First aid at work is mandatory in Belgium from your first employee. Based on your risk analysis, you make sure a victim is helped as quickly as possible and the emergency services are alerted. To do so you provide basic equipment and a first aid kit, appoint first aiders with basic training of at least 15 teaching hours and an annual refresher of 4 hours, and keep a register of every intervention. Exactly how much you arrange depends on your company's group and the risks of your work. Below is what the Code requires, with a planning example for an SME with shifts.
What is first aid at work in Belgium?
The rules are in Book I, Title 5 of the Code on Well-being at Work, which implements the Well-being at Work Act. First aid is the help a colleague gives after an accident or sudden illness, while waiting for the specialised emergency services. The Code calls that colleague the first aider: an employee who gives first aid at the workplace and has taken the training and refresher required by the Code, adapted to the risks of your activities.
The shortest version of the rule is in is first aid mandatory. This guide goes further: what you arrange per group, how the training works and how to plan it.
What every employer must arrange
Your obligations follow from the nature of your activities and the risk analysis. You take the necessary measures to:
- give victims of an accident or employees who fall ill first aid as quickly as possible and alert emergency medical services or a hospital where needed;
- have the employee transported, if there is no contraindication, to the first aid room, home or a suitable care facility;
- make contact in advance with the emergency services and care facilities you can call on.
These measures also apply to contractors, subcontractors and other people at your workplace. With the cooperation of your internal or external service and after the Committee's advice, you set out: the first aid procedures in your internal emergency plan, the resources, the number of employees for first aid and their qualifications, and the specific risks for which basic training is not enough. You evaluate these measures after incidents and accidents and adjust them.
Your internal prevention advisor follows this up. The internal emergency plan and the evaluation fit into the annual action plan of your global prevention plan.
First aid at work Belgium by company group
The Code divides companies into four groups, according to the number of employees and the sector. That division also determines first aid.
| Group | Who | First aid room | Who gives first aid |
|---|---|---|---|
| A | More than 1,000 employees, fewer in certain risk sectors | Mandatory, unless the risk analysis shows it is not needed | Enough nurses, first aiders or designated persons, for the whole working time |
| B | 200 to 1,000 employees; in construction, transport and storage, healthcare and other sectors from 50 | Same | Same |
| C | Fewer than 200 employees, outside A and B | Same | Same |
| D | Fewer than 20 employees, the employer is his own prevention advisor | Not required by the Code | The employer himself or one or more trained employees he appoints |
Which group you are in is explained in detail in the guide on the internal prevention advisor. A construction company with 50 employees is already in group B, see also our page on construction.
The first aid room is at or near the workplace, large enough, has hot and cold running water, is ventilated, lit and heated, and is accessible with a stretcher. A sign marks it. On the occupational physician's advice, it can also serve as a rest room for pregnant and breastfeeding employees, see maternity protection.
The first aid kit and equipment
The basic resources are basic equipment, a first aid kit and, where needed, a first aid room. The Code sets no fixed contents. On the advice of the occupational physician and the Committee, you decide which equipment is needed and where, set the contents of the first aid kit and decide whether additions are needed for your specific risks, such as burns in a kitchen or eye injuries in a workshop. You check regularly that everything is actually there. The inspectorate can impose additions or a different organisation.
The Code does not list an AED as mandatory equipment. Whether you install one follows from the risk analysis and the occupational physician's advice. The basic training does teach resuscitation according to the guidelines of the European Resuscitation Council, with the AED where there is one.
First aid employer duties: training and refreshers for first aiders
An employee counts as a first aider if he has successfully completed training and an annual refresher with an organisation on the list of the Federal Public Service Employment. The Code sets the minimum:
| Part | Minimum | Content |
|---|---|---|
| Objective 1 | 3 hours | Basic principles: the first aider's role, hygiene, raising the alarm, evacuation |
| Objective 2 | 6 hours | Vital functions: unconsciousness, breathing difficulty, chest pain, resuscitation |
| Objective 3 | 6 hours | Other injuries: bleeding, wounds, fractures, head injuries, burns, eye injuries |
| Basic training in total | 15 hours, breaks not included | Certificate after a competence assessment, at most 15 trainees per trainer |
| Refresher | 4 hours per year | Maintaining knowledge and new practices |
Two exceptions. The refresher may take place every 2 years if you show, with a prior risk analysis and after advice from the occupational physician and the Committee, that this does not affect your first aiders' knowledge. And if a first aider misses a refresher, he must attend another session within 12 months. If that fails, he no longer counts as a first aider.
For risks specific to your activity, such as chemical substances, specific training comes on top. The training costs the employee nothing, like all training on well-being.
Worked example: how many first aiders does an SME with shifts need?
The Code gives no number, only the result: first aid must be possible for as long as people are working. A planning example.
A wholesaler with 18 employees works two shifts, from 6 am to 2 pm and from 2 pm to 10 pm, each with 8 people in the warehouse and 2 in the office during the day. The managing director is his own prevention advisor, so group D.
| Question | Answer |
|---|---|
| How many shifts at the same time? | Two in succession, never together |
| Minimum per shift | One first aider present |
| Allowing for leave, sickness and training | A second per shift as back-up |
| Number to train | 2 shifts x 2 = 4 first aiders |
| Training time in the first year | 4 x 15 hours = 60 hours |
| Training time in following years | 4 x 4 hours = 16 hours per year |
Record the choice in the risk analysis and the emergency plan, with the names per shift. A Saturday shift or a seasonal peak with student workers changes the calculation. Agree it with your external service, see external prevention service.
First aid register: what the first aider records
You keep a register. For each intervention, the first aider records 5 details:
- his name;
- the victim's name;
- the place, date, time, description and circumstances of the accident or illness;
- the nature, date and time of the intervention;
- the identity of any witnesses.
The register is more than paperwork. It shows where things often go wrong, and it helps with the report if a small cut turns out to be a workplace accident. You report a workplace accident to your insurer within 8 days, see reporting a workplace accident and is workplace accident insurance mandatory.
What the work rules say about first aid
The work rules state where the first aid kit is and where to find the first aider. If that changes, you update the rules. How to do that is in drafting work rules. Also post the names next to the first aid kit: in an emergency nobody reads the work rules.
What do you risk?
An infringement of the Well-being Act or the Code is a level 3 sanction in the Social Penal Code: an administrative fine of € 1,000 to € 10,000, higher if it causes damage to health or a workplace accident. What changes in the fines this year is in Social Penal Code 2026.
Mistakes we often see
- A first aider who has not had a refresher for years. After 12 months he no longer counts.
- One first aider for two shifts. Half the time there is nobody.
- A first aid kit nobody checks. Empty boxes and expired products do not count as equipment.
- No register. Without a register, an accident is hard to reconstruct afterwards.
- Outdated work rules. If the kit or the first aider are somewhere other than the rules say, people look in the wrong place in an emergency.
- No arrangements for contractors. First aid must work for them too on your site.
What Business Centrum does for you
Business Centrum does not give first aid courses or carry out risk analyses: that is the job of recognised trainers and your external service. We handle the administration attached to it: the first aid details in the work rules we draw up for you, and processing absences after a workplace accident, together with Acerta. Taking on staff for the first time? We go through the first steps with you, see becoming an employer and our page for small SMEs. Unsure whether your first aid is in order? Have it checked.