home Business List of harmful factors during medical examination order 302. List of harmful and dangerous production factors by profession - order on medical examinations

List of harmful factors during medical examination order 302. List of harmful and dangerous production factors by profession - order on medical examinations

The organization of medical examinations is the prerogative of the employer. Employees of the enterprise or an employee who is only hired do not need to search for a medical examination medical institution and find money for it. The personnel department of any company is responsible for the timeliness of the implementation of this measure and must correctly draw up the relevant documents and monitor compliance with the requirements of the law. We will figure out according to which order of the Russian Federation mandatory medical examinations are carried out , And what documents do they need to be supported by?

Order 302 for medical examinations: for whom they are required

According to Art. 76 of the Labor Code of the Russian Federation, an employee who has not passed a mandatory medical examination is suspended from work. However, this does not mean that all employees without exception should be examined, because we are talking for mandatory inspection. By order of the Ministry of Health and Social Development of the Russian Federation of April 12, 2011 No. 302-n, a list of hazardous and hazardous work and production factors, the implementation of which is accompanied by mandatory periodic medical examinations. The same act defines the procedure for conducting medical examinations.

age group up to 21 years;
employed in hazardous industries, heavy and dangerous work;
related to traffic, incl. railway;
working in the energy and construction industries;
departmental security;
enterprises Food Industry, trade and catering;
medical and children's institutions;
employees of water conduits and water supply facilities;
professional athletes.

Medical examination by order 302-n can be preliminary (i.e., when applying for a job), periodic or extraordinary. Any type of inspection is organized at the expense of the employer. Surveys are carried out on a reimbursable basis by medical institutions with which companies enter into appropriate agreements. We should remember that medical examinations of workers (order 302-n speaks directly about this) are carried out by medical organizations of any form of ownership that have a license to conduct them, as well as examinations of professional suitability. Mandatory details of such contracts are:

thing;
information on the availability of a license to conduct medical activities;
list of paid medical services;
conditions, cost and terms of their implementation;
calculation procedure.

Stages of personnel work to implement the requirements of order 302-n

Personnel officers are guided by Appendix No. 3, which determines the conduct of a medical examination by order of 302-n. Having concluded an agreement with a medical institution, the personnel service is obliged to establish an internal procedure for sending employees for medical examinations:

issue an appropriate order (sample) and familiarize employees with it against signature;

draw up a list of employees by order 302-n (sample below) who must be sent for a medical examination. It is issued in 2 copies - for a medical institution and a department of Rospotrebnadzor. The list determines the full name of employees for whom a medical examination is mandatory, lists professions and positions, indicates a harmful production factor and the workshop or unit where the employee works. The document is approved by the head and submitted to the RPN within 10 days, and to the medical institution 2 months before the agreed date of the medical examination.

Sample list for a medical examination by order 302-n:

Having received a list of the contingent by order 302-n, the medical organization develops a calendar plan periodic inspections, coordinates it with the management of the company, approves and submits to the company no later than 14 days before the agreed date;

issue a form for a medical examination by order 302-n, i.e. referral to a medical facility. 10 days before the agreed date for the start of the medical examination, the employee of the enterprise must be familiarized with calendar plan and hand him (against signature), following Order 302 of the Ministry of Health, a referral for a medical examination. The company develops the form of the document independently, since the law does not provide for unified forms. Sample referral for a medical examination by order 302-n:

Personnel officers register in the register each referral issued to employees for medical checkup according to order 302-n. The form of the journal is also developed at the enterprise, approved by the management and used to control the passage of medical examinations by employees.

The results of the examination at the health facility are recorded in the outpatient card stored in the clinic. The results of the examination of the employee, i.e., the medical report, is recorded in a special document - the form of the final act by order 302-n - the employee's health passport, which is given to him in his hands. If this document already exists, then new entries are made in it and returned to the owner. In addition, the employee is issued a certificate by order 302-n for transfer to the employer. It contains the conclusion of the medical board, indicating professional suitability, and is certified by doctors' signatures, stamps and the seal of the medical institution. Sample certificate form 302-n:

Periodic medical examination

Order 302 involves passing medical examinations, passing tests. To issue a certificate by order 302, the conclusions of a therapist, surgeon, ENT specialist, ophthalmologist, narcologist and psychiatrist are usually required, as well as blood tests and fluorography. This is a general set, which is adjusted by the addition or exclusion of specialized specialists, detailed blood tests, etc., depending on the characteristics of the industry or profession. It is important to know that a certificate issued for the first time can and should subsequently be extended in accordance with the established frequency.

Employee health passport by order 302-n: form

This is form No. 004-P / U, relating to medical documentation, which is issued to each person who has passed a medical examination, and consists of a general and effective parts. The general information contains information about the employee who applied, the company that sent him for examination, working conditions and influencing factors, as well as work experience. This information is filled in by the personnel officer of the company, and the number of the document is assigned already in the health facility. The date when the medical examination ends is also indicated there. One health passport is issued for each person. For greater clarity, we present the form of the document.

Upon hiring, within labor activity, as well as extraordinary, depending on the state of health. Such workers, in particular, include workers who work in jobs with harmful or hazardous conditions labor. They undergo mandatory medical examinations when applying for a job and periodic medical examinations to determine their state of health. This is necessary to understand whether the employee can perform his job duties, as well as to timely diagnose the occurrence of occupational diseases.

Harmful and dangerous production factors

Order No. 302n regulates the procedure for conducting inspections and their frequency. However, the list of harmful and dangerous factors, when working with which it is necessary to undergo examinations, are also approved by this order of the Ministry of Health and Social Development of Russia, adopted on 04/12/2011.

Harmful factors by order No. 302n

It is the responsibility of the employer to organize a pre-employment medical examination or a scheduled examination of employees during their working life. Harmful production factors in order 302n, which make certain types of activities harmful and even hazardous to health, are contained in Appendix 1. The list of factors is presented in the form of a table divided into several columns:

p / p number;
a group of substances that are harmful to health;
frequency of medical examination;
specialists who take part in the inspection;
medical procedures and examinations that employees need to undergo;
additional medical contraindications.

Appendix 2 approved the directory of factors of order 302n by profession. It is also designed as a table with five columns:

activity, profession in which it is necessary to undergo an examination;
the frequency of medical examinations;
doctors who take part in the examination;
studies and procedures to be completed;
additional contraindications.

The table of harmful factors by profession in order 302n is very detailed. Harmful factors are divided into chemical (among them are allergens, carcinogens, natural asbestos, clay and cement, etc.); biological factors including compound feed, biological toxins (animal or plant poisons), etc.; physical factors such as different kinds radiation, industrial noise, etc., as well as factors labor process in particular various overloads.

For each factor, it is prescribed how often and which medical specialists should conduct a medical examination of workers who have to work in harmful or dangerous conditions in accordance with the listed factors.

The table of order No. 302n with harmful production factors by profession from Appendix 1 can be downloaded below.

1) Visual acuity with correction below 0.6 in the best eye, below 0.2 - in the worst. Permissible correction for myopia and hyperopia 8.0 D, including contact lenses, astigmatism - 3.0 D (the sum of the sphere and cylinder should not exceed 8.0 D). The difference in the power of the lenses of the two eyes should not exceed 3.0 D.

2) Lack of vision in one eye with visual acuity below 0.8 (without correction) in the other.

3) Central scotoma absolute or relative (with scotoma and the presence of changes in visual function not lower than the values specified in paragraph 1 of this column of the subparagraph - tolerance without restrictions).

4) Condition after refractive operations on the cornea (keratotomy, keratomileusis, keratocoagulation, refractive keratoplasty). A person is allowed to drive 3 months after the operation with visual acuity with a correction of at least 0.6 per best eye, not lower than 0.2 - at worst.

5) Permissible correction for myopia and hyperopia 8.0 D, including contact lenses, astigmatism - 3.0 D (the sum of the sphere and the cylinder should not exceed 8.0 D). The difference in the power of the lenses of the two eyes should not exceed 3.0 D, in the absence of complications and the initial (before surgery) refraction - from +8.0 to -8.0 D. eyes from 21.5 to 27.0 mm.

6) An artificial lens, at least in one eye. Experienced drivers are allowed with visual acuity with a correction of at least 0.6 in the best eye, not lower than 0.2 in the worst. Permissible correction for myopia and hyperopia 8.0 D, including contact lenses, astigmatism - 3.0 D (the sum of the sphere and cylinder should not exceed 8.0 D). The difference in the power of the lenses of the two eyes should not exceed 3.0 D, a normal field of vision and no complications within six months after surgery.

7) Chronic diseases of the membranes of the eye, accompanied by a significant impairment of the function of vision, persistent changes in the eyelids, including their mucous membranes, paresis of the muscles of the eyelids that impede vision or limit the movement of the eyeball (after surgical treatment with a positive result, admission is carried out individually).

8) Chronic, not amenable to conservative treatment, inflammation of the lacrimal sac, as well as persistent, untreated lacrimation.

9) Paralytic strabismus and other disorders of the friendly movement of the eyes.

10) Persistent diplopia due to strabismus of any etiology.

11) Spontaneous nystagmus when the pupils deviate 70 ° from the average position.

12) Restriction of the field of view by more than 20° in any of the meridians.

13) Violation of color perception.

14) Diseases of the retina and optic nerve (retinitis pigmentosa, optic nerve atrophy, retinal detachment, etc.).

15) Glaucoma.

16) Absence of one upper or lower limb, hand or foot, as well as deformity of the hand or foot, significantly hindering their movement. As an exception, persons with one amputated lower leg may be allowed if the amputation stump is at least 1/3 of the lower leg and the mobility in the knee joint of the amputated limb is fully preserved.

17) Absence of fingers or phalanges, as well as immobility in the interphalangeal joints:

the absence of two phalanges of the thumb on the right or left hand;

absence or immobility of two or more fingers on the right hand or complete reduction of at least one finger;

the absence or immobility of three or more fingers on the left hand or the complete reduction of at least one finger (while maintaining the grasping function and strength of the hand, the issue of access to control is decided individually).

18) Shortening of the lower limb by more than 6 cm - examined can be considered fit if the limb has no defects in bones, soft tissues and joints, the range of motion is preserved, the length of the limb is more than 75 cm (from the calcaneus to the middle of the greater trochanter of the thigh) .

19) Absence of an upper limb or hand, absence of a lower limb at any level of the thigh or lower leg in case of impaired mobility in the knee joint.

20) Traumatic deformities and defects of the skull bones with severe neurological symptoms that impede control vehicles. In the presence of minor neurological symptoms, admission is carried out individually with a re-examination after one year.

21) Complete deafness in one ear (hearing acuity: colloquial speech in the other ear less than 3 m, whisper speech less than 1 m, or colloquial speech in each ear less than 2 m per year), with the exception of the absence of hearing, severe and severe hearing impairment (deafness and III, IV degree of hearing loss))

22) Chronic unilateral or bilateral purulent inflammation of the middle ear, complicated by cholesteatoma, granulations or polyps (epithympanitis). The presence of a fistula symptom (after surgical treatment with a good result, the issue is resolved individually).

23) Chronic purulent mastoiditis, complications due to mastoidectomy (cyst, fistula).

24) Diseases of any etiology that cause dysfunction of the vestibular analyzer, dizziness syndromes, nystagmus (Ménière's disease, labyrinthitis, vestibular crises of any etiology, etc.).

25) Diseases of the endocrine system of a progressive course with persistent, pronounced dysfunctions of other organs and systems (permission to drive is decided individually, subject to annual re-examination after examination and treatment by an endocrinologist).

26) Ischemic heart disease: unstable angina, exertional angina, grade III FC, high-grade cardiac arrhythmias or a combination of these conditions (permission to drive is decided individually, subject to annual re-examination after examination and treatment by a cardiologist).

27) Hypertension stage III, grade 3, risk IV (permission to drive is decided individually, subject to annual re-examination based on the results of treatment and the recommendations of a cardiologist).

28) Diseases of the bronchopulmonary system with symptoms of respiratory failure or pulmonary heart failure 2-3 tbsp. (Admission to driving is decided individually after examination and treatment by a pulmonologist).

29) Prolapse of the uterus and vagina, retrovaginal and vesico-vaginal fistulas, ruptures of the perineum with violation of the integrity of the sphincters of the rectum, dropsy of the testicle or spermatic cord, hernia and other diseases that cause restrictions and pain in movements that prevent driving.

In accordance with Art. 212 of the Labor Code of the Russian Federation, the employer is obliged to provide his subordinates with safe working conditions. He is also obliged to comply with all labor protection standards - this is a vast and rather complex area in Russian legislation. Occupational safety measures include, among other things, medical examinations of employees. It is regulated by the Order of the Ministry of Health and Social Development on mandatory medical examinations, effective from January 1, 2012.

At the time of entry into force, this act caused a lot of controversy and discussion, and I must say that they still do not stop. The provisions of the document cover a huge list of professions and jobs, so not only OHS inspectors need to study them. We will tell you what the main provisions are contained in order 302n dated 04/12/11 of the Ministry of Health and Social Development (as amended in 2018-2019). Its full text in current edition can be downloaded at the end of the article.

Order 302n - general information

Article 213 of the Labor Code of the Russian Federation requires regular medical examinations of workers employed in hazardous industries. The purpose of the events is to establish fitness for the profession, early detection of health problems among employees and prevention of the spread of infectious diseases.

In fact, the circle of workers who must undergo a medical examination (and not only in the course of work, but also at the time of employment) is much wider. The fact is that the harmfulness of working conditions determines the SOUT ( special assessment working conditions). And if it has not been carried out or its validity period has expired, then all jobs in an organization that has not passed the SOUT are considered "harmful".

The costs of medical services - tests, diagnostics and other procedures - are borne by the employer. It is the duty of the employees to pass the examination. Refused the federal law No. 52-FZ "On the sanitary and epidemiological well-being of the population" of March 30, 1999 prohibits admission to work (clause 4 of article 34).

The factors determining the need for medical examinations are called by the order of the Ministry of Health and Social Development 302n dated April 12, 2011 “On approval of the lists of harmful and (or) dangerous production factors and work, during which mandatory preliminary and periodic medical examinations (examinations) are carried out, and the procedure for conducting mandatory preliminary and periodic medical inspections (surveys) of employees employed in hard work and at work with harmful and (or) dangerous working conditions.

It consists of three applications:

the first lists potential hazards;
the content of the second - types of work that can be performed only with the permission of medical specialists;
the third dictates the procedure for organizing medical examinations, provides samples of referrals, a medical report and explains how to fill them out.

This order came into force shortly before the dissolution of the Ministry of Health and Social Development. Since then, it has been adjusted several times - already by orders of the Ministry of Health, which was separated from the reorganized Ministry.

The current version contains amendments to the first two sections (by order No. 801n dated December 5, 2014, the lists of harmful factors and contraindications were changed), as well as changes made to paragraph 20 of Appendix No. 2 "Names of work and professions" by orders of the Ministry of Labor No. 62n, Ministry of Health 49n February 6, 2018 and effective from March 16, 2018.

Annex 1. Harmful and dangerous factors

The first appendix, compiled in the form of a table, indicates the circumstances-grounds for conducting mandatory medical examinations. Adverse factors divided into four groups:

chemical - substances and mixtures, allergens, carcinogens, etc.;
biological - hepatitis B and C viruses, poisons of animals, plants, etc.;
physical - radiation, radioactive substances, noise from technological equipment(included in 2015 by order of the Ministry of Health No. 801n), etc.;
factors of the labor process - physical and sensory loads, etc.

For most factors, the degree of threat to human health is determined by a special assessment of working conditions (SAUT).

Other columns of the table contain information:

how often medical examinations are carried out;
which doctors of narrow specialties need to be examined;
about the tests and procedures necessary for the delivery and passage;
on medical contraindications for work requiring contact with these factors.

For example, an employee of an enterprise working with inorganic nitrogen compounds (paragraph 1.2.1) needs to be examined by an otolaryngologist and dermatovenereologist once every two years. Among the mandatory procedures is the study of the function of external respiration and analysis for reticulocytes and the level of methemoglobin. Applicants with chronic diseases of the bronchi and lungs cannot apply for a position involving contact with ammonia - order 302n (as amended in 2018-2019) on medical examinations prohibits them from being employed.

Annex 2. Harmful and dangerous working conditions

The following appendix lists the types of work for which medical examinations are prescribed:

conducted in the Far North and other territories with a harsh climate, in uninhabited, remote places, located far from settlements with medical institutions oil rigs, drilling rigs, exploration and hydrometeorological stations, etc.;
associated with the danger of a natural and man-made nature - the prevention and elimination of accidents, emergencies, gas and oil fountains in the fields;
associated with risk and requiring special physical training - at height, under water, underground; in the collection service, paramilitary security, etc.;
involving direct contact with a large number of people - in medical and educational institutions, including preschool, school and other areas of trade and Catering, household and transport services;
involving contact with food products (food industry, food warehouses, distribution points, as well as transportation of such products);
on the industrial production(associated with welding, machine tools, pressure vessels, etc.);
associated with driving vehicles (from a crane operator to a driver and even an elevator operator).

The second appendix of the document numbered 302n (order of the Ministry of Health on professional examinations with changes for 2018-2019) explains in the same detail as the first one how often an employee should visit specific specialist doctors. So, paramilitary guards, in order to confirm their suitability for further service, need to undergo a medical examination once a year. Signatures in the medical report must be put by a neurologist, ophthalmologist, otolaryngologist, dermatovenereologist and surgeon. If problems with hearing, vision and diseases are identified, which are listed by order 302n dated 12.04.11 Appendix 2 in paragraph 7, the guard will not be able to continue working.

In addition, there is a list of general studies that, in without fail each person undergoing a medical examination passes. This is general analysis blood and urine, ECG, fluorography, blood test for glucose, cholesterol. Mandatory visits to a therapist, psychiatrist and narcologist have been established.

For women, an additional appointment with a gynecologist is mandatory (with a bacteriological and cytological analysis, and for women over 40, also mammography (or ultrasound) every 2 years).

Annex 3. The procedure for conducting medical examinations

Order No. 302n regulates the organization of two types of medical examinations:

preliminary (at the stage of employment of future employees);
periodic (regularly among existing employees).

For a preliminary medical examination, the employer must issue a referral to the applicant for vacant position. to the periodic personnel services you need to prepare in advance:

make a list of employees indicating their full names, positions, the nature of the work they perform;
provide it to the medical institution with which the contract is concluded. Order 302n (as amended in 2018-2019) on medical examinations requires that the list be submitted no later than two months before the start of procedures;
after the approval of the list, send it to the sanitary and epidemiological supervision within 10 days;
familiarize employees with the schedule of medical examinations at least 10 days before the event;
give them directions.

The conclusion on the examination passed is issued by a commission headed by an occupational pathologist. Based on the recommendations of doctors, extraordinary examinations may also be prescribed.

Responsibility

For failure to comply with the requirements of Article 213 of the Labor Code of the Russian Federation and the order of the Ministry of Health on examinations for professional suitability, a fine is threatened (Part 3 of Article 5.27.1 of the Code of Administrative Offenses of the Russian Federation):

from 15,000 to 25,000 rubles - for officials and IP;
from 110,000 to 130,000 rubles - for legal entities.

At the same time, liability may arise even for untimely medical examinations. office workers, which confirms the decision Supreme Court No. 34-AD17-5 dated December 6, 2017, which found justified a fine of 120,000 rubles imposed on a Murmansk company selling cars and spare parts. The above argument that the employees who did not pass the medical examination - specialists performing analytical work, was considered by the highest judicial body of Russia to be untenable: studying the materials of the case, the Supreme Court of the Russian Federation came to the conclusion that all employees of trade organizations should regularly take medical tests and be examined by doctors.

;
III. PROCEDURE FOR PERIODIC INSPECTIONS (P.P. 15 - 47);
IV. MEDICAL CONTRAINDICATIONS FOR ADMISSION TO WORK (P.P. 48 - 49);

Preliminary and periodic medical examinations: affordable prices at the "Clinic of Occupational Medicine" in Moscow

An obligatory condition for the interaction between employers and employees is the organization by the enterprise of preliminary and periodic medical examinations for personnel. The difference between these types of professional examination according to the provisions of Order 302n is that a preliminary examination is carried out upon admission to work and can be carried out on an individual basis.

At the same time, periodic medical examinations are aimed at a dynamic study of the health status of personnel, early detection of occupational diseases, as well as symptoms / pathologies that are incompatible with working conditions. This examination may be carried out collectively.

According to the Order of the Ministry of Health and Social Development 302n dated April 12, 2011, periodic examinations must be carried out at least once a year. Moreover, if there are no hazardous production factors at the enterprise, an examination of employees can be organized in any medical institution that has a license to carry out this type of activity.

Order of the Ministry of Health and Social Development of Russia 302n dated April 12, 2011 also determines the procedure for organizing professional examinations at enterprises where factors harmful and dangerous for specialists are observed. The personnel of such companies for at least 5 years must be examined in specialized centers occupational pathologies or medical institutions licensed for the examination of aptitude.

The preparation of lists for periodic medical examinations, as well as the approval of their calendar plan, is carried out by the employer together with the medical organization. By contacting our clinic, you can arrange a medical examination at any convenient time. affordable price.

Registration of a driver's medical certificate and EEG

The procedure for obtaining a driver's license or opening a new category changes regularly. However, for some categories, in particular:

C, C1, CE, C1E;
D, D1, DE, D1E;
Tm, Tb,

A prerequisite is the passage of the electroencephalogram of the brain.

If you have a question: “Where can I get a daily EEG in Moscow at an affordable price?” Our clinic offers to sign up for diagnostics. Here you can get fast and inexpensive results of the daily electroencephalogram.

ORDER 302 N dated April 12, 2011 OF THE MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION (MINISTRY OF HEALTH AND DEVELOPMENT OF RUSSIA) MOSCOW

"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 from dated May 15, 2013 N 296n.

Published: October 28, 2011 at"RG" - Federal issue No. 5619
Effective: November 8, 2011

Registered with the Ministry of Justice of the Russian Federation on October 21, 2011.Registration N 22111

According to article 213 Labor Code Russian Federation(Sobraniye zakonodatelstva Rossiyskoy Federatsii, 2002, N 1 (part 1), art. Z; 2004, N 35, art. 3607; 2006, N 27, art. 2878; 2008, N 30 (part 2), art. 3616) and paragraph 5.2.100.55 of the Regulation on the Ministry of Health and social development of the Russian Federation, approved by Decree of the Government of the Russian Federation of June 30, 2004 N 321 (Collected Legislation of the Russian Federation, 2004, N 28, Art. 2898; 2009, N 3; Art. 378), I order:

1. Approve:

a list of harmful and (or) hazardous production factors, in the presence of which mandatory preliminary and periodic medical examinations (examinations) are carried out, in accordance with Appendix No. 1;

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 No. 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, a document in state registration does not need, letter dated December 30, 1996 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, 12 (with the exception of subparagraphs 12.2, 12.11, 12.12), 13 of Appendix N 2 to the order of the Ministry of Health of the USSR of September 29, 1989 N 555 "O" do not apply on the territory of the Russian Federation improvement of the system of medical examinations of workers and drivers of individual vehicles.

Minister

T. Golikova

ORDER MINISTRIES OF HEALTH OF THE RUSSIAN FEDERATIONdated May 15, 2013 N 296 n

"On amendments to Appendix No. 2 to Order No. 302 n dated April 12, 2011. Ministry of Health and Social Development of the Russian Federation "On Approval of the Lists of Harmful and (or) Hazardous Production Factors and Works, in the Performance of which Mandatory Preliminary and Periodic Medical Examinations (Examinations) Are Conducted, and the Procedure for Mandatory Preliminary and Periodic Medical Examinations (Examinations) of Employees, employed in heavy work and in work with harmful and (or) dangerous working conditions"

Registered with the Ministry of Justice of Russia on July 3, 2013. Registration N 28970

I order:

Amend Appendix No. 2 to Order No. 302n of April 12, 2011 of the Ministry of Health and Social Development of the Russian Federation "On Approval of Lists of Harmful and (or) Hazardous Production Factors and Works, During the Performance of Which Mandatory Preliminary and Periodic Medical Examinations (Examinations) Are Conducted ), and the Procedure for Conducting Mandatory Preliminary and Periodic Medical Examinations (Examinations) of Employees Engaged in Heavy Work and Work with Harmful and (or) Dangerous Working Conditions" (registered by the Ministry of Justice of the Russian Federation on October 21, 2011, registration N 22111) according to application.

Minister

V.I. Skvortsova

Paragraph 19 shall be stated in the following wording:

19. Works in children and adolescents

seasonal wellness

organizations

1 time per year

Dermatovenereologist,

Otorhinolaryngologist,

*Infectionist

Fluorography of the lungs
Blood test for
syphilis
smears for gonorrhea
upon admission to
work
Research on
carriage
intestinal pathogens
infections and
serological
examination for
typhoid fever in
applying for a job
and further on
epidemiological indications
Research on
helminthiases with
applying for a job
and in the future - not
less than once a year
either by
epidemiological indications

Diseases and bacterial carriage:
1) typhoid fever, paratyphoid,
salmonellosis, dysentery;
2) helminthiases;
3) syphilis in the infectious period;
4) leprosy;
5) contagious skin diseases:
scabies, trichophytosis, microsporia,
scab, actinomycosis with ulceration
or fistulas on exposed parts of the body;
6) infectious and destructive forms
pulmonary tuberculosis, extrapulmonary
tuberculosis with fistulas,
bacteriuria, lupus erythematosus
face and hands;
7) gonorrhea (all forms) for a period
treatment with antibiotics
and getting negative results
first control;
8) ozena

Application No. 3
to the Order of the Ministry
health and social
development of the Russian Federation
dated April 12, 2011 No. 302 n

PROCEDURE FOR COMPULSORY PRELIMINARY (WHEN ENTRY TO WORK) AND PERIODIC MEDICAL EXAMINATIONS (EXAMINATIONS) FOR EMPLOYEES ENGAGED IN HARD WORK AND WORK WITH HARMFUL AND (OR) DANGEROUS LABOR CONDITIONS

I. General provisions

1. 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 (hereinafter referred to as the Procedure), establishes the rules for conducting mandatory preliminary (when employment) and periodic medical examinations (examinations) of persons employed in heavy work and in work with harmful and (or) dangerous working conditions (including underground work), in work related to traffic, as well as in work , during which it is mandatory to conduct preliminary and periodic medical examinations (examinations) in order to protect public health, prevent the occurrence and spread of diseases 1 .

2. Mandatory preliminary medical examinations (examinations) upon admission to work (hereinafter referred to as preliminary examinations) 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.

4. 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 (hereinafter referred to as medical organizations).

5. To conduct a preliminary or periodic examination by a medical organization, a permanent medical commission is formed.

Part medical commission includes an occupational pathologist, as well as specialist doctors who have completed in due course advanced training in the specialty "occupational pathology" or having a valid certificate in the specialty "occupational pathology".

The medical commission is headed by an occupational pathologist.

The composition of the medical commission is approved by order (instruction) of the head medical organization.

6. Responsibilities for organizing preliminary and periodic examinations of employees are assigned to the employer 2 .

Responsibility for the quality of preliminary and periodic examinations of employees rests with the medical organization.

II. The procedure for conducting preliminary inspections

7. Preliminary examinations are carried out upon admission to work on the basis of a referral for a medical examination (hereinafter referred to as the referral) issued to the person applying for work by the employer.

8. The direction is filled out on the basis of the list of contingents approved by the employer and it indicates:

the name of the employer;
type of medical examination (preliminary or periodic),
surname, name, patronymic of the person entering the work (employee);
date of birth of the person entering the work (employee);
Name structural unit employer (if any), in which the person entering the work will be employed (employed employee);
the name of the position (profession) or type of work;
harmful and (or) dangerous production factors, as well as the type of work in accordance with the contingent of employees approved by the employer, subject to preliminary (periodic) examinations.

The direction is signed by an authorized representative of the employer indicating his position, surname, initials.

The direction is issued to the person entering the work (employee), against signature.

The employer (his representative) is obliged to organize the registration of issued referrals.

9. To undergo a preliminary examination, a person entering a job submits the following documents to a medical organization:

direction;
passport (or other document of the established form proving his identity);
employee health passport (if available);
the decision of the medical commission that conducted the mandatory psychiatric examination (in cases provided for by the legislation of the Russian Federation).

10. For a person undergoing a preliminary examination, the following are issued in a medical organization:

10.1 outpatient medical record (registration form No. 025/u-04, approved by order of the Ministry of Health and Social Development of Russia dated November 22, 2004 No. 255) (registered by the Ministry of Justice of Russia on December 14, 2004 No. 6188) (hereinafter referred to as the medical record), which reflects conclusions of medical specialists, results of laboratory and instrumental studies, conclusions based on the results of a preliminary or periodic medical examination.

The medical record is kept in accordance with the established procedure in a medical organization;

the name of the medical organization, the actual address of its location and the OGRN code;
last name, first name, patronymic, date of birth, gender, passport data (series, number, issued by whom, date of issue), address of registration at the place of residence (stay), telephone number, number of the compulsory medical insurance policy of the person entering work (employee);
the name of the employer;
form of ownership and type economic activity employer according to OKVED;
the name of the structural subdivision of the employer (if any), in which the person entering the work will be employed (the employee is employed), the name of the position (profession) or type of work;
the name of the harmful production factor and (or) type of work (indicating the class and subclass of working conditions) and the length of contact with them;
the name of the medical organization to which the employee is assigned for permanent monitoring (name, actual location address);
conclusions of medical specialists who took part in the preliminary or periodic medical examination of the employee, the results of laboratory and instrumental studies, the conclusion on the results of the preliminary or periodic medical examination.

Each health passport is assigned a number and the date it was completed.

One health passport is maintained for each employee.

For persons attached to the FMBA of Russia for medical care, an employee's health passport is not issued.

During the examination, the health passport is kept in a medical organization. Upon completion of the examination, the health passport is issued to the employee in his hands.

If an employee loses a health passport, the medical organization, at the request of the employee, issues a duplicate of the health passport to him.

11. The preliminary examination is completed in the case of examination of the person entering the work, all medical specialists, as well as the completion of the full scope of laboratory and functional research provided by the List of harmful and (or) dangerous production factors, in the presence of which mandatory preliminary and periodic medical examinations (examinations) of factors are carried out (Appendix No. medical examinations (examinations) of employees (Appendix No. 2 to the order) (hereinafter - the List of Works).

12. Upon completion of the preliminary examination by a person entering the job, a medical organization draws up a conclusion based on the results of a preliminary (periodic) medical examination (hereinafter referred to as the Conclusion).

13. The conclusion states:

date of issue of the Conclusion;
surname, name, patronymic, date of birth, gender of the person entering the work (employee);
the name of the employer;
the name of the structural unit of the employer (if any), position (profession) or type of work;
name of the harmful production factor(s) and (or) type of work;
the result of a medical examination (medical contraindications identified, not identified).

The conclusion is signed by the chairman of the medical commission indicating the surname and initials and certified by the seal of the medical organization that conducted the medical examination.

14. The conclusion is drawn up in two copies, one of which, based on the results of the medical examination, immediately after the completion of the examination, is issued to the person entering the job, or who has completed the periodic medical examination, in his hands, and the second is attached to the medical record of the outpatient.

III. The procedure for conducting periodic inspections

15. The frequency of periodic inspections is determined by the types of harmful and (or) dangerous production factors affecting the employee, or the types of work performed.

16. Periodic inspections are carried out at least within the time periods specified in the List of Factors and the List of Works.

17. Employees under the age of 21 undergo periodic examinations annually.

18. Extraordinary medical examinations (examinations) are carried out on the basis of medical recommendations specified in the final act, drawn up in accordance with paragraph 43 of this Procedure.

19. Periodic inspections are carried out on the basis of lists of names developed on the basis of contingents of workers subject to periodic and (or) preliminary inspections (hereinafter - lists of names) indicating harmful (dangerous) production factors, as well as the type of work in accordance with the List of factors and the List works.

The following employees are subject to inclusion in the contingent lists and name lists:

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 3 . As a source of information about the presence of harmful production factors at workplaces, in addition to the results of attestation of workplaces for working conditions, the results of laboratory research and testing obtained as part of control and supervision activities, production laboratory control, as well as operational, technological and other documentation for machines, mechanisms, equipment, raw materials and materials used by the employer in the implementation of production activities;
performing the work provided for by the List of Works.

20. The list of the contingent of employees subject to preliminary and periodic medical examination shall indicate:

the name of the profession (position) of the employee according to the staffing table;
the name of a harmful production factor according to the List of factors, as well as harmful production factors established as a result of certification of workplaces for working conditions, as a result of laboratory research and tests obtained as part of control and supervision activities, production laboratory control, as well as using operational, technological and other documentation for machines, mechanisms, equipment, raw materials and materials used by the employer in the course of production activities.

21. The list of the contingent, developed and approved by the employer, is sent within 10 days to the territorial body of the federal executive body authorized to carry out federal state sanitary and epidemiological supervision at the actual location of the employer.

22. Name lists are compiled on the basis of the approved list of the contingent of employees subject to preliminary and periodic medical examination, which indicates:

surname, name, patronymic, profession (position) of the employee subject to periodic medical examination;
the name of the harmful production factor or type of work;
name of the structural unit of the employer (if any).

23. Name lists are compiled and approved by the employer (his authorized representative) and no later than 2 months before the start date of the periodic examination agreed with the medical organization, they are sent by the employer to the specified medical organization.

24. Before conducting a periodic examination, the employer (his authorized representative) is obliged to hand over to the person sent for a periodic examination a referral for a periodic medical examination, drawn up in accordance with paragraph 8 of this Procedure.

25. 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 examination agreed with the employer), on the basis of the specified list of names, draws up a calendar plan for conducting a periodic examination (hereinafter - the schedule ).

The calendar plan is coordinated by the medical organization with the employer (his representative) and approved by the head of the medical organization.

26. The employer, no later than 10 days before the start date of the periodic examination agreed with the medical organization, is obliged to familiarize the employees subject to periodic examination with the calendar plan.

27. The medical commission of a medical organization on the basis of those indicated in name list, harmful production factors or work determines the need for participation in preliminary and periodic examinations of the relevant specialist doctors, as well as the types and volumes of necessary laboratory and functional studies.

28. To undergo a periodic examination, the employee is obliged to arrive at the medical organization on the day established by the calendar plan and present the documents specified in paragraph 10 of this Procedure at the medical organization.

29. For an employee undergoing a periodic examination, the medical organization draws up the documents established by paragraph 10 of this Procedure (if not available).

30. Periodic examination is completed in case of examination of the employee by all medical specialists, as well as the completion of the full scope of laboratory and functional studies provided for in the List of Factors or the List of Works.

31. Upon completion of the employee's periodic examination by a medical organization, a medical report is issued in the manner prescribed by paragraphs 12 and 13 of this Procedure.

32. Based on the results of the periodic examination in accordance with the established procedure 4, the employee’s belonging to one of the dispensary groups is determined in accordance with the current regulatory legal acts, with subsequent registration in the medical record and health passport of recommendations for the prevention of diseases, including occupational diseases, and if available medical indications - for further observation, treatment and rehabilitation.

33. Data on the passage of medical examinations shall be entered into personal medical books and recorded by medical and preventive organizations of the state and municipal health care systems, as well as by bodies exercising federal state sanitary and epidemiological supervision.

34. In the event of liquidation or change of a medical organization that performs preliminary or periodic examinations, the medical record is transferred to the occupational pathology center of the constituent entity of the Russian Federation, on whose territory it is located, or in cases provided for by the legislation of the Russian Federation, to the occupational pathology centers of the FMBA of Russia, where it is stored in for 50 years.

35. The Center for Occupational Pathology, on the basis of a written request from a medical organization with which the employer has concluded an agreement for preliminary and (or) periodic examinations, transfers medical records of employees within 10 days from the date of receipt of the request from the specified medical organization. A copy of the contract for preliminary and (or) periodic inspections must be attached to the request.

36. A medical organization with which the employer has not renewed the contract for conducting preliminary and (or) periodic examinations of employees, at the written request of the employer, must transfer the medical records of employees according to the inventory to the medical organization with which the employer has currently entered into an appropriate contract.

37. Members emergencies or incidents, workers employed in work with harmful and (or) hazardous substances and production factors with a single or multiple excess of the maximum allowable concentration (MPC) or maximum allowable level (MPL) for the current factor, employees who have (had) a conclusion on a preliminary diagnosis of an occupational disease, persons with persistent consequences of accidents at work, as well as other employees, if the medical commission makes an appropriate decision, at least once every five years, undergo periodic examinations in occupational pathology centers and other medical organizations that have the right to conduct preliminary and periodic examinations , to conduct an examination of professional suitability and examination of the connection of the disease with the profession.

38. If a psychiatrist and (or) narcologist identifies persons suspected of having medical contraindications corresponding to the profile of these specialists, to be admitted to work with harmful and (or) dangerous production factors, as well as to work, during the performance of which it is necessary to carry out preliminary and periodic medical examinations (examinations) of employees, these persons, in cases provided for by the legislation of the Russian Federation, are sent for examination by a medical commission authorized by the health authority.

39. Occupational pathology centers and other medical organizations that have the right to conduct periodic examinations, to conduct an examination of professional suitability and an examination of the relationship of a disease with a profession, during a periodic examination, may involve medical organizations that have the right, in accordance with the current regulatory legal acts, to conduct preliminary and periodic examinations and examinations of professional suitability.

40. If it is suspected that an employee has an occupational disease during a periodic examination, a medical organization issues a referral to an occupational pathology center or a specialized medical organization that has the right to conduct an examination of the relationship of the disease with the profession, and also draws up and sends, in the prescribed manner, a notice of the establishment of a preliminary diagnosis of an occupational disease to the territorial body of federal executive bodies authorized to exercise state control and supervision in the field of ensuring sanitary and epidemiological well-being.

41. In cases of difficulty in determining the professional suitability of an employee due to his illness and for the purpose of examination of professional suitability, a medical organization sends an employee to an occupational pathology center or a specialized medical organization that has the right to conduct an examination of the connection of the disease with the profession and professional suitability, in accordance with the current legislation of the Russian Federation.

42. Based on the results of the examinations, the medical organization, no later than 30 days after the completion of the periodic medical examination, summarizes the results of the periodic examinations of employees 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 welfare of the population and representatives of the employer, draws up the final act.

43. The final act states:

44. The final act is approved by the chairman of the medical commission and certified by the seal of the medical organization.

45. The final act is drawn up in four copies, which are sent by the medical organization within 5 working days from the date of approval of the act to the employer, to the center of occupational pathology of the subject of the Russian Federation, the territorial body of the federal executive body authorized to exercise state control and supervision in the field of ensuring sanitary epidemiological well-being of the population.

One copy of the final act is stored in the medical organization that conducted periodic examinations for 50 years.

46. The Center for Occupational Pathology of a constituent entity of the Russian Federation summarizes and analyzes the results of periodic medical examinations of workers employed in work with harmful and (or) dangerous working conditions on the territory of this constituent entity of the Russian Federation, and no later than February 15 of the year following the reporting one, sends summarized information to Federal Center for Occupational Pathology of the Ministry of Health and Social Development of Russia and to the health management body of this constituent entity of the Russian Federation.

47. The Federal Center for Occupational Pathology of the Ministry of Health and Social Development of Russia, no later than April 1 of the year following the reporting year, submits information on the conduct of periodic examinations of workers employed in work with harmful and (or) dangerous working conditions to the Ministry of Health and Social Development of Russia.

IV. Medical contraindications for admission to work

49. Additional medical contraindications are specified in the List of factors and the List of works.

1 Article 213 of the Labor Code of the Russian Federation.

2 Article 212 of the Labor Code of the Russian Federation.

3 Order of the Ministry of Health and Social Development of Russia dated August 31, 2007 N 569 "On approval of the procedure for attestation of workplaces in terms of working conditions" (registered by the Ministry of Justice of Russia on November 29, 2007 N 10577).

4 Order of the Ministry of Health and Social Development of Russia dated February 4, 2010 N 55n (as amended on March 3, 2011) "On the procedure for additional medical examination of working citizens" (together with the "Procedure and volume of additional medical examination of working citizens") (registered by the Ministry of Justice of Russia on March 4, 2010 No. 16550).

5 In cases of pronounced forms of mood disorders, neurotic, stress-related, somatoform, behavioral and personality disorders, the issue of professional suitability for the relevant work is decided individually by a commission of specialist doctors corresponding to the profile of the disease, with the participation of a professional pathologist.

6 After the treatment, the issue is resolved individually by a commission of medical specialists, an occupational pathologist, an oncologist.

7 Only for persons working in contact with harmful and (or) dangerous production factors specified in the List of Factors.

APPENDICES TO APPENDIX No. 3 "PROCEDURE FOR CARRYING OUT ..." ORDER No. 302N OF THE MINISTRY OF HEALTH OF RUSSIA DATED 12.04.11

The applications listed below have not been registered with the Ministry of Justice of the Russian Federation and are provided for review. The reliability of the materials is confirmed by their presence in the bases of legal documents "Garant" and "Consultant Plus".

Download: "Appendix No. 1. Referral for a preliminary (periodic) medical examination (examination), form."