An occupational health nurse (OHN) is a registered nurse who protects and promotes the health and safety of workers. Occupational health nurses treat injuries and illnesses on the job, run health screenings and vaccination programs, help injured employees return to work, keep workplaces in line with OSHA safety rules and design wellness programs that keep employees healthy. They work in factories, corporate offices, hospitals, construction sites, government agencies and anywhere else people work.
This guide covers what occupational health is, what occupational health nurses do, where they work, employee health nursing, respirator fit testing, hearing conservation, the OSHA 300 log and recordable injuries, pre-employment and DOT physicals, how to become an occupational health nurse, COHN certification, salary and Occupational Health Nurses Week.
In this guide
- What is occupational health?
- What is an occupational health nurse?
- What does an occupational health nurse do?
- Where do occupational health nurses work?
- Employee health nursing in hospitals
- Respirator fit testing
- Hearing conservation and audiometric testing
- The OSHA 300 log and recordable injuries
- Pre-employment and DOT physicals
- How to become an occupational health nurse
- COHN and COHN-S certification
- How much do occupational health nurses make?
- What is it like to be an occupational health nurse?
- A short history of occupational health nursing
- When is Occupational Health Nurses Week?
- Gifts for occupational health nurses
- Occupational health nurse humor
- Frequently asked questions
What is occupational health?
Occupational health is the field of health care focused on the connection between work and health. It aims to prevent work-related injuries and illnesses, care for workers when they do get hurt or sick and help them return to work safely. Occupational health teams often include occupational health nurses, occupational medicine physicians, nurse practitioners, safety professionals, industrial hygienists and ergonomists.
What is an occupational health nurse?
An occupational health nurse, sometimes called an occupational and environmental health nurse, occupational nurse, employee health nurse, corporate nurse or, historically, an industrial nurse, is an RN who specializes in worker health. OHNs combine clinical nursing with public health, safety, case management and business skills.
Unlike most nurses, whose patients are sick or injured, occupational health nurses spend much of their time keeping healthy people healthy. Their "patients" are a whole workforce.
What does an occupational health nurse do?
- Treat work injuries and illnesses: first aid, triage and care for cuts, burns, sprains, chemical exposures and sudden illnesses on the job
- Case management: coordinating care for injured workers, managing workers' compensation cases and planning safe return-to-work and light-duty programs
- Health screenings: pre-placement exams, vision and hearing tests, blood pressure checks, TB testing and drug and alcohol screening
- Surveillance programs: monitoring workers exposed to noise, chemicals, dust or other hazards
- Respirator programs: medical evaluations and fit testing for workers who wear respirators
- Vaccinations: flu shots, hepatitis B vaccines and other immunizations
- OSHA compliance: recordkeeping, injury logs and helping employers meet safety regulations
- Health promotion and wellness: programs for weight, stress, smoking cessation, ergonomics and mental health
- Emergency preparedness: planning for workplace emergencies and training first responders and AED teams
- Hazard assessments: walking the worksite to identify risks and recommend changes
Where do occupational health nurses work?
- Manufacturing plants and warehouses
- Corporate offices, often running on-site clinics and wellness programs
- Hospitals and health systems, as employee health nurses
- Construction, energy, mining and utilities
- Occupational medicine clinics that serve many local employers
- Government and military, including federal agencies and military bases
- Insurance companies, as workers' compensation case managers
- Universities, airlines, theme parks and school districts
Employee health nursing in hospitals
Hospitals have their own occupational health departments, usually called employee health. Employee health nurses care for the people who care for patients. They manage new-hire health screenings, TB testing, vaccinations (including annual flu campaigns), respirator fit testing, needlestick and blood exposure follow-up, and return-to-work clearances for staff. During outbreaks, employee health is often at the center of keeping the workforce safe.
Respirator fit testing
When workers need to wear a tight-fitting respirator, such as an N95, OSHA's respiratory protection standard requires that they be medically evaluated and fit tested before using it, and fit tested again at least once a year. Fit testing makes sure the specific make, model and size of respirator seals properly on the worker's face.
- Qualitative fit testing: the worker wears the respirator under a hood while a test agent with a noticeable taste or smell is sprayed. If they can taste or smell it, the respirator does not fit.
- Quantitative fit testing: a machine measures how much air leaks into the respirator and gives a numeric fit factor.
Occupational health nurses often run respirator programs, completing medical evaluations, performing fit tests and keeping records.
Hearing conservation and audiometric testing
Noise-induced hearing loss is one of the most common work-related illnesses. OSHA requires employers to run a hearing conservation program when workers are exposed to noise at or above an average of 85 decibels over an eight-hour workday. These programs include noise monitoring, hearing protection, training and audiometric testing: a baseline hearing test and then hearing tests at least every year to catch changes early.
Many occupational health nurses become certified to perform audiometric testing, often through a Council for Accreditation in Occupational Hearing Conservation (CAOHC) course.
The OSHA 300 log and recordable injuries
Many employers must keep records of serious work-related injuries and illnesses on OSHA forms:
- OSHA Form 300 (the "300 log"): a log of each recordable work-related injury and illness
- OSHA Form 301: an incident report with details about each case
- OSHA Form 300A: an annual summary, which must be posted in the workplace from February 1 to April 30 each year
An injury or illness is generally OSHA recordable if it is work-related and results in death, days away from work, restricted work or job transfer, medical treatment beyond first aid, loss of consciousness, or a significant injury or illness diagnosed by a health care provider. Occupational health nurses often help employers decide whether cases are recordable and keep the logs accurate.
This is a general overview. Employers should review current OSHA recordkeeping rules for their industry.
Pre-employment and DOT physicals
- Pre-employment (pre-placement) physicals: exams done after a job offer to make sure a worker can safely perform the job, often including vital signs, vision and hearing tests, drug screening, TB testing and sometimes lifting or fitness tests.
- DOT physicals: exams required by the Department of Transportation for commercial truck and bus drivers. They must be performed by a certified medical examiner listed on the Federal Motor Carrier Safety Administration's National Registry, which can include physicians, physician assistants, advanced practice nurses and chiropractors. Occupational health nurses often help with these exams, vision and hearing tests and drug screening.
How to become an occupational health nurse
- Earn a nursing degree (ADN or BSN) and pass the NCLEX-RN. Many employers prefer a BSN, and the COHN-S requires one.
- Gain clinical experience, often in emergency, urgent care, med-surg or community health. (See our ER nurse guide.)
- Get BLS certified, and learn first aid, CPR and AED training so you can teach others.
- Learn the regulations: OSHA standards, workers' compensation and privacy rules for employee health records.
- Take specialty training such as audiometric testing, spirometry, drug screen collection and respirator fit testing.
- Earn the COHN or COHN-S once you meet the experience requirements.
- Consider advancing to manager, consultant or occupational health nurse practitioner. (See our nurse practitioner guide.)
COHN and COHN-S certification
The American Board for Occupational Health Nurses (ABOHN) offers the main certifications for occupational health nurses:
- COHN (Certified Occupational Health Nurse): for RNs working in occupational health
- COHN-S (Certified Occupational Health Nurse-Specialist): for RNs with at least a bachelor's degree, focusing more on management, program development and consulting
- Case management add-on (CM): an additional credential for COHN or COHN-S holders who focus on case management
Eligibility generally requires an active RN license plus either several thousand hours of occupational health experience within recent years or completion of an academic occupational health program. Check ABOHN for current requirements. The American Association of Occupational Health Nurses (AAOHN) is the main professional organization for the specialty.
How much do occupational health nurses make?
The U.S. Bureau of Labor Statistics does not publish a separate salary for occupational health nurses, because it groups them with all registered nurses. The median annual wage for registered nurses was $97,550 in May 2025, according to the BLS.
Occupational health nurse pay depends on industry (energy, manufacturing and large corporations often pay well), location, experience, certification and role. Management and consulting roles typically pay more. Many OHN jobs also offer weekday hours, which some nurses value as much as pay.
What is it like to be an occupational health nurse?
- Business hours: many OHN jobs are Monday to Friday during the day, with no nights, weekends or holidays, though some plants run 24/7.
- Independence: OHNs often work as the only nurse on site and make many decisions on their own.
- Prevention focus: much of the job is keeping people from getting hurt in the first place.
- Business skills: OHNs work with managers, human resources, safety teams and insurers, and show how health programs save money.
- Variety: one hour might be a forklift injury, the next a flu shot clinic and the next an OSHA log review.
A short history of occupational health nursing
- 1895: the Vermont Marble Company hires nurse Ada Mayo Stewart to care for its workers and their families, and she is widely considered the first industrial nurse in the United States.
- Early 1900s: more factories, mines and railroads hire nurses as industrial nursing spreads.
- 1942: about 300 nurses from 16 states found the American Association of Industrial Nurses, the organization that later became AAOHN.
- 1970: the Occupational Safety and Health Act creates OSHA, greatly expanding the need for occupational health programs.
- 1972: the American Board for Occupational Health Nurses is founded to certify nurses in the specialty.
- 1977: the association is renamed the American Association of Occupational Health Nurses.
- Today: occupational health nurses support worker health in every industry, from on-site clinics to telehealth.
When is Occupational Health Nurses Week?
Occupational Health Nurses Week (OHN Week) is celebrated each April, led by AAOHN. In 2025, it ran from April 6 to 12. The April timing honors the founding of the first professional association for occupational health nurses in April 1942.
OHN Week ideas
- Have managers and employees send thank-you notes to the on-site health team.
- Share a "by the numbers" recap: flu shots given, screenings done, injuries prevented.
- Sponsor COHN exam fees or AAOHN memberships.
- Recognize the safety team, industrial hygienists and first responders who work alongside OHNs.
- Give a practical gift for the nurse who keeps everyone on their feet.
Gifts for occupational health nurses
For the coffee that fuels flu shot clinics, fit tests and OSHA log reviews. An easy OHN Week gift. $15.99
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The occupational health nurse's mission in one sticker. Perfect for hard hats, water bottles and laptops. $3.99
Shop now →Occupational health nurse humor
- "Keeping workers on their feet, one steel-toed boot at a time."
- "Is it OSHA recordable? Let me get back to you after I read the flowchart. Again."
- "Yes, you need a fit test. Yes, every year. No, your beard can't stay."
- "I've given more flu shots this month than I can count. My arm hurts and I'm not the one getting them."
- "Lift with your legs. I'm begging you."
- "My office has no night shift, no holidays and no call lights. Just 2,000 employees."
Frequently asked questions
What does an occupational health nurse do?
Occupational health nurses protect and promote worker health. They treat work injuries and illnesses, manage workers' compensation and return-to-work cases, run screenings and vaccination programs, perform respirator fit testing and hearing tests, help with OSHA compliance and create wellness programs.
Where do occupational health nurses work?
They work in manufacturing plants, corporate offices, hospitals (as employee health nurses), construction and energy companies, occupational medicine clinics, government agencies, insurance companies and many other workplaces.
What is the COHN certification?
The COHN (Certified Occupational Health Nurse) is a certification from the American Board for Occupational Health Nurses. The COHN-S is the specialist version for nurses with at least a bachelor's degree. Both require an RN license and occupational health experience or education.
How much do occupational health nurses make?
BLS does not report occupational health nurse pay separately. Registered nurses overall earned a median of $97,550 in May 2025. Pay varies by industry, location, experience, certification and role.
What is an employee health nurse?
An employee health nurse is an occupational health nurse who works for a hospital or health system, caring for staff through new-hire screenings, vaccinations, TB testing, fit testing, exposure follow-up and return-to-work clearances.
How often is respirator fit testing required?
Under OSHA's respiratory protection standard, workers who wear tight-fitting respirators must be medically evaluated and fit tested before first use and fit tested again at least once a year.
What makes an injury OSHA recordable?
Generally, a work-related injury or illness is recordable if it results in death, days away from work, restricted work or job transfer, medical treatment beyond first aid, loss of consciousness or a significant diagnosed injury or illness.
When is Occupational Health Nurses Week?
Occupational Health Nurses Week is celebrated each April, led by the American Association of Occupational Health Nurses. In 2025, it ran April 6 to 12.
Exploring other specialties? See our full guide to nurse specialties and the types of nurses.
Celebrate the occupational health nurses in your life
For OHN Week, a new COHN or the nurse who keeps your whole workplace healthy.
Shop the Occupational Health Collection →Sources
- U.S. Bureau of Labor Statistics, Occupational Outlook Handbook: Registered Nurses
- American Association of Occupational Health Nurses, OHN Week
- Occupational Safety and Health Administration, Respiratory Protection Standard (29 CFR 1910.134)
- Occupational Safety and Health Administration, Occupational Noise Exposure Standard (29 CFR 1910.95)
- Occupational Safety and Health Administration, Recordkeeping Requirements (29 CFR Part 1904)
- Federal Motor Carrier Safety Administration, National Registry of Certified Medical Examiners
- American Board for Occupational Health Nurses (ABOHN), COHN and COHN-S Certification