Order 302 n list of professions. List of harmful and dangerous production factors by profession - order on medical examinations

Attracting employees to employment contracts, the administration of the company is responsible for the state of their health. Therefore, it must prevent and minimize the impact of harmful conditions on the health of workers. To this end, when hiring, the employer sends employees to undergo medical examinations, and for some categories of employees, it is mandatory to periodic medical examinations. All these points are considered by Order 302n dated 04/12/11 of the Ministry of Health and Social Development with changes in 2018.

The main legislative act that regulates the procedure for employees of organizations to undergo medical examinations is Order No. 302 approved by the Ministry of Health. Its norms were adopted back in 2011. Three times the provisions of this normative act were supplemented. This happened in 2013, 2015, 2018.

This order establishes not only the basic concepts and procedures, but also the cases when a medical examination is mandatory for the company's management.

Changes and additions to the order dated April 12, 2011 No. 302n 2018

Currently, the following changes and additions to the Order of the Ministry of Health Development can be distinguished:

AT new edition the order provides for a wider list of factors that have a harmful and dangerous effect on the health of an employee, in the presence of which a periodic medical examination and other types of it are mandatory. For example, welding aerosols with manganese-containing and silicon-containing compounds are added to the factors with a chemical effect; to the factors that may have a biological effect, added large quantity allergens, infected material, as well as AIDS, hepatitis B, C viruses; the list of physical impact factors – ionizing radiation and increased gravitational overloads – has been expanded.
The list of doctors by specialization who examine employees during medical examinations has been significantly expanded. Now it has endocrinologists, dentists, allergists.
For cases where an employee is employed in jobs where there is an impact of certain factors, the list of additional contraindications (for example, exposure to electromagnetic fields) has been expanded, just like for certain jobs, for example, in geographically remote areas, when working on machines.
A new section has been introduced into the order, which defines substances and compounds that have a common chemical structure and lead to various diseases, and the list of hazardous pesticides has been expanded.

Download (as amended on 02/06/2018).

For whom a medical examination under order 302 is mandatory

The order establishes a list of employees who must undergo a medical examination.

This includes workers:

In which working conditions involve the impact of dangerous and harmful factors. These include chemical, physical, biological. A complete list of these factors is defined in Appendix No. 1 to the Order of the Ministry of Health Development 302.
Employed in the types of work listed by law. These include work underground, under water, at height, etc. They are listed in Appendix No. 2 to the Order of the Ministry of Health 302.

To assign the status of harmful or dangerous to working conditions, it is necessary. Only after the assessment, the hazard class of the factor and the need for a medical examination are established.

Important! Do not forget about the need to undergo a medical examination in accordance with the Labor Code of the Russian Federation. This regulation defines employees who must undergo a medical examination before they are allowed to work.

This includes:

Employees who have not reached the age of majority (18 years).
Entering a company where jobs are exposed to hazardous and harmful factors.
Applicants to work for a job in an organization Food Industry, public catering, trade, working at water utilities, medical and children's institutions.
When working on a watch.
Underground employees.
When you have to work in the regions of the Far North, as well as areas equated to them.

Procedure for referral for a medical examination

For the preliminary

In order for an employee to pass, a referral must be issued to him. This form, along with an identity document, must be presented at the medical facility. If the employee is not being examined for the first time, then he must have a health passport in his hands, which must also be presented.

The medical institution opens a card for this employee, and if there is no health passport, it draws up such a document.

All those specialists whose opinion must be taken into account for examination according to labor standards should take part in the medical examination.

As the examination progresses, the doctors will put down the results of the examination on the card, and they will also enter the results of the analysis of analyzes in the laboratories. Based on the results of the examination, the card reflects its result, after which this document remains in storage at the medical facility.

The employee is issued a conclusion in which it is necessary to reflect whether there are any contraindications for working in the desired position. The conclusion is drawn up in two copies, one must be stored in a medical institution, and the second is transferred to the employer.

Attention! A health passport must be opened for each employee who undergoes a preliminary medical examination or a periodic one in a medical institution. Initially, this form is stored together with the employee's card. After the inspection is completed, data is entered into the passport, and then it is handed over to the employee.

On periodic

This kind of medical examination is carried out on the basis of lists that are compiled by the responsible person of the business entity. They must include all employees who are employed in workplaces with harmful or dangerous factors. The list of employees must be formed at least 2 months before the start date of the medical examination.

One of the innovations was the fact that even during a periodic inspection, a company representative must hand over a referral to the employee. It is done in a standard way.

The medical organization with which the contract for the medical examination has been concluded, prepare lists of specialists and establish the procedure for conducting it. Transfer All necessary papers it is due to the employer no later than 14 days before the start of the medical examination.

The procedure for examining employees takes place according to the usual scheme and ends with the issuance of a medical report. After that, the organization draws up a final report on the inspection.

A fully completed referral is signed by the person responsible for this with personal data. In the case when a newly arriving employee is sent for a mandatory inspection, the referral must be issued to him against signature. To record this fact, it is necessary to have a special journal or sheet in the company.

Attention! The type of direction is not established by law. Each business entity develops it himself, taking into account the needs, but using the required details.

Responsibility of the employer for the admission of the employee to work without a medical examination

The law establishes liability for those employers who allow their employees to start work without carrying out the necessary medical examination. This responsibility is established in the Code of Administrative Offenses.

According to this legislative act, for violation, liability is imposed:

For an official - 15-25 thousand rubles;
Entrepreneurs - 15-25 thousand rubles;
For a company - 110-130 thousand rubles.

The amount of the fine imposed will be determined based on the number of employees allowed to work in this way.

In the event that the health of an employee who has not passed a medical examination is damaged or his death occurs, then non-compliance with the norms of the law will be considered from the perspective of the Criminal Code.

Important! In turn, if the employee refuses to undergo a medical examination, then the Labor Code provides for his removal from work in this case. This measure is introduced after the written acquaintance of the employee against signature.

It will be valid until he provides the administration of the company with a document confirming his suitability for implementation. labor activity. The employee will not be paid for the period of such temporary suspension.

23.04.2013 10:53:00

On January 1, 2012, the order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n “On Approval of Lists of Harmful and (or) Dangerous production factors and work, during the performance of which preliminary and periodic medical examinations (examinations) are carried out, and the Procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of workers engaged in hard work and work with harmful and (or) dangerous working conditions "(hereinafter - Order No. 302n).

One of the main objectives of this document is to create uniform rules for all employers for organizing and conducting mandatory medical examinations by combining requirements that were previously scattered across various documents.

Order No. 302n, as its name implies, approved:

The list of harmful and (or) hazardous production factors, in the presence of which mandatory preliminary and periodic medical examinations (examinations) are carried out (hereinafter - the List of factors);
- a list of works, during the performance of which mandatory preliminary and periodic medical examinations (examinations) of employees are carried out (hereinafter - the List of Works);
- 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 - Procedure No. 302n).

The step-by-step procedure for conducting preliminary and periodic medical examinations described in Order No. 302n is schematically shown in Fig. 12.

Article 213 Labor Code Russian Federation provides for the need to organize medical examinations when an employee comes into contact with production factors only if he is employed in harmful and (or) dangerous working conditions.

Order No. 302n provides for a strict delimitation of the areas of responsibility of the employer, employee and medical organization. Thus, the employer is responsible for:
- assessment of working conditions;
- formation (formation) of groups of workers subject to medical examination;
- sending employees to a medical organization.

The employee is obliged to come to the medical organization with the necessary package of documents and undergo a medical examination. The medical organization is responsible for conducting a high-quality full-fledged medical examination in accordance with the regulatory rules.

According to R 2.2.2006-05 “Guidelines for hygiene assessment factors of the working environment and the labor process. Criteria and classification of working conditions ”(approved by Rospotrebnadzor on July 29, 2005) harmful and dangerous classes of working conditions are classes 3 and 4, respectively.

Classes of working conditions 1 and 2, according to the current legislation, are not capable of harming the health of an employee in the near and long term, as well as his offspring.

Therefore, in accordance with clause 19 of Order No. 302n, note 2 to the List of Factors, the employer is obliged to send the employee for a preliminary or periodic medical examination, and the employee must undergo it if the latter:

Is exposed at the workplace to the impact of production factors classified as harmful and (or) dangerous classes of working conditions (class of working conditions 3.1 and higher);
- performs the work provided for by the List of Works (excluding classes of working conditions).

When concluding an agreement for mandatory medical examinations, the employer (his authorized representative) should take into account legal formalities, namely:

All types of mandatory medical examinations can be carried out by medical organizations of any form of ownership that have the right (license) to conduct preliminary and periodic medical examinations, as well as to examine professional suitability;
- the medical commission should include an occupational pathologist, and "narrow" specialist doctors must have a valid certificate in the specialty "occupational pathology" (issued after passing advanced training in the specialty "occupational pathology" in the prescribed manner);
- the head (deputy head) of a medical organization or its head has the right to head a medical commission structural unit(Order of the Ministry of Health and Social Development of Russia dated 05.05.2012 No. 502n “On approval of the procedure for the creation and activities of the medical commission of a medical organization”). In any case, the person heading the medical commission must have a diploma of an occupational pathologist and a valid certificate of an occupational pathologist.

The employer is responsible for completing the following documents:

List of the contingent (list of jobs) indicating, in accordance with the List of Factors and the List of Works, production factors and types of work identified (performed) at the relevant workplace based on the results of the assessment of working conditions. Based on this document, candidates are determined who are subject to a preliminary medical examination;
- a list of names of employees subject to mandatory periodic medical examination in the current year, which is compiled on the basis of the list of the contingent and sent to the medical organization no later than two months before the agreed start date for the periodic medical examination;
- referral for a preliminary (periodic) medical examination (examination).

There are no requirements for the design (form) of the listed documents. However, Procedure No. 302n determines what information they should contain.

So, in the direction for a preliminary (periodic) medical examination, among other things, the following should be indicated:

Name of 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) inspections.

If the referral does not contain or does not fully reflect the mandatory information provided for by Procedure No. 302n, then this may become a formal reason for refusing to conduct a medical examination.

As a result of the inspection medical organization draws up:

Outpatient medical record;
- employee's health passport (if the employee already has a health passport, additional entries are made in it);
- conclusion based on the results of the preliminary (periodic) medical examination (issued to the employee for transfer to the employer after the employee has passed the medical examination);
- the final act based on the results of the periodic medical examination.

It is important to note that in accordance with Procedure No. 302n, the final act can only be approved by a medical organization. The current regulation also determines that the completed final act must be signed by the chairman of the medical commission (and no one else) and certified by the seal of the medical organization. There are no requirements for the mandatory presence of other marks in the final act. Thus, teamwork on drawing up the final act should be carried out exclusively until the moment of its approval, i.e. at the project stage.

To ensure the continuity of medical examinations, their results are reflected in the outpatient card and health passport of the employee, which is kept in the hands of the latter throughout his life and presented during medical examinations. Order No. 302n defines the procedure for transferring medical records of employees when changing or liquidating a medical organization conducting medical examinations.

SUSPECTED INNOVATIONS IN ORDER No. 302n

During the year after the entry into force of Order No. 302n, the Ministry of Health and Social Development of Russia, and after its division, the Ministry of Health of Russia, as well as the Government of Russia, received numerous appeals from citizens and organizations with comments and suggestions to improve the procedure for conducting mandatory medical examinations. A thorough analysis of these appeals was carried out, as a result of which a list of changes to Order No. 302n was prepared.

At the end of November 2011, Federal Law No. 323-FZ of November 21, 2011 “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation” (hereinafter referred to as Law No. 323-FZ) came into force, containing rules on medical examinations, examination of professional suitability, formation medical boards, etc.

Given the significant number of planned changes in relation to the procedure for conducting mandatory medical examinations, as well as the new requirements of Law No. 323-FZ, a decision was made to issue a new order regulating the procedure for conducting mandatory preliminary and periodic medical examinations (examinations).

The above basic positions of Order No. 302n will remain, the most important of the proposed innovations will be listed below.

1. The obligation of the employer to conclude an agreement for mandatory medical examinations with a medical organization will be more clearly and unambiguously spelled out (with the exception of employers attached to the FMBA of Russia).

2. It is planned to add an extract from the medical record of an outpatient and a military ID (if any) to the list of documents required for submission by an employee.

3. The presence at the workplace of allergenic, carcinogenic or reproductive system factors (in the list of factors they will be marked respectively with the letters A, K, P) will be the basis for a medical examination of the employee, regardless of the class of working conditions in connection with the possibility of non-threshold effects.

4. The following provisions of Order No. 302n will be seriously revised:

Aerosols of predominantly fibrogenic and mixed type of action (clause 1.1.4 of the List of factors);
- underground work (clause 12 of the List of Works), especially with regard to medical contraindications;
- types of work provided for in paragraphs. 14 - 26 of the List of Works (workers in the food industry, educational institutions and etc.);
- ground control vehicles(clause 27 of the List of Works).

5. New items will be added to the list of works, during the performance of which mandatory preliminary and periodic medical examinations (examinations) of employees are carried out:

Diving operations (six sub-items);
- work on transport management on the subway.

6. The factor "forced eye contact with the video terminal" will be singled out as an independent item with a separately agreed scope of the examination and medical contraindications.

7. In the list of harmful and (or) hazardous production factors, in the presence of which mandatory preliminary and periodic medical examinations (examinations) are carried out, overloading of the vocal apparatus will be added. This is one of the most important innovations of this classifier.

8. The psychiatrist and narcologist will be excluded from the mandatory scope of examinations.

9. An ophthalmologist and ophthalmotonometry will be included in the mandatory list of examinations.

10. Specialist doctors (surgeon, neurologist, otorhinolaryngologist, dermatovenereologist, oncologist, urologist, allergist) can be involved in the work of the medical commission if (on the basis of) medical indications.

11. An examination by an ENT doctor will become mandatory for all workers performing work at height.

12. Pure tone audiometry will remain mandatory only for workers working in noisy environments. In all other cases, acumetry (a study of whispered speech) will be carried out.

13. Fibrogastroduodenoscopy for workers in special geographical areas will be marked with an “*” (only by indications).

14. In relation to workers performing work related to exposure to ionizing radiation, as well as a number of chemicals, a psychophysiological study will be carried out.

15. In the event that the frequency of laboratory or functional studies exceeds the frequency of periodic medical examinations, the employer will refer to these studies, and the conclusion on the presence (absence) of medical contraindications will be issued by the chairman of the medical commission together with a specialist doctor corresponding to the profile of the study.

16. Glaucoma of any degree and compensation will be included in the number of medical contraindications for work at height.

17. The presence of an artificial lens will be excluded from the list of medical contraindications for working as a driver.

18. Lack of binocular vision is planned to be added to the number of medical contraindications for working with optical instruments.

19. The degree of color perception impairment, which serves as a contraindication for working as a driver, will be specified - dichromasia and monochromasia.

20. Post-infarction cardiosclerosis will serve as a general medical contraindication for the decreed contingent (i.e., for workers not employed in harmful and (or) dangerous working conditions, but subject to mandatory medical examination) only if there is a circulatory disorder of the 2nd degree or higher.

21. Hearing loss is planned to be excluded from the number of medical contraindications for work in noise conditions and with moving mechanisms for persons who have undergone special training.

22. In relation to such diseases as coronary heart disease, hypertension, discirculatory encephalopathy, etc., appearing as medical contraindications to certain types of work, references to the degree (stage) of the disease will be added.

23. An occupational disease will be defined as a medical contraindication to the performance of work associated with exposure to harmful factors that caused it.

24. Clause 48 of Order No. 302n, dedicated to general medical contraindications, will be revised.

25. Drawing up a conclusion based on the results of a periodic medical examination will not be mandatory for all employees, but only for those with medical contraindications. The medical organization will be obliged to transfer information about this to the employer within three days.

26. After the release of the new order, it is planned to approve guidelines on the organization and conduct of preliminary and periodic medical examinations (examinations), containing forms required documents. In the future, it is planned to develop methods for assessing the risk of development occupational diseases.

27. A separate order of the Ministry of Health of Russia is planned to approve the procedure for medical examination for the right to drive personal vehicles.

A.Yu. Bushmanov,
first deputy CEO FGBU SSC“Federal Medical Biophysical Center. A.I. Burnazyan”FMBA of Russia,Chief Freelance Occupational PathologistFMBA of Russia and Ministry of Health of Russia

A.S. Kretov,
expert-professional pathologist of the Federal State Budgetary Institution SRC “Federal Medical Biophysical Center named after A.I. A.I. Burnazyan” FMBA of Russia, secretary of the profile working group on occupational pathology of the Ministry of Health of Russia

;
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 harmful and dangerous factors for specialists are observed. The personnel of such companies for at least 5 years must be examined in specialized Occupational Pathology Centers or medical institutions licensed for professional suitability examination.

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 professional examination at any convenient time at an affordable price.

Registration of a driver's medical certificate and EEG

Obtaining procedure driving license or opening 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

In accordance with Article 213 of the Labor Code of the Russian Federation (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2002, N 1 (part 1), Art. 3; 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 Regulations 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, the document does not need state registration, letter dated December 30, 1996 Mr. N 07-02-1376-96);

order of the Ministry of Health and Social Development of the Russian Federation of August 16, 2004 N 83 "On approval of the lists of harmful and (or) hazardous production factors and work, during the performance of which preliminary and periodic medical examinations (examinations) are carried out, and the procedure for conducting these examinations ( examinations)" (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 USSR Ministry of Health 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 open parts 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 applicable regulatory legal acts(hereinafter - medical organizations).

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

The composition of the medical commission includes an occupational pathologist, as well as specialist doctors who have completed advanced training in the specialty "occupational pathology" in the prescribed manner or who have 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 of the 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);
the name of the structural unit 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;
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) inspections.

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 carried out the mandatory psychiatric examination(in cases stipulated 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 unit 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 case of examination of the person entering the work by all medical specialists, as well as the completion of the full scope of laboratory and functional studies provided for by the List of harmful and (or) hazardous production factors, in the presence of which mandatory preliminary and periodic medical examinations are carried out. examinations (examinations) of factors (Appendix No. 1 to the order (hereinafter - the List of factors) and the List of works, during the performance of which mandatory preliminary and periodic medical examinations (examinations) of employees are carried out (Appendix No. 2 to the order) (hereinafter - the List of works).

12. At the end of the preliminary examination by a person entering work, 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 terms 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 name lists developed on the basis of contingents of workers subject to periodic and (or) preliminary inspections (hereinafter referred to as 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 of 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. 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 inspection agreed with the employer), on the basis of the specified list of names, the medical organization shall calendar plan conducting a periodic inspection (hereinafter referred to as the calendar plan).

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 the hazardous production factors or work specified in the list of names, 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 are subject to entering into personal medical books and accounting 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, according to the inventory, the medical records of employees 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 (MAC) or maximum acceptable level(PDU) according to 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 relevant decision is made by the medical commission, undergo periodic examinations at least once every five years in the centers of occupational pathology and other medical organizations that have the right to conduct preliminary and periodic examinations, to conduct an examination of professional suitability and an 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, the medical organization issues the employee a referral to the center of occupational pathology or a specialized medical organization that has the right to conduct an examination of the connection 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:

the name of the medical organization that conducted the preliminary examination, the address of its location and the OGRN code;
date of drawing up the act;
the name of the employer;
total strength workers, including women, workers under the age of 18, workers who have a persistent degree of disability;
the number of employees engaged in heavy work and work with harmful and (or) dangerous working conditions;
the number of employees employed in jobs that require periodic medical examinations (examinations) to protect public health, prevent the occurrence and spread of diseases, including women, workers under the age of 18, workers who have established a persistent degree of loss ability to work;
the number of employees subject to periodic medical examination, including women, employees under the age of 18, employees who have a persistent degree of disability;
the number of employees who have undergone a periodic medical examination, including women, employees under the age of 18, employees who have been diagnosed with a persistent degree of disability;
the percentage of coverage of employees with periodic medical examinations;
a list of persons who have undergone a periodic medical examination, indicating gender, date of birth, structural unit (if any), conclusion of the medical commission;
the number of employees who have not completed a periodic medical examination, including women, employees under the age of 18, employees who have a persistent degree of disability;
a list of employees who have not completed a periodic medical examination;
the number of employees who have not undergone a periodic medical examination, including women, employees under the age of 18, employees who have been diagnosed with a persistent degree of disability;
a list of employees who have not undergone a periodic medical examination;
the number of employees who do not have medical contraindications to work;
the number of employees with temporary medical contraindications to work;
the number of employees with permanent medical contraindications to work;
the number of employees in need of an additional examination (conclusion not given);
the number of employees who need to be examined in the center of occupational pathology;
the number of employees requiring outpatient examination and treatment;
the number of employees in need of inpatient examination and treatment;
the number of employees in need of sanatorium treatment;
the number of employees in need of dispensary observation;
a list of persons with a preliminary diagnosis of an occupational disease, indicating gender, date of birth; structural subdivision (if any), profession (position), harmful and (or) hazardous production factors and work;
a list of newly established chronic somatic diseases indicating the class of diseases according to the International Classification of Diseases - 10 (hereinafter - ICD-10);
a list of newly established occupational diseases with an indication of the class of diseases according to ICD-10;
the results of the implementation of the recommendations of the previous final act;
recommendations to the employer on the implementation of the complex recreational activities including preventive and other measures.

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 databases legal documents"Garant" and "Consultant Plus".

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

to the order of the Ministry of Health and Social Development of the Russian Federation

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

I. GENERAL PROVISIONS

1. The procedure for conducting mandatory preliminary (upon admission to work) 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 (upon admission to work) 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.

3. Mandatory periodic medical examinations (examinations) (hereinafter referred to as periodic examinations) are carried out in order to:

1) dynamic monitoring of the health status of workers, timely detection of diseases, initial forms of occupational diseases, early signs of the impact of harmful and (or) dangerous production factors on the health of workers, the formation of risk groups for the development of occupational diseases;

2) detection of diseases, conditions that are medical contraindications for continuing work associated with exposure to harmful and (or) hazardous production factors, as well as work in the performance of which it is mandatory to conduct preliminary and periodic medical examinations (examinations) of employees in order to protect public health , preventing the occurrence and spread of diseases;

3) timely implementation of preventive and rehabilitation measures aimed at maintaining the health and restoring the working capacity of employees;

5) prevention of accidents at work.

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.

The composition of the medical commission includes an occupational pathologist, as well as medical specialists who have completed advanced training in the specialty "occupational pathology" in the prescribed manner or who have 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 of the medical organization.

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

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

II. PROCEDURE FOR PRELIMINARY INSPECTIONS

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

- 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);
- the name of the structural unit 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;
- 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) inspections.

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's health passport (if available);
- the decision of the medical commission that conducted the mandatory psychiatric examination (in cases stipulated by the legislation of the Russian Federation).

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

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 code according to the OGRN;
- 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 CHI insurance policy of the person entering work (employee);
- name of the employer;
- form of ownership and type of economic activity of the 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, a conclusion based 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.

12. Upon completion of the preliminary examination by a person entering the work, 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);
- name of the employer;
- 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.

III. PROCEDURE FOR 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 name lists developed on the basis of contingents of workers subject to periodic and (or) preliminary inspections (hereinafter - name lists) 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 based on the results of attestation of workplaces in terms of working conditions, carried out in the prescribed manner. As a source of information about the presence of harmful production factors in the workplace, in addition to the results of certification of workplaces for working conditions, the results of laboratory studies and tests obtained as part of control and supervision activities, production laboratory control can be used. , as well as use 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 attestation 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 implementation of production activities.

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).

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 inspection agreed with the employer), on the basis of the specified list of names, draws up a calendar plan for conducting a periodic inspection (hereinafter referred to as the calendar plan).

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 inspection agreed with the medical organization, is obliged to familiarize the employees subject to the periodic inspection with the calendar plan.

28. To undergo a periodic examination, the employee must 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).

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 a periodic examination, in the prescribed manner, 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 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.

37. Participants in 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 with ( who 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 relevant decision is made by the medical commission, at least once every five years, undergo periodic examinations at occupational pathology centers and other medical organizations that have the right to conducting preliminary and periodic examinations, to conduct an examination of professional suitability and examination of the connection of the disease with the profession.

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 the 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 sanitary and epidemiological well-being of the population and representatives of the employer, is the final act.

43. The final act states:

- the name of the medical organization that conducted the preliminary examination, the address of its location and the OGRN code;
- date of drawing up the act;
- name of the employer;
- the total number of employees, including women, employees under the age of 18, employees who have a persistent degree of disability;
- the number of workers employed in heavy work and in work with harmful and (or) dangerous working conditions;
- the number of employees employed in jobs that require periodic medical examinations (surveys), in order to protect public health, prevent the occurrence and spread of diseases, including women, workers under the age of 18, workers who have a persistent degree of disability;
- the number of employees subject to periodic medical examination, including women, employees under the age of 18, employees who have been diagnosed with a persistent degree of disability;
- the number of employees who have undergone a periodic medical examination, including women, employees under the age of 18, employees who have been diagnosed with a persistent degree of disability;
- the percentage of employees covered by periodic medical examinations;
- a list of persons who have undergone a periodic medical examination, indicating gender, date of birth, structural unit (if any), conclusion of the medical commission;
- the number of employees who have not completed a periodic medical examination, including women, employees under the age of 18, employees who have been diagnosed with a persistent degree of disability;
- a list of employees who have not completed a periodic medical examination;
the number of employees who have not undergone a periodic medical examination, including women, employees under the age of 18, employees who have been diagnosed with a persistent degree of disability;
- a list of employees who have not undergone a periodic medical examination;
- the number of employees who do not have medical contraindications to work;
- number of employees with temporary medical contraindications to work;
- the number of employees with permanent medical contraindications to work;
- the number of employees in need of an additional survey (conclusion not given);
- the number of employees who need to be examined in the center of occupational pathology;
- the number of employees in need of outpatient examination and treatment;
- the number of employees in need of inpatient examination and treatment;
- the number of employees in need of sanatorium treatment;
- the number of employees in need of dispensary observation;
- a list of persons with a preliminary diagnosis of an occupational disease, indicating gender, date of birth;
- structural subdivision (if any), profession (position), harmful and (or) hazardous production factors and work;
- a list of newly established chronic somatic diseases with an indication of the class of diseases according to the International Classification of Diseases - 10 (hereinafter - ICD-10);
- a list of newly established occupational diseases with an indication of the class of diseases according to ICD-10;
- the results of the implementation of the recommendations of the previous final act;
- recommendations to the employer on the implementation of a complex of health-improving measures, including preventive and other measures.

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

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 the Federal Center for Occupational Pathology of the Ministry of Health and Social Development of Russia and to the health management authority of this constituent entity of the Russian Federation.

IV. MEDICAL CONTRAINDICATIONS TO ADMISSION TO WORK

48. Employees (persons entering work) are not allowed to perform work with harmful and (or) dangerous working conditions, as well as work, during the performance of which it is mandatory to conduct preliminary and periodic medical examinations (surveys), in order to protect public health, prevent occurrence and spread of diseases, in the presence of the following general medical contraindications:

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

Article 213 of the Labor Code of the Russian Federation.

Article 212 of the Labor Code of the Russian Federation.

Order of the Ministry of Health and Social Development of Russia dated August 31, 2007 No. 569 “On Approval of the Procedure for Certification of Workplaces for Working Conditions” (registered by the Ministry of Justice of Russia on November 29, 2007
№ 10577).

Order of the Ministry of Health and Social Development of Russia dated 04.02.2010 No. 55n (as amended on 03.03.2011) “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 03.04.2010 No. 16550).

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 an occupational pathologist.

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

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

The organization of medical examinations at some enterprises is mandatory. And the admission of employees to work without passing it entails serious legal consequences for the employer. We decided to investigate in detail and tell you in which cases employees are required to undergo a medical examination, what threatens the employer for admission to work without an examination, and how to issue a referral.

Article 46 federal law dated November 21, 2011 No. 323-FZ, medical examination is a complex of medical interventions aimed at identifying pathological conditions in workers. Thus, this is not only a useful measure for workers, allowing early detection of dangerous diseases, but also good opportunity for employers to avoid accidents at work with all the ensuing legal consequences.

Types of medical examinations

Article 46 of the Federal Law of November 21, 2011 No. 323-FZ highlights the following types medical examinations:

preventive - aimed at early detection of dangerous diseases and conditions;
preliminary - carried out when applying for a job;
periodical – carried out at enterprises during the periods specified by regulatory enactments in order to detect and prevent occupational and other diseases;
pre-shift or pre-trip - are made immediately before the employee leaves for the shift;
post-shift or post-trip - held at the end of the working day.

All of the listed types of medical examinations, in accordance with articles and 213 of the Labor Code must be paid by the employer. And for the duration of its passage, the employee must keep the average wage and position. This is stated in the articles, and 219 of the Labor Code of the Russian Federation. The costs of such medical examinations can be taken into account in the cost of profit, in accordance with subpara. 7 p. 1 Art. 264 Tax Code of the Russian Federation. The Ministry of Finance reminded of this in Letter No. 03-03-06/1/85069 dated November 26, 2018.

Order No. 302n on passing medical examinations

Order No. 302n dated 04/12/2011, adopted by the Ministry of Health and Social Development, establishes mandatory preliminary and periodic medical examinations for workers associated with hazardous types of production and in contact with factors harmful to health. Order No. 302n contains Appendix 1, which contains a list of harmful and dangerous production factors, in the presence of which mandatory medical examinations are carried out. Their approval has become one of the main innovations in the field of monitoring the health of workers. The information in this regulatory act is presented in the form of a table, which, in addition to the names of harmful phenomena at work, indicates the frequency of examinations, as well as a list of doctors who must be visited by employees. For example, workers who have contact with nitrogen compounds should visit an otorhinolaryngologist and dermatovenereologist once every two years.

As for the list of jobs for which it is mandatory to undergo medical examinations, Order No. 302n in Appendix 2 contains relevant information. The table directly lists the types of activities, the frequency of visiting doctors, their list, as well as the types of necessary tests and contraindications for continuing work. For example, land transport drivers should visit a neurologist, an ophthalmologist, an otorhinolaryngologist, a surgeon, and a dermatovenereologist once every two years.

In 2018, by Order No. 49n dated February 6, 2018, the Procedure was amended - the list of social workers who must undergo an annual examination by a dermatovenereologist, otorhinolaryngologist, dentist and infectious disease specialist, as well as a number of examinations, was expanded and clarified: now the requirements apply to those workers who render social services in stationary and semi-stationary form social service as well as at home.

In particular, employees under the age of 18 are subject to a mandatory medical examination, and employees under the age of 21 are required to undergo a medical examination annually.

The procedure for conducting a medical examination

The procedure for conducting a medical examination of employees is regulated by chapters 1 and 3 of Order 302 of the Ministry of Health. This document contains a detailed algorithm for organizing an event. The procedure for conducting preliminary and periodic inspections is somewhat different from each other. Let's consider both algorithms in more detail.

Preliminary medical examination

This type of inspection is carried out when an employee is hired on the basis of a referral. This document is filled out on the basis of the list of contingents for which a medical examination is mandatory. The existing legislation does not provide unified form directions. However, Order 302 for medical examinations contains a list of information that must be indicated. Thus, each enterprise can independently develop a form for this document. However, in practice, employers try to use the forms used in medical institutions, as this avoids controversial issues.

The referral for medical examination must contain the following information:

the name of the employer;
form of ownership and type of economic activity;
name of the medical institution, its address and PSRN code;
type of inspection;
FULL NAME. employee;
Date of Birth;
name of the structural unit and position;
hazards and the types of work that the employee will face;
FULL NAME. and the signature of the person responsible for issuing the referral;
employee's signature;
FULL NAME. officer responsible for accounting for issued referrals.

An example of a direction is shown below.

After receiving this document, the candidate for the vacancy is sent to a medical institution, where he provides a referral, passport, health passport (if any) and, if necessary, a psychiatric report. Then a medical card and a health passport are entered for the employee, where the conclusions of specialists are entered.

As a result of the medical examination, the employee is issued a conclusion, which indicates the result of the examination. Namely, whether any contraindications for the implementation of a particular type of activity have been identified. This document is made in two copies. One of them is attached to the outpatient card, and the second is issued to the employee.

Periodic medical examination

The considered type of inspections is carried out on the basis of the lists of names. They include all employees employed in hazardous or hazardous work, indicating the position and harmful factor. The list must be prepared no later than two months before the start of the medical examination.

An important innovation was that immediately before undergoing a medical examination, the employer must give the employee a referral, which is drawn up in the same way as during the preliminary examination.

The medical organization with which the employer must conclude an agreement prepares a schedule of examinations, which must be provided to the employer no later than 14 days before the start of the examination. Further, the process of medical examination takes place in the same order as the preliminary one, and ends with the issuance of conclusions to employees. Then the medical organization summarizes the results and reflects them in the final act. This document states:

the number of employees who have been inspected;
the number of employees with contraindications;
how many employees need treatment and additional examinations, and so on.

The act is drawn up in four copies, which are certified by the head of the commission. One copy is sent to the enterprise, the second remains in the medical institution, the third - to the occupational pathology center, the fourth - to the territorial executive authority responsible for the sanitary and epidemiological situation.

Responsibility of the employer and employee for admission to work without a medical examination

Existing legislation provides for liability for employers who allow employees to work without undergoing a mandatory medical examination. The punishment for such an offense is provided for in part 3 Article 5.27.1 of the Code of Administrative Offenses of the Russian Federation. According to this rule, officials faces a fine in the amount of 15,000 to 25,000 rubles. Persons carrying out entrepreneurial activity without forming a legal entity - from 15,000 to 25,000 rubles. For legal entities promises a fine of 110,000 to 130,000 rubles. At the same time, it should be borne in mind that the amount of the fine depends on the number of workers illegally admitted to work. If, due to evading a medical examination, an employee’s health is harmed or his death occurs, the actions of the employer will be qualified in accordance with the provisions of the Criminal Code.

As for employees who refuse to undergo a medical examination for any reason, they should be suspended from work until they have a certificate confirming their fitness for work. Such responsibility provides. We emphasize that during the suspension, the employee’s salary is not saved, and he must be familiar with this fact.