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The document ceased to be valid since  September 19, 2015 according to Item 1 of the Order of the Government of the Republic of Kazakhstan of September 8, 2015 No. 754

ORDER OF THE GOVERNMENT OF THE REPUBLIC OF KAZAKHSTAN

of January 25, 2012 No. 166

About approval of the list of harmful production factors, professions in case of which obligatory medical examinations, Rules of performing obligatory medical examinations are performed

(as amended of the Order of the Government of the Republic of Kazakhstan of 31.07.2014 No. 867)

According to item 4 of article 155 of the Code of the Republic of Kazakhstan of September 18, 2009 "About health of the people and health care system" the Government of the Republic of Kazakhstan DECIDES:

1. Approve enclosed:

1) the list of harmful production factors, professions in case of which obligatory medical examinations are performed;

2) Rules of performing obligatory medical examinations.

2. This resolution becomes effective after ten calendar days after the first official publication.

Prime Minister of the Republic of Kazakhstan

K. Masimov

Approved by the Order of the Government of the Republic of Kazakhstan of January 25, 2012 No. 166

Rules of performing obligatory medical examinations

1. General provisions

1. These rules of performing obligatory medical examinations (further - Rules) determine procedure and frequency of performing obligatory medical examinations.

2. Obligatory medical examinations are subdivided on preliminary and periodic.

3. Preliminary obligatory medical examinations are performed in case of revenues to work or study for the purpose of clarification of suitability to accomplishment of obligations by profession or study, and also preventions of general, professional and non-proliferation of infectious and parasitic diseases.

4. Periodic obligatory medical examinations are performed for the purpose of ensuring dynamic observation of the state of health working, timely establishment of initial signs of diseases, the prevention of general, professional and non-proliferation of infectious and parasitic diseases.

5. Obligatory preliminary medical examinations are performed by the medical organizations having qualified specialists, necessary devices, the equipment, chemical reactants for carrying out functional and diagnostic and laboratory researches and the material resources having the license for implementation of medical activities for assessment of suitability surveyed to work (work practice), according to professional suitability for health reasons.

2. Procedure for performing obligatory preliminary medical examinations

6. The health workers of the medical organizations participating in performing obligatory preliminary medical examinations perform survey of the worker and direct surveyed on laboratory researches.

7. Data of obligatory preliminary medical examination are entered in the medical record of the ambulatory patient in the form approved by authorized body in the field of health care with execution of the conclusion about compliance or discrepancy of the state of health of the worker to the performed work (work practice).

8. Results of obligatory preliminary medical examinations are drawn up in the personal medical book for persons going to work on epidemiologically significant objects. The medical certificate in the form approved by authorized body in the field of health care is issued to the persons who had obligatory preliminary medical examination and recognized suitable for work with harmful production factors.

9. The conclusion about compliance of the state of health to the requirements necessary for performance of work, including the provided work practice during training of pupils in educational institutions the ranking health worker appointed by the order of the head of the medical organization accepts.

10. The conclusion about the state of health, is put down in the personal medical book by the ranking health worker of the medical organization in the presence in the personal medical book of all signatures of all health workers and seals participating in obligatory preliminary medical examination about passing of obligatory preliminary medical examination.

3. Procedure for performing obligatory periodic medical examinations

11. Frequency of performing obligatory periodic medical examinations:

1) annual medical examination - once a year;

2) prereplaceable medical examination - in 1 hour and in 30 minutes before working shift;

3) pretrip and posttrip medical examination - in 30 minutes before flight, and within 30 minutes after the end of flight.

12. State bodies of sanitary and epidemiological surveillance:

1) no later than December 1 of prior year together with the employer or the responsible person is determined by the list of productions, shops, professions and positions, the list of hard work, works with harmful (especially harmful) and (or) dangerous working conditions;

2) exercise control of completeness of scope, quality and timeliness of performing obligatory medical examinations;

3) participate in generalization of results of obligatory medical examinations of workers;

4) at the request of the medical organization represent the sanitary and epidemiologic characteristic of working conditions.

13. In case of diagnosing of infectious or parasitic disease, identification of carriage of causative agents of the infectious diseases which are contraindications to the performed work, the ranking health worker of the medical organization sends the emergency notice to state bodies of sanitary and epidemiological surveillance and sends the patient for treatment to the relevant treatment-and-prophylactic organization for the residence.

14. The state body of sanitary and epidemiological surveillance in the corresponding territory and on transport discharges such persons of work if these persons already work at epidemiologically significant objects.

15. Medical organization:

1) in case of receipt of the lists of the contingents which are subject to obligatory periodic medical examinations approved with state bodies of sanitary and epidemiological surveillance is created by the commissions for performing obligatory periodic medical examinations and constitute the schedule in which determine structure of the medical commission, type and amount of laboratory and other researches taking into account specifics of the operating harmful production factors, time and terms of work of the medical commission. In case of shortcoming and absence of the health workers performing obligatory periodic medical examinations, necessary researches are conducted in other medical organizations having the license for the specified type of activity. The plan is approved with administration of the organization (employer);

2) the head of the medical organization approves structure of the medical commission which chairman shall be pathologist having occupational retraining on professional pathologies and the certificate of the specialist (pathologist). Health workers are part of the medical commission: the therapist, the surgeon, the neuropathologist, the otolaryngologist, the ophthalmologist, the dermatovenerologist, the gynecologist, the radiologist, the doctor on functional diagnostics, the laboratory doctor who had within the specialty training on professional pathology.

In need of the medical commission also other specialists (the stomatologist, the cardiologist, the allergist, the endocrinologist, the phthisiatrician, the hematologist) are involved;

3) the health workers participating in obligatory periodic medical examinations shall be informed of the characteristic of the professional activity and working conditions of workers provided by the employer;

4) quarterly submit the summary report on work of the medical organization for performing obligatory periodic medical examinations in territorial state bodies of sanitary and epidemiological surveillance according to appendix 1 to these rules;

5) on the end of performing obligatory periodic medical examinations is generalized by results of the workers occupied on hard work in harmful (especially harmful) and (or) dangerous working conditions and draw up the final statement in 5 copies in form according to appendix 2 to these rules, provided in state bodies of sanitary and epidemiological surveillance, within 30 calendar days after the performed obligatory periodic medical examination. In appendices to the act the list of names of persons to which transfer to other work is recommended is given, stationary and sanatorium treatment, dietary food, dynamic observation is shown. Final acts after signing are transferred for execution of administration, to trade-union committee of the organization, to state bodies of sanitary and epidemiological surveillance for control, to the territorial medical organizations for the location of the employer for work, one copy remains at the medical organization performing obligatory periodic medical examination;

6) data of obligatory periodic medical examination are entered in the medical record of the ambulatory patient in the form approved by authorized body in the field of health care and on the loose leaf in form according to appendix 3 to these rules which is attached to the medical record of the ambulatory patient. At the same time, each health worker who is taking part in obligatory periodic medical examination draws the conclusion about professional suitability. In the loose leaf of the medical record of the ambulatory patient data of professional route are taken out. In case of dismissal and transfer to other organization the medical record of the ambulatory patient with data of obligatory medical examinations is transferred to the medical organization for the place of new work.

Obligatory periodic medical examinations shall be performed in the presence of the medical record of the ambulatory patient at the place of residence or statements from it;

7) the medical certificate in the form approved by authorized body in the field of health care is issued to the persons who had obligatory periodic preliminary medical examination and recognized suitable for work with harmful production factors.

The expert opinion on professional suitability is drawn up taking into account medical documentation from the residence irrespective of type of medical examination;

8) to persons to whom work in harmful and (or) dangerous working conditions is contraindicated the conclusion is not handed out, and goes to three-day time to the employer, with the notice of person to which work with harmful production factors is contraindicated.

16. Employer:

Constitutes 1) in a month, after obtaining from state bodies of the sanitary and epidemiological surveillance of data on the contingent which is subject to obligatory periodic medical examinations, the list of names of persons with indication of production, shops, professions, hard work, works in harmful (especially harmful) and (or) dangerous working conditions by which workers, and also length of service in these working conditions are affected;

2) is organized at the expense of own means by performing periodic medical examination;

3) is provided by the timely direction of persons with occupational diseases and suspicion on them in the medical organization for profound inspection and treatment;

4) is annually developed by the actions plan on improvement of the revealed patients approved with territorial state body of sanitary and epidemiological surveillance.

17. By results of obligatory periodic medical examination groups, with the subsequent determination of belonging of the worker to one of dispensary groups and execution of recommendations about prevention of occupational diseases and socially important diseases - on further observation, treatment and rehabilitation are created:

1) the healthy workers who are not needing rehabilitation;

2) almost healthy workers having unstable functional changes of various bodies and systems;

3) the workers having the initial forms of general diseases;

4) the workers having the expressed forms of general diseases, both being and which are not contraindication for further work in profession;

5) the workers having impact signs on organism of harmful production factors;

6) the workers having signs of occupational diseases.

18. Almost healthy workers having unstable functional changes of various bodies and systems are exposed to dispensary observation in the medical organization for the residence by results of obligatory periodic medical examinations; the workers having the initial forms of general diseases; the workers having the expressed forms of general disease both being, and not being contraindication for further work in profession; and persons with occupational diseases.

19. The workers having the expressed forms of general diseases, both being and which are not contraindication for further work in profession go for rehabilitation in the medical organizations of medical and rehabilitation profile then in their relation examination of professional suitability is performed. The workers recognized after stage of medical rehabilitation suitable for professional work are subject to dispensary observation in group of persons with initial forms of general diseases.

20. The workers having impact signs on organism of harmful production factors and signs of occupational diseases go to the medical organization performing activities for establishment of communication of disease with profession.

21. Persons with occupational diseases are on dispensary accounting at the pathologist of the medical organization serving industrial enterprise or at the place of residence.

22. Medical examination of workers by results of obligatory periodic medical examinations is performed on the basis of the principles of landmark rehabilitation which consists of three main stages:

1) first stage: actions for prevention of diseases at almost healthy workers on health centers under industrial enterprises, in sanatorium dispensary;

2) second stage: medical rehabilitation of persons from "risk group": it is frequent and long having catarrhal diseases, persons with various functional violations, initial forms of general diseases, preclinical signs of occupational diseases by the organization of dispensary observation and regular preventive treatment in out-patient and stationary conditions with obligatory inclusion of sanatorium stage of improvement;

3) third stage: rehabilitation of patients with occupational diseases, including disabled people owing to these diseases in conditions the medical organization performing activities for establishment of communication of disease with profession, the health resorts of sanatorium base having the license for this type of activity.

23. Control of medical examination and medical rehabilitation of patients, workers at the companies, is assigned to regional (city) professional pathological offices with involvement of the territorial medical organizations and medical organizations performing servicing of the companies.

24. General and private medical contraindications in case of determination of suitability to accomplishment of obligations by profession are established by authorized body in the field of health care.

25. Prereplaceable medical examination - establishment or confirmation of availability or absence at physical person of disease, determination of the state of health, and also temporary disability, professional suitability to work in this change.

25-1. Pretrip and posttrip medical examination - establishment or confirmation of availability or absence at physical person of disease, determination of the state of health, and also determination of alcohol intoxication and the use of drugs of drivers of motorized vehicles before flight and after the end of flight. Rules of performing obligatory pretrip and posttrip medical examinations of transport drivers affirm authorized body in the field of health care.

26. Prereplaceable medical examination (further - survey) by professions is carried out by the regular health worker of the organization (the performing operation of transport and the equipment which had special training in narcological dispensary (hospital), or the health worker of the medical organization for the contract between the organization (individual entrepreneur).

27. The medical organization renders services in survey in professions according to the license obtained according to the procedure established by the legislation of the Republic of Kazakhstan.

28. Training of the health worker concerning carrying out survey by professions is performed by narcological dispensaries (hospitals).

29. Survey by professions is carried out under control of the employer and in case of methodical management of the health worker of the medical organization.

30. For carrying out survey the organization (individual entrepreneur) or the medical organization allocates the special room equipped with systems of heating, water supply, the sewerage, lighting, is equipped with the medical equipment and tools.

31. Survey is made not earlier than before 30 minutes (for drivers of vehicles) in 1 hour before working shift (watch), flight (flight) in case of presentation of route (traveling) leaf, task on accomplishment of flight or the job specification. In need of accomplishment of several flights (flights) during the day survey is carried out once, before maiden voyage (flight).

32. Results of carrying out survey are registered in the magazine, according to appendix 4 to these rules.

33. The magazine is filled in with the health worker who was carrying out survey and stored in office where survey is performed.

34. Health workers analyze the reasons of discharge of persons working by the specified professions and on the basis of the analysis create risk groups where persons inclined to abuse of alcohol and psychoactive agents join, is long and often ill (having chronic diseases).

Appendix 1

to Rules of performing obligatory medical examinations

Form

The report of the subject of health care on the performed periodic medical examination for _______ quarter 20 __ years

 

Name

Is subject to survey

To survey

It is revealed with suspicion of occupational disease

In total

women

In total

In total

women

 

 

 

 

 

 

 

 

It is revealed with somatic diseases

from them need

It is directed to stationary inspection and treatment

In total

including it is revealed for the first time

in temporary transfer

in permanent translation

 

 

 

 

 

 

Head of the subject of health care _________________________

F.I.O. Signature

Appendix 2

to Rules of performing obligatory medical examinations

Form

The final act from "___" ___________ 20 ___.

By results of the performed periodic medical inspection (inspection) of workers _________________________

_____________________________________________________________________________________________________________

                                               (name of the organization (company), shop)

for 20 ____ the final statement is drawn up with participation:

Chairman

medical commission ___________________________________________________________________________________________

                                                                     (Full name, position)

Occupational therapist of state body of sanitary and epidemiologic service

Representative

работодателя__________________________________________________________________________________________________

                                                                           (Full name, position)

Representative

labor collective __________________________________________________________________________________________

                                                                           (Full name, position)

1. Number of persons employed of the organization (company), shop:

 

only,

 

including women

 

 

2. Number of persons employed of the organization (company), the shop working with hazardous and (or) dangerous substances and production factors, and also on rabotakh*:

 

only,

 

including women

 

 

3. Number of persons employed, subject to periodic medical examination (inspection), working in contact with hazardous and (or) dangerous substances and production factors, and also at works * in this year:

 

only,

 

including women

 

 

4. Number of persons employed, had periodic medical examination (inspections):

 

only,

 

including women

 

 

5. scope % periodic medical examinations:

 

only,

 

including women

 

 

6. Number of persons employed, not finished periodic medical examination (inspections):

 

only,

 

including women

 

 

The list of names of the workers who did not finish periodic medical examination (inspections):

 

Surname, name, middle name

Division of the company

 

 

 

 

 

 

 

7. Number of persons employed, not had periodic medical examination (inspection):

 

only,

 

including women

 

including for the reasons from total number:

 

sick leave note

 

business trip

 

next leave

 

dismissal

 

refusal of passing

 

 

The list of names of the workers who did not have periodic medical examination (inspection):

 

Surname, name, middle name

Division of the company

Reason

 

 

 

 

 

 

 

 

 

 

 

 

 

8. The conclusion by results of this periodic medical examination (inspection)

Summary table No. 1:

Results of periodic medical examination (inspection)

In total

Including women

1

2

3

Number of persons professional suitable for work with hazardous and (or) dangerous substances and production factors, to work types *

 

 

Number of persons temporarily professional unsuitable to work with hazardous and (or) dangerous substances and production factors, to work types *

 

 

Number of persons constantly professional unsuitable to work with hazardous and (or) dangerous substances and production factors, to work types *

 

 

Number of faces of persons in need in additional examination (the conclusion is not drawn)

 

 

Number of persons with suspicion of occupational disease

 

 

Number of persons needing inspection in the center of professional pathology

 

 

Number of persons needing out-patient inspection and treatment

 

 

Number of persons needing stationary inspection and treatment:

 

 

Number of persons needing sanatorium treatment

 

 

Number of persons needing treatment-and-prophylactic food

 

 

Number of persons needing dispensary observation

 

 

Summary table No. 2:

F.I.O.

Floor

Year of birth

Site

Profession

Hazardous and (or) dangerous substances and production factors, work types **

Length of service with hazardous and (or) dangerous substances and production factors, work types

Disease class on MKB-10, group of dispensary

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