Introduction Thanks to ILO Recommendation 112, companies with more than 100 workers must carry out pre-occupational, periodic and retirement medical evaluations. A study of these services has not yet been carried out in Ecuador. There is an underreporting of occupational diseases.

Objectives 1. To know the health prevention activities of the occupational medical services 2. To know the opinion of the workers about the work of these services.

Methods A representative sample of company doctors belonging to the National Association was obtained. An anonymous questionnaire was administered to 64 doctors, with 42 questions about the characteristics of the company and the workforce, the equipment, the medical evaluations, the health promotion activities they carry out and about professional secrecy. Another survey was carried out on union organizations of 21 companies on similar aspects.

Results The incidence of occupational accidents was 14.34 x 1000. The prevalence of occupational diseases was 1.01 x 1000. 83% of the services did not have an audiometer or spirometer, 86%. Only 56% of the services met the threshold of audibility during the pre-occupational evaluation. 76.6% of workers who moved weights had a lumbar X-ray. A significant proportion could not maintain professional secrecy, due to company requirements. The opinion of the workers contrasted with the opinion of the medical services. Only 19% of the services delivered the results of the evaluations to the workers. 52.38% considered that the medical service kept professional secrecy.

Conclusions There was a low detection and notification of occupational diseases, little equipment of services for preventive activities, and it is necessary to ensure that the medical service has the power to keep medical secrecy.