), metabolic syndrome screening. This is administered by the health insurance fund rather than the employer and includes overlapping tests plus targeted metabolic syndrome screening.

If you receive a workplace health check that covers the required tests, you may not need to separately attend the insurance-administered metabo kenshin. Check with your health insurance fund.

Hazardous work examinations

Employees working in environments with specific hazards — exposure to organic solvents, heavy metals, radiation, dust, noise, or extreme temperatures — must undergo additional periodic examinations (特殊健康診断, tokushu kenkō shindan) targeting the specific exposure risks. These are more frequent than annual in some cases and are also at employer expense.

If you work in construction, manufacturing, agriculture, healthcare, or any environment with chemical or physical hazard exposure, ask your employer whether additional health examinations apply to your work.

Using your results

Your health check results are provided in a report (健康診断結果通知書, kenkō shindan kekka tsūchisho). If your results indicate findings outside the normal range — elevated blood pressure, abnormal blood tests, suspected lung finding on X-ray — you should discuss them with a physician. The occupational physician at large companies can provide guidance; for smaller companies, your personal clinic physician is the appropriate contact.

Results are confidential between you and the physician. Your employer receives only what the physician determines is relevant to work adjustment decisions, and even that is limited by privacy regulations.

Last reviewed: September 2026