A special “round table” was devoted to the problems of medical support for employees of the Traction Directorate within the framework of the 3rd meeting of machinists, which took place within the walls of the Scientific and Clinical Center of Russian Railways. It was attended by representatives of the Department of Health and leading specialists of the center.
Drivers complained about long procedures for medical examinations, incomprehensible referrals for additional diagnostics, suspensions from the flight with pressure and pulse overestimated by just one. All this sometimes creates a “white coat syndrome”. Man just crosses the threshold medical institution, and his blood pressure and pulse are already starting to go off scale.
The driver-instructor of the Chita depot, Gennady Polevoy, stated that in Lately medical requirements toughened - the pulse should not be more than 85 beats, and the pressure should not be higher than 130 units. “Even those who are only 20-25 years old are forced to take pills because of this, and they often cause drowsiness. And in this state, the brigade is driving the train. Half of the passages of prohibiting signals are due to pills, ”the driver-instructor is convinced.
Maybe the requirements for the health of drivers are excessive? Yes, according to the participants of the rally. One of them gave the following example: “In 2001, our military air unit was disbanded on the Transbaikal road. The military pilot wanted to retrain as a machinist, but did not pass the medical examination at the railway clinic. And for a long time later I was surprised: how is it that I can fly a supersonic plane, but I can’t drive trains. ”
The reason for this situation is Order 15-TsZ, which was adopted by the Ministry of Railways of Russia in 2001. He reflected the provisions of the relevant document of the Ministry of Health and Social Development, which determined very strict, and the same health requirements for a huge group of professions - in particular, from an electric locomotive driver to a steam locomotive stoker. At the same time, according to the order, people with lung diseases, such as bronchitis, heart pathologies, etc., should not be allowed to work. The department, without thinking twice, put into this document the entire international classification of diseases and health-related problems, accompanying them with the instruction “do not allow!”. And they didn't listen to any objections. That is why the military pilot was not taken as a machinist.
Realizing the redundancy of health requirements locomotive crews, specialists of Russian Railways tried to convince the Ministry of Health and Social Development of the need to reduce them. In the meantime, the court and the case, experienced, highly professional machinists who could still work and work were written off from the railway transport.
“In 1991-1999, there was only one case per 100 inspections when the health condition of the driver or assistant forced us to conclude that they were unsuitable for work. But with the adoption of order 15-TsZ, the number of such cases has increased,” said Artyom Shashkov, head of the sector of the health department.
The situation was corrected only in 2006, when new order No. 796 of the Ministry of Health and Social Development of the Russian Federation, which is still in force. He somewhat softened the requirements, but representatives of industry medicine believe that they still remain redundant. Although the statistics certainly improved. Today, there are only 0.8 cases per 100 professional examinations when the question of professional suitability is raised. But it did not cure the "white coat syndrome". Locomotive crews still live under eternal fear - at one fine moment to be out of the profession and be left without a job.
Unnecessarily stringent requirements affect today and when applying for a job. Alexey Vorotilkin, Vice-President of Russian Railways JSC, Head of the Traction Directorate, gave a typical example: “In Taishet, out of a hundred people who came to get a job at a locomotive depot, 34% could not pass the initial professional selection, another 18% did not pass a medical examination for an assistant and driver. In fact, only 20-25 people out of 100 can work in these specialties.”
Today, according to Artyom Shashkov, the Russian Railways Health Department is actively working to make the necessary changes to Order No. 796 in order to reduce medical contraindications for admission to work of persons associated with the movement of trains, including drivers working without an assistant. Unreasonable severe restrictions on the work of a machinist should be removed. Because of them, the company bears absolutely unjustified losses.
Now, according to Rosprofzhel, 123 thousand members of locomotive crews work on the network. Every year, from 0.7 to 1% of assistants and drivers are deducted from transport for medical reasons. That is, more than a thousand people of highly qualified, scarce personnel! And the most a large number of prohibitions is in the 1st group of admission: a person loses access to work after the treatment. And it is very difficult to explain this with some reasonable arguments.
In this regard, it was very characteristic to correlate our standards with the European recommendations for the driver's health. They have much in common with the 796th order, but there are also softer positions. Moreover, what in Europe has the character of recommendations has for some reason become an order in our country.
Meanwhile, it’s not a sin for us to adopt some of the European rules: there, if a driver suffering from hypertension is overweight and smokes, he is obliged to lose weight within six months, bring pressure back to normal and stop smoking, otherwise will be removed from work. However, this rule is already in effect in our country: last year, an assistant driver complained to the editorial office - he could not lose weight and cope with pressure, so he had to look for another job.
Well, and the threat of incompetence will probably not force many to quit smoking. “73% of our drivers smoke!” - Artyom Shashkov cited sad data.
It is very difficult to convince people to leave this bad habit. Alas, the current mode of work and rest of locomotive crews does not contribute to this. Drivers say that they are often called on a flight in advance and have to wait hours for the train to depart. There are also problems with resting at turnover points - and on paper everything goes smoothly, but in reality - lack of sleep, insomnia, hassle. All this, of course, affects health. And when the first alarming symptoms appear, not everyone turns to doctors for help, fearing that they will simply be written off from transport.
“Contact us, don’t joke with your health, don’t repeat like children: “I don’t have any pain,” medical drivers are urging. And they explain: we are able to return to service up to 60% of workers, subject to timely appeal.
As you know, the company has a powerful healthcare system. So, medical control more than 200 medical commissions are carried out, 1,500 professional examination rooms operate on the network, where up to 30 million examinations are carried out per year. Modern high-tech methods of diagnostics and treatment allow us to apply an individual approach and achieve a speedy cure. At the same time, the healthcare sector has its own specifics. It is determined by factors that negatively affect the state of health. In particular, the drivers are familiar with noise and vibration, magnetic fields in the cab of the locomotive.
Experts are looking for a way to compensate for hazardous effects. At the Scientific and Clinical Center of Russian Railways, guests were shown a special chamber with an artificial magnetic field. They also talked about the fact that experiments are being carried out to protect the driver's cab from harmful effects direct, and especially alternating current. If you manage to achieve an effect, many will say thank you.
Anyone who visited the Scientific and Clinical Center could appreciate everything that is being done to preserve the health of representatives of the leading profession in railway transport. We saw the EP1M simulator there - the cabin of the latest electric locomotive, in which the influence of various factors on the parameters of the driver's heart rate and blood pressure is studied. Undoubtedly, this will make it possible to develop medical recommendations - both for members of locomotive crews and for designers of traction equipment.
Well, what about that driver from the Urals, whom the doctors wrote down in hypertensive patients? As it turned out, the verdict is not final. It can be appealed to the Central Medical Expert Commission. The burden of responsibility for an important decision is placed on the shoulders of its chairman Viktor Kotenko - whether it is possible to remove a railway worker from work, whom linear and regional expert commissions deemed unsuitable.
The conversation with the "hypertensive" was short.
"Don't you want to take advantage of the privilege of retiring early?" the doctor joked.
- I'm healthy, - proudly answered the driver, - I want to work and calmly pass the medical examination.
- Come, I will remove this diagnosis, - sounded in response.
No one needs to explain what a change of profession means for the driver himself and his family. It ruins a person's life. And it is clear that the risk of such a situation must be minimized.
4.3. Persons applying for work and employees of railway transport according to list employees of certain professions, industries, enterprises, institutions and organizations that undergo a mandatory medical examination to detect HIV infection during mandatory preliminary upon admission to work and periodic medical examinations, approved resolution Governments Russian Federation of September 4, 1995 N 877 *(7).
4.4. Persons entering courses and schools vocational training, applicants and students of institutions of higher and secondary vocational education of the Ministry of Railways of Russia (hereinafter - educational institutions of railway transport), entering and studying in specialties and professions, during which mandatory medical examinations are carried out, according to paragraph 5.2 of Annex 1 to the order of the Ministry of Health of Russia of December 10, 1996 N 405, registered by the Ministry of Justice of Russia on December 31, 1996, N 1224 *(8), And paragraph 13 of annex 2 To order Ministry of Health and Medical Industry of Russia and the State Committee for Sanitary and Epidemiological Supervision of Russia dated October 5, 1995 N 280/88.
5. Persons entering work, courses and vocational training schools, employees of organizations and students of educational institutions of railway transport undergo mandatory medical examinations in accordance with this Regulation.
Applicants of educational institutions of railway transport undergo mandatory medical examinations in accordance with this Regulation and regulatory legal acts Ministry of Health of Russia and Ministry of Education of Russia, adopted in the prescribed manner.
II. The procedure for conducting mandatory medical examinations
6. The decision to conduct mandatory medical examinations of specific railway workers is made by a commission consisting of representatives of the employer, the trade union organization and the center for sanitary and epidemiological surveillance of the health care system of the Ministry of Railways of Russia (hereinafter - TSES of the Ministry of Railways of Russia).
7. Mandatory medical examinations are carried out by medical expert commissions of medical and preventive institutions of the healthcare system of the Ministry of Railways of Russia (hereinafter referred to as LPU of the Ministry of Railways of Russia), to which organizations and educational institutions of railway transport are attached in accordance with orders of the heads of railways.
8. Compulsory medical examinations of persons sent by an organization or an educational institution of railway transport are carried out upon presentation of the Compulsory Card medical examination(registration form AKU-22 of the Ministry of Railways of Russia) and an identity document. Persons applying for work or study must also present a military ID, an extract from a polyclinic on the absence of registered diseases from the psycho-neurological and narcological dispensaries of the Ministry of Health of Russia, which provide medical care at their place of residence.
9. The decision on the professional suitability of persons subject to mandatory medical examinations is made by the medical expert commission of the healthcare facility of the Ministry of Railways of Russia (hereinafter referred to as the EEC), which issues a conclusion on the compliance of their health status with the requirements necessary to perform the work, including the one provided for field trip during the period of study of students of educational institutions of railway transport.
Persons who have not passed mandatory medical examinations or who have an EEC conclusion on professional unsuitability for work ( industrial practice) not allowed.
10. Mandatory medical examinations of railway workers are carried out:
10.1. Employees directly involved in the movement of trains, taking into account the profession and age, with the following frequency:
10.1.1. Locomotive drivers working without assistant drivers on the train and shunting work, machinists and assistant machinists serving high-speed trains, and mechanics of refrigerator sections - annually.
10.1.2. Other machinists, drivers and their assistants, workers performing dispatching and operator and station-shunting works that ensure the movement of trains, under the age of 50 years - every 2 years, after 50 years - annually.
10.1.3. Other employees directly related to the movement of trains - once every 3 years.
10.2. Workers exposed to hazardous and harmful production factors, - with the frequency established by the regulatory legal acts of the Ministry of Health of Russia, adopted in the prescribed manner.
10.3. Employees directly involved in the movement of trains and at the same time exposed to dangerous and harmful production factors - with the frequency established by this Regulation and the regulatory legal acts of the Ministry of Health of Russia, adopted in the prescribed manner. If the dates for mandatory medical examinations coincide, the Card of mandatory medical examination for examination under combined programs indicates all types of work and production factors for which a conclusion is required on the compliance of the health status of workers with their professional activities.
15.2. Maintain statistical records and reports in accordance with the forms of accounting and reporting medical documentation approved by the Ministry of Railways of Russia.
15.3. use information materials And guidelines developed by the All-Russian Research Institute of Railway Hygiene of the Ministry of Railways of Russia and the Center for Occupational Pathology and Expertise of Professional Suitability of the Ministry of Railways of Russia.
16. Heads of TsSEN Ministry of Railways of Russia provide:
16.1. Participation of occupational health sanitary doctors in the annual compilation of lists of employees subject to mandatory medical examinations in the coming year, indicating for each employee a list of hazardous and harmful production factors affecting him, their levels and concentrations exceeding the maximum allowable.
16.2. In the event of an unfavorable sanitary-hygienic or epidemiological situation, a conclusion (with specific reasons) on the more frequent mandatory medical examinations than provided for by this Regulation.
17. Shop doctors of healthcare facilities of the Ministry of Railways of Russia:
17.1. They directly participate in the conduct of mandatory medical examinations or provide epicrises of their observation of workers assigned to shop medical stations to the EEC.
17.2. Prepare employees assigned to shop medical stations for mandatory medical examinations (conduct mandatory and individual additional laboratory research and draw up the necessary accompanying medical documents) in order to reduce the time of examination in the EEC and ensure continuity in the medical care of railway workers by specialists from linear, nodal, departmental, road and central healthcare facilities of the Ministry of Railways of Russia.
17.3. Together with doctors of other specialties of health care facilities of the Ministry of Railways of Russia, they decide the issue of conducting early mandatory medical examinations of workers attached to shop medical stations, if they detect (assume) changes in their health status that affect professionally significant functions of the body.
17.4. Making adjustments to medical appointments other attending physicians, taking into account the knowledge of the characteristics of the work of workers attached to shop medical stations, and training in the clinical section of railway medicine. Carry out sanitary and educational work among workers directly related to the movement of trains, other dangerous working conditions, about the inadmissibility of self-treatment.
17.5. The data indicated in the medical reports (extracts) or received at the request of non-departmental health facilities about cases of diseases with temporary disability of workers who ensure the movement of trains attached to shop medical stations are registered in the Medical Card of the Outpatient and the Personal Medical Card.
Taking into account the registered data, an analysis of the general morbidity and morbidity with temporary disability of these employees is carried out and proposals are made to their employers to improve working conditions and improve the health of employees of railway transport organizations.
18. Railway workers subject to mandatory medical examinations must:
18.1. Timely undergo mandatory medical examinations, fulfill the individual conditions of admission to work prescribed by the conclusion of the EEC.
18.2. To receive, when non-departmental health facilities establish temporary disability, medical reports (extracts) on the disease, examination, treatment and recommendations issued for presentation to shop doctors of health facilities of the Ministry of Railways of Russia, who carry out an examination of their professional suitability and treatment, taking into account the characteristics of therapeutic schemes that allow maintaining professionally significant mental functions of the body . This subparagraph applies only to employees who ensure the movement of trains.
*(10) Collection of acts of the President and Government of the Russian Federation, 1993, N 18, item 1602; Collection of Legislation of the Russian Federation, 1998, N 22, article 2459.
First step– medical board
In the subway and commuter trains every now and then they announce the hiring of machinists. Pretty modest initial requirements (it is enough to be a man under 40 with a secondary education) and a good salary attracts many, but the path to the chair of the "electric train captain" turns out to be long and full of obstacles...
The driver needs to have iron health: driving an electric train is a harmful job. This is a big load on vision and hearing, the impact electromagnetic radiation and vibrations, dusty air (including metal dust, especially in the subway). It is no coincidence that the driver's working day (or night) begins with a mandatory medical examination: checking pressure, temperature, cardiac activity, and an alcohol test. Therefore, wherever you decide to study: in one of the electric depots (if we are talking about the subway) or in college (for work on trains), the first thing you will have to face is a harsh medical board. First, doctors will carefully check your health, then you will undergo a psychological test to find out if you are ready to be responsible for hundreds of people, to be collected and attentive for a long time, to make decisions in just a split second.
In some educational institutions x, for example, in the specialized Railway College N 52, the requirements are softer: it is enough to bring a regular medical certificate (086-y). However, before the last - train - practice, you still have to go through a medical examination in full: after two years of study, your health may deteriorate (vision - due to computers, hearing - due to players, etc.). And if some indicators turn out to be below the norm (most of the candidates are eliminated at medical examinations), then you will not be a machinist - you will have to be content with the profession of a locksmith and repair cars.
The main stages of the medical examination:
vision test (it must be perfect), fundus conditions
audiogram (hearing test)
bicycle ergometry
fluorography
tests, certificates of vaccinations, an extract from a medical card
examine medical specialists: a surgeon, a neurologist, a dentist, an otolaryngologist, a general practitioner.
If there is a deferment from military service, then it should not be related to health. Drivers undergo a medical examination once every three years.
The machinists– through college
If everything is in order with health and psyche, you can start training. Electric train drivers in Moscow are trained by two educational institutions: Railway College N 52 and Moscow College of Railway Transport. Here, within the framework of primary vocational education (VET), one can learn to become an assistant driver in ten months (after grade 11) or in two years and ten months (after grade 9). In principle, this may be enough to start a profession, but it is better to get deeper knowledge and an average professional education(SPO), enrolling in the specialty " Technical operation rolling stock of railways. The study will take two years and ten months after the 11th grade and almost four years after the 9th, but college graduates receive a higher qualification of "technician".
To enter the Railway College N 52 after the 9th grade, you need to pass an exam in physics and the Russian language (dictation), after the 11th - in mathematics and Russian (exposition). At the Moscow College of Railway Transport, Russian (dictation) and mathematics (oral) are waiting for you.
During your studies, you will receive the rank of a rolling stock repairman (having passed the exam after industrial training), and then proceed to study the main disciplines: Maintenance electric trains, auto brakes, etc.
To study in the underground
Colleges train universal specialists for both commuter trains and subways, but those who want to work in the subway usually prefer a different path: they choose a depot (subway line), go to the appropriate personnel department and declare their intention to become a machinist. The Depot sends the candidate for training to the Training and Production Center (UPC) of the Moscow Metro.
Studying is rich: first you need to go through a mandatory locksmith practice and get a grade, then study the equipment of an electric train, get acquainted with numerous instructions and professional terminology.
Vyacheslav Garanin, Head of the UOC of the Moscow Metro:
“Recently, we have managed to significantly reduce the training period: now we train assistant drivers in one month, and drivers in six months. This was achieved through the introduction modern technologies: computer programs that allow you to study in detail the equipment of wagons, educational films (to see with your own eyes how, for example, wagons are assembled, you don’t have to go to the factory), unique simulators, ready-made illustrated notes for each student (they save 70% of the teacher’s time).
The final of the first stage of training is train practice. It runs for several weeks on an electric train along a specific route. An important condition is that by this time the student must already be 18 years old. After successful delivery examination, the graduate is awarded the qualification of "assistant driver". He will have to work in this position from several months (in the subway) to two years (on suburban trains): technical condition trains, observe the boarding, respond to requests via the “passenger-driver” connection and, of course, learn from the driver the experience in driving an electric train.
Here, locomotive control is learned at a new level: future drivers are engaged in simulators that imitate train control, learn to get out of emergencies. Training lasts four to six months, after which the graduate receives the right to drive an electric train.
Finally, the "fired" newcomer sits down at the driver's controller - the main train control lever. He must gain experience, grow from a 4th class driver to a 1st class driver, and then take the position of an instructor driver. To increase the rank, the driver again undergoes training and takes an exam.
For those who have proven themselves, the depot can offer free education at the Moscow State University of Communications, and a specialist with a higher engineering education railway much more room for growth. So, in the administration of JSC Russian Railways or in the Office of State Railway Supervision there are leaders who once worked as machinists.
Career and salary
The volume of passenger traffic is constantly growing, the lines are developing. therefore suburban trains and subways are in constant need of drivers and assistants. But, before you connect your life with driving an electric train, you should know that this is not a job for a year or two. In order to become "their own" on the railway, she will have to devote most of her life. The salary of the driver's assistants is from 15 thousand rubles, experienced drivers, receiving bonuses and allowances, earn up to 25-30 thousand rubles.
| You can ask your questions on the topic of the presented article by leaving your comment at the bottom of the page. Deputy will answer you CEO driving school "Mustang" academic work Teacher high school, candidate of technical sciences Kuznetsov Yury Alexandrovich |
New List diseases that prevent driving
In accordance with the Order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n “On approval of the lists of harmful and (or) dangerous production factors and work, during the performance of which preliminary and periodic medical examinations (examinations) are carried out, and the Procedure for conducting preliminary and periodic medical examinations (examinations ) workers engaged in hard work and work with harmful and (or) dangerous working conditions "from January 1, 2012, subparagraphs 11, 12 (with the exception of 12.2, 12.11, 12.12), 13 of Appendix No. 2 to the order of the Ministry of Health are recognized as invalid USSR dated September 29, 1989 No. 555 “On improving the system of medical examinations of workers and drivers of individual Vehicle». (http://www.xn--80aaaaaq6azamaccckfprc6hzfvc.xn--p1ai/blog/faktory_provociruyuschie_dtp/perechen_zabolevaniy_zapreschayuschih_vozhdenie/11-176 ).
According to paragraph 28 of Appendix No. 2 to this order (with full text Order you can find on our website in the section "Legislation") establishes the following requirements for drivers of land vehicles.
28. Driving ground vehicles:
Periodicity
1 time in 2 years
Laboratory and functional studies
Height, weight, determination of blood type and Rh factor (during the preliminary medical examination) Audiometry Examination of the vestibular analyzer Visual acuity Color perception Determination of visual fields Biomicroscopy of the media of the eye Ophthalmoscopy of the fundus
Corrected visual acuity below 0.6 in the best eye, below 0.2 in the worst. Permissible correction for myopia and hyperopia 8.0 D D D D .
Central scotoma absolute or relative (with scotoma and the presence of changes in visual function not lower than the values \u200b\u200bspecified in paragraph 1 of this column of the subparagraph - tolerance without restrictions).
Condition after refractive operations on the cornea (keratotomy, keratomileusis, keratocoagulation, refractive keratoplasty). Persons are allowed to drive 3 months after surgery with visual acuity with a correction of at least 0.6 in the best eye, not lower than 0.2 in the worst.
Permissible correction for myopia and hyperopia 8.0 D , including contact lenses, astigmatism - 3.0 D (the sum of sphere and cylinder must not exceed 8.0 D ). The difference in the power of the lenses of the two eyes should not exceed 3.0 D , in the absence of complications and initial (before surgery) refraction - from +8.0 to -8.0 D . If it is impossible to establish preoperative refraction, professional suitability issues are resolved positively with an eye axis length of 21.5 to 27.0 mm.
An artificial lens, at least in one eye. Experienced drivers are allowed with visual acuity with a correction of at least
0.6 on the best eye, not less than 0.2 - on the worst. Permissible correction for nearsightedness and farsightedness 8.0 D , including contact lenses, astigmatism -
3,0
D (the sum of the sphere and the cylinder must not exceed 8.0 D ). The difference in the power of the lenses of the two eyes should not exceed 3.0 D ,
normal field of vision and no complications within six months after surgery.
Chronic diseases of the membranes of the eye, accompanied by a significant impairment of the function of vision, persistent changes in the eyelids, including their mucous membranes, paresis of the muscles of the eyelids that impede vision or limit the movement of the eyeball (after surgical treatment with a positive result, admission is carried out individually).
Chronic inflammation of the lacrimal sac that does not respond to conservative treatment, as well as persistent, lacrimation that does not respond to treatment.
Paralytic strabismus and other concomitant eye movement disorders.
Persistent diplopia due to strabismus of any etiology.
Spontaneous nystagmus with pupil deviation of 70° from the middle position.
Limitation of the field of view by more than 20 0 in any of the meridians.
Violation of color perception.
Diseases of the retina and optic nerve (retinitis pigmentosa, optic nerve atrophy, retinal detachment, etc.).
Compensated glaucoma (normal fundus; change in visual acuity not less than 0.6 in the best eye, not less than 0.2 in the worst) (allowed with re-examination after one year).
Absence of one upper or lower limb, hand or foot, as well as deformity of the hand or foot, which significantly impedes their movement. As an exception, persons with one amputated lower leg may be allowed if the amputation stump is at least 1/3 of the lower leg and the mobility in the knee joint of the amputated limb is fully preserved.
Absence of fingers or phalanges, as well as immobility in the interphalangeal joints:
the absence of two phalanges of the thumb on the right or left hand;
absence or immobility of two or more fingers on the right hand or complete reduction of at least one finger;
the absence or immobility of three or more fingers on the left hand or the complete reduction of at least one finger (while maintaining the grasping function and strength of the hand, the issue of access to control is decided individually).
Shortening of the lower limb by more than 6 cm - examined can be considered fit if the limb has no defects on the part of bones, soft tissues and joints, the range of motion is preserved, the length of the limb is more than 75 cm (from the calcaneus to the middle of the greater trochanter of the thigh).
Absence of an upper limb or hand, absence of a lower limb at any level of the thigh or lower leg with impaired mobility in the knee joint.
Traumatic deformities and defects of the skull bones with severe neurological symptoms that prevent driving. In the presence of minor neurological symptoms, admission is carried out individually with a re-examination after one year.
Complete deafness in one ear when perceiving colloquial speech to the other at a distance of less than 3 m, whispering speech - at a distance of 1 m, or perception of colloquial speech in each ear less than 2 m of the year).
Chronic unilateral or bilateral purulent inflammation of the middle ear, complicated by cholesteatoma, granulations or polyps (epithympanitis). The presence of a fistula symptom (after surgical treatment with a good result, the issue is resolved individually).
Chronic purulent mastoiditis, complications due to mastoidectomy (cyst, fistula).
Diseases of the endocrine system of a progressive course with persistent, pronounced dysfunctions of other organs and systems (permission to drive is decided individually, subject to annual re-examination after examination and treatment by an endocrinologist).
III Art., high-grade heart rhythm disturbances, or a combination of these conditions (permission to drive is decided individually, subject to annual re-examination after examination and treatment by a cardiologist).
Hypertension II I stages, 3 degrees, risk 1 V (admission to drive is decided individually, subject to annual re-examination based on the results of treatment and the recommendations of a cardiologist)
Diseases of the bronchopulmonary system with symptoms of respiratory failure or pulmonary heart failure 2-3 tbsp. (Admission to driving is decided individually after examination and treatment by a pulmonologist).
Additional medical contraindications
Additional medical contraindications
Visual acuity below 0.5 in the best eye and below 0.2 in the worst eye (corrected); lack of vision in one eye with visual acuity below 0.8 (without correction) in the other.
Complete deafness (for deafness, deaf-mutism, admission is carried out individually with re-examination after one year).
Absence of an upper limb or hand, absence of a lower limb at any level of the thigh or lower leg with impaired mobility in the knee joint.
Diseases of any etiology that cause dysfunction of the vestibular analyzer, dizziness syndromes, nystagmus (Ménière's disease, labyrinthitis, vestibular crises of any etiology, etc.).
Prolapse of the uterus and vagina, retrovaginal and vesicovaginal fistulas, perineal ruptures with violation of the integrity of the rectal sphincters, dropsy of the testicle or spermatic cord, hernia and other diseases that cause restrictions and pain in movements that prevent driving.
Additional medical contraindications
Medical contraindications set out in paragraph 3-25 of this column of subparagraph 28.1.
Decreased visual acuity below 0.5 in the best eye and below 0.2 in the worst eye (corrected).
Loss of vision in one eye with visual acuity below 0.8 (without correction) in the other.
For taxi drivers and drivers of vehicles of operational services (ambulance health care, fire service, police, emergency rescue service, military automobile inspection), - visual acuity with correction below 0.8 in one eye, below 0.4 - in the other. Permissible correction for myopia and hyperopia 8.0 D, including contact lenses, astigmatism - 3.0 D (the sum of the sphere and cylinder should not exceed 8.0 D). The difference in the power of the lenses of the two eyes should not exceed 3.0 D.
Additional medical contraindications
Medical contraindications set out in subparagraph 28.1 of this column.
Condition after refractive surgery on the cornea) - allowed to drive a person 3 months after the operation with visual acuity with a correction of at least 0.6 in the best eye, not lower than 0.2 - in the worst.
Additional medical contraindications
Medical contraindications set out in subparagraph 28.4.
Additional medical contraindications
Medical contraindications set out in paragraph 3-25 of this column of subparagraph 28.1.
Corrected visual acuity below 0.8 in one eye, below 0.4 in the other. Permissible correction for nearsightedness and farsightedness 8.0 D , including contact lenses, astigmatism -3.0 D (the sum of sphere and cylinder must not exceed 8.0 D ). The difference in the power of the lenses of the two eyes should not exceed 3.0 D.
Loss of vision in one eye with visual acuity below 0.8 (without correction) in the other. An artificial lens, at least in one eye.
Perception of conversational speech in one or both ears at a distance of less than 3 m, whispering speech - at a distance of 1 m (with complete deafness in one ear and perception of spoken speech at a distance of less than 3 m in the other ear or perception of spoken speech at least 2 m in each ear, the issue of admission of trained drivers is decided individually during the annual re-examination).
The absence of one upper or lower limb, hand or foot, as well as the deformity of the hand or foot, which significantly hinders their movement, is not allowed in all cases.
The absence of fingers or phalanges, as well as immobility in the interphalangeal joints of the hands, are not allowed even with intact grasping function.
Traumatic deformities and defects of the skull bones with severe neurological symptoms.
Ischemic heart disease: unstable angina, exertional angina, FC III , high-grade cardiac arrhythmias, or a combination of these conditions.
Hypertonic disease II-III Art. Hypertensive disease 1 tbsp. admission is carried out individually, subject to an annual survey.
Diabetes (all types and forms).
Growth below 150 cm (the issue is decided individually), a sharp lag in physical development.
Additional medical contraindications
Additional medical contraindications
Medical contraindications set out in paragraph 3-25 of this column of subparagraph 28.6.
Additional medical contraindications
Additional medical contraindications
With speech defects and logoneurosis (stuttering) in severe forms - for drivers of passenger transport, admission is carried out individually.
Additional medical contraindications
Medical contraindications set out in subparagraph 28.6. of this column.
28.12. Tram, trolleybus
Additional medical contraindications
Medical contraindications set out in subparagraph 28.6 of this column.
Tram and trolleybus drivers with implanted artificial pacemakers are not allowed to work.
28.13. Tractors and self-propelled machines
Additional medical contraindications
28.14. Mini tractors, walk-behind tractors, forklifts, electric cars, traffic controllers, etc.
Additional medical contraindications
Medical contraindications set out in subparagraph 28.4 of this column.
The subcategories of vehicles specified in the Order have not yet entered into force.
