Its implementation is dictated by the established legislation. The purpose of the survey is to protect the health of the worker 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. It is necessary to understand in what cases and who needs to undergo a medical examination.
Types of medical examination
Preventive examinations of employees - a set of therapeutic and preventive measures taken to identify deviations in the state of health, 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 types has a specific purpose, timing, indications, procedure, required documentation.
Periodic medical examination
Applicants 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.
Health is a state of complete mental, physical, social and spiritual 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 health 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.
The medical examination has the following features:
- It is carried out within the time limits established by law.
- The frequency of carrying out depends on working conditions and factors of production.
- Persons under the age of 21 are screened annually.
- It is 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.
- The employee receives a referral for a medical examination from the employer.
- The employee is examined by all the necessary specialists, laboratory and clinical analyzes 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.
Frequency of inspections by type of work activity
The list of works for which preventive examinations are mandatory, as well as the frequency of the examination:
- high-rise and work 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 offshore drilling - every 2 years;
- underground work - annually;
- hydrometeorological facilities - annually;
- work in the field of geology, topography and construction - every 2 years;
- pressure vessel maintenance work - every 3 years;
- machinists, employees of boiler houses, gas supervision - every 2 years;
- work with explosive and flammable substances - annually;
- work in a banking, cash 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 and preventive institutions, pharmaceutical organizations, medical industry - annually.
Extraordinary inspections
According to the legislation, each person holding a position in an enterprise has the right to an extraordinary examination in accordance with medical recommendations, during which he retains his position and salary.
This type of medical examination does not have a fixed frequency. Conducted in two cases:
- the employee's initiative - he has health complaints related to occupational hazards or other reasons;
- the employer's initiative - has suspicions that the level of health 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 conducting an extraordinary inspection are borne by the employer, regardless of on whose initiative the appeal to the health facility occurred.
Why conduct a preliminary examination?
A preliminary medical examination is carried out in order to assess the state of health of the applicant for employment, its compliance with the future position, and also to identify the presence of diseases at the time of employment.
The following groups are subject to mandatory examination:
- Minor citizens.
- Employees whose preliminary medical examination is provided for by regulatory legal acts:
- persons employed in heavy and hazardous work;
- positions related to the transport industry;
- food production workers;
- persons working in the conditions of trade;
- 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 regulations were approved that are the basis for conducting an examination of employees: on harmful and hazardous substances, work and specialties, general and highly specialized medical contraindications, on the procedure and rules for conducting examinations.
Direction and procedure for its preparation
The administration of the enterprise issues a referral for a medical examination to a person entering a job. It contains the following data:
- name of the enterprise, form of ownership and economic status;
- data of a medical health facility, indicating its address and code according to the OGRN;
- what inspection will be carried out;
- FULL NAME. and date of birth of the applicant;
- the unit to which the future place of work belongs, what position will be held;
- production factors.
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 directions.
The order of the survey
After receiving the referral, the employee applies to the specified medical institution. Preliminary and periodic medical examinations are supervised by a general practitioner who independently sums up the results of a comprehensive examination.
Other narrow specialists participating in the examination:
- ophthalmologist;
- otorhinolaryngologist;
- neuropathologist;
- surgeon;
- dermatovenereologist;
- dentist;
- infectious disease specialist (according to indications).
Of the laboratory and functional methods of examination, X-ray of the lungs, electrocardiography, blood examination for syphilis, bacteriological smear for gonorrhea, studies for the carriage of intestinal diseases and helminthiasis are carried out annually.
Women are examined by a gynecologist, take smears for cytology, and after 40 years, ultrasound of the mammary glands, mammography and consultation with a mammologist are mandatory. Men undergo an oncological examination by a urologist with a digital examination of the rectum.
It is mandatory to take a general blood test, specifying the level of formed elements, hemoglobin, a color indicator, an expanded leukocyte formula, ESR. Clinical analysis of urine determines the presence of sugar and protein, specific gravity, sediment microscopy. A biochemical blood test is carried out.
Based on the results of examinations of narrow specialists and clinical examinations, the therapist makes a decision on professional suitability, the presence or absence of systemic diseases.
Psychiatric examination
Some working conditions require a psychiatric examination, and not just a psychiatric examination conducted under the conditions of a conventional medical examination. The examination is carried out by the following persons:
- minors;
- the future position is 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 certification process takes place in specialized institutions licensed for such activities. The commission consists of 3 specialists. The legislation says that the 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, 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.
Based on the results of the survey, the commission has the right to recognize the employee as unsuitable for a certain type of activity (up to 5 years), but with the possibility of further re-examination.
Examination by a narcologist
A preliminary medical examination by a narcologist consists of three stages: direct examination, psychological testing, laboratory blood tests. Drug examinations allow you to identify possible signs of the disease, and if they are found, the employee is sent to a hospital for further examination.
In the absence of problems, a certificate is issued confirming the passage of a preventive examination. The document conforms to the established sample.
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 health facility provides a referral received from the employer, an identity document (birth certificate, passport), a health document (if any), a decision on a psychiatric examination (in cases established by law).
Medical examination of employees requires the execution of certain documents. This:
- Medical outpatient card - it records the data of the examination by doctors, the results of tests, the conclusion of the examination.
- A sanitary book is issued if the employee does not already have one. It specifies data on the organization of the employer, personal data of the employee, brief conclusions of doctors during the examination. A sanitary book is assigned once, even if a person changes jobs.
Suitability 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. The conclusion contains the following information:
- date of registration of the result;
- Full name, gender, date of birth of the employee;
- information about the employer;
- working conditions of the person, indicating the structural unit, future position, hazard factors;
- final result (medical contraindications for holding a future position were identified or not identified).
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, and the other is given to him in his hands.
Employer costs
By law, all costs for mandatory preliminary and periodic medical examinations are borne by the employer. Expenses are classified as 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 and preventive institution that has the appropriate license. Payment is made in stages. 30% of the cost of services is paid in advance, and occurs as a result of passing the examination.
Conclusion
The administration of the enterprise not only has the right, but also the obligation to prevent an employee from work or employment who did not undergo 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 preserve the health of the employee, but to prevent the development of possible diseases.
