How many first-aid boxes does a factory need?

Under rule 54 of the OSH (Central) Rules 2026, at least one fully equipped first-aid box in every department or section, kept within reach during working hours, and more once a department has over 200 employees. Each box holds at least the 17 items in Annexure I to the rules and is in the charge of a certified first-aider on every shift. The old one-box-per-150-workers scale of the Factories Act no longer applies.

What percentage of workers must be trained in first aid?

At least 33% of the workers in the establishment, under rule 54(iv) of the OSH (Central) Rules 2026, with refresher training every three years. Where women are employed, at least one woman must be trained. The trainer must hold a recognised medical qualification or a qualification in industrial, public or emergency health. Separately, every box needs a certified first-aider readily available on every shift.

Does the principal employer provide first aid for contract workers?

Yes. Section 53 of the OSH Code 2020 requires the principal employer to provide the welfare facilities in sections 23 and 24 to the contract labour in its establishment, and first-aid boxes and the ambulance room are section 24 facilities. The site and the contractor can agree who trains first-aiders for a contract shift, but the crew's access to the box, the first-aider and the ambulance room is not negotiable.

When does a site need an ambulance room?

When a factory, mine or construction site ordinarily employs more than 500 workers, under section 24(2)(i) of the OSH Code 2020 and rule 55 of the Central rules. The room must be equipped to the Annexure II list and run by a full-time qualified medical practitioner, with at least one nurse and one assistant. Smaller sites must still arrange quick transport of a seriously injured worker to the nearest hospital.

What first aid must a site keep?

Under rule 54 of the OSH (Central) Rules 2026, a site needs at least one stocked first-aid box in every department, a certified first-aider in charge of each box on every shift, a third of its workers trained in first aid, and a notice naming the first-aider and the nearest hospitals. A factory with more than 500 workers also needs an ambulance room with a full-time doctor. The principal employer provides all of it to the contract crew too.

Which sites the rules cover

Rule 54 covers every factory, mine, building or construction site, beedi and cigar premises, motor transport undertaking, dock and plantation. Section 24(1)(vii) of the OSH Code 2020 makes first-aid boxes one of the welfare facilities an employer must provide, in the form the Central Government prescribes. Rule 54 of the OSH (Central) Rules 2026, notified on 8 May 2026, is that prescription.

Because the Code gives the rule-making power for welfare facilities to the Centre, rule 54 applies to a Tamil Nadu factory as well. Tamil Nadu's draft OSH rules of 2022 add more only for factories running a hazardous process [VERIFY: whether Tamil Nadu has notified final rules since the 2022 draft]. The list in rule 54 does not name warehouses. A distribution centre that is not a factory under the Code should ask its own counsel which standard it is held to. Most keep the rule 54 standard anyway, because an injury on a dock does not wait for that question to be settled.

Boxes, notices and what goes in the box

The rule asks for enough boxes to be readily reached during working hours: at least one in every department or section, and more once a department has over 200 employees (r.54(ii)). This replaces the old Factories Act scale of one box for every 150 workers [VERIFY: Factories Act 1948, s.45(1)]. Under the new rule the box count follows the floor plan rather than the headcount. A long warehouse with one department and 180 people may still need several boxes to stay within reach.

Annexure I to the rules lists 17 items as the minimum for each box. The list includes sterile dressings and burn dressings, an antiseptic solution, scissors, tweezers, a tourniquet, gloves, crepe and roller bandages, splints, eye pads, ORS sachets, paracetamol and an antacid, aspirin and isosorbide dinitrate, an anti-allergic, an ambu bag for resuscitation, and a leaflet with the emergency numbers of nearby hospitals. The employer may add more.

Each box needs a notice at a conspicuous place, in English or Hindi and in the local language. The notice gives the location of the first-aid facilities, the name and contact details of the person in charge, and the nearest hospitals (r.54(i)). On a Tamil Nadu site that means Tamil, which is also the language most of a contract crew reads.

1+first-aid box in every department or section, more above 200 employees (r.54(ii))

33%of workers trained in first aid, refreshed every three years (r.54(iv))

17items on the minimum contents list for a box (Annexure I)

500+workers: an ambulance room with a full-time doctor (OSH Code s.24(2)(i); r.55)

Who must be trained, and on which shift

There are two separate tests, and sites tend to meet the first and miss the second. The first is coverage on every shift: each box is in the charge of a worker or supervisor who holds a first-aid certificate and is readily available while that shift runs (r.54(ii)). The second is depth: at least 33% of the workers in the establishment trained in first-aid procedures, with refresher training every three years, and at least one woman trained wherever women are employed (r.54(iv)).

The trainer must be medically qualified: a doctor qualified under the schedules to the Indian Medical Council Act 1956, or someone with a diploma or degree in industrial, public or emergency health, or an Associate Fellow in Industrial Health (r.54(iv)). A short course run by an untrained in-house trainer does not count toward the 33%.

Who provides it for a contract crew

The site provides it. Section 53 of the OSH Code says the welfare facilities in sections 23 and 24 "shall be provided by the principal employer" to the contract labour employed in the establishment, and first-aid boxes and the ambulance room are both section 24 facilities. A contract worker who is cut on the line gets the same box, the same first-aider and the same ambulance room as a direct employee.

What the site and the contractor can split is the training. A contractor that supplies a crew for a whole shift is the natural place to put certified first-aiders, and the work order can require a set number per shift and the certificates to prove it. Whether contract workers count toward the 33%, and who answers if a shift has no first-aider, depends on the terms of the engagement and is a question for the site's own counsel.

When an ambulance room is required

An ambulance room is required once a factory, mine or construction site ordinarily employs more than 500 workers (OSH Code s.24(2)(i); r.55(i)). It can be a room or a dispensary, run round the clock or during working hours, and the employer may also tie up with hospitals for emergency services. The room must be under a full-time qualified medical practitioner appointed directly by the employer, assisted by at least one nurse and one general duty or nursing assistant (r.55(iv)). The doctor must earn a qualification in industrial or occupational health within a year of appointment (r.55(v)). The nurse needs Basic Life Support training and six months of emergency experience in a multispeciality hospital (r.55(vi)). Annexure II lists the room's equipment, from an examination couch and oxygen to IV sets and emergency injections.

Below 500, rule 54(viii) still requires suitable arrangements to move a seriously injured worker quickly to the nearest dispensary or hospital, "preferably by means of a proper ambulance van". Under Tamil Nadu's draft rules, a factory running a hazardous process must keep an equipped ambulance van with a driver trained in first aid (draft r.93), and needs at least five people trained in first aid even when it employs 100 or fewer (draft r.92) [VERIFY: draft rule numbers and status].

How Velura Services helps

We plan first-aid cover into each contract shift with your site, so a certified first-aider is rostered on the floor. We report injuries through your site's process and record them, which keeps first-aid cover and the accident register in step with the people actually working.

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Sources

Occupational Safety, Health and Working Conditions Code, 2020 (Act 37 of 2020), Gazette text hosted by DGFASLI. Sections cited: s.24(1)(vii) (first-aid boxes as a prescribed welfare facility), s.24(2)(i) (ambulance room above 500 workers in factories, mines and construction), s.53 (principal employer provides s.23 and s.24 facilities to contract labour). Opened and read.
Occupational Safety, Health and Working Conditions (Central) Rules, 2026, G.S.R. 345(E) dated 8 May 2026. Rules cited: r.54 (first aid and medical appliances: boxes per department, certified first-aider per shift, 33% trained, trainer qualifications, notice, transport), r.55 (ambulance room), Annexure I (box contents), Annexure II (ambulance room equipment). Opened and read from a mirrored copy of the Gazette [VERIFY: against the e-Gazette original].
Occupational Safety, Health and Working Conditions (Tamil Nadu) Rules, 2022 (draft), G.O. Ms. No. 38, Labour Welfare and Skill Development (H2), 11 April 2022, Tamil Nadu Government Gazette Extraordinary No. 216. Draft r.92 (occupational health centres in hazardous-process factories) and draft r.93 (ambulance van). Opened and read [VERIFY: status of the final rules].
Factories Act, 1948, s.45 (first-aid appliances: one box per 150 workers; ambulance room above 500), repealed by the OSH Code from 21 November 2025 [VERIFY: section text; India Code not opened this run].