Preliminary medical examination: direction, order of passage

In some cases, a preliminary medical examination is a prerequisite for hiring . The conditions of its conduct are dictated by the established legislation. The purpose of the survey is to protect the health of the worker directly and of persons with whom contact occurs in the work environment.

There are cases of ignoring the rules and procedure for conducting inspections. This can happen both on the part of the employer and the employee. It is necessary to understand, in what cases and to whom it is necessary to pass a physical examination.

Types of medical examination

Preventive examinations of employees - a set of therapeutic and preventive measures taken to identify abnormalities in health status, prevent the development and spread of diseases. Depending on how often preventive medical examinations are conducted, they are classified as follows:

• Periodic;
• Preliminary;
• Extraordinary.

Each species has a specific purpose, timing, evidence, order, required documentation.

Periodic medical examination

Applicants must undergo surveys throughout the period of their work in accordance with their positions. This is done in order to confirm the professional suitability of the employee and in time to prevent or identify a developing preventive disease.

Health is a state of complete mental, physical, social and mental well-being, and not just the absence of disease. Its level varies depending on many internal and external factors. Periodic medical examination reveals the dynamics in the changes in health that arise under the influence of labor factors. Identification of problems allows to take necessary measures in the early period of pathology development.

Passage of medical examination has the following features:

1. It is carried out within the time limits established by the legislation.
2. The frequency of the conduct depends on the working conditions and factors of production.
3. Persons under 21 are examined annually.
4. It is carried out on the basis of a roll-call list formed by the administration of the enterprise, which is sent to a territorial treatment and prophylactic institution.
5. The employee receives a referral for the medical examination from the employer.
6. The employee is inspected by all necessary specialists, laboratory and clinical tests are carried out in full.
7. On the basis of the results, a final conclusion is made, which determines the professional suitability and the possibility of the employee to hold his office.

Periodicity of examinations by types of work activity

The list of works for which preventive examinations are mandatory, as well as the frequency of the examination:

• Altitude and steeple works, labor associated with cranes and elevators - every 2 years;
• Maintenance of electrical installations, commissioning and installation work - every 2 years;
• Forest protection, work with forest - every 2 years;
• Oil and gas industry, offshore drilling - every 2 years;
• Underground works - annually;
• Hydrometeorological facilities - annually;
• Work in the field of geology, topography and construction - every 2 years;
• Maintenance of pressure vessels - every 3 years;
• Engineers, employees of boiler houses, gaznadzor - every 2 years;
• Work with explosive and flammable substances - annually;
• Work in the banking, cash collection, security, other types of work related to the use of firearms - annually;
• Work with mechanized installations - every 2 years;
• Work in school-preschool, medical and preventive institutions, pharmaceutical organizations, medical industry - annually.

Extraordinary inspections

According to the legislation, each person holding a position at the enterprise has the right to an extraordinary examination in accordance with medical recommendations, during which he retains his position and salary.

Passage of a medical examination of this type does not have a fixed periodicity. Carried out in two cases:

• The initiative of the employee - he has complaints about his health related to occupational hazards or other reasons;
• The employer initiative - has a suspicion that the employee's health level has worsened due to the negative impact of working conditions or other reasons.

Based on the application of the employee or letter to the health facility, the administration of the enterprise issues an order to send for an emergency examination. The document specifies the period in which the examination will be carried out, the data on the medical and preventive institution (name, address, location of the enterprise) and the amount of the saved salary for the period of absence of the employee.

In addition, all costs for an extraordinary inspection are assigned to the employer, regardless of who initiated the treatment at the health facility.

Why do a preliminary examination?

Preliminary medical examination is conducted in order to assess the health status of the person applying for the purpose of employment, its compliance with the future occupying position, and also to identify the presence of diseases at the time of employment.

The following groups are subject to mandatory examination:

1. Underage citizens.
2. Workers, conducting preliminary medical examination of which is provided by regulatory legal acts:
   • Persons engaged in heavy and harmful work;
   • Posts related to the transport industry;
   • Employees of food production;
   • Persons working in the conditions of trade;
   • Employees of children's and treatment and prevention institutions.
3. Persons carrying out preventive medical examinations of which are provided by other legislative documents.

On the basis of state orders, lists and regulations have been approved, which are the basis for conducting a survey of employees: on harmful and dangerous substances, work and specialties, general and narrowly specialized medical contra-indications, and the procedure and rules for conducting inspections.

Direction and procedure for its compilation

To the person entering the work, the administration of the enterprise issues a referral for a physical examination. It contains the following data:

• Name of the enterprise, form of ownership and economic status;
• Data of the medical health facility, indicating its address and code for PSRN;
• What kind of inspection will be conducted;
• FULL NAME. And the date of birth of the applicant;
• The division to which the future work place belongs, what position it will occupy;
• Factors of production.

The document is confirmed by the signature of the authorized person, indicating his surname, name, patronymic and position held. The employee is given a signature, and the authorized person keeps records of issued directions.

The procedure for the survey

After receiving the referral, the employee applies to the indicated treatment and prophylactic institution. Preliminary and periodic medical examinations are supervised by a physician-therapist, who independently sums up the complex examination.

Other narrow specialists taking part in the survey:

• Oculist;
• Otorhinolaryngologist;
• The neuropathologist;
• surgeon;
• Dermatovenereologist;
• dentist;
• Infectiologist (according to indications).

From the laboratory and functional methods of examination, lung radiography, electrocardiography, a blood test for syphilis, a bacteriological smear for gonorrhea, studies on the carriage of intestinal diseases and helminthiases are performed annually.

Women are examined by a gynecologist, takes swabs for cytological and bacteriological examination, and after 40 years, breast ultrasound, mammography and mammal consultation are mandatory. Men undergo an oncological examination with a urologist with a finger examination of the rectum.

They must pass a general blood test, which specifies the level of the formed elements, hemoglobin, color index, developed leukocyte formula, ESR. Clinical analysis of urine determines the presence of sugar and protein, specific gravity, microscopy of sediment. A biochemical blood test is performed.

For all categories of people undergoing a preliminary medical examination, a medical examination by a psychiatrist and a narcologist is mandatory.

Based on the results of examinations of narrow specialists and clinical examinations, the therapist decides on the suitability, the presence or absence of systemic diseases.

Psychiatric examination

Some working conditions require a psychiatric examination, and not just an examination of a psychiatrist under normal medical examination. The survey is conducted by the following persons:

• Minors;
• The future position is connected with the conditions of increased danger (chemical production, activities related to weapons, high-altitude or underground work, employees of the transport industry);
• Teachers;
• Public catering workers;
• medical workers.

The inspection process takes place in specialized institutions licensed for such activities. The commission consists of 3 specialists. The legislation says that the medical examination of workers by a psychiatrist is voluntary, but in case of refusal to undergo an examination the administration of the enterprise has the right to refuse to employ a person.

For the purposes of the survey, specialists who are members of the commission can request additional information from the administration of the enterprise, which the employee is notified about. The decision is taken by vote and issued in writing within three days.

Based on the results of the survey, the commission has the right to recognize the employee as unfit for performing a certain type of activity (up to 5 years), but with the possibility of further re-examination.

Examination by a narcologist

Preliminary medical examination by a narcologist consists of three stages: immediate examination, psychological testing, laboratory examination of blood. Narcological examinations can identify possible signs of the disease, and if they are found, the employee is sent to a hospital for further examination.

In the absence of problems, a certificate is issued confirming the passage of the preventive examination. The document corresponds to the established pattern.

The narcologist is examined at the place of residence or in the district centers (for the villagers). The company pays for the expenses, which sent the employee for examination.

Features of the documentation

The person who will undergo a preliminary medical examination in the health facility will provide the direction received from the employer, an identity document (birth certificate, passport), a health certificate (if any), a decision on psychiatric examination (in cases prescribed by law).

Medical examination of employees requires the processing of certain documents. It:

1. Medical outpatient card - it records the data of the examination by the doctors, the results of the tests, the conclusion of the examination.
2. A health record book is issued if the employee does not yet have it. It specifies the data on the organization of the employer, the personal data of the employee, brief conclusions of doctors on examination. The sanitary book is assigned once, even if the person changes his place of work.

Conclusion on suitability

Compulsory medical examination of employees requires fixation of the final decision, according to which the employer will be able to take a specialist to work. The conclusion is as follows:

• Date of registration of the result;
• Full name, sex, date of birth of the employee;
• Information about the employer;
• Working conditions of the person, indicating the structural unit, the future position, the factors of harmfulness;
• The final result (medical contraindications were revealed or not revealed for holding a future position).

The conclusion is signed by the therapist, indicating personal data and assuring with personal seal and seal of the medical-preventive institution. The document is issued in several copies, one of which is entered in the outpatient card of the employee, and the other is issued to him in his arms.

Costs of the employer

Under the law, all costs for compulsory preliminary and periodic medical examinations are assigned to the employer. Expenditures relate to the category of those that provide normal working conditions and safety measures and are confirmed by documentary fixation.

A budgetary or private enterprise, whose employees will participate in medical examinations, enters into a contract with a medical and preventive institution that has a corresponding license. Payment goes through the stages. 30% of the cost of services are paid in advance, and the final calculation is based on the results of the survey.

Conclusion

The administration of the enterprise not only has the right, but also is obliged not to admit to work or employment of the employee who did not pass the medical examination on time without good reason. In the event of evasion from a preventive examination, the worker is suspended from the labor process without pay. A timely inspection allows not only to preserve the health of the worker, but also to prevent the development of possible diseases.