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Guarantor plus order 302 changes, with changes and additions from


Order 302n dated 04/12/11 of the Ministry of Health and Social Development on medical examinations and commissions is given. A form of referral from the employer for a mandatory medical examination or medical examination when applying for a job is given. This sample form in the form from 2018 - 2019 can be downloaded for free. A list of harmful production factors of order 302n by profession for a mandatory medical examination is given.

The procedure for conducting medical examinations

The procedure for conducting mandatory medical examinations of employees is given in Appendix 3 to the order of the Ministry of Health and Social Development dated April 12, 2011 No. 302n. The procedure for conducting pre-shift, pre-trip and post-shift, post-trip medical examinations of people. Which manage transport, approved by order of the Ministry of Health of December 15, 2014 No. 835n. For all other categories of employees, these documents can also be applied.

Types of medical examinations

Mandatory medical examinations are divided into three types:

  • preliminary;
  • periodic;
  • extraordinary.

Such a classification of medical examinations is provided for by the provisions of part 1.

For certain categories of employees, mandatory medical examinations (examinations) may be provided. They are carried out at the beginning of the working day (shift). And also during and (or) at the end of the working day (shift). The time for passing such medical examinations (examinations) is included in working hours. This procedure is provided for by part 3 of Article 213 of the Labor Code. Such medical examinations are required to pass employees engaged in underground work (Article 330.3 of the Labor Code).

Medical examination at work, when is an employee required to undergo an examination in accordance with order 302n?

List of harmful or dangerous production factors and works. During which a periodic medical examination is carried out. And mandatory preliminary and periodic medical examinations at the doctor's office, approved by order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n. Medical examinations are mandatory if the work is associated with harmful or dangerous factors. Among such factors, the electromagnetic field of the broadband frequency spectrum from a PC is mentioned. Work on reading and entering information. Work in the dialogue mode in the amount of at least 50% of the working time. At the same time, it is not stipulated that the need for a medical commission depends on working conditions.

An employee who uses a computer for more than 50% of the working time must undergo a medical examination. Between medical examinations, not only periodic (once every two years), but also a preliminary medical examination. That is, before getting a job (letters dated 03.21.14 No. 15-2 / OOG-242, dated 08.18.15 No. 15-1 / OOG-4397).

Who conducts medical examinations

The employer is required to organize medical examinations of employees. To do this, the organization concludes an appropriate agreement with a medical institution. Who has a license for medical activities (clause 6 of the Procedure, approved by order of the Ministry of Health and Social Development of April 12, 2011 No. 302n, clause 46, part 1 of article 12 of the Law of May 4, 2011 No. 99-FZ).

Also, the employer can conduct medical examinations (for example, pre-trip) in their own first-aid post. Who has a license to practice medicine. The right to conduct preliminary and periodic medical examinations (clause 46, part 1, article 12 of the Law of May 4, 2011 No. 99-FZ, clause 4 of the Procedure, approved by order of the Ministry of Health and Social Development of April 12, 2011 No. 302n).

Should the organization, when conducting medical examinations (including pre-trip) in its own first-aid post, obtain a license for this type of activity. Conducting medical examinations is not the main activity of the organization

Yes, it should. Medical activity is licensed. Medical examinations (including pre-trip) are medical services. They are subject to licensing (clause 46, part 1, article 12 of the Law of 04.05.2011 No. 99-FZ. List to the Regulation, approved by Government Decree of 16.04.2012 No. 291). No exemptions for medical activities. For own needs, the legislation on licensing does not provide. Therefore, when conducting medical examinations (including pre-trip ones) in your own first-aid post, you must obtain a license for this type of activity.

The need to obtain a license for medical examinations is also indicated in paragraph 8 of the Procedure approved by order of the Ministry of Health dated December 15, 2014 No. 835n.

Is an employee of the organization (for example, an accountant) who has a diploma of medical education entitled to conduct pre-trip medical examinations of drivers. The organization does not have its own medical center

No, not right. Organizations of all forms of ownership and entrepreneurs are required to organize mandatory pre-trip medical examinations of drivers. For those who have road transport (clause 1, article 20, article 23 of the Law of December 10, 1995 No. 196-FZ).

An organization can organize a mandatory medical examination either in its own first-aid post. Or under an agreement with a medical institution. A medical institution with which a contract for medical examinations has been concluded. It must have a license for this type of activity (clause 46, part 1, article 12 of the Law of May 4, 2011 No. 99-FZ).

If the organization independently conducts a pre-trip medical examination. It is necessary that only medical professionals do this. In this case, the organization itself must obtain a license. This is provided for by paragraph 8 of the Procedure, approved by order of the Ministry of Health of December 15, 2014 No. 835n.

Thus, if an employee of an organization has only a diploma of medical education, but does not have the appropriate certificate, then he is not entitled to conduct mandatory medical examinations.

The requirement for the qualifications of employees is not the only one when conducting a medical examination on their own.

Medical examinations are mandatory even when selling manufactured goods, according to the Supreme Court

Preliminary and periodic medical examinations must be passed by all employees of trade organizations. Including those who are not directly involved in the sale of products. It does not matter what exactly the company sells - food products or machines. This conclusion was reached by the Supreme Court in its decision dated December 6, 2017 No. 34-AD 17-5.

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For example, mandatory medical examinations are provided for those who are employed:

  • in public utility organizations. Providing hairdressing and cosmetic services (clause 9.29 SanPiN 2.1.2.2631-10, approved by the decision of the chief sanitary doctor of May 18, 2010 No. 59);
  • construction industry (clause 13.1 of SanPiN 2.2.3.1384-03. approved by the decision of the chief sanitary doctor of 11.06.2003 No. 141);
  • in public catering organizations (clause 13.1 of SanPin 2.3.6.1079-01. approved by the decision of the chief sanitary doctor of 08.11.2001 No. 31);
  • at work related to the maintenance of electric power facilities (Procedure approved by order of the Ministry of Energy of August 31, 2011 No. 390);
  • on public railway transport (Procedure, approved by order of the Ministry of Transport dated July 16, 2010 No. 154).

Employees under 18 and professional athletes also undergo mandatory medical examinations (Articles 69, 266, 348.3 of the Labor Code).

An entrepreneur-driver must undergo mandatory pre-trip medical examinations. And post-flight health checks too. If he is engaged in transportation and manages transport himself. This is provided for by paragraph 4 of Article 23 of the Law of December 10, 1995 No. 196-FZ. Clause 3 of the Procedure approved by the order of the Ministry of Health of December 15, 2014 No. 835n.

Is the administration of a medical institution, when hiring an employee who has no contact with patients, entitled to undergo a medical examination and a medical book

Yes, right. Employees of medical institutions, including children's. Must undergo pre-employment health screenings. No exceptions for employees. All employees pass. Even those who are in direct contact with children (sick) are not.

Data on the passage of medical examinations is entered into the personal medical book of the employee. When hiring, the administration may require the employee to undergo a medical examination. Or a medical book with data on its passage. An employee who refuses to undergo a medical examination should not be allowed to work. (Article 69, part 2 of article 213 of the Labor Code, article 34 of the Law of March 30, 1999 No. 52-FZ, clause 15.1 of SanPiN 2.1.3.2630-10, approved by the decision of the chief state sanitary doctor of May 18, 2010 No. 58) .

Who should pay for the issuance of a personal medical book for an employee - an organization or an employee

The organization must pay these costs. A personal medical book indicates the suitability of an employee for health reasons to perform a certain job. To obtain the appropriate marks, the employee takes tests, undergoes an examination, etc. All these activities must be financed by the employer (Articles 213, 266 and 348.3 of the Labor Code).

What liability is provided for an employee if, having received a medical book at the expense of the employer, he quit or did not start work at all

The employee does not bear any responsibility for such actions. Firstly, the law obliges the employer to pay for all medical examinations (examinations) (Articles 213, 266 and 348.3 of the Labor Code). And secondly, the termination of the employment contract of one's own free will is the voluntary expression of the will of the employee. Therefore, it is impossible to oblige an employee to pay the costs of obtaining a personal medical book. Labor legislation does not provide for the possibility of recovering damages from an employee. If caused due to refusal to conclude an employment contract.

Medical examinations and SOUT can be carried out at the expense of the FSS. Please submit your application by August 1st

The following activities can be financed by the Social Insurance Fund:

  • labor protection training for established categories of employees;
  • Spa treatment;
  • purchase of personal protective equipment;
  • mandatory periodic medical examinations;
  • purchase of first aid kits, tachographs, breathalyzers.

All documents must be properly completed. Contain correct information. The applicant on the day of submission of documents should not have arrears in payment of insurance premiums. Unpaid penalties and fines.

Note: Download the financial security application form. Format.doc 41 Kb, Ministry of Labor of the Russian Federation: Order 598n dated 09/02/14 (as amended on 04/04/2017)

Documents are submitted by the public services insurer through the MFC. With a personal visit to the FSS or by mail.


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When employees who work at a computer should not undergo medical examinations

When employees work at the computer for more than half of their working time. But at the same time, their working conditions are recognized as optimal or acceptable. The employer may not send them to preliminary and periodic medical examinations. This was announced by Rostrud in a letter dated February 28, 2017 No. ТЗ / 942-03-3.

With regard to a number of factors listed in the List, it is indicated. What passing medical examinations necessary when classifying working conditions as harmful. For example, for the factor "Low air temperature in industrial premises". And for the factor “electromagnetic field of the broadband frequency spectrum from a PC, there is no such clause. The presence of hazardous radiation and the assignment of work on this factor to "harmful" is possible only according to working conditions. In this part, Order No. 302n contradicts the provisions. This article directly states: employees are sent to undergo mandatory preliminary and periodic medical examinations. Those who are employed in jobs with harmful or dangerous working conditions.

Rostrud officials draw the following conclusion. If the current results confirm that the working conditions of the employee. Who works at the computer, optimal or acceptable. The employer is not obliged to send him for a medical examination.

Kontur.Accounting: Keep personnel records and calculate salaries in a web service for free

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Preliminary medical examinations

Preliminary mandatory medical examinations are carried out upon employment. Their goal is to determine before concluding an employment contract. Can a candidate apply for a particular position for health reasons.

If a preliminary medical examination is carried out in a medical institution. To obtain a medical certificate, the candidate must be issued a referral. In the direction for a medical examination issued to the applicant for a position in hazardous (dangerous) work, indicate the harmful (dangerous) production factors. With which the employee will encounter after employment in a vacant position. In addition, in the direction indicate:

  • the name of the employer;
  • form of ownership and organization according to OKVED;
  • the name of the medical organization, the actual address of its location and the OGRN code;
  • type of medical examination (preliminary);
  • surname, name, patronymic, date of birth of the applicant;
  • the name of the structural unit of the organization (if any), in which the candidate will be employed;
  • the name of the position (profession) of the applicant or the types of work that he will perform.

A referral for medical examinations is issued to a person against a signature. The employer must organize the accounting of issued referrals.

Note: See paragraphs 7, 8 of the Procedure approved by the order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n.

Currently, there is no unified referral form for medical examinations. The organization has the right to develop it independently.

Is it necessary to undergo a medical examination for an employee who was fired and then re-hired for the same job?

If an employee who was employed in "harmful" jobs quit. And then again accepted for the same job. Then he must re-pass a preliminary medical examination. That is, if the employee was fired (with the termination of the employment contract). And then he is accepted for the same job, he is subject to all the requirements of labor legislation. Including in terms of passing a mandatory preliminary medical examination. This conclusion follows from the letter of the Ministry of Labor of Russia dated April 28, 2017 No. 15-2 / OOG-1224.


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Periodic medical examination

Periodic mandatory medical examinations are carried out during the entire period of work of the employee in the organization. Their goal is to monitor the health of employees. Timely detection of occupational diseases. For periodic medical examinations, create a list of employees who:

  • are exposed to harmful production factors specified in the list. Approved by the order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n. Also, harmful factors are established based on the results of a special assessment of working conditions (attestation of workplaces) and in the course of laboratory research and testing;
  • carry out work according to the list approved by the order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n.

Note: Clause 19 of Procedure No. 302n, clause 5 of Article 7 and subparagraph 1 of clause 3 of Article 10 of Law No. 426-FZ.

Send the approved list to the territorial body of Rospotrebnadzor within 10 days (clause 21 of Procedure No. 302n).

Based on this list, make a list of names of employees. which need to undergo periodic inspection. If a medical examination is carried out in relation to employees. Employed in harmful (dangerous) work. It must indicate harmful (dangerous) production factors. that affect employees.

Send the name list of employees to the medical organization. Not later than two months before the start date of the periodic medical examination agreed with this organization

Note: a (clause 23 of the Order)

.

Having received a list of names, the medical institution draws up a calendar plan for conducting medical examinations. Coordinate with the organization. The employer must familiarize employees with this plan. But no later than 10 days before the start of the medical examination.

Give the employee a referral before the periodic medical examination. It is issued in the same manner as during the preliminary medical examinations. (clause 24 of Order No. 302n). The direction is issued to the person under the signature. The employer must organize the accounting of issued referrals.


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Form 302n Direction for medical examination of the driver, sample, example excel format, guarantor

There is no unified referral form for a preliminary periodic medical examination. The organization has the right to develop it independently. A form for a medical examination, a referral for a medical examination from the employer is issued to a person against signature. Specify the type of medical examination (preliminary or periodic). Indicate in it the harmful (dangerous) production factors that the employee will encounter after employment in a vacant position. The employer must organize the accounting of issued referrals

Below is an example of a medical referral. Suitable for the driver, the seller. It can be downloaded for free.


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Reporting

Information about the preliminary and periodic mandatory medical examinations carried out should be reported to the FSS. Fill in table 5 in the calculation in the form 4-FSS. Based on these data, the FSS will set a discount for the organization. Or a surcharge to the contribution rate. For compulsory insurance against accidents at work and occupational diseases (subclause 18, clause 2, article 17 of the Law of July 24, 1998 No. 125-FZ).

Responsibility for not conducting a medical examination

An employee who has not passed the mandatory medical examination cannot be allowed to work. By virtue of paragraph 12 of part 2 of Article 212 of the Labor Code. For violation of this requirement, the labor inspectorate may fine:

  • organization in the amount of 110,000 to 130,000 rubles;
  • officials of the organization (for example, the head) in the amount of 15,000 to 25,000 rubles;
  • entrepreneur in the amount of 15,000 to 25,000 rubles.

Inspectors can learn about a violation from an employee's complaint or during an inspection.

For violation of the procedure for conducting mandatory medical examinations of drivers, administrative liability is provided. If the waybill does not contain a record of the driver passing a medical examination. Or an unqualified doctor made a note about the examination of the driver in the waybill. And someone else.

The amount of the fine under Article 11.32 of the Code of Administrative Offenses:

  • for citizens - from 1000 to 1500 rubles;
  • for officials of the organization (for example, the head) - from 2000 to 3000 rubles;
  • for organizations - from 30,000 to 50,000 rubles.

For the absence of a note on the driver's pre-trip medical examination in the waybill, the traffic police inspector may fine:

  • manager - 5000 rubles;

  • The article will help in a dispute with an employer regarding the qualification of an injury at work. To do this, you need to contact the labor inspectorate with a complaint. It will set out in detail all the circumstances of his injury.

Hello friends! I propose to discuss an entertaining read: Conclusion of the Ministry of Economic Development of Russia dated May 28, 2015 N 13875-OF / D26i "On the examination of the order of the Ministry of Health of Russia dated April 12, 2011 No. 302n" On the approval of lists of harmful and (or) dangerous mandatory preliminary and periodic medical examinations (examinations), and the Procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of employees engaged in heavy work and in work with harmful and (or) dangerous working conditions.

During the examination of Order No. 302n, from September 17, 2013 to October 17, 2013, public consultations were held in order to collect information about the provisions of Order No. 302n, which unreasonably impede business and investment activities. Information about the ongoing public consultations was posted on the official website of the Ministry of Economic Development of Russia, as well as on the Internet at regulation.gov.ru.

Additionally, requests for information were sent to the federal executive body that adopted the regulatory legal act (hereinafter referred to as the developer, the Ministry of Health of Russia), and the Ministry of Labor of Russia (letter dated September 18, 2013 N D26i-1034), as well as to the Chamber of Commerce and Industry of the Russian Federation, the All-Russian public organization "Russian Union of Industrialists and Entrepreneurs", the All-Russian public organization "Business Russia".

Based on the results of public consultations, positions were received from 27 subjects of entrepreneurial and other activities (the list of participants in public consultations is given in Appendix 1 to this conclusion). The results of public consultations are summarized in the Certificate of the results of public consultations by order No. 302n.

An expert group was created to conduct an expert study of the provisions of Order No. 302n.

I myself managed to look at it diagonally, and even then not completely. But the meaning of all this is this: order 302n makes it difficult to conduct entrepreneurial and investment activities, and also causes unreasonable expenses for business entities. Among other things, order 302n conflicts with the requirements of other regulatory legal acts.

1. General description of the regulation in question.

1.1. Place of order No. 302n in the system of legal regulation.
Order No. 302n approved the 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. The specified Lists and Procedure were put into effect from January 1, 2012.

Mandatory preliminary medical examinations (examinations) upon admission to work are carried out in order to determine whether the state of health of a person entering a job is in line with the work assigned to him, as well as for the purpose of early detection and prevention of diseases.

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 the current regulatory legal acts.

Responsibilities for organizing preliminary and periodic examinations of employees are assigned to the employer.

Order No. 302n was issued in accordance with Article 213 of the Labor Code of the Russian Federation (hereinafter referred to as the Labor Code), Article 46 of the Federal Law of November 21, 2011 No. March 30, 1999 No. 52-FZ "On the sanitary and epidemiological well-being of the population."

As established by Article 213 of the Labor Code, “employees engaged in work with harmful and (or) dangerous working conditions (including underground work), as well as in work related to traffic, undergo mandatory preliminary (upon employment) and periodic (for persons under the age of 21, annual) medical examinations to determine the suitability of these workers for the performance of assigned work and the prevention of occupational diseases.

Harmful and (or) dangerous production factors and work, during the performance of which mandatory preliminary and periodic medical examinations are carried out, the procedure for conducting such examinations is determined by the federal executive body authorized by the Government of the Russian Federation.

According to Article 209 of the Labor Code, a hazardous production factor is a production factor, the impact of which on an employee can lead to his injury.

In order to identify harmful and dangerous production factors in accordance with the Federal Law of December 28, 2013 No. 426-FZ "On a special assessment of working conditions" (hereinafter - Law No. 426-FZ), each employer must conduct a special assessment of working conditions.

Based on the results of a special assessment of working conditions, classes (subclasses) of working conditions at workplaces are established.

The results of a special assessment of working conditions are used, in particular, to organize preliminary (upon employment) and periodic (during employment) medical examinations of employees.

At the same time, in accordance with Appendix No. 2, a mandatory medical examination is established for the types of work in the course of which mandatory preliminary and periodic medical examinations (examinations) of workers are carried out, regardless of the presence in these industries of signs that allow them to be attributed to increased danger, and indicators occupational injuries and occupational diseases.

1.2. Addressees of regulation.
In accordance with Article 212 of the Labor Code, the employer is responsible for organizing preliminary and periodic examinations of employees. The heads of organizations, within the framework of which the types of work included in Appendix No. 2 are performed, as well as at the workplaces of which there are harmful factors defined in Appendix No. 1, are obliged to ensure the passage of preliminary (upon employment) and periodic (during employment) ) medical examinations (examinations) of employees, regardless of the form of ownership of the enterprise.

1.3. Goals of regulation.
The objectives of the regulation of Order No. 302n are the high-quality protection of public health, the prevention of the occurrence and spread of occupational diseases and industrial injuries.
Conducting preliminary and periodic medical examinations of certain groups of the population is an important component of protecting public health and epidemiological well-being in the Russian Federation.

The normative act under consideration serves to identify the contingent of employees subject to preliminary and periodic medical examinations by the employer. At the same time, Order No. 302n defines a list of types of analyzes and medical specialists that an employee who has contact with one or another harmful factor (or performs certain types of work) must undergo. This is necessary in order to prevent employees with appropriate contraindications from performing certain work at the stage of hiring (and then at a specified frequency), and thereby prevent the development of occupational pathologies or accidents.

According to the developer, to date, preliminary and periodic medical examinations are the most effective mechanism for identifying patients with suspected occupational disease. A significant part of registered occupational diseases are detected during periodic medical examinations of workers: the State Report of Rospotrebnadzor “On the state of sanitary and epidemiological welfare of the population in the Russian Federation in 2012” (hereinafter referred to as the Report) indicates that in 2012, during periodic medical examinations, 69 .62% ​​of newly diagnosed occupational diseases.

1.4. Expenses of business entities for fulfilling the requirements of Order No. 302n.
In accordance with the requirements of Order No. 302n, during preliminary and periodic examinations, all subjects are required to undergo: a clinical blood test (hemoglobin, color index, erythrocytes, platelets, leukocytes, leukocyte formula, ESR); clinical analysis of urine (specific gravity, protein, sugar, sediment microscopy); electrocardiography; digital fluorography or radiography of the chest in 2 projections (direct and right lateral), in the conditions of an occupational pathology center or a medical institution that has the right to conduct an examination of professional suitability and the connection of the disease with the profession in accordance with applicable law, a chest x-ray is performed in 2 projections (direct and right side); biochemical screening: serum glucose, cholesterol. All women are examined by an obstetrician-gynecologist with bacteriological (for flora) and cytological (for atypical cells) studies at least 1 time per year; women over the age of 40 undergo mammography or ultrasound of the mammary glands once every 2 years.

The participation of a general practitioner, a psychiatrist and a narcologist during preliminary and periodic examinations is mandatory for all categories of subjects.
In addition, Annexes No. 1 and No. 2 establish requirements for additional examinations by specialist doctors and laboratory tests for certain hazard factors or industries.

The Ministry of Economic Development of Russia, on the basis of data provided by subjects of entrepreneurial and other activities, analyzed the average costs of organizations (entrepreneurs) to meet the requirements for mandatory preliminary and periodic medical examinations (examinations) of employees.

The cost of surveys, as a rule, depends on the region and the number of surveys established for the industry and varies from 1500 rubles. up to 10 thousand rubles on the worker.
The amount of costs for fulfilling the requirements of Order No. 302n is presented in Table 1.

In addition, experts note an increase in the cost of medical examinations over the past two years. This is partly due to the change in the status of medical institutions that have been transformed from municipal budgetary to state budgetary institutions, in which the determination of the cost of medical services is carried out independently at rates and tariffs, regulated or established without the participation of municipal authorities. Another reason for the increase in cost, experts call the expansion of the quantitative composition of medical specialists involved in medical examinations, and the increase in the required laboratory and functional research methods.

According to experts, at oil and gas production enterprises, on average, 60-70% of employees undergo medical examinations annually. At oil refining, petrochemical, chemical enterprises, due to industry specifics, more than 90% of employees are subject to medical examinations, and a significant part of the employees subject to medical examinations (from 10 to 40%), according to the results of attestation of workplaces, works in optimal or acceptable working conditions.

The Report provides indicators of occupational morbidity per 10,000 workers for the most unfavorable types of economic activity in this respect: mining - 31.41, manufacturing - 3.14, agriculture, hunting and forestry - 2.89, transport and communications - 2.86.

2. Grounds for conducting an examination of Order No. 302n.

The basis for the examination of Order No. 302n in order to identify provisions that unreasonably impede the conduct of business and investment activities was the written appeals of Surgutneftegaz OJSC about the difficulties in conducting medical examinations due to the lack of definitions of the terms “medical facilities” and “significant removal” as in the order No. 302n, and in the legislation of the Russian Federation.

According to the expert group, the provisions of Order No. 302n unreasonably impede the conduct of entrepreneurial and investment activities, and also draw attention to the fact that the performance of the same types of work as a result of the "intersection" of the subject of regulation of Order No. 302n with a number of regulatory legal acts, including Federal Law of March 30, 1999 No. 52-FZ "On the Sanitary and Epidemiological Well-Being of the Population", the Labor Code of the Russian Federation, Resolution of the Chief State Sanitary Doctor of the Russian Federation of September 7, 2001 No. 23 "On the Enactment of the Sanitary Rules" ( together with "SP 2.3.6.1066-01. 2.3.5. Trade enterprises. Sanitary and epidemiological requirements for trade organizations and the circulation of food raw materials and food products in them. Sanitary and epidemiological rules"), Federal Law of January 2, 2000 No. 29-FZ "On the quality and safety of food products" has different requirements.

In addition, according to experts, the practical application of a number of provisions of Order No. 302n contains excessive administrative and other restrictions for subjects of entrepreneurial and other activities, as well as provisions that contribute to the emergence of unreasonable expenses for subjects of entrepreneurial and other activities due to duplication of medical examinations with medical examinations. carried out as part of the implementation of basic compulsory health insurance programs approved by the Federal Law of November 21, 2011 No. 323-FZ “On the Fundamentals of Protecting the Health of Citizens of the Russian Federation” and Order of the Ministry of Health of Russia of December 3, 2012 No. 1006n “On Approval of the Procedure for Conducting medical examination of certain groups of the adult population.

3. The results of the examination.

As a result of the examination, provisions were identified that impede effective regulation under Order No. 302n and lead to unreasonable difficulties in doing business and investment activities, as well as cause unreasonable expenses for business entities.

3.1. According to the order of the Ministry of Health of Russia dated December 3, 2012 No. 1006n “On approval of the procedure for conducting medical examinations for certain groups of the adult population”, a citizen (aged 18 years and older), working, unemployed or studying, undergoes a medical examination once every 3 years as part of the compulsory medical insurance program .

At the same time, in accordance with Order No. 302n, medical examinations of employees employed in work with harmful and (or) dangerous working conditions, as well as in work related to the movement of transport, employees of organizations in the food industry, public catering and trade, waterworks, medical organizations and children's institutions should be carried out once a year or every 2-3 years at the expense of the employer.

At the same time, a number of duplicate studies are provided both as part of the medical examination and during preliminary, periodic, preventive examinations organized at the expense of the employer in accordance with order No. 302n.

In order to avoid such duplication, reduce the time costs of both employees and employers, as well as the financial costs of employers, we consider it appropriate to provide for a mechanism that provides for the possibility of taking into account procedures during medical examinations at the expense of passing a medical examination.

3.2. In addition, within the framework of the examination, a discrepancy between the provisions of Order No. 302n and the current regulatory documents in the field of labor protection, adopted earlier, was established.

There are discrepancies between the requirements of Order No. 302n and the current sanitary norms and rules in terms of the volume and frequency of examinations for certain types of work, during the performance of which mandatory preliminary and periodic medical examinations (examinations) of employees are carried out.

Thus, the volume of examinations of medical workers, set out in paragraph 17 of Appendix No. 2 "The work of medical personnel of medical institutions, as well as maternity hospitals (departments), children's hospitals (departments), children's clinics, departments of pathology of newborns, premature babies", do not meet the requirements , set out in the Decree of the Chief State Sanitary Doctor of the Russian Federation dated May 18, 2010 No. 58 "On approval of SanPiN 2.1.3.2630-10" Sanitary and epidemiological requirements for organizations engaged in medical activities ", in terms of the frequency and volume of examinations.

According to Note 5 to Appendix No. 1 and Note 3 to Appendix No. 2, the participation of a psychiatrist and a narcologist during preliminary and periodic examinations is mandatory for all categories of subjects.

At the same time, the provisions of Decree of the Government of the Russian Federation of April 28, 1993 No. 377 "On the implementation of the Law of the Russian Federation "On psychiatric care and guarantees of the rights of citizens in its provision" established that persons "associated with the work indicated in column two of the List medical psychiatric contraindications for the implementation of certain types of professional activities associated with the influence of harmful substances and adverse production factors, undergo a psychiatric examination at least once every five years.

Thus, for example, psychiatrists should conduct examinations only of persons engaged in work directly related to the circulation of narcotic drugs and psychotropic substances, while in accordance with Order No. 302n, all employees involved in both production and and sale of medicines.

Also, in the opinion of business entities, a significant point that makes it difficult to apply Order No. 302n is the inconsistency in the names of harmful production factors listed in Appendix No. 1 and in the decision of the Chief State Sanitary Doctor of the Russian Federation dated April 30, 2003 No. 76 “On Introduction to effect of GN 2.2.5.1313-03" (together with "GN 2.2.5.1313-03. Chemical factors of the working environment. Maximum permissible concentrations (MPC) of harmful substances in the air of the working area. Hygienic standards)".

As a result, the employer is faced with controversial situations arising from different interpretations of the names of certain factors, as well as the correlation of the measurement results and assessments of the factors of the working environment from the materials for assessing working conditions with the names of the factors from order No. 302n. In addition, there are controversial situations arising from different interpretations of the names of certain factors.

It seems appropriate to establish uniform names of harmful production factors that are subject to both hygienic regulation and consideration when determining the need for medical examinations of workers.

3.3. As part of public consultations, business entities received complaints about the excessive requirements set forth in Appendix No. 1 and No. 2, as well as about the presence (absence) of specialists in medical organizations providing services for medical examinations.

3.3.1. It seems that for retail workers either not in direct contact with food products and engaged in administrative work (accountants, economists, etc.), or not in contact with disease transmission factors (for example, food products), or for employees of non-food trade enterprises, it seems excessive carrying out all types of examinations and studies provided for by order No. 302n.

For example, the cost of medical examinations for one large business entity in the retail trade is 295 million rubles. in year. The number of employees who undergo mandatory medical examinations exceeds 84,000 people. Please note that not all of these employees have food contact. At the same time, retail employees, including those who do not have contact with food products, are required to undergo preliminary and periodic medical examinations in full, including a dentist, otorhinolaryngologist, obstetrician-gynecologist, narcologist, psychiatrist.

3.3.2. According to note 3 to Appendix No. 1, all women are examined by an obstetrician-gynecologist with bacteriological (for flora) and cytological (for atypical cells) studies at least once a year. In fact, this means that all women subject to medical examinations in accordance with Appendix No. 1 must undergo it once a year, regardless of the frequency established in accordance with the danger of production, due to the impact of which they undergo a medical examination. This requirement creates additional obligations for the employer to form a list of employees subject to medical examinations in the current year, as well as the costs of organizing and conducting a medical examination to identify occupational diseases.

3.3.3. Experts in the framework of public consultations noted the problem of the absence of a number of specialist doctors, especially in medical organizations located in remote regions of the country, or there is no lack of technical ability to conduct laboratory and functional studies in accordance with the requirements of Order No. 302n, namely:

1) the necessary medical equipment is missing or does not function (in particular, devices that allow X-rays in two projections);
2) in medical organizations (especially those located outside regional centers) there are no narcologists and psychiatrists, which forces employers to conclude additional contracts with specialized medical institutions that have relevant specialists, or to limit the choice of medical organizations, which is not always possible, especially in remote regions ;
3) low staffing of medical personnel and their quality.

3.3.4. The annexes to the order (Note 5 to Appendix No. 1, Note 3 to Appendix No. 2) establish a mandatory requirement for the participation of a psychiatrist and a narcologist in the procedure for undergoing a preliminary and periodic medical examination by all categories of subjects. At the same time, in accordance with Appendix No. 3:

- a person sent for examination must submit “the decision of the medical commission that conducted the mandatory psychiatric examination (in cases provided for by law)”;
- a psychiatrist and (or) narcologist, when identifying persons with suspected medical contraindications, should refer these persons in cases provided for by the legislation of the Russian Federation for examination by a medical commission authorized by the health authority.

According to experts, in practice, the participation of a psychiatrist in the work of the commission for conducting mandatory medical examinations comes down to checking the results of a psychiatric examination conducted by another medical commission and sending employees for examination to another medical commission. A similar situation is observed with the participation of a narcologist.

Please note that the procedure for sending for a psychiatric examination and the need to undergo such an examination is established once every 5 years for employees engaged in certain types of activities, including activities associated with sources of increased danger (with the influence of harmful substances and adverse production factors), and also working in conditions of increased danger, by Decree of the Government of the Russian Federation of September 23, 2002 No. 695 “On the passage of a mandatory psychiatric examination by employees engaged in certain types of activities, including activities associated with sources of increased danger (with the influence of harmful substances and adverse production factors), as well as those working in conditions of increased danger.

Given the above, we believe that when sending employees for examination, which is the responsibility of the employer, the requirement for the participation of the above-mentioned specialist doctors in the work of the commission for conducting mandatory medical examinations is excessive.

3.3.5. Similar to the list of harmful factors that is not consistent with the relevant hygienic standards, the names of the types of work given in Appendix No. 2 are not consistent with the relevant concepts defined by the legislation of the Russian Federation in the field of industrial safety and labor protection. In particular:
- the term "climbing work", defined in Note 5 to Appendix No. 2, does not correspond to the definition of climbing work established by paragraph 1.1 of the Intersectoral Rules for Labor Protection when Working at Height POT R M-012-2000, approved by the Decree of the Ministry of Labor of Russia dated October 4, 2000 city ​​No. 68;
- the type of work specified in clause 6 of Appendix No. 2 - "Works directly related to the use of flammable and explosive materials, work in explosive and fire hazardous industries" is not consistent with the concepts defined in the legislation of the Russian Federation in the field of industrial safety. This type of work is formulated ambiguously and, as a result, allows for various interpretations. It seems appropriate to divide these concepts into two separate concepts: “work with the use of explosive materials” and “work at hazardous production facilities where flammable and (or) oxidizing and (or) combustible substances");
- the type of work defined in paragraphs 4.1 and 4.4 of Appendix No. 2 in the part related to work in the regions of the Far North and equivalent areas has a broader wording than in Article 302 of the Labor Code, relating to guarantees and compensations for workers leaving for performing work on a rotational basis in the regions of the Far North and equivalent areas from other regions, which infringes on the interests of workers permanently residing in these regions (in fact, they are forced to undergo medical examinations when taking any job, and if there are contraindications in accordance with the above paragraphs 4.1 and 4.2 of Annex 2 do not have any legal employment opportunities);
- the type of work specified in paragraph 24 of Appendix No. 2 "Work in organizations of the medical industry and pharmacy chains related to the manufacture, packaging and sale of medicines" provides an opportunity to separate work related to the sale of finished medicines in their original packaging. So, in the Federal Law of April 12, 2010 No. 61-FZ “On the Circulation of Medicines”, the following concepts are given: “pharmaceutical activity is an activity that includes the wholesale trade in medicines, their storage, transportation and (or) retail trade in medicines medicines, their dispensing, storage, transportation, manufacture of medicines”; "organization of wholesale trade in medicinal products - an organization engaged in wholesale trade in medicinal products, their storage, transportation in accordance with the requirements of this Federal Law"; "pharmacy organization - an organization, a structural subdivision of a medical organization engaged in retail trade in medicines, storage, manufacture and distribution of medicines for medical use in accordance with the requirements of this Federal Law." Based on the above concepts, it can be concluded that we are talking only about work in pharmacy organizations directly related to the manufacture, packaging and sale of in-pharmacy medicines, and not the sale of medicines. Otherwise, it remains unclear why drug wholesalers are not included in Order No. 302n. At the same time, in practice, Rospotrebnadzor imposes the same requirements on pharmacy organizations that carry out such types of work as “retail trade in medicines” and “manufacture and distribution of medicines for medical use”.

4. Preparation of a draft conclusion on the examination of order No. 302n.

A request for comments on the draft conclusion as part of the examination procedure for Order No. 302n was sent to the Russian Ministry of Health, the Russian Ministry of Labor and Rospotrebnadzor by letter No. D26i-536 dated August 27, 2014.

The Ministry of Health of Russia, in a letter dated September 17, 2014 No. 24-1-2078287, reported a significant number of applications from citizens and legal entities regarding the implementation of the provisions of Order No. 302n. According to the Ministry of Health of Russia, Order No. 302n requires serious changes, as well as bringing its provisions into line with the Federal Law of November 21, 2011 No. 323-FZ “On the Basics of Protecting the Health of Citizens in the Russian Federation” (hereinafter - Law No. 323-FZ ).

Bringing into line with Law No. 323-FZ is provided for by Order No. 32 of the Ministry of Health of Russia dated July 13, 2012 "On the preparation of regulatory legal acts of the Ministry of Health of the Russian Federation necessary for the implementation of the Federal Law "On the Fundamentals of Protecting the Health of Citizens in the Russian Federation" by September 20, 2012

The Ministry of Labor of Russia, in a letter dated September 17, 2014 No. 15-2 / 10 / V-5937, indicated that it considers it necessary to bring the names of physical factors in accordance with Appendix 1 to the order of the Ministry of Labor of Russia dated January 24, 2014 No. 33n "On approval of the methodology for conducting special assessment of working conditions, the Classifier of harmful and (or) hazardous production factors, the form of a report on the special assessment of working conditions and instructions for filling it out, ”and also said that the proposal had already been sent to the Russian Ministry of Health.

Rospotrebnadzor, in a letter dated November 17, 2014 No. 01/13471-14-23, announced its support for the need to make conceptual changes to Order No. 302n. However, according to Rospotrebnadzor, an analysis of the impact of working conditions on occupational and professionally conditioned morbidity with recommendations for improving preventive measures and an analysis of the comments set out in Appendix No. 1 to the conclusion on the possibility of reducing the frequency of medical examinations can only be given by doctors - specialists in the field of hygiene .

According to paragraph 1 of section 5 of this opinion, Rospotrebnadzor proposes to exclude from the contingent of persons subject to medical examination in accordance with the order of the Ministry of Health of Russia dated December 3, 2012 No. in accordance with order No. 302n.

According to paragraph 2 of section 5 of this opinion, Rospotrebnadzor considers it necessary to maintain the existing principle of distribution according to harmful and (or) dangerous production factors of a chemical nature and proposes to bring the names of the production factors of a chemical nature specified in paragraphs of Order No. 302n in accordance with the rules of the International Union of Theoretical
chemistry and applied chemistry, IUPAC (International Union of Pure and Applied Chemistry, IUPAC).
According to paragraph 3 of section 5 of this opinion, Rospotrebnadzor proposes to revise the wording of the list of works specified in Appendix No. 2 to Order No. 302n, indicating the contingent of persons subject to medical examinations.

All comments and proposals received on the draft opinion were considered by the Ministry of Economic Development of Russia and used in the preparation of this opinion on the examination of Order No. 302n.

5. Conclusions on the results of the examination of order No. 302n.

Based on the results of the examination of Order No. 302n, the Ministry of Economic Development of Russia came to the conclusion that there are provisions in Order No. 302n that unreasonably impede business activities, and considers it necessary, in accordance with paragraph 3 of Resolution No. 633, to submit a proposal to the Ministry of Justice of the Russian Federation on the need to make the following changes to Order No. 302n:

1. Determine a mechanism that provides for the possibility of taking into account procedures during medical examinations at the expense of passing a medical examination.
2. Establish uniform names of harmful production factors that are subject to hygienic regulation, as well as to be taken into account when determining the need for medical examinations of workers.
3. Eliminate the need to conduct all types of examinations and studies provided for by Order No. 302n for retail workers who are either not in direct contact with food products and are engaged in administrative work (accountants, economists, etc.), or who are not in contact with disease transmission factors (for example, food products), as well as for employees of enterprises selling non-food products.
4. It is expedient to exclude the requirement for the participation of a psychiatrist and a narcologist in the work of the commission for conducting mandatory medical examinations when sending employees for examination, which is the responsibility of the employer.
5. Bring the provisions of Order No. 302n in line with the current versions of Law No. 323-FZ and Law No. 426-FZ, as well as regulatory legal acts in pursuance of these laws.

The end...

That's all for me. Until new expert opinions.

To be continued...

New requirements for the organization and conduct of mandatory medical examinations of employees

  • In accordance with this order, from January 1, 2012, lists of harmful and / or dangerous production factors and types of work are approved, in the presence and performance of which mandatory preliminary (when applying for a job) and periodic medical examinations are carried out. At the same time, a new procedure for their implementation is being introduced.
  • At the same time, orders of the Ministry of Health and Medical Industry of Russia dated March 14, 1996 No. 90 and the Ministry of Health and Social Development of Russia dated August 16, 2004 No. 83, as well as p.p. 11-12 (with the exception of clauses 12.2, 12.11, 12.12) and clause 13 of Appendix No. 2 to the order of the USSR Ministry of Health of September 29, 1989 No. 555, which regulate the requirements for organizing and conducting m / o to the present, have lost strength.
  • The new order fixed the obligation of the employer to organize medical examinations of employees, and also determined the responsibility of the medical organization for the quality of their conduct.
  • The goals of medical examinations, a list of factors and a list of works, requirements for honey. organizations entitled to conduct medical examinations have not changed.
  • Medical examinations are carried out on the basis of the lists of professions approved by the employer and the lists of names of employees compiled on their basis.
  • Workers exposed to harmful production factors specified in the list of factors, as well as harmful production factors, the presence of which is established by the results of attestation of workplaces for working conditions, carried out in the prescribed manner, are subject to inclusion in the contingent lists and name lists.

Name lists, directions, calendar plans

  • The contingents, as well as the lists of names compiled on their basis, are compiled and approved by the employer or his authorized representative. Not later than 2 months before the start date of the periodic examination agreed with the medical organization, they must be sent to the specified medical organization. Now the employer's responsibility is only to send the list of contingents of professions to the territorial body of Rospotrebnadzor at its actual location within 10 days after its approval.
  • When conducting medical examinations, the employer or his authorized representative is obliged to hand over, against signature, to each employee a referral for a preliminary or periodic medical examination. The employer is responsible for accounting for referrals issued to employees.
  • The medical organization, within 10 days from the date of receipt of the list of names from the employer, but not later than 14 days before the start date of the periodic medical examination agreed with the employer, on the basis of the specified list of names, draws up a calendar plan for such an examination. The calendar plan must be agreed with the employer or his representative. The plan is approved by the head of the medical organization. The employer is obliged to familiarize the employees with the calendar plan no later than 10 days before the start date of the periodic examination agreed with the medical organization.

Medical Commission

  • When concluding an agreement with an employer on conducting a preliminary or periodic examination, a medical organization must form a permanent medical commission, which includes an occupational pathologist, as well as doctors who have undergone advanced training in the specialty "occupational pathology" in the prescribed manner. The occupational pathologist should head the medical commission. The composition of the medical commission must be approved by order of the medical organization.
  • The medical commission, on the basis of a list of names, a list of factors and (or) a list of works, determines the need for participation in preliminary and periodic examinations of relevant specialists, as well as the types and volumes of necessary laboratory and functional studies. During preliminary and periodic medical examinations, the following studies are mandatory for all examinees:

Complete blood count (hemoglobin, color index, erythrocytes, leukocytes, leukocyte formula, ESR);

Urinalysis (specific gravity, protein, sugar, sediment microscopy);

electrocardiography;

Radiography of the lungs in two projections or fluorography;

Biochemical screening (blood sugar, cholesterol).

  • All women are examined by an obstetrician-gynecologist. At least once a year, they undergo bacteriological (for flora) and cytological (for atypical cells) studies. Women over 40 years of age should have a mammogram or ultrasound of the mammary glands once every 2 years.
  • The conclusion of a psychiatrist and narcologist is mandatory for all categories of subjects

Outpatient cards and health passports

  • For an employee undergoing preliminary or periodic medical examinations, a medical organization issues an outpatient medical card (form 025 / y-04), a health passport, as well as a conclusion based on the results of a medical examination.
  • For each employee, 1 health passport is issued, which is stored in a medical organization for the period of medical examinations, and upon completion, together with a copy of the medical report, they are handed over to employees.
  • Medical cards are stored in the prescribed manner in a medical organization that performs preliminary and periodic medical examinations. Information from the medical card containing the results of examinations of specialists, the results of the lab. and instrumental studies are entered in the health passport.

Commission Decisions and Final Acts

  • Within 3 calendar days after the end of the preliminary medical examination and within 15 days from the date of the end of the periodic medical examination, the medical commission makes a decision and draws up a medical report based on its results.
  • Information about employees who have undergone a preliminary medical examination and who have identified contraindications to the profession are sent to the employer that issued the referral.
  • Based on the results of medical examinations, the medical organization, no later than 30 days after the completion of periodic medical examinations, summarizes the results 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, representatives of the employer draws up the final act. One copy of it must be kept in a medical organization that conducted periodic medical examinations for 50 years.
  • In case of liquidation or change of the medical organization that carries out medical examinations, the medical records of employees are transferred to the center of occupational pathology of the constituent entity of the Russian Federation. They must also be stored there for 50 years, and on the basis of a written request from another medical organization with which the employer has entered into an agreement for medical examinations, within 10 days from the date of receipt of the request, transfer the medical cards of employees (a copy must be attached to the request contracts).

Special cases

  • Employees employed in work with harmful or hazardous substances and production factors, employees who have a preliminary diagnosis of an occupational disease, other categories of employees, if the medical commission makes an appropriate decision, at least once every 5 years, must undergo periodic examinations at occupational pathology centers and other medical organizations that have the right to conduct preliminary and periodic medical examinations, conduct an examination of professional suitability and examination of the connection of the disease with the profession.
  • At least once a year in occupational pathology centers or other medical organizations, workers suffering from acute and chronic diseases must undergo medical examinations. occupational diseases.
  • State supervision (control) over compliance with the requirements for organizing and conducting preliminary (when applying for a job) and periodic medical examinations of employees is carried out by the federal executive body, which is entrusted with the functions of control and supervision in the field of ensuring the sanitary and epidemiological welfare of the population, within the scope of their powers.

The practice of applying the new order will show its effectiveness, or determine the range of issues that need to be addressed. In particular, an appropriate document flow is provided, including lists of contingents and persons subject to prof. examinations, referrals for professional medical examinations, health passports, final acts, etc. At the same time, the forms of these documents have not yet been approved in the prescribed manner.

The system of medical examinations is aimed at preventing the development of occupational diseases among employees of the enterprise, the spread of infectious diseases, as well as to assess the suitability of a person for health reasons to perform the assigned work.

Who must undergo a medical examination at the enterprise.

According to the order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 No. 302n, a list of harmful and (or) dangerous production factors has been established, in the presence of which mandatory preliminary (when hiring) and periodic medical examinations(surveys).

The costs of conducting a health examination of their employees, according to the Labor Code of the Russian Federation, are borne by the employer.

Preliminary medical examinations for employment are mandatory in the following cases.

  • Employment of employees under the age of 18;
  • If employees are engaged in hard work and work with harmful and (or) dangerous working conditions (including underground work), as well as in work related to traffic (pilots, machinists, drivers);
  • If work is carried out in the conditions of the Far North;
  • Athletes;
  • If employees go to work in organizations of the food industry, public catering and trade, water supply facilities, medical and preventive and children's institutions, as well as some other employers (see Article 213 of the Labor Code of the Russian Federation);
  • Additional conditions put forward by local governments to the management of the enterprise (part 4 of article 213 of the Labor Code of the Russian Federation).

In addition, there are areas of activity for employees who also need an initial medical examination. This category includes employees of the Ministry of Emergency Situations, customs, judges, railway employees.

The following groups of people undergo periodic medical examinations:

  • workers who perform work in harmful as well as dangerous conditions;
  • employees performing work related to the movement of transport, including employees of subways;
  • workers employed in the food industry;
  • employees of trade and public catering organizations;
  • plumbing workers;
  • employees of medical organizations;
  • employees of children's institutions;
  • workers involved in the production and circulation of food products;
  • employees providing hairdressing and beauty services in public utility organizations;
  • health workers, lifeguards, other personnel of the water park located in the water zone;
  • Employees under the age of 21.

The frequency with which periodic medical examinations are carried out is determined by the conditions of the working environment or types of work. Employees under the age of 21 undergo a medical examination annually, the rest of the employees are subject to a medical examination once every 1-2 years.

Medical board by order 302n: which doctors to pass.

To conduct periodic medical examinations, the medical institution creates a medical board of doctors acting on a permanent basis, who have specialized in occupational pathology.

Employees subject to a medical examination must pass a therapist, narcologist and psychiatrist. Depending on the type of activity of the organization, working conditions and recommendations of medical specialists, doctors from other specializations are involved in the medical commission, in particular, an otorhinolaryngologist, dermatovenereologist, neurologist, ophthalmologist, allergist, gynecologist, endocrinologist.

Mandatory diagnostic examinations.

The list of mandatory diagnostic procedures for employees undergoing periodic examinations includes laboratory and functional studies in the form of:

  • clinical analyzes of urine and blood;
  • fluorography or radiography of the chest;
  • biochemical screening.

A female medical examination involves an annual appointment with an obstetrician-gynecologist with a mandatory bacteriological and cytological examination.

Women over the age of 40 should undergo a breast examination by mammography or ultrasound once every 2 years. Depending on the working conditions, ultrasound, spirometry, blood tests, including hormonal tests, and other specific medical tests can be additionally performed.

What are the consequences of refusing medical examinations?

Requirements for an enterprise to ensure regular scheduled medical examinations based on order 302n are mandatory. The amount of the fine in case of non-performance ranges from 15,000 rubles. for individual entrepreneurs and from 110,000 for other forms of ownership. If, due to the lack of a medical examination, the health of an employee is seriously harmed or his death occurs, officials will be held criminally liable (Article 143 of the Criminal Code of the Russian Federation).

Where to pass mandatory medical examinations in Bor.

Order of the Ministry of Health and Social Development of the Russian Federation of April 12, 2011 N 302n "On approval of the 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 employed in hard work and in work with harmful and (or) dangerous working conditions" (with amendments and additions)

Order of the Ministry of Health and Social Development of the Russian Federation of April 12, 2011 N 302n
"On approval of the 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"

With changes and additions from:

a list of works, during the performance of which mandatory preliminary and periodic medical examinations (examinations) of employees are carried out, in accordance with Appendix No. 2;

The procedure for conducting mandatory preliminary (when applying for a job) and periodic medical examinations (examinations) of employees engaged in hard work and work with harmful and (or) dangerous working conditions, in accordance with Appendix N 3.

2. To put into effect the lists of harmful and (or) hazardous 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) 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 of 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 need state registration, letter dated December 30, 1996 Mr. N 07-02-1376-96);

order of the Ministry of Health and Social Development of the Russian Federation of August 16, 2004 N 83 "On approval of the lists of harmful and (or) hazardous production factors and work, during the performance of 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 of May 16, 2005 N 338 "On Amendments to Appendix No. 2 to the Order of the Ministry of Health and Social Development of Russia of August 16, 2004 N 83" On Approval of Lists of Harmful and (or) Hazardous Production Factors and Works 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, (with the exception of subparagraphs 12.2, 12.11, 12.12), Appendix N 2 to the order of the Ministry of Health of the USSR of September 29, 1989 N 555 "On improving the system medical examinations of workers and drivers of individual vehicles.

New lists of harmful and (or) hazardous production factors and works have been approved, during the performance of which preliminary and periodic medical examinations (examinations) are carried out. The procedure for conducting such inspections has been revised.

The lists set the frequency of examinations, the composition of the medical specialists participating in them. The ongoing laboratory and functional studies are listed, medical contraindications for the performance of work are given.

Inspection can be carried out by any medical organization that has such a right, as well as carrying out an examination of professional suitability. The composition of the medical commission includes an occupational pathologist and medical specialists who have undergone advanced training in the specialty "occupational pathology" or have a valid certificate in it.

The direction for inspection is issued by the employer. The requirements for its completion are given. The employee presents a passport and referral to the medical organization. A medical card and a health passport (in its absence) are issued for it. The latter, after inspection, is handed over to the employee.

For periodic examinations, the employer sends the name lists of employees to the medical organization, on the basis of which a schedule of examinations is drawn up. Upon completion of the examination, a medical report is issued in 2 copies (the first is issued to the employee, the second is attached to the medical card). The employee is assigned to one of the dispensary groups, they give recommendations on the prevention of diseases, if there are medical indications - on further observation, treatment and rehabilitation. If an occupational disease is suspected, a referral to an occupational pathology center is issued.

Participants in accidents, persons with persistent consequences of accidents at work and a number of other workers once every 5 years undergo periodic examinations at occupational pathology centers.

Based on the results of the examinations, the medical organization draws up a final act and sends it to the employer, to the occupational pathology center, as well as to the territorial body of Rospotrebnadzor.

Order of the Ministry of Health and Social Development of the Russian Federation of April 12, 2011 N 302n "On approval of the 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 hard work and work with harmful and (or) dangerous working conditions"