Sample letter for medical examination of an electrician 302 n. We make a referral for periodic medical examination
Each business entity using the labor of hired workers, must take care of their health. All full-time employees must periodically or in accordance with an approved schedule undergo medical checkup. Many business entities require a certificate or medical book from persons planning to find employment with them.
In some sectors of the national economy, for example, in trade, catering, schools and preschool institutions, workers must at regular intervals undergo examination by certain specialists. In order for a current full-time employee to undergo a medical examination, he must be issued appropriately issued direction.
Every leader has a legal right not allow your staff member to perform professional duties if he has not passed the mandatory medical examination, in accordance with Article 212 of the Labor Code of the Russian Federation.
For some categories of workers, the Labor Code () provides obligation to undergo periodic medical examination. This group includes blue-collar professions related to:
- harmful working conditions;
- working in hazardous production;
- management of automobile and specialized transport.
The basis for undergoing a mandatory or periodic medical examination is in addition to the regulations of the Labor legislation direction issued at the place of official employment.
With this document, the individual is sent to a clinic or other medical institution with which the employer previously concluded a corresponding agreement.
Referral form for a medical examination by an employee is not a unified form, since it was not legitimized either by ministerial orders or regulations.
That is why business entities can independently develop the form of the document, which should subsequently be enshrined in their accounting policies.
It is worth noting that in the process of developing a referral form for legal entities and individual entrepreneurs, it is necessary to take into account the regulations of Order of the Ministry of Health and Social Development No. 302n dated April 12, 2011. This document provides guidance on what information should be included in a referral for a medical examination.
Stages of personnel work
Each business entity that has a staff must register each issued referral for a medical examination in the appropriate accounting register.
The employee will be required to sign and date the receipt in the referral log. Legal entities and individual entrepreneurs can compile such a register in tabular form, thanks to which it will be easy for them to enter the necessary data.
In accordance with Order No. 302n, business entities must make up staff lists who are required to undergo mandatory or periodic medical examinations. In the future, based on these lists, employers will issue referrals to their employees.
The list of staff members must be approved by the director. After this, the document is sent to a medical institution with which an appropriate agreement has been concluded for the provision of specialized services. It's done no later than two months in advance before the agreed date for the medical examination.
The list form is the same as the directions is not unified. Business entities can draw up a document in free form, but it must contain following data:
- Full name of employees (in alphabetical order);
- their dates of birth;
- gender;
- registration address;
- profession or position;
- work experience in the organization;
- name of the hazardous type of work or production factor;
- name of the organization or its separate division;
- date of compilation;
- date of last medical examination;
- signatures of responsible persons.
The list can be submitted to a medical institution either on paper or electronically. After receiving this document, the medical institution within ten days is obliged to draw up a schedule for the inspection of employees, which is agreed upon with the employer.
The business entity, in turn, will have to convey to staff employees information about the timing of the medical examination.
Periodic
Individuals who are not yet under 21 years of age. Also, such an examination is indicated for other persons officially employed in the organization in order to prevent the development of occupational diseases.
Federal legislation defines a list of working professions that require periodic medical examinations before each shift, for example, drivers of cars, trucks or specialized vehicles.
If an employer requires full-time employees to undergo a medical examination, they are required to comply with such an order. This may be due to the presence of harmful or dangerous working conditions, the specifics of the business area, or the requirements of Labor legislation.
Refusal to undergo a medical examination may lead to termination of the employment agreement between the employer and employee.
Preliminary
Many business entities send applicants for vacant positions to preliminary medical examinations. The individual will have to pass on the received expert opinion to the potential employer. If he is found to have any health problems that may interfere with his professional duties, he will be denied employment.
When undergoing a standard medical examination, an employee of the organization will have to contact:
Employees are required to undergo all basic tests: urine, feces, blood. They will have to do a fluorography, cardiogram and possibly an ultrasound of the internal organs. Based on the survey results, experts will give their conclusion, on the basis of which the corresponding certificate will be issued.
Instructions for filling out and contents of the form
When drawing up a referral for a medical examination, the person responsible for issuing the document must indicate following data:
- Enter the full name of the commercial organization or individual entrepreneur.
- The type of ownership of the employer is indicated.
- Codes are entered, in particular OKVED.
- The full name of the medical institution with which the employer has an agreement for the provision of specialized services is indicated.
- The type of examination that the employee will undergo.
- Full name of the employee who is sent for a medical examination.
- Date of birth of the employee.
- Position or profession.
- Working conditions that may have a detrimental effect on the health of the worker.
Individuals who are officially employed in a commercial organization or an individual entrepreneur are required to undergo a medical examination at the request of the employer.
This procedure is regulated by Article 213 of the Labor Code of the Russian Federation. Refusal to undergo examination at a medical institution will be considered grounds for dismissal or exclusion from the workplace.
An employee who agrees with the employer’s requirement receives a written referral with which he goes to the clinic or hospital. After passing all the specialists and tests, the employee receives a document, one copy of which is handed over to the management of the organization, and the second remains in the medical institution.
Additional information about pre-employment medical examinations can be obtained from this legal aid video blog.
23.04.2013 10:53:00
On January 1, 2012, the order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n “On approval of lists of harmful and (or) hazardous production factors and work, during which preliminary and periodic medical examinations (examinations) are carried out, and the Procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions” (hereinafter referred to as Order No. 302n).
One of the main objectives of this document is to create uniform rules for all employers for organizing and conducting mandatory medical examinations by combining requirements previously scattered across different documents.
Order No. 302n, as its name suggests, approved:
List of harmful and (or) dangerous production factors, in the presence of which mandatory preliminary and periodic medical examinations (examinations) are carried out (hereinafter referred to as the List of Factors);
- a list of works during the performance of which mandatory preliminary and periodic medical examinations (examinations) of workers are carried out (hereinafter referred to as the List of Works);
- The procedure for conducting mandatory preliminary (upon entry to work) and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions (hereinafter referred to as Procedure No. 302n).
The step-by-step procedure for conducting preliminary and periodic medical examinations described in Order No. 302n is schematically presented in Fig. 12.
Article 213 of the Labor Code of the Russian Federation provides for the need to organize medical examinations when an employee comes into contact with production factors only if he is employed in harmful and (or) dangerous working conditions.
Order No. 302n provides for a strict delineation of the areas of responsibility of the employer, employee and medical organization. Thus, the employer is responsible for:
- assessment of working conditions;
- education (formation) of groups of workers subject to medical examination;
- sending employees to a medical organization.
The employee is obliged to come to the medical organization with the necessary package of documents and undergo a medical examination. The medical organization is responsible for conducting a high-quality, comprehensive medical examination in accordance with regulatory rules.
According to R 2.2.2006-05 “Guide to the hygienic assessment of factors in the working environment and the labor process. Criteria and classification of working conditions” (approved by Rospotrebnadzor on July 29, 2005) harmful and dangerous classes of working conditions are classes 3 and 4, respectively.
Classes of working conditions 1 and 2, according to current legislation, are not capable of harming the health of the employee in the immediate and long-term periods, as well as his offspring.
Therefore, in accordance with clause 19 of Procedure No. 302n, Note 2 to the List of Factors, the employer is obliged to send the employee for a preliminary or periodic medical examination, and the employee is obliged to undergo it if the latter:
Is exposed at the workplace to production factors classified as harmful and (or) dangerous classes of working conditions (class of working conditions 3.1 and higher);
- performs the work provided for in the List of Works (without taking into account classes of working conditions).
When concluding an agreement to conduct mandatory medical examinations, the employer (his authorized representative) should take into account legal formalities, namely:
All types of mandatory medical examinations can be carried out by medical organizations of any form of ownership that have the right (license) to conduct preliminary and periodic medical examinations, as well as to examine professional suitability;
- the medical commission must include an occupational pathologist, and “narrow” medical specialists must have a valid certificate in the specialty “occupational pathology” (issued after completing advanced training in the specialty “occupational pathology” in the prescribed manner);
- the head (deputy head) of a medical organization or the head of its structural unit has the right to head a medical commission (Order of the Ministry of Health and Social Development of Russia dated 05.05.2012 No. 502n “On approval of the procedure for the creation and activities of a medical commission of a medical organization”). In any case, the person heading the medical commission must have a diploma of an occupational pathologist and a valid certificate of an occupational pathologist.
The employer's responsibilities include preparing the following documents:
List of contingent (list of workplaces) indicating, in accordance with the List of Factors and the List of Works, production factors and types of work identified (performed) at the relevant workplace based on the results of an assessment of working conditions. Based on this document, candidates who are subject to a preliminary medical examination are determined;
- a list of employees by name who are subject to mandatory periodic medical examination in the current year, which is compiled on the basis of the contingent list and sent to the medical organization no later than two months before the agreed date for the start of the periodic medical examination;
- referral for a preliminary (periodic) medical examination (examination).
There are no requirements for the execution (form) of the listed documents. However, Order No. 302n determines what information should be contained in them.
Thus, in a referral for a preliminary (periodic) medical examination, among other things, the following must be indicated:
Name of position (profession) or type of work;
- harmful and (or) dangerous production factors, as well as the type of work in accordance with the contingent of workers approved by the employer, subject to preliminary (periodic) inspections.
If the mandatory information provided for by Order No. 302n is missing or insufficiently reflected in the referral, this may become a formal reason for refusing to conduct a medical examination.
Based on the results of the examination, the medical organization draws up:
Outpatient medical record;
- employee health passport (if the employee already has a health passport, then additional entries are made in it);
- conclusion based on the results of a preliminary (periodic) medical examination (issued to the employee for transmission to the employer after the employee has undergone a medical examination);
- final report based on the results of periodic medical examination.
It is important to note that in accordance with Order No. 302n, the final act can only be approved by a medical organization. The current regulations also determine that the completed final act must be signed by the chairman of the medical commission (and no one else) and certified by the seal of the medical organization. There are no requirements for the mandatory presence of other marks in the final act. Thus, joint work on drawing up the final act should be carried out exclusively until the moment of its approval, i.e. at the project stage.
To ensure continuity of medical examinations, their results are reflected in the employee’s outpatient card and health passport, which is kept in the hands of the employee throughout his life and presented during medical examinations. Order No. 302n defines the procedure for transferring medical records of employees upon change or liquidation of a medical organization conducting medical examinations.
PROPOSED INNOVATIONS TO ORDER No. 302n
During the year after Order No. 302n came into force, the Ministry of Health and Social Development of Russia, and after its division, the Ministry of Health of Russia, as well as the Government of Russia, received numerous requests from citizens and organizations with comments and suggestions for improving the procedure for conducting mandatory medical examinations. A thorough analysis of these appeals was carried out, based on the results of which a list of changes to Order No. 302n was prepared.
At the end of November 2011, the Federal Law of November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” (hereinafter referred to as Law No. 323-FZ) came into force, containing rules on medical examinations, examination of professional suitability, formation medical commissions, etc.
Taking into account the significant number of planned changes in relation to the procedure for conducting mandatory medical examinations, as well as the new requirements of Law No. 323-FZ, a decision was made to issue a new order regulating the procedure for conducting mandatory preliminary and periodic medical examinations (examinations).
The basic positions of Order No. 302n outlined above will remain; the most important of the proposed innovations will be listed below.
1. The employer’s obligation to enter into an agreement for mandatory medical examinations with a medical organization (with the exception of employers affiliated with the FMBA of Russia) will be more clearly and unambiguously stated.
2. It is planned to add an extract from the outpatient’s medical record and a military ID (if available) to the list of documents required to be provided by the employee.
3. The presence in the workplace of allergenic, carcinogenic or factors affecting the reproductive system (in the list of factors they will be marked with the letters A, K, P, respectively) will be the basis for a medical examination of the employee, regardless of the class of working conditions in connection with the possibility of the occurrence of non-threshold effects.
4. The following provisions of Order No. 302n will be seriously revised:
Aerosols are predominantly fibrogenic and mixed type of action (clause 1.1.4 of the List of factors);
- underground work (clause 12 of the List of Works), especially in relation to medical contraindications;
- types of work provided for in paragraphs. 14 - 26 of the List of Works (workers in the food industry, educational institutions, etc.);
- control of ground vehicles (clause 27 of the List of Works).
5. New items will be added to the list of works during which mandatory preliminary and periodic medical examinations (examinations) of workers are carried out:
Diving work (six sub-items);
- work on transport management on the metro.
6. The factor “forced eye contact with a video terminal” will be highlighted as a separate item with a separately specified scope of examination and medical contraindications.
7. Overload of the vocal apparatus will be added to the list of harmful and (or) dangerous production factors, in the presence of which mandatory preliminary and periodic medical examinations (examinations) are carried out. This is one of the most important innovations of this classifier.
8. The psychiatrist and narcologist will be excluded from the mandatory scope of examinations.
9. An ophthalmologist and ophthalmotonometry will be included in the mandatory list of examinations.
10. Specialist doctors (surgeon, neurologist, otorhinolaryngologist, dermatovenerologist, oncologist, urologist, allergist) can be involved in work as part of the medical commission if there are (based on) medical indications.
11. An examination by an ENT doctor will become mandatory for all workers performing work at heights.
12. Pure-tone threshold audiometry will remain mandatory only for workers performing work in noisy conditions. In all other cases, acumetry (study of whispered speech) will be performed.
13. Fibrogastroduodenoscopy for employees of special geographical zones will be marked with a “*” (only if indicated).
14. A psychophysiological study will be conducted for workers performing work involving exposure to ionizing radiation, as well as a number of chemical substances.
15. If the frequency of laboratory or functional tests exceeds the frequency of periodic medical examinations, the employer will carry out the referral for these studies, and the conclusion on the presence (absence) of medical contraindications will be issued by the chairman of the medical commission together with a medical specialist corresponding to the profile of the study.
16. Glaucoma of any degree and compensation will be included among the medical contraindications for working at heights.
17. The presence of an artificial lens will be excluded from the list of medical contraindications for working as a driver.
18. It is planned to add the lack of binocular vision to the number of medical contraindications for working with optical instruments.
19. The degrees of color vision impairment, which serves as a contraindication for working as a driver, will be specified - dichromasia and monochromasia.
20. Post-infarction cardiosclerosis will serve as a general medical contraindication for the decreed contingent (i.e., for workers not engaged in harmful and (or) dangerous working conditions, but subject to mandatory medical examination) only in the presence of circulatory disorders of degree 2 or higher.
21. Lack of hearing is planned to be excluded from the number of medical contraindications for performing work in conditions of noise and with moving mechanisms for persons who have undergone special training.
22. In relation to diseases such as coronary heart disease, hypertension, discirculatory encephalopathy, etc., which appear as medical contraindications to performing certain types of work, references to the degree (stage) of the disease will be added.
23. An occupational disease will be defined as a medical contraindication to performing work associated with exposure to harmful factors that caused it.
24. Clause 48 of Order No. 302n, dedicated to general medical contraindications, will be revised.
25. Drawing up a conclusion based on the results of a periodic medical examination will not be mandatory for all employees, but only for those with medical contraindications. The medical organization will be obliged to transmit information about this to the employer within three days.
26. After the release of the new order, it is planned to approve methodological recommendations for organizing and conducting preliminary and periodic medical examinations (examinations), containing the forms of necessary documents. In the future, it is planned to develop methods for assessing the risk of developing occupational diseases.
27. By a separate order of the Russian Ministry of Health it is planned to approve the procedure for medical examination for the right to drive personal vehicles.
A.Yu. Bushmanov,
first deputy General Director of the Federal State Budgetary Institution State Research Center“Federal Medical Biophysical Center named after. A.I. Burnazyan”FMBA of Russia,chief freelance occupational pathologistFMBA of Russia and the Ministry of Health of Russia
A.S. Kretov,
expert-occupational pathologist of the Federal State Budgetary Institution State Scientific Center “Federal Medical Biophysical Center named after. A.I. Burnazyan” FMBA of Russia, secretary of the specialized working group on occupational pathology of the Ministry of Health of Russia
Arranging medical examinations is the prerogative of the employer. The company’s personnel or an employee just being hired does not need to look for a medical institution to undergo a medical examination and find money for it. The HR department of any company is responsible for the timely execution of this event and must correctly draw up the relevant documents and monitor compliance with legal requirements. Let's figure out according to which order of the Russian Federation mandatory medical examinations are carried out , and what documents they must be supported by.
302 order on medical examinations: for whom they are mandatory
According to Art. 76 of the Labor Code of the Russian Federation, an employee who has not passed the mandatory medical examination is suspended from work. However, this does not mean that all employees must be examined, because we are talking about mandatory examination. Order No. 302 of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 approved a list of hazardous and harmful work and production factors, the implementation of which is accompanied by mandatory periodic medical examinations. The same act defines the procedure for conducting medical examinations.
- age group up to 21 years;
- those employed in hazardous industries, heavy and dangerous work;
- related to traffic, incl. railway;
- working in the energy and construction industries;
- departmental security;
- food industry, trade and catering enterprises;
- medical and children's institutions;
- employees of water pipelines and water supply facilities;
- professional athletes.
The medical examination under order 302-n can be preliminary (i.e. upon entry to work), periodic or extraordinary. Any type of inspection is organized at the expense of the employer. Examinations are carried out on a reimbursable basis by medical institutions, with which companies enter into appropriate agreements. We should remember that medical examinations of workers (Order 302-n speaks directly about this) are carried out by medical organizations of any form of ownership that have a license to conduct them, as well as examinations of professional suitability. Mandatory details of such agreements are:
- item;
- information about the availability of a license to conduct medical activities;
- list of paid medical services;
- conditions, cost and timing of their implementation;
- calculation procedure.
Stages of personnel work to implement the requirements of Order 302-
Personnel officers are guided by Appendix No. 3, which determines the conduct of a medical examination by order 302-n. Having concluded an agreement with a medical institution, the personnel service is obliged to establish an internal procedure for sending employees for medical examinations:
- issue an appropriate order (sample) and familiarize employees with it against signature;
- draw up a list of employees by name according to order 302-(sample below) who must be sent for a medical examination. It is issued in 2 copies - for the medical institution and the Rospotrebnadzor department. The list identifies the full names of employees for whom a medical examination is required, lists professions and positions, indicates a harmful production factor and the workshop or department where the employee works. The document is approved by the manager and submitted to the RPN within 10 days, and to the medical institution 2 months before the agreed date of the medical examination.
Sample list for medical examination according to order 302-:
Having received the list of contingents by order 302-n, the medical organization develops a calendar plan for periodic examinations, coordinates it with the company management, approves and submits it to the enterprise no later than 14 days before the agreed date;
- fill out a form for a medical examination according to order 302-n, i.e. referral to a medical facility. 10 days before the agreed date for the start of the medical examination, the employee of the enterprise must be familiarized with the calendar plan and handed over to him (against signature), following order 302 of the Ministry of Health, a referral for a medical examination. The company develops the form of the document independently, since there are no standardized forms provided by law. Sample referral for medical examination under order 302-:
Personnel officers record in the logbook each referral issued to employees for a medical examination in accordance with Order 302-. The log form is also developed at the enterprise, approved by management and used to monitor the completion of medical examinations by employees.
The results of the examination in the health care facility are recorded in the outpatient card stored in the clinic. The results of the employee’s examination, i.e., the medical report, are recorded in a special document - the form of the final act according to order 302-n - the employee’s health passport, which is handed to him. If this document already exists, then new entries are made into it and returned to the owner. In addition, the employee is issued a certificate according to order 302 for transmission to the employer. It contains the conclusion of the medical commission, indicating professional suitability, and is certified by doctors’ signatures, stamps and the seal of the medical institution. Sample certificate form 302-n:
Periodic medical examination
Order 302 requires medical examinations and tests. To issue a certificate under Order 302, opinions of a therapist, surgeon, ENT specialist, ophthalmologist, narcologist and psychiatrist are usually required, and blood tests and fluorography are also provided. This is a general set, which is adjusted by adding or excluding specialized specialists, detailed blood tests, etc., depending on the characteristics of the industry or profession. It is important to know that the certificate issued for the first time can and should subsequently be extended in accordance with the established frequency.
Employee health passport according to order 302-n: form
This is form No. 004-P/U, relating to medical documentation, which is issued to each person who has undergone a medical examination, and consists of a general and effective part. The general information includes information about the employee who applied, the company that sent him for inspection, working conditions and influencing factors, as well as length of service. This information is filled in by the company’s personnel officer, and the document number is assigned to the health care facility. The date when the medical examination ends is also indicated there. One health passport is issued for each person. For greater clarity, we present the document form.
;
III. PROCEDURE FOR PERIODIC INSPECTIONS (P.P. 15 - 47);
IV. MEDICAL CONTRAINDICATIONS FOR ADMISSION TO WORK (P.P. 48 - 49);
Preliminary and periodic medical examinations: affordable prices at the “Occupational Medicine Clinic” in Moscow
A mandatory condition for interaction between employers and employees is the organization of preliminary and periodic medical examinations for personnel by the enterprise. The difference between these types of medical examinations in accordance with the provisions of Order 302n is that the preliminary examination is carried out upon entry to work and can be carried out on an individual basis.
At the same time, periodic medical examinations are aimed at dynamically studying the health status of personnel, early detection of occupational diseases, as well as symptoms/pathologies incompatible with working conditions. Such a medical examination can be carried out collectively.
According to Order of the Ministry of Health and Social Development 302n dated April 12, 2011, periodic examinations must be carried out at least once a year. Moreover, if there are no hazardous production factors at the enterprise, examination of employees can be organized in any medical institution that has a license to carry out this type of activity.
Order of the Ministry of Health and Social Development of Russia No. 302n dated April 12, 2011 also determines the procedure for organizing medical examinations at enterprises where factors harmful and dangerous to specialists are observed. The personnel of such companies must undergo examination for at least 5 years in specialized Occupational Pathology Centers or medical institutions licensed to examine professional suitability.
The compilation of lists for periodic medical examinations, as well as the approval of their calendar plan, is carried out by the employer together with the medical organization. By contacting our clinic, you can arrange a medical examination at any convenient time at an affordable price.
Registration of a driver's medical certificate and EEG
The procedure for obtaining a driver's license or opening a new category changes regularly. Moreover, for some categories, in particular:
- C, C1, CE, C1E;
- D, D1, DE, D1E;
- Tm, Tb,
A prerequisite is to undergo an electroencephalogram of the brain.
If you have a question: “Where to get a daily EEG in Moscow at an affordable price?”, our clinic offers to sign up for diagnostics. With us you can get the results of a 24-hour electroencephalogram quickly and inexpensively.
ORDER 302 N dated April 12, 2011 of the MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION (MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIA) MOSCOW
"On approval of lists of harmful and (or) dangerous production factors and work, during the performance of which mandatory preliminary and periodic medical examinations (examinations) are carried out, and the Procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions." with changes from dated May 15, 2013 N 296n.
Published: October 28, 2011 at"RG" - Federal issue No. 5619
Effective: November 8, 2011
Registered with the Ministry of Justice of the Russian Federation on October 21, 2011.Registration N 22111
In accordance with Article 213 of the Labor Code of the Russian Federation (Collection of Legislation of the Russian Federation, 2002, No. 1 (Part 1), Art. Z; 2004, No. 35, Art. 3607; 2006, No. 27, Art. 2878; 2008, N 30 (part 2), art. 3616) and clause 5.2.100.55 of the Regulations on the Ministry of Health and Social Development of the Russian Federation, approved by Decree of the Government of the Russian Federation of June 30, 2004 N 321 (Collected Legislation of the Russian Federation, 2004, N 28, Art. 2898; 2009, N 3; Art. 378), I order:
1. Approve:
a list of harmful and (or) dangerous production factors, in the presence of which mandatory preliminary and periodic medical examinations (examinations) are carried out, in accordance with Appendix No. 1;
a list of works during the performance of which mandatory preliminary and periodic medical examinations (examinations) of workers are carried out, in accordance with Appendix No. 2;
The procedure for conducting mandatory preliminary (upon entry to work) and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions, in accordance with Appendix No. 3.
2. Enact lists of harmful and (or) dangerous production factors and work, during which preliminary and periodic medical examinations (examinations) are carried out, and the Procedure for conducting preliminary and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions, from January 1, 2012.
Order of the Ministry of Health and Medical Industry of the Russian Federation dated March 14, 1996 N 90 “On the procedure for conducting preliminary and periodic medical examinations of workers and medical regulations for admission to the profession” (according to the conclusion of the Ministry of Justice of Russia, the document does not require state registration, letter dated December 30, 1996 N 07-02-1376-96);
Order of the Ministry of Health and Social Development of the Russian Federation dated August 16, 2004 N 83 “On approval of lists of harmful and (or) hazardous production factors and work, during which preliminary and periodic medical examinations (examinations) are carried out, and the procedure for conducting these examinations ( surveys)" (registered by the Ministry of Justice of the Russian Federation on September 10, 2004 N 6015);
Order of the Ministry of Health and Social Development of the Russian Federation dated May 16, 2005 N 338 "On amendments to Appendix No. 2 to the order of the Ministry of Health and Social Development of Russia dated August 16, 2004 N 83 "On approval of lists of harmful and (or) hazardous production factors and work , during which preliminary and periodic medical examinations (examinations) are carried out, and the procedure for conducting these examinations (examinations)" (registered by the Ministry of Justice of the Russian Federation on June 3, 2005 N 6677).
4. Establish that from January 1, 2012, subparagraphs 11, 12 (with the exception of subparagraphs 12.2, 12.11, 12.12), 13 of Appendix No. 2 to the order of the USSR Ministry of Health dated September 29, 1989 No. 555 "On improving the system of medical examinations of workers and drivers of individual vehicles."
Minister
T. Golikova
ORDER MINISTRY OF HEALTH OF THE RUSSIAN FEDERATIONdated May 15, 2013 N 296 n
"On amendments to Appendix No. 2 to Order No. 302 n dated April 12, 2011 Ministry of Health and Social Development of the Russian Federation "On approval of lists of harmful and (or) dangerous production factors and work, during the performance of which mandatory preliminary and periodic medical examinations (examinations) are carried out, and the Procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of workers, those employed in heavy work and in work with harmful and (or) dangerous working conditions"
Registered with the Russian Ministry of Justice on July 3, 2013. Registration N 28970
I order:
Amend Appendix No. 2 to the order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 No. 302n “On approval of lists of harmful and (or) hazardous production factors and work, during the performance of which mandatory preliminary and periodic medical examinations (examinations) are carried out ), and the Procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions" (registered by the Ministry of Justice of the Russian Federation on October 21, 2011, registration N 22111) according to application.
Minister
V.I.Skvortsova
Clause 19 should be stated as follows:
|
19. Work in children and teenagers seasonal health organizations |
1 time per year |
Dermatovenerologist, Otorhinolaryngologist, *Infectious disease specialist |
Fluorography of the lungs |
Diseases and bacterial carriage: |
Appendix No. 3
to the Order of the Ministry
health and social
development of the Russian Federation
dated April 12, 2011 No. 302 n
PROCEDURE FOR CONDUCTING MANDATORY PRELIMINARY (UPON ENTRY TO WORK) AND PERIODIC MEDICAL EXAMINATIONS (SURVEYS) OF EMPLOYEES WORKING IN HEAVY WORK AND IN WORK WITH HARMFUL AND (OR) DANGEROUS WORKING CONDITIONS
I. General provisions
1. The procedure for conducting mandatory preliminary (upon entry to work) and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions (hereinafter referred to as the Procedure), establishes the rules for conducting mandatory preliminary (when admission to work) and periodic medical examinations (examinations) of persons engaged in heavy work and work with harmful and (or) dangerous working conditions (including underground work), work related to traffic, as well as work , during which it is necessary to conduct preliminary and periodic medical examinations (examinations) in order to protect public health and prevent the occurrence and spread of diseases 1 .
2. Mandatory preliminary medical examinations (examinations) upon entry to work (hereinafter referred to as preliminary examinations) are carried out in order to determine the compliance of the health status of the person entering work with the work assigned to him, as well as for the purpose of early detection and prevention of diseases.
4. Preliminary and periodic examinations are carried out by medical organizations of any form of ownership that have the right to conduct preliminary and periodic examinations, as well as to examine professional suitability in accordance with current regulations (hereinafter referred to as medical organizations).
5. To conduct a preliminary or periodic examination, a medical organization shall form a permanent medical commission.
The medical commission includes an occupational pathologist, as well as medical specialists who have undergone advanced training in the specialty “occupational pathology” in the prescribed manner or have a valid certificate in the specialty “occupational pathology”.
The medical commission is headed by an occupational pathologist.
The composition of the medical commission is approved by order (instruction) of the head of the medical organization.
6. Responsibilities for organizing preliminary and periodic examinations of employees rest with the employer 2 .
Responsibility for the quality of preliminary and periodic examinations of workers rests with the medical organization.
II. Procedure for conducting preliminary inspections
7. Preliminary examinations are carried out upon entry to work on the basis of a referral for a medical examination (hereinafter referred to as the referral) issued to the person applying for work by the employer.
8. The direction is filled out on the basis of the list of contingents approved by the employer and it indicates:
- employer's name;
- type of medical examination (preliminary or periodic),
- last name, first name, patronymic of the person applying for work (employee);
- date of birth of the person applying for work (employee);
- name of the structural unit of the employer (if any) in which the person applying for work will be employed (employee);
- name of position (profession) or type of work;
- harmful and (or) dangerous production factors, as well as the type of work in accordance with the contingent of workers approved by the employer, subject to preliminary (periodic) inspections.
The referral is signed by an authorized representative of the employer indicating his position, surname, and initials.
The referral is issued to the person applying for work (employee) against signature.
The employer (his representative) is obliged to organize a record of issued directions.
9. To undergo a preliminary examination, a person applying for work submits the following documents to the medical organization:
- direction;
- passport (or other standard document proving his identity);
- employee health passport (if available);
- decision of the medical commission that conducted a mandatory psychiatric examination (in cases provided for by the legislation of the Russian Federation).
10. For a person undergoing a preliminary examination, the following is issued by a medical organization:
10.1 medical record of an outpatient (registration form No. 025/u-04, approved by order of the Ministry of Health and Social Development of Russia dated November 22, 2004 No. 255) (registered by the Ministry of Justice of Russia on December 14, 2004 No. 6188) (hereinafter referred to as the medical record), which reflects conclusions of medical specialists, results of laboratory and instrumental studies, conclusions based on the results of a preliminary or periodic medical examination.
The medical record is stored in accordance with the established procedure in the medical organization;
- name of the medical organization, actual address of its location and OGRN code;
- last name, first name, patronymic, date of birth, gender, passport data (series, number, by whom it was issued, date of issue), registration address at the place of residence (stay), telephone number, compulsory medical insurance policy number of the person applying for work (employee);
- employer's name;
- form of ownership and type of economic activity of the employer according to OKVED;
- the name of the structural unit of the employer (if any) in which the person applying for work will be employed (employee), the name of the position (profession) or type of work;
- name of the harmful production factor and (or) type of work (indicating the class and subclass of working conditions) and length of contact with them;
- name of the medical organization to which the employee is attached for constant monitoring (name, actual address);
- conclusions of medical specialists who took part in the preliminary or periodic medical examination of the employee, results of laboratory and instrumental studies, conclusions based on the results of the preliminary or periodic medical examination.
Each health passport is assigned a number and the date it was completed is indicated.
One health passport is maintained for each employee.
For persons assigned for medical care to the FMBA of Russia, an employee health passport is not issued.
During the examination, the health passport is stored in the medical organization. At the end of the examination, a health passport is issued to the employee.
If an employee loses a health passport, the medical organization, upon the employee’s application, issues him a duplicate health passport.
11. A preliminary examination is completed if a person entering work is examined by all medical specialists, as well as the full scope of laboratory and functional tests provided for in the List of harmful and (or) dangerous production factors, in the presence of which mandatory preliminary and periodic medical examinations are carried out examinations (examinations) of factors (Appendix No. 1 to the order (hereinafter referred to as the List of Factors) and the List of Works, during the performance of which mandatory preliminary and periodic medical examinations (examinations) of workers are carried out (Appendix No. 2 to the Order) (hereinafter referred to as the List of Works).
12. Upon completion of a preliminary examination by a medical organization, a conclusion is drawn up based on the results of the preliminary (periodic) medical examination (hereinafter referred to as the Conclusion).
13. The Conclusion states:
- date of issue of the Conclusion;
- last name, first name, patronymic, date of birth, gender of the person applying for work (employee);
- employer's name;
- name of the employer's structural unit (if any), position (profession) or type of work;
- name of the harmful production factor(s) and (or) type of work;
- the result of the medical examination (medical contraindications were identified or not identified).
The conclusion is signed by the chairman of the medical commission indicating the surname and initials and certified by the seal of the medical organization that conducted the medical examination.
14. The conclusion is drawn up in two copies, one of which, based on the results of the medical examination, is immediately given to the person entering work or who has completed a periodic medical examination, and the second is attached to the medical record of the outpatient.
III. Procedure for periodic inspections
15. The frequency of periodic inspections is determined by the types of harmful and (or) dangerous production factors affecting the employee, or the types of work performed.
16. Periodic inspections are carried out at least within the periods specified in the List of Factors and the List of Works.
17. Employees under the age of 21 undergo periodic examinations annually.
18. Extraordinary medical examinations (examinations) are carried out on the basis of medical recommendations specified in the final act, drawn up in accordance with paragraph 43 of this Procedure.
19. Periodic inspections are carried out on the basis of name lists developed on the basis of contingents of workers subject to periodic and (or) preliminary inspections (hereinafter referred to as name lists) indicating harmful (hazardous) production factors, as well as the type of work in accordance with the List of Factors and the List works
The following employees are subject to inclusion in the contingent and name lists:
- exposed to harmful production factors specified in the List of Factors, as well as harmful production factors, the presence of which was established based on the results of certification of workplaces for working conditions, carried out in the prescribed manner 3 . As a source of information about the presence of harmful production factors in workplaces, in addition to the results of certification of workplaces for working conditions, the results of laboratory research and tests obtained as part of control and surveillance activities, production laboratory control, as well as operational, technological and other data can be used. documentation for machines, mechanisms, equipment, raw materials and materials used by the employer in carrying out production activities;
- performing work specified in the List of Works.
20. The list of employees subject to preliminary and periodic medical examinations indicates:
- name of the employee’s profession (position) according to the staffing table;
- the name of the harmful production factor according to the List of factors, as well as harmful production factors established as a result of certification of workplaces for working conditions, as a result of laboratory research and testing obtained as part of control and surveillance activities, production laboratory control, as well as using operational, technological and other documentation for machines, mechanisms, equipment, raw materials and materials used by the employer in carrying out production activities.
21. The list of contingents, developed and approved by the employer, is sent within 10 days to the territorial body of the federal executive body authorized to carry out federal state sanitary and epidemiological surveillance at the actual location of the employer.
22. Name lists are compiled on the basis of an approved list of employees subject to preliminary and periodic medical examinations, which indicates:
- last name, first name, patronymic, profession (position) of the employee subject to periodic medical examination;
- name of the harmful production factor or type of work;
- name of the employer's structural unit (if any).
23. Name lists are compiled and approved by the employer (his authorized representative) and no later than 2 months before the date agreed with the medical organization for the start of the periodic examination, they are sent by the employer to the specified medical organization.
24. Before conducting a periodic examination, the employer (his authorized representative) is obliged to give the person sent for a periodic examination a referral for a periodic medical examination, issued in accordance with paragraph 8 of this Procedure.
25. The medical organization, within 10 days from the moment of receiving a list of names from the employer (but no later than 14 days before the start date of the periodic examination agreed with the employer), based on the specified list of names, draws up a calendar plan for conducting a periodic examination (hereinafter referred to as the calendar plan ).
The calendar plan is agreed upon by the medical organization with the employer (his representative) and approved by the head of the medical organization.
26. The employer, no later than 10 days before the start date of the periodic examination agreed with the medical organization, is obliged to familiarize the employees subject to the periodic examination with the calendar plan.
27. The medical commission of a medical organization, based on the harmful production factors or work indicated in the list, determines the need for participation in preliminary and periodic examinations of relevant medical specialists, as well as the types and volumes of necessary laboratory and functional tests.
28. To undergo a periodic examination, the employee must arrive at the medical organization on the day established by the calendar plan and present to the medical organization the documents specified in paragraph 10 of this Procedure.
29. For an employee undergoing a periodic examination, the medical organization draws up the documents established by paragraph 10 of this Procedure (if not available).
30. A periodic examination is completed if the employee is examined by all medical specialists, as well as the full scope of laboratory and functional tests provided for in the List of Factors or the List of Works is completed.
31. Upon completion of the employee’s periodic examination by a medical organization, a medical report is issued in the manner established by paragraphs 12 and 13 of this Procedure.
32. Based on the results of a periodic examination in the prescribed manner 4, the employee’s membership in one of the dispensary groups is determined in accordance with current regulatory legal acts, with subsequent registration in the medical record and health passport of recommendations for the prevention of diseases, including occupational diseases, and if any medical indications - for further observation, treatment and rehabilitation.
33. Data on medical examinations must be entered into personal medical records and recorded by treatment and preventive organizations of the state and municipal health care systems, as well as by bodies exercising federal state sanitary and epidemiological supervision.
34. In the event of liquidation or change of a medical organization carrying out preliminary or periodic examinations, the medical record is transferred to the occupational pathology center of the constituent entity of the Russian Federation, on the territory of which it is located, or in cases provided for by the legislation of the Russian Federation - to the occupational pathology centers of the FMBA of Russia, where it is stored in for 50 years.
35. The Center for Occupational Pathology, on the basis of a written request from a medical organization with which the employer has entered into an agreement to conduct preliminary and (or) periodic examinations, transfers the medical records of employees to the specified medical organization within 10 days from the date of receipt of the request to the specified medical organization. The request must be accompanied by a copy of the agreement for preliminary and (or) periodic inspections.
36. A medical organization with which the employer has not renewed the contract for conducting preliminary and (or) periodic examinations of employees, at the employer’s written request, must transfer the employees’ medical records according to the inventory to the medical organization with which the employer has currently concluded a corresponding agreement.
37. Participants in emergency situations or incidents, workers engaged in work with harmful and (or) hazardous substances and production factors with a one-time or multiple excess of the maximum permissible concentration (MPC) or maximum permissible level (MAL) for the current factor, workers with ( those who have had a conclusion on a preliminary diagnosis of an occupational disease, persons with persistent consequences of industrial accidents, as well as other workers, if the corresponding decision is made by the medical commission, at least once every five years, undergo periodic examinations in occupational pathology centers and other medical organizations that have the right to carrying out preliminary and periodic examinations, to conduct an examination of professional suitability and an examination of the connection of the disease with the profession.
38. In the event that a psychiatrist and (or) narcologist identifies persons with suspected medical contraindications corresponding to the profile of these specialists, permission to work with harmful and (or) hazardous production factors, as well as to work for which preliminary preparations are required and periodic medical examinations (examinations) of employees, these persons, in cases provided for by the legislation of the Russian Federation, are sent for examination by a medical commission authorized by the health authority.
39. Occupational pathology centers and other medical organizations that have the right to conduct periodic examinations, to conduct an examination of professional suitability and an examination of the connection of a disease with a profession, when conducting a periodic examination, may involve medical organizations that have the right, in accordance with current regulatory legal acts, to conduct preliminary and periodic examinations and examinations of professional suitability.
40. If there is a suspicion that an employee has an occupational disease during a periodic examination, the medical organization issues the employee a referral to an occupational pathology center or a specialized medical organization that has the right to conduct an examination of the connection of the disease with the profession, and also draws up and sends, in the prescribed manner, a notice of the establishment of a preliminary diagnosis of an occupational disease to the territorial body of the federal executive authorities authorized to exercise state control and supervision in the field of ensuring sanitary and epidemiological well-being.
41. In cases where it is difficult to determine the professional suitability of an employee due to his illness and for the purpose of examining professional suitability, the medical organization sends the employee to an occupational pathology center or a specialized medical organization that has the right to conduct an examination of the connection between the disease and the profession and professional suitability, in accordance with current legislation of the Russian Federation.
42. Based on the results of the examinations, the medical organization, no later than 30 days after the completion of the periodic medical examination, summarizes the results of the periodic examinations of workers and together with the territorial bodies of the federal executive body authorized to exercise state control and supervision in the field of ensuring the sanitary and epidemiological well-being of the population and representatives of the employer, draws up the final act.
43. The final act states:
- name of the medical organization that conducted the preliminary examination, address of its location and OGRN code;
- date of drawing up the act;
- employer's name;
- the total number of workers, including women, workers under 18 years of age, workers who have been diagnosed with a permanent degree of disability;
- the number of workers engaged in heavy work and work with harmful and (or) dangerous working conditions;
- the number of workers employed in jobs that require periodic medical examinations (examinations) in order to protect public health, prevent the occurrence and spread of diseases, including women, workers under the age of 18, workers who have been diagnosed with a permanent degree of loss ability to work;
- the number of workers subject to periodic medical examination, including women, workers under the age of 18, workers who have been determined to have a permanent degree of disability;
- the number of workers who have undergone periodic medical examinations, including women, workers under the age of 18, workers who have been diagnosed with a permanent degree of disability;
- percentage of employees covered by periodic medical examinations;
- a list of persons who have undergone a periodic medical examination, indicating gender, date of birth, structural unit (if any), conclusion of the medical commission;
- the number of workers who have not completed periodic medical examinations, including women, workers under the age of 18, workers who have been determined to have a permanent degree of disability;
- a list of employees who have not completed periodic medical examinations;
- the number of workers who have not undergone periodic medical examinations, including women, workers under the age of 18, workers who have been determined to have a permanent degree of disability;
- a list of employees who have not undergone periodic medical examinations;
- the number of employees who do not have medical contraindications to work;
- the number of employees with temporary medical contraindications to work;
- the number of employees with permanent medical contraindications to work;
- number of employees requiring additional examination (no conclusion given);
- the number of workers who need examination at the occupational pathology center;
- the number of workers in need of outpatient examination and treatment;
- the number of workers in need of inpatient examination and treatment;
- the number of employees in need of sanatorium-resort treatment;
- the number of employees in need of dispensary observation;
- a list of persons with a preliminary diagnosis of an occupational disease, indicating gender and date of birth; structural unit (if any), profession (position), harmful and (or) hazardous production factors and work;
- a list of newly diagnosed chronic somatic diseases indicating the class of diseases according to the International Classification of Diseases - 10 (hereinafter referred to as ICD-10);
- a list of newly identified occupational diseases indicating the class of diseases according to ICD-10;
- results of implementation of recommendations of the previous final act;
- recommendations to the employer on the implementation of a set of health-improving measures, including preventive and other measures.
44. The final act is approved by the chairman of the medical commission and certified by the seal of the medical organization.
45. The final act is drawn up in four copies, which are sent by the medical organization within 5 working days from the date of approval of the act to the employer, to the center of occupational pathology of a constituent entity of the Russian Federation, the territorial body of the federal executive body authorized to exercise state control and supervision in the field of ensuring sanitary epidemiological well-being of the population.
One copy of the final act is kept in the medical organization that conducted periodic examinations for 50 years.
46. The Center for Occupational Pathology of a constituent entity of the Russian Federation summarizes and analyzes the results of periodic medical examinations of workers engaged in work with harmful and (or) dangerous working conditions on the territory of a given constituent entity of the Russian Federation, and no later than February 15 of the year following the reporting year, sends the summarized information to Federal Center for Occupational Pathology of the Ministry of Health and Social Development of Russia and the health care management body of this constituent entity of the Russian Federation.
47. The Federal Center for Occupational Pathology of the Ministry of Health and Social Development of Russia, no later than April 1 of the year following the reporting year, submits information on periodic examinations of workers engaged in work with harmful and (or) dangerous working conditions to the Ministry of Health and Social Development of Russia.
IV. Medical contraindications for permission to work
49. Additional medical contraindications are indicated in the List of Factors and the List of Works.
1 Article 213 of the Labor Code of the Russian Federation.
2 Article 212 of the Labor Code of the Russian Federation.
3 Order of the Ministry of Health and Social Development of Russia dated August 31, 2007 N 569 “On approval of the Procedure for certification of workplaces for working conditions” (registered by the Ministry of Justice of Russia on November 29, 2007 N 10577).
4 Order of the Ministry of Health and Social Development of Russia dated 02/04/2010 N 55n (as amended on 03/03/2011) “On the procedure for conducting additional medical examination of working citizens” (together with the “Procedure and volume of additional medical examination of working citizens”) (registered by the Ministry of Justice of Russia on 03/04/2010 N 16550).
5 In cases of severe forms of mood disorders, neurotic, stress-related, somatoform, behavioral and personality disorders, the issue of professional suitability for the relevant work is decided individually by a commission of medical specialists corresponding to the profile of the disease, with the participation of an occupational pathologist.
6 After treatment, the issue is resolved individually by a commission of medical specialists, an occupational pathologist, and an oncologist.
7 Only for persons working in contact with harmful and (or) dangerous production factors specified in the List of Factors.
APPENDICES TO APPENDIX No. 3 "PROCEDURE FOR CARRYING OUT..." ORDER No. 302N OF THE MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIA DATED 04/12/11
The applications given below have not been registered with the Ministry of Justice of the Russian Federation and are provided for informational purposes only. The reliability of the materials is confirmed by their presence in the databases of legal documents "Garant" and "Consultant Plus".
| Download: "Appendix No. 1. Referral for a preliminary (periodic) medical examination (examination), form." |
In accordance with Art. 212 of the Labor Code of the Russian Federation, the employer is obliged to provide his subordinates with safe working conditions. He is also obliged to comply with all labor safety standards - this is a vast and rather complex area in Russian legislation. Occupational safety measures include, among other things, medical examinations of workers. It is regulated by the Order of the Ministry of Health and Social Development on compulsory medical examinations, in force since January 1, 2012.
At the time of entry into force, this act caused a lot of controversy and discussion, and it must be said that they still do not stop. The provisions of the document cover a huge list of professions and jobs, so not only occupational safety inspectors need to study them. We will tell you what the main provisions are contained in order 302n dated April 12, 2011 of the Ministry of Health and Social Development (as amended in 2018-2019). Its full text in the current version can be downloaded at the end of the article.
Order 302n - general information
Article 213 of the Labor Code of the Russian Federation requires regular medical examinations of workers employed in hazardous industries. The purpose of the measures is to establish suitability for the profession, early detection of health problems among employees and prevention of the spread of infectious diseases.
In fact, the circle of workers who must undergo a medical examination (not only during work, but also at the time of employment) is much wider. The fact is that the harmfulness of working conditions is determined by the SOUT (special assessment of working conditions). And if it is not carried out or its validity period has expired, then all jobs in an organization that has not passed the SUT are considered “harmful”.
The costs of medical services - tests, diagnostics and other procedures - are borne by the employer. The duty of employees is to undergo examination. Federal Law No. 52-FZ “On the Sanitary and Epidemiological Welfare of the Population” of March 30, 1999 prohibits those who refuse from being allowed to work (clause 4 of Article 34).
The factors determining the need for medical examinations are called by the order of the Ministry of Health and Social Development 302n dated April 12, 2011 “On approval of lists of harmful and (or) hazardous production factors and work, during the performance of which mandatory preliminary and periodic medical examinations (examinations) are carried out, and the procedure for conducting mandatory preliminary and periodic medical inspections (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions.”
It consists of three applications:
- the first lists potentially dangerous factors;
- the contents of the second are types of work that can only be performed with the permission of medical specialists;
- the third dictates the procedure for organizing medical examinations, provides samples of directions, medical reports and explains how to fill them out.
This order came into force shortly before the dissolution of the Ministry of Health and Social Development. Since then, it has been adjusted several times - already by orders of the Ministry of Health, which was separated from the reorganized ministry.
The current version contains amendments to the first two sections (order No. 801n dated December 5, 2014 amended the lists of harmful factors and contraindications), as well as changes made to clause 20 of Appendix No. 2 “Name of work and professions” by orders of the Ministry of Labor No. 62n, Ministry of Health 49n dated 02/06/2018 and entered into force on 03/16/2018.
Appendix 1. Harmful and dangerous factors
The first appendix, compiled in the form of a table, indicates the circumstances and grounds for conducting mandatory medical examinations. Unfavorable factors are divided into four groups:
- chemicals – substances and mixtures, allergens, carcinogens, etc.;
- biological – hepatitis B and C viruses, poisons of animals, plants, etc.;
- physical - radiation, radioactive substances, noise from technological equipment (included in 2015 by order of the Ministry of Health No. 801n), etc.;
- labor process factors – physical and sensory stress, etc.
For most factors, the degree of threat to human health is determined by a special assessment of working conditions (SAW).
Other columns of the table contain information:
- how often medical examinations are carried out;
- Which doctors of narrow specialties need to be examined;
- about the tests and procedures required for taking and passing;
- about medical contraindications for work requiring contact with these factors.
For example, an employee of an enterprise working with inorganic nitrogen compounds (clause 1.2.1) needs to be examined by an otolaryngologist and dermatovenerologist once every two years. Mandatory procedures include a study of pulmonary function and an analysis of reticulocytes and methemoglobin levels. Applicants with chronic diseases of the bronchi and lungs cannot apply for a position involving contact with ammonia - order 302n (as amended in 2018-2019) on medical examinations prohibits them from employing them.
Appendix 2. Harmful and dangerous working conditions
The following appendix lists the types of work for which medical examinations are prescribed:
- carried out in the Far North and other territories with a harsh climate, in uninhabited, remote places located far from populated areas with medical facilities - on oil rigs, drilling rigs, geological exploration and hydrometeorological stations, etc.;
- related to natural and man-made hazards - prevention and elimination of accidents, emergencies, gas and oil blowouts in fields;
- involving risk and requiring special physical training - at heights, under water, underground; in the collection service, paramilitary security, etc.;
- involving direct contact with a large number of people - in medical and educational institutions, including preschools, schools and others, in the areas of trade and public catering, consumer and transport services;
- involving contact with food products (food processing, food warehouses, distribution points, as well as transportation of such products);
- in industrial production (related to welding, machine tools, pressure vessels, etc.);
- related to driving vehicles (from crane operator to driver and even elevator operator).
The second appendix of the document, numbered 302n (order of the Ministry of Health on medical examinations as amended for 2018-2019), explains in as much detail as the first how often an employee should visit specific medical specialists. Thus, paramilitary security personnel must undergo a medical examination once a year to confirm their suitability for further service. The medical report must be signed by a neurologist, ophthalmologist, otolaryngologist, dermatovenerologist and surgeon. If problems with hearing, vision and diseases are identified, which are listed by order 302n dated April 12, 2011, Appendix 2 in paragraph 7, the security guard will not be able to continue working.
In addition, there is a list of general tests that every person undergoing a medical examination must undergo. This is a general blood and urine test, ECG, fluorography, blood test for glucose, cholesterol. Mandatory visits to a therapist, psychiatrist and narcologist have been established.
For women, an additional appointment with a gynecologist is required (with bacteriological and cytological analysis, and for women over 40 - also mammography (or ultrasound) once every 2 years).
Appendix 3. Procedure for conducting medical examinations
Order No. 302n regulates the procedure for organizing two types of medical examinations:
- preliminary (at the stage of employment of future workers);
- periodic (regularly among existing employees).
For a preliminary medical examination, the employer must issue a referral to the applicant for the vacant position. You need to prepare for periodic personnel services in advance:
- make a list of employees indicating their names, positions, and the nature of the work they perform;
- provide it to the medical institution with which the contract is concluded. Order 302n (as amended in 2018-2019) on medical examinations requires that the list be submitted no later than two months before the start of the procedures;
- after approval of the list, send it to the sanitary and epidemiological inspection within 10 days;
- familiarize employees with the medical examination calendar at least 10 days before the event;
- give them directions.
A conclusion on the examination completed is issued by a commission headed by an occupational pathologist. Based on medical recommendations, extraordinary examinations may be scheduled.
Responsibility
Failure to comply with the requirements of Article 213 of the Labor Code of the Russian Federation and the order of the Ministry of Health on examinations for professional suitability is subject to a fine (Part 3 of Article 5.27.1 of the Code of Administrative Offenses of the Russian Federation):
- from 15,000 to 25,000 rubles – for officials and individual entrepreneurs;
- from 110,000 to 130,000 rubles – for legal entities.
At the same time, liability can arise even for untimely medical examinations of office workers, which is confirmed by the Supreme Court decision No. 34-AD17-5 dated December 6, 2017, which considered a fine of 120,000 rubles imposed on a Murmansk company selling cars and spare parts justified. The highest judicial body of Russia considered the argument that employees who did not undergo a medical examination - specialists performing analytical work - to be untenable: after studying the case materials, the Supreme Court of the Russian Federation came to the conclusion that all employees of trade organizations must regularly undergo medical tests and be examined by doctors.
