of July 29, 2019 No. 74
About performing the obligatory and extraordinary medical examinations working
Based on part three of subitem 2.6 of Item 2 of the Presidential decree of the Republic of Belarus of April 5, 2021 No. 137 "On regulation of activities in the field of use of atomic energy and sources of ionizing radiation", parts two of article 27 of the Law of the Republic of Belarus of June 23, 2008 No. 356-Z "About labor protection", parts two of article 26 of the Law of the Republic of Belarus of January 7, 2012 No. 340-Z "About sanitary and epidemiologic wellbeing of the population", parts two of article 17 of the Law of the Republic of Belarus of May 22, 2000 No. 395-Z "About social servicing", the paragraph of the fourteenth subitem 8.8-5 of Item 8 and subitem 9.1 of Item 9 of the Regulations on the Ministry of Health of the Republic of Belarus approved by the resolution of Council of Ministers of the Republic of Belarus of October 28, 2011 No. 1446, the Ministry of Health of the Republic of Belarus DECIDES:
1. Approve the Instruction about procedure for performing the obligatory and extraordinary medical examinations working it (is applied).
1-1. No. 213 is excluded according to the Resolution of the Ministry of Health of the Republic of Belarus of 29.12.2023
2. Recognize invalid:
the resolution of the Ministry of Health of the Republic of Belarus of April 28, 2010 No. 47 "About approval of the Instruction about procedure for performing the obligatory medical examinations working and recognition voided some resolutions of the Ministry of Health of the Republic of Belarus";
the resolution of the Ministry of Health of the Republic of Belarus of April 26, 2011 No. 31 "About modification and amendments in the resolution of the Ministry of Health of the Republic of Belarus of April 28, 2010 No. 47".
3. This resolution becomes effective after its official publication.
Minister |
V. S. Karanik |
It is approved Ministry of Labour and Social Protection of the Republic of Belarus |
|
to the Resolution of the Ministry of Health of the Republic of Belarus of July 29, 2019 No. 74
The list of the organizations which along with the main activities also perform medical activities according to the procedure established by the legislation, and has the right to perform obligatory and extraordinary medical examinations only concerning the citizens working in these organizations (going to work in these organizations)
1. Atlant private company.
2. Minsk Automobile Plant open joint stock company – managing company of BELAVTOMAZ holding.
3. Open joint stock company "Minsk mechanical plant of S. I. Vavilov" – managing company of BELOMO holding.
4. Open joint stock company "Managing company of MINSK MOTOR PLANT holding.
5. INTEGRAL open joint stock company – managing company of INTEGRAL holding.
6. Minsk Tractor Plant open joint stock company.
7. Naftan open joint stock company.
8. Grodno Nitrogen open joint stock company.
9. Grodnozhilstroy open joint stock company.
10. Gomel Chemical Plant open joint stock company.
11. Belarusian Steel Works open joint stock company – managing company of Belarusian Metallurgical Company holding.
Approved by the Resolution of the Ministry of Health of the Republic of Belarus of July 29, 2019 No. 74
1. This Instruction establishes procedure for carrying out preliminary (in case of revenues to work) and periodic (during labor activity) obligatory medical examinations (further - obligatory medical examinations) working, occupied at works with harmful and (or) dangerous working conditions and (or) at works where according to the legislation there is need for professional selection, and also the extraordinary medical examinations working in case of deterioration in condition of their health (further - extraordinary medical examinations).
Obligatory and (or) extraordinary medical examinations are carried out concerning the physical persons working according to employment contracts, the physical persons working under civil agreements and other physical persons according to the legislation.
2. For the purposes of this Instruction terms and their determinations in the values established by the Labor code of the Republic of Belarus, the Law of the Republic of Belarus of June 18, 1993 No. 2435-XII "About health care", the Law of the Republic of Belarus "About labor protection", the Law of the Republic of Belarus "About sanitary and epidemiologic wellbeing of the population" and also the following terms and their determinations are used:
professional selection - assessment of the state of health working regarding its validity (worthlessness) to accomplishment of separate work types;
complex hygienic assessment of working conditions - final hygienic assessment of parameters of all production factors on workplace with establishment of class of harm of working conditions according to requirements of the Sanitary standards and the rules "Hygienic Classification of Working Conditions" approved by the resolution of the Ministry of Health of the Republic of Belarus of December 28, 2012 No. 211;
general medical contraindications - diseases (condition) in the presence of which work in harmful and (or) dangerous working conditions, including with harmful and (or) dangerous production factors (factors of the production circle and factors of labor process) which levels and values exceed hygienic standard rates and which according to hygienic classification of working conditions are referred to class of working conditions 3.1 and above is contraindicated;
assessment of working conditions - results of production laboratory researches of factors of the production circle, complex hygienic assessment of working conditions on indicators of harm and danger of factors of the production circle and labor process and (or) certification of workplaces under the terms of work.
3. Obligatory and (or) extraordinary medical examinations of working are carried out for the purpose of:
work safety;
preventions of occupational diseases;
health protection of working.
By results of performing the obligatory and (or) extraordinary medical examinations working it is determined:
the validity (worthlessness) for health reasons working to works in harmful and (or) dangerous working conditions depending on harmful and (or) dangerous production factors;
the validity (worthlessness) for health reasons working to works where there is need for professional selection.
4. Obligatory and (or) extraordinary medical examinations of working are carried out in case of performance of works:
in harmful and (or) dangerous working conditions depending on harmful and (or) dangerous production factors according to the scheme of performing obligatory and (or) extraordinary medical examinations during the works in harmful and (or) dangerous working conditions depending on harmful and (or) dangerous production factors according to appendix 1 taking into account diseases (conditions) according to the list of diseases (conditions) which are general medical contraindications to works in harmful and (or) dangerous working conditions according to appendix 2;
where there is need for professional selection, according to the scheme of performing obligatory and (or) extraordinary medical examinations where there is need for professional selection, according to appendix 3.
In case of performance of works, specified in Item 21-1 of appendix 3 to this Instruction, obligatory medical examinations are carried out.
5. Obligatory and (or) extraordinary medical examinations of working are carried out by the medical commissions on performing obligatory and extraordinary medical examinations created of number of health workers (further if other is not established, - medical commissions).
6. Medical commissions are created in the state organizations of health care, medical parts, hospitals of correctional facilities, medical parts of medical and labor dispensaries and in the organizations which along with the main activities also perform medical activities according to the procedure, established by the legislation (further if other is not established, – the organizations).
7. Heads of the organizations provide the organization of performing the obligatory and (or) extraordinary medical examinations working.
The number of medical commissions in the organizations is determined by heads of these organizations.
The members, operating procedure of medical commissions affirm heads of the organizations.
8. Medical commissions perform the following functions:
8.1. consider the provided employer (employer) working the following documents:
the statement from medical documents from the state organization of health care for the residence (the place of stay), for place of employment (studies, services);
the direction of the employer (employer) (further if other is not established, - the direction) in form according to appendix 5;
the list of professions of workers (positions of employees) of the workers who are subject to obligatory periodic medical examinations (further if other is not established, – the list of professions of workers (positions of employees), in form according to appendix 6;
the list of the workers who are subject to obligatory periodic medical examinations (further if other is not established, - the list of workers), in form according to appendix 7;
8.2. carry out obligatory and (or) extraordinary medical examinations of working;
8.3. draw up protocols of medical examination (further if other is not established, - the protocol) in form according to appendix 8;
8.4. draw up the medical certificate about the state of health or the act of obligatory periodic medical examination (further if other is not established, - the act) in form according to appendix 9;
8.5. request data from the employer (employer) and (or) the state organization of health care, necessary for decision making about the validity (worthlessness) working to work in harmful and (or) dangerous working conditions depending on harmful and (or) dangerous production factors and (or) to work where there is need for professional selection (further - the validity (worthlessness) working to work);
8.6. explain the questions entering competence of medical commissions;
8.7. other functions connected with performing obligatory and (or) extraordinary medical examinations.
9. The chairman and at least two members (specialists doctors and (or) general practitioners) is part of medical commission.
In case of need the specialists doctors and (or) general practitioners who are not part of medical commission can be involved in activities of medical commission.
10. Obligatory and (or) extraordinary medical examinations of working are carried out taking into account studying:
information containing in the statement from the medical documents working on the postponed diseases, results of dispensary surveys and dynamic medical observation; the diagnostic, medical and other medical interventions which are carried out working in the organizations of health care, other organizations providing medical care, for the period, constituting at least five years preceding performing obligatory preliminary medical examination, or for the period time, passed after performing the previous obligatory periodic and (or) extraordinary medical examination;
data on the working conditions and the performed works specified in the direction or in the list of professions of workers (positions of employees), the list of workers according to assessment of working conditions which is carried out according to the procedure, the provided Regulations on procedure for carrying out certification of workplaces under the terms of work approved by the resolution of Council of Ministers of the Republic of Belarus of February 22, 2008 No. 253, the Instruction on assessment of working conditions in case of the certification of workplaces under the terms of work approved by the resolution of the Ministry of Labour and Social Protection of the Republic of Belarus of February 22, 2008 No. 35, Sanitary standards and the rules "Hygienic Classification of Working Conditions";
the medical record of the patient for the out-patient and polyclinic organizations;
other medical documents necessary for decision making on the validity (worthlessness) working to work.
In case of performance of works, specified in appendix Items 20-26 3, the request of data is carried out from information systems, information resources, bases (banks) of data and (or) registers (registers) of the psychiatric (psychoneurological) organization of health care or the organization of health care which is not psychiatric (psychoneurological) and rendering according to the procedure, established by the legislation, psychiatric (including narcological) the help, about lack (availability) of data on rendering to the patient psychiatric (including narcological) the help.
11. When performing the obligatory and (or) extraordinary medical examinations working the laboratory, tool and other researches specified in the column 4 of appendix 1 and the column 5 of appendix 3, and also medical examinations by the general practitioners and (or) specialists doctors specified in the column 3 of appendix 1 and the column 4 of appendix 3 are performed.
12. When implementing obligatory and (or) extraordinary medical examinations the dispensary surveys, surveys of specialists doctors and (or) general practitioners which are carried out at the place of residence (the place of stay), place of employment (studies, services) working, within six months preceding month in which working obligatory and (or) extraordinary medical examination is carried out are considered.
In case of need medical commissions send working, undergoing obligatory and (or) extraordinary medical examinations, to other state organizations of health care, the state medical scientific organizations for performing additional diagnostics and (or) consultation.
13. The decision on the validity (worthlessness) working to work is made by medical commission taking into account:
availability or absence of diseases (conditions) in the presence of which work in the harmful and (or) dangerous working conditions specified in the column 5 of appendix 1, taking into account diseases (conditions) determined by the list of diseases (conditions) which are general medical contraindications to works in harmful and (or) dangerous working conditions, and also the diseases (conditions) which are medical contraindications to performance of works, specified in the column 6 of appendix 3 is contraindicated;
the conclusions of the medical and consulting commission created in the psychiatric (psychoneurological) organizations, and also the medical and consulting commission of other organizations of health care which are not the psychiatric (psychoneurological) organizations and rendering according to the procedure, established by the legislation, mental health services;
degrees of expressiveness of functional violations;
possibilities of compensation of the broken functions by medicines and (or) technical means of social resettlement.
By results of performing obligatory and (or) extraordinary medical examinations by medical commission one of the following decisions is accepted:
it is suitable for work (with indication of harmful and (or) dangerous production factors, type of the performed works);
it is unusable to work (with indication of harmful and (or) dangerous production factors, type of the performed works);
it is suitable for work (with indication of separate harmful and (or) dangerous production factors, type of the performed works) and is unusable to work (with indication of separate harmful and (or) dangerous production factors, type of the performed works);
it is suitable for work (with indication of harmful and (or) dangerous production factors, type of the performed works) and needs performing extraordinary medical examination;
it is suitable for work (it is unusable to work) with indication of harmful and (or) dangerous production factors, type of the performed works and suspicion of chronic occupational disease is revealed.
14. Results of the obligatory and (or) extraordinary medical examinations working are entered in minutes which are subject to storage in the medical record of the patient for the out-patient and polyclinic organizations in the organization which was carrying out obligatory and (or) extraordinary medical examination.
Copies of protocols go medical commission to the state organizations of health care for the residence (the place of stay), for place of employment (studies, services) working for attaching to the medical record of the patient for the out-patient and polyclinic organizations.
15. By results of performing the obligatory and (or) extraordinary medical examinations working the medical certificate about the state of health, the confirmatory validity (worthlessness) working to work, or the act is drawn up.
16. If necessary by results of performing obligatory periodic and (or) extraordinary medical examinations medical commissions direct working for meeting of the medical and consulting commission of the organization which was carrying out obligatory periodic and (or) extraordinary medical examinations, for receipt of the conclusion about provision working other work.
17. In case of suspicion of chronic occupational disease the medical commission directs working to the pathologist.
18. If when performing obligatory periodic and (or) extraordinary medical examination of working diseases (condition) which are medical contraindications to works are revealed, the medical commission within five working days from the date of detection of this disease (condition) informs the employer (employer) on establishment of worthlessness working to work.
19. Preliminary obligatory medical examinations going to work (further - preliminary medical examinations) are performed based on the direction.
20. Preliminary medical examinations are carried out in case of performance of works:
in harmful and (or) dangerous working conditions depending on the harmful and (or) dangerous production factors specified in the column 2 of appendix 1;
with impact of the factors of the production circle specified in the column 2 appendices 1, which cause allergic diseases, irrespective of their level (concentration) on workplace;
with impact of the biological factors specified in subitems 2. 4, 2.5 and 2.8 Items 2 appendices 1, irrespective of their level (concentration) on workplace;
with impact of the physical factors specified in subitems 4.1 and 4.6 of item 4 of appendix 1, irrespective of their level on workplace;
with impact of chemical factors (chemicals of the 1st and (or) 2nd class of danger) specified in the column 2 appendices 1, irrespective of their level (concentration) on workplace;
where there is need for professional selection and specified in the column 2 of appendix 3.
21. By results of the preliminary medical examinations working the medical certificate about the state of health, the confirmatory validity (worthlessness) working to work is issued.
22. For performing obligatory periodic medical examinations (further – periodic medical examinations) workers the employer annually constitutes the list of professions of workers (positions of employees).
Periodic medical examinations of the workers who are not included in the list of professions of workers (positions of employees), the physical persons working under civil agreements and other physical persons according to the legislation are carried out based on the direction.
23. The list of professions of workers (positions of employees) is constituted in duplicate with indication of results of assessment of working conditions on each harmful and (or) dangerous production factor, one of which remains at the employer, the second – goes to the organization till January 1 of calendar year during which workers need to carry out the planned periodic medical examination (further – calendar year).
24. The organization based on the list of professions of workers (positions of employees) constitutes and sends to the employer no later than February 1 of calendar year the schedule of performing periodic medical examinations of workers created taking into account the term of earlier carried out periodic medical examination.
25. The employer based on the list of professions of workers (positions of employees) and the schedule of performing periodic medical examinations constitutes the list of workers.
The list of workers in 20 working days prior to periodic medical examination goes the employer to the organization.
26. In case of non-compliance with the schedule of performing periodic medical examination and (or) absence of workers on periodic medical examination the organization within five working days from the date of completion of periodic medical examination informs the employer on non-compliance with the schedule of performing periodic medical examinations and (or) absence of workers on periodic medical examination.
27. Periodic medical examinations of working are carried out from January 1 to December 31 calendar year.
28. In case of impact of the harmful and (or) dangerous production factors specified in appendix 1, frequency of passing of periodic medical examinations it is determined by results of assessment of working conditions with the following frequency:
Once a year:
in case of impact of harmful and (or) dangerous production factors which by results of assessment of working conditions are referred to harmful the third class of the third, fourth degree (class 3.3, 3. 4) and (or) dangerous fourth class (class 4);
in case of impact of chemical factors irrespective of their level (concentration) on workplace (chemicals of the 1st and (or) 2nd class of danger) specified in Item 1 of appendix 1;
in case of impact of the chemical factors irrespective of their level (concentration) on workplace specified in subitem 1.2.2 of Item 1 of appendix 1;
in case of impact of the biological factors irrespective of their level (concentration) on workplace specified in subitems 2. 4, 2.5, 2.8 of Item 2 of appendix 1;
in case of impact of the physical factors specified in subitems 4.1.1 (irrespective of their level (concentration) on workplace) and 4.6 items 4 of appendix 1;
1 time in 2 years:
in case of impact of harmful and (or) dangerous production factors which by results of assessment of working conditions are referred to harmful the third class of the first, second degree (class 3.1, 3. 2);
in case of impact of the chemical factors specified in subitems 1.2. 5, 1.2.7 and 1.2.8 Items 1 of appendix 1;
in case of impact of the biological factors specified in subitems 2.1-2. 3, 2.6 and 2.7 Items 2 of appendix 1;
in case of impact of the aerosols mainly the fibrogenny and mixed type of action specified in subitems 3.1-3.9 of Item 3 of appendix 1;
1 time in 3 years:
in case of impact of chemical factors (chemicals of the 3rd and (or) 4th class of danger) specified in Item of 1 appendix 1, which by results of assessment of working conditions are carried to admissible (class 2);
in case of impact of the chemical factors specified in subitems 1.2. 1, 1.2. 3, 1.2.4 and 1.2.6 Items of 1 appendix 1, which by results of assessment of working conditions are carried to admissible (class 2);
in case of impact of the harmful and (or) dangerous production factors specified in the column 2 appendices 1, which cause allergic diseases, irrespective of the level (concentration) on workplace of these factors.
29. In case of the impact of factors of weight and intensity of labor process specified in appendix Item 5 1, periodic medical examination it is performed in case of assessment of working conditions on separate factors of labor process as harmful the third class of the first degree above (class 3.1 above).
30. In case of performance of works, 2 appendices specified in the column 3, periodic medical examinations are carried out according to the terms specified in the column 3 of appendix 3.
31. By results of the periodic medical examinations working the organization draws up the statement and (or) fills in the medical certificate about the state of health, the confirmatory validity (worthlessness) working to work.
The act is drawn up within 30 working days from the date of the end of periodic medical examinations in duplicate, one of which within five working days goes to the employer and (or) the employer, the second – remains in the organization.
32. The term of performing the next periodic medical examination is estimated of the end date of the previous periodic medical examination specified in the act or of date of issue of the medical certificate about the state of health when performing preliminary medical examination.
33. Extraordinary medical examinations of working are carried out in case of the deterioration in the state of health working at the initiative of the employer and (or) the employer, the state organizations of health care and other organizations of health care performing delivery of health care, and working.
34. Extraordinary medical examinations of working are performed based on the direction.
35. In case of need carrying out working extraordinary medical examination the organization in writing informs the employer (employer) on carrying out working extraordinary medical examination.
36. By results of extraordinary medical examinations the medical certificate about the state of health, the confirmatory validity (worthlessness) working to work is issued to working.
to the Instruction about procedure for performing the obligatory and extraordinary medical examinations working
The scheme of performing obligatory and (or) extraordinary medical examinations during the works in harmful and (or) dangerous working conditions depending on harmful and (or) dangerous production factors
№ |
Names of harmful and (or) dangerous production factors |
The general practitioners and (or) specialists doctors performing medical examination |
Laboratory, tool and other researches |
Diseases (condition) in the presence of which work in harmful and (or) dangerous working conditions is contraindicated (diagnosis code according to the International Statistical Classification of the diseases and problems connected with health, the tenth review) |
1 |
2 |
3 |
4 |
5 |
1 |
CHEMICAL FACTORS | |||
1.1 |
the substances and connections united by chemical structure: | |||
1.1.1 |
nitrogen inorganic compounds (ammonia, nitric acid and others) |
the general practitioner who is part of medical commission (further – VOP) and (or) |
general blood test |
1. Diseases of respiratory organs: |
1.1.2 |
aldehydes aliphatic (limiting, nonlimiting and aromatic): formaldehyde (carcinogen (further – To), allergen (further – And), ethyl aldehyde, akrolein, benzole aldehyde, phthalic (And), glutarovy aldehyde (A) and others |
VOP and (or) |
OAK, |
1. Diseases of respiratory organs: |
1.1.3 |
amides of organic acids, anilida and other derivatives (N, N-dimetilformamid, dimethylacetamide, caprolactam and others) |
VOP and (or) |
OAK1, |
1. Diseases of respiratory organs: |
1.1.4 |
beryllium and its connections (And, To) |
VOP and (or) |
OAK, |
1. Diseases of respiratory organs: |
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