Test instructions and examination information

If the applicant needs an HbA1C test, you must:

• enter the value in mmol/mol
• enter the value as a whole number.

If the HbA1C value is greater than 80mmol/mol, the applicant must be assessed by an endocrinologist. You must include the endocrinologist's report when you submit the applicant's results.

HbA1c conversion calculator | New Zealand Society for the Study of Diabetes

If the applicant needs to be tested for estimated glomerular filtration rate (eGFR), you must:

• enter the value as a whole number
• enter the value in mL/min/1.73m²
• attach the creatinine test result
• enter the exact value if it is provided — enter 91 if the eGFR is greater than 90.

Use pediatric eGFR calculators for applicants under the age of 18.

Paediatric Estimated Glomerular Filtration Rate (eGFR) calculator National Kidney Foundation website

If the eGFR is less than 30, the applicant must get a nephrologist's report. You must include the nephrologist's report when you submit the applicant's results.

Pregnant applicants

If the applicant is pregnant, you must:

• complete the serum creatinine test and attach the result to the examination
• finalise the eGFR test results as incomplete.

eGFR conversion calculator Kidney Health Australia website

​Renal failure calculator

Use the kidney failure risk equation to estimate the risk of progression to kidney failure requiring dialysis or renal transplantation.

Kidney failure risk equation | Calculate by QxMD

If the applicant needs to be tested for Hepatitis B and their surface antigen test is positive, you must also test for:

• Hepatitis B e-antigen
• HBV DNA
• LFTs
• AFP, if the applicant is over 30 years of age
• a liver FibroScan scan report — this can be up to 3 years old
• a current liver ultrasound if a liver FibroScan is not available in your country.

A specialist report is required if:

• the ALT is greater than 40
• the HBV DNA is greater than 2000 IU/mL
• the AFP is positive
• the liver FibroScan is greater than 8.5kPA
• there is any evidence of severe fibrosis or cirrhosis on the liver FibroScan or liver ultrasound
• the applicant has any history consistent with severe fibrosis or cirrhosis.

If the applicant needs to be tested for Hepatitis C and their serology test is positive you must add an HCV-RNA test.

If the applicant needs to be tested for HIV, and their test is positive you must add confirmatory tests, such as the Western Blot test or line-blot test.

HIV tests for children under 15

You must test for HIV in children 15 years of age and under if:

• the mother is HIV positive, or
• the child has history of blood or blood product transfusion.

If the applicant needs to be screened for syphilis and their test is positive, you must confirm the result with one of these treponemal specific tests:

• treponema pallidum particle agglutination test (TP-PA)
• fluorescent treponemal antibody absorption test (FTA-ABS)
• microhaemagglutination for treponema pallidum (MHA-TP).

You must provide specific management details for any applicant with syphilis including drug names, doses and dates.

If the applicant needs a full blood count, you must include:

• haemoglobin (HGB) — values must be recorded in g/L
• white blood cells (WBC) — values must be recorded in cells x 10⁹/L
• platelets (PLT) — values must be recorded in in cells x 10⁹/L.

Enter HBG and PLT values as whole numbers. Enter WBC values to WBC need to be recorded in cells x 10⁹/L to 1 decimal place.

If test results show significant anaemia — for example, less than 110 HGB for men and less than 90 HGB for women — then repeat the full blood count test after 2 weeks using ferritin.

If applicants have significantly abnormal values — less than 60 HGB for men and less than 50 WBC for women — your clinic or an appropriate professional needs to provide urgent medical follow-up care.

Haemoglobin conversion tool UnitsLab website

White blood count conversion tool | UnitsLab website

All applicants 5 years of age or older must have their urine tested. Female applicants cannot be menstruating during urine tests.

You must add a mid-stream urine sample if the dipstick urinalysis is positive for any:

• albumin
• protein
• red cells
• glucose.

Send this to a laboratory to be examined for red cell casts or dysmorphic cells on microscopy.

If the urine sample is positive for glucose then check HbA1C and add the albumin:creatinine ratio.

Haematuria

If an applicant's results are greater than 10 cells per high power field, you need to repeat the test.

You must refer males with repeat urine red cells greater than 20 cells per high power field to a urologist.

Females with repeat urine red cells greater than 20 cells per high power field must have:

• 3 urine cytology specimens and renal ultrasound scan if they are less than 40 years of age
• 3 urine cytology specimens, a renal ultrasound scan and referral to urologist if they are older than 40 years of age.

You only need to test an applicant's liver function if we ask you to.

Liver function tests must include:

• total bilirubin
• alkaline phosphatase
• AST — aspartate aminotransferase (SGOT)
• ALT — alanine aminotransferase (SGPT)
• GGT — gamma glutamyltransferase
• albumin
• total protein.

If you are concerned about an applicant’s liver function, for example they have severe fibrosis or cirrhosis, then the applicant must have a gastroenterology assessment. You must include the gastroenterology assessment when you submit the applicant's results.

You only need to provide an applicant's full lipid profile if we ask for it. These do not need to be fasting lipids.

The lipid profile must include:

• total cholesterol
• LDL
• HDL
• triglycerides
• Chol:HDL ratio.

If you think the applicant may be a risk to public and occupational health because they have, or may have, intestinal parasites, you need to test the applicant's faeces for organisms, such as ascaris.

You do not need to screen for Thalassemia, unless you think it is necessary.

If the applicant has known Thalassemia, you must include this information, including the type, for example major or minor.

Applicants who have declared they do have hypothyroidism or hyperthyroidism will need thyroid function tests if they also have:

• a large goitre that is obstructing their airway — they need to have a thyroid ultrasound
• thyroid nodules and:
• no previous investigations — they need to have a thyroid ultrasound
• previous investigations — you must provide us with a copy of the previous reports
• thyroid cancer — they need to provide a specialist assessment.

You must test any applicant with functional impairment for Activities of Daily Living (ADLs).

If applicants are 70 years of age and older, you need to consider if they need a formal ADLs assessment.