In some cases, a preliminary medical examination is a prerequisite for employment. The conditions for its implementation are dictated by the established legislation. The purpose of the survey is to protect the he alth of the employee himself and those with whom there is contact in the working environment.
There are cases of ignoring the rules and procedures for conducting inspections. This can happen both on the part of the employer and on the part of the employee. You should figure out in what cases and who needs to undergo a medical examination.
Types of medical examinations
Prophylactic examinations of workers - a set of therapeutic and preventive measures taken to identify deviations in he alth, prevent the development and spread of diseases. Depending on how often preventive medical examinations are carried out, they are classified as follows:
- periodic;
- preliminary;
- extraordinary.
Each of the species has a specific purpose, timing, indications, procedure, required documentation.
Periodicmedical examination
Employees must undergo examinations throughout the entire period of employment in accordance with the position held. This is done in order to confirm the professional suitability of the employee and in time to prevent or detect a developing preventive disease.
He alth is a state of complete mental, physical, social and mental well-being and not merely the absence of disease. Its level fluctuates depending on many internal and external factors. Periodic medical examination reveals the dynamics in he alth changes that occur under the influence of labor factors. Identification of problems allows you to take the necessary measures in the early period of the development of pathology.
Passing a medical examination has the following features:
- Held within the time limits established by law.
- The frequency depends on working conditions and factors of production.
- Persons under 21 are screened annually.
- Carried out on the basis of a list of names formed by the administration of the enterprise, which is sent to the territorial medical institution.
- Employee receives a referral for a medical examination from the employer.
- The employee is examined by all the necessary specialists, laboratory and clinical tests are carried out in full.
- Based on the results, a final conclusion is issued, which determines the professional suitability and ability of the employee to hold his position.
The frequency of inspections by type of laboractivities
List of works for which preventive examinations are mandatory, as well as the frequency of examinations:
- high-rise and steeplejack work, labor associated with cranes and elevators - every 2 years;
- maintenance of electrical installations, adjustment and installation work - every 2 years;
- forest protection, work with the forest - every 2 years;
- oil and gas industry, offshore drilling - every 2 years;
- underground work - annually;
- meteorological facilities - annually;
- work in the field of geology, topography and construction - every 2 years;
- pressure vessel maintenance work - every 3 years;
- drivers, workers of boiler houses, gas supervision - every 2 years;
- work with explosive and flammable substances - annually;
- work in the banking, collection structure, security, other types of work related to the use of firearms - annually;
- work with mechanized installations - every 2 years;
- work in preschool, medical institutions, pharmaceutical organizations, medical industry - annually.
Extraordinary inspections
According to the law, every person holding a position in the enterprise has the right to an extraordinary examination in accordance with medical recommendations, during which the position and salary are retained.
WalkthroughThis type of medical examination does not have a fixed frequency. Conducted on two occasions:
- employee initiative - he has he alth complaints related to occupational hazards or other reasons;
- Employer's initiative - has suspicions that the he alth level of the employee has deteriorated due to the negative impact of working conditions or other reasons.
Based on the application of the employee or a letter to the hospital administration of the enterprise, an order is issued to send him for an extraordinary examination. The document indicates the period in which the examination will take place, data on the medical institution (name, address, location of the enterprise) and the amount of wages saved for the period of absence of the employee.
In addition, all costs for an extraordinary inspection are borne by the employer, regardless of on whose initiative the appeal to the he alth facility occurred.
Why is a preliminary examination done?
A preliminary medical examination is carried out in order to assess the state of he alth of the applicant for employment, its suitability for the future position, and also to identify the presence of diseases at the time of employment.
The following groups are subject to mandatory screening:
- Minor citizens.
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Employees whose preliminary medical examination is provided for by regulatory legal acts:
- persons engaged in heavy and hazardous work;
- positions related to the transport industry;
- food production workers;
- trade workers;
- employees of children's and medical institutions.
- Persons whose preventive medical examinations are provided for by other legislative documents.
On the basis of state orders, lists and provisions were approved that are the basis for conducting an examination of employees: on harmful and hazardous substances, work and speci alties, general and highly specialized medical contraindications, on the procedure and rules for conducting examinations.
Direction and order of its compilation
The administration of the enterprise issues a referral for a medical examination to a person entering a job. It contains the following data:
- enterprise name, ownership and economic status;
- data of a medical facility, indicating its address and code according to PSRN;
- what inspection will be carried out;
- Full name and date of birth of the applicant;
- department to which the future place of work belongs, what position will he occupy;
- factors of production.
The document is confirmed by the signature of the authorized person, indicating his last name, first name, patronymic and position. The employee is issued against a signature, and an authorized person keeps a record of the issued referrals.
Survey Procedure
After receiving a referral, the employee applies to the specifiedmedical institution. Preliminary and periodic medical examinations are supervised by a general practitioner who independently sums up the results of a comprehensive examination.
Other subspecialists involved in the examination:
- oculist;
- otorhinolaryngologist;
- neurologist;
- surgeon;
- dermatovenereologist;
- dentist;
- infectionist (according to indications).
From laboratory and functional examination methods, X-ray of the lungs, electrocardiography, blood tests for syphilis, bacteriological smears for gonorrhea, tests for carriage of intestinal diseases and helminthiases are annually performed.
Women are examined by a gynecologist, swabs are taken for cytological and bacteriological examination, and after 40 years, ultrasound of the mammary glands, mammography and consultation with a mammologist are mandatory. Men undergo oncological examination at the urologist with a digital examination of the rectum.
It is mandatory to take a general blood test, specifying the level of formed elements, hemoglobin, color index, expanded leukocyte formula, ESR. Clinical analysis of urine determines the presence of sugar and protein, specific gravity, sediment microscopy. A biochemical blood test is underway.
For all categories of persons undergoing a preliminary medical examination, a he alth examination by a psychiatrist and narcologist is mandatory.
According to the results of examinations of narrow specialists and clinical examinations, the therapist takesdecision on suitability, presence or absence of systemic diseases.
Psychiatric examination
Some working conditions require a psychiatric evaluation, and not just a psychiatric examination conducted under the conditions of a normal medical examination. The examination is carried out by the following persons:
- minors;
- future position associated with conditions of increased danger (chemical production, activities related to weapons, high- altitude or underground work, employees of the transport industry);
- teachers;
- catering workers;
- medical workers.
The examination process takes place in specialized institutions licensed for such activities. The commission consists of 3 specialists. The legislation says that a medical examination of employees by a psychiatrist is a voluntary measure, however, in case of refusal to undergo an examination, the administration of the enterprise has the right to refuse employment to a person.
For the purpose of examination, the specialists who are members of the commission may request additional data from the administration of the enterprise, about which the employee is notified. The decision is made by voting and issued in writing within three days.
According to the results of the survey, the commission has the right to recognize the employee as unfit to perform a certain type of activity (up to 5 years), but with the possibility of further re-examination.
Examination by a narcologist
Preliminary medical examination by a narcologist consists of three stages: direct examination, psychological testing, laboratory blood tests. Drug examinations allow to identify possible signs of the disease, and if they are found, the employee is sent to a hospital for further examination.
If there are no problems, a certificate is issued confirming the passage of a preventive examination. The document conforms to the established pattern.
An examination by a narcologist is carried out at the place of registration or in district centers (for villagers). The enterprise that sent the employee for examination pays the expenses.
Documentation Features
The person who will undergo a preliminary medical examination at the he alth facility provides a referral received from the employer, an identity document (birth certificate, passport), a he alth document (if any), a decision on a psychiatric examination (in accordance with the legislation cases).
Medical examination of employees requires the execution of certain documents. This is:
- Medical outpatient card - it records the data of examination by doctors, test results, the conclusion of the examination.
- A sanitary book is issued if the employee does not yet have one. It specifies data on the organization of the employer, personal data of the employee, brief conclusions of doctors during the examination. The sanitary book is assignedonce, even if the person changes jobs.
Fitness Conclusion
Mandatory medical examination of employees requires fixing the final decision, according to the results of which the employer will be able to hire a specialist. In conclusion, the following data is indicated:
- date of registration of the result;
- Name, gender, date of birth of the employee;
- employer data;
- working conditions of the person, indicating the structural unit, future position, hazard factors;
- final result (Identified or not identified medical contraindications for holding a future position).
The conclusion is signed by the therapist, indicating personal data and certifying with a personal seal and the seal of the medical institution. A document is drawn up in several copies, one of which is entered into the employee's outpatient card, and the other is given to him in his hands.
Employer costs
Under the law, all costs of mandatory preliminary and periodic medical examinations are borne by the employer. Expenses are those that provide normal working conditions and safety measures and are documented.
A budgetary or private enterprise, whose employees will participate in medical examinations, concludes an agreement with a medical institution that has the appropriate license. Payment is made in stages. 30% of the cost of services are paid in advance, and the final paymentoccurs as a result of the examination.
Conclusion
The administration of the enterprise not only has the right, but is also obliged to prevent an employee from work or employment who did not pass a medical examination on time without a good reason. In case of evasion from the preventive examination, the employee is removed from the labor process without pay. Timely examination allows not only to maintain the he alth of the employee, but to prevent the development of possible diseases.
