Order of the Ministry of Health and social development Russian Federation of April 12, 2011 N 302n "On approval of the lists of harmful and (or) dangerous 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) workers engaged in hard work and work with harmful and (or) dangerous working conditions" (with amendments and additions)

Order of the Ministry of Health and Social Development of the Russian Federation of April 12, 2011 N 302n
"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 hard work and work with harmful and (or) dangerous working conditions"

With changes and additions from:

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 workers engaged in hard work and work with harmful and (or) dangerous working conditions, in accordance with Appendix N 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 Russian Federation dated 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) dangerous 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, (with the exception of subparagraphs 12.2, 12.11, 12.12), Appendix N 2 to the order of the Ministry of Health of the USSR of September 29, 1989 N 555 "On improving the system medical examinations of workers and individual drivers Vehicle".

New lists of harmful and (or) hazardous production factors and works have been approved, during the performance of which preliminary and periodic medical examinations (examinations) are carried out. The procedure for conducting such inspections has been revised.

The lists set the frequency of examinations, the composition of the medical specialists participating in them. The ongoing laboratory and functional studies are listed, medical contraindications for the performance of work are given.

Inspection can be carried out by any medical organization that has such a right, as well as carrying out an examination of professional suitability. The composition of the medical commission includes an occupational pathologist and medical specialists who have undergone advanced training in the specialty "occupational pathology" or have a valid certificate in it.

The direction for inspection is issued by the employer. The requirements for its completion are given. The employee presents a passport and referral to the medical organization. A medical card and a health passport (in its absence) are issued for it. The latter, after inspection, is handed over to the employee.

For periodic examinations, the employer sends the name lists of employees to the medical organization, on the basis of which a schedule of examinations is drawn up. Upon completion of the examination, a medical report is issued in 2 copies (the first is issued to the employee, the second is attached to the medical card). The employee is assigned to one of the dispensary groups, they give recommendations on the prevention of diseases, if there are medical indications - on further observation, treatment and rehabilitation. If an occupational disease is suspected, a referral to an occupational pathology center is issued.

Participants in accidents, persons with persistent consequences of accidents at work and a number of other workers once every 5 years undergo periodic examinations at occupational pathology centers.

Based on the results of the examinations, the medical organization draws up a final act and sends it to the employer, to the occupational pathology center, as well as to the territorial body of Rospotrebnadzor.

Order of the Ministry of Health and Social Development of the Russian Federation of April 12, 2011 N 302n "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 hard work and work with harmful and (or) dangerous working conditions"

Changes and amendments

Registration N 22111

According to article 213 Labor Code of the 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), 3616) and clause 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, article 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) dangerous 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 N 2 to the order of the Ministry of Health and Social Development of Russia dated May 16, 2005

August 16, 2004 N 83 "On approval of the 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 these examinations (examinations)" (registered by the Ministry of Justice of the Russian Federation 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

Annexes N 1 - 2 to the order are published on the official website of the Ministry of Health and Social Development of Russia at:http://www.minzdravsoc.ru/docs/mzsr/salary/37

Appendix No. 3

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 (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 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 1 .

2. Mandatory preliminary medical examinations (examinations) upon admission to work (hereinafter referred to as preliminary examinations) are carried out in order to determine the compliance of the health status of a person entering a job with the work assigned to him, as well as for the purpose of early detection and prevention 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 occupational diseases, early signs of the impact of harmful and (or) hazardous 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 the impact of 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 passed 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 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);

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) 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 established sample certifying his identity);

employee health passport (if available);

the decision of the medical commission that conducted the mandatory psychiatric examination (in cases where provided by law 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 N 025 / y-04, approved by order of the Ministry of Health and Social Development of Russia dated November 22, 2004 N 255) (registered by the Ministry of Justice of Russia on December 14, 2004 N 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 the case of an 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 card 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 - 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 by the results of attestation of workplaces in terms of 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, industrial 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 inspection, the employer (his authorised 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. 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 - 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 calendar plan.

27. The medical commission of a medical organization, on the basis of the hazardous production factors or work indicated 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 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 Federal Medical and Biological Agency 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 conducting 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 currently entered into an agreement.

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 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 conducting 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 connection of a disease with a profession, when conducting 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 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 relationship 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;

the total number of employees, including women, employees under the age of 18, employees 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 (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 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 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;

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;

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 in the territory given subject of the Russian Federation, and no later than February 15 of the year following the reporting one, sends generalized 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.

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

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:

congenital malformations, deformities, chromosomal abnormalities with persistent pronounced dysfunctions of organs and systems;

consequences of damage to the central and peripheral nervous system, internal organs, musculoskeletal system and connective tissue from exposure external factors(injuries, radiation, thermal, chemical and other effects, etc.) with the development of irreversible changes that caused dysfunction of organs and systems of a pronounced degree;

diseases of the central nervous system of various etiologies with motor and sensory disorders of a pronounced degree, disorders of coordination and statics, cognitive and mnestic-intellectual disorders;

narcolepsy and cataplexy;

diseases accompanied by disorders of consciousness: epilepsy and epileptic syndromes of various etiologies, syncopal syndromes of various etiologies, etc.;

mental illnesses with severe, persistent or often exacerbated painful manifestations and conditions equated to them, subject to mandatory dynamic monitoring in neuropsychiatric dispensaries 5 ;

alcoholism, substance abuse, drug addiction;

diseases of the endocrine system of a progressive course with signs of damage to other organs and systems and a violation of their function of 3-4 degrees;

malignant neoplasms of any localization 6 ;

diseases of the blood and hematopoietic organs with a progressive and recurrent course (hemoblastosis, severe forms of hemolytic and aplastic anemia, hemorrhagic diathesis);

hypertension stage III,

3 degrees, risk IV;

chronic diseases of the heart and pericardium with circulatory failure of FC III, NC 2 or more degrees;

cardiac ischemia:

angina FC III - IV;

with impaired conduction (sinoauricular blockade of the III degree, weakness of the sinus node);

paroxysmal arrhythmias with potentially malignant ventricular arrhythmias and hemodynamic disturbances;

postinfarction cardiosclerosis, heart aneurysm;

aneurysms and dissections of any parts of the aorta and arteries;

obliterating atherosclerosis of the aorta with obliteration of the visceral arteries and dysfunction of organs;

obliterating atherosclerosis of the vessels of the extremities, thromboangiitis, aortoarteritis with signs of decompensated blood supply to the extremity (limbs);

varicose and post-thrombophlebitic disease of the lower extremities with symptoms of chronic venous insufficiency of grade 3 and above;

lymphangitis and other disorders of lymphatic drainage of 3-4 degrees;

rheumatism: active phase, frequent relapses with damage to the heart and other organs and systems and chronic heart failure of 2-3 degrees;

diseases of the bronchopulmonary system with symptoms of respiratory failure or pulmonary heart failure

2 - 3 degrees;

active forms of tuberculosis of any localization;

complicated course of gastric ulcer, duodenal ulcer with chronic often (3 times or more per calendar year) recurrent course and development of complications;

chronic hepatitis, decompensated cirrhosis of the liver and other liver diseases with signs of liver failure of 2-3 degrees and portal hypertension;

chronic diseases of the kidneys and urinary tract with symptoms of chronic renal failure of 2-3 degrees;

nonspecific ulcerative colitis and severe Crohn's disease;

diffuse connective tissue diseases with dysfunction of organs and systems of 3-4 degrees, systemic vasculitis;

chronic diseases of the peripheral nervous system and neuromuscular diseases with significant dysfunction;

chronic diseases of the musculoskeletal system with dysfunctions of 2-3 degrees;

chronic skin diseases:

chronic widespread, often recurrent (at least 4 times a year) eczema;

psoriasis universal, common, arthropathic, pustular, psoriatic erythroderma;

pemphigus vulgaris;

chronic irreversible widespread ichthyosis;

chronic progressive atopic dermatitis;

pregnancy and lactation 7 ;

history of recurrent miscarriage and fetal anomalies in women of childbearing age 7 ;

glaucoma of any stage with an unstabilized course.

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 04.02.2010 N 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).

5 In cases pronounced forms 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.

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 medical examinations by employees of organizations 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:

• IN 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, for factors chemical exposure added welding aerosols with manganese-containing and silicon-containing compounds; more allergens, infected material, as well as AIDS, hepatitis B, C viruses were added to the factors that can have a biological effect; 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 while 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:

• whose working conditions involve exposure to hazardous 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 normative act employees who must undergo a medical examination before being allowed to work are determined.

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, doctors will put down the results of the examination on the card, as well as the results of the laboratory analysis. 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 facility. 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 responsible person 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. It must transfer all the necessary papers 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 work. The employee will not be paid for the period of such temporary suspension.

Since January 2012, the Order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 No. 302N “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), and the procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of employees engaged in hard work and work with harmful and (or) dangerous working conditions.

Order No. 302N approved and put into effect three complementary regulations

At the same time, the following regulatory documents were declared invalid and canceled

1. 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).
2. 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 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).
3. 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. Subparagraphs 11, 12 (with the exception of subparagraphs 12.2, 12.11, 12.12), 13 of Appendix No. 2 to the order of the Ministry of Health of the USSR of September 29, 1989 No. 555 "On improving the system of medical examinations of workers and drivers of individual vehicles."

Annex No. 1 To the order of the Ministry of Health and Social Development of the Russian Federation No. 302N

Appendix No. 1 to Order 302n of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 is presented in the form of a table and has the following content:

1. Directly a list of harmful and (or) hazardous production factors in the following sections: chemical factors, biological factors, physical factors, factors of the labor process.
2. The frequency of medical examinations.
3. Participation in medical examinations of doctors of certain specialties (in addition to the mandatory list of medical specialists).
4. The volume of laboratory and functional studies (in addition to the mandatory scope of studies).
5. Additional medical contraindications to work, which are in addition to medical contraindications (Appendix No. 3, section IV, p. 48)

Mandatory examination for all categories of employees

The mandatory scope of the examination of an employee undergoing a preliminary or periodic medical examination includes:

1. Examination by an occupational pathologist, general practitioner, psychiatrist, psychiatrist-narcologist, obstetrician-gynecologist (for women).
2. When conducting preliminary and periodic medical examinations, all subjects are required to undergo: a clinical blood test (hemoglobin, color index, erythrocytes, platelets, leukocytes, leukocyte formula, ESR); clinical analysis of urine ( specific gravity, protein, sugar, sediment microscopy); electrocardiography; digital fluorography or radiography in 2 projections (direct and right lateral) of the lungs; biochemical screening: serum glucose, cholesterol.
3. All women are examined by an obstetrician-gynecologist with a bacteriological (for flora) and cytological (for atypical cells) examination at least once a year; women over the age of 40 undergo mammography or ultrasound of the mammary glands once every 2 years.

Appendix No. 2 to the order of the Ministry of Health and Social Development of the Russian Federation No. 302N

Appendix No. 2 to Order 302n of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 is presented in the form of a table and includes:

Appendix 2 consists of 27 items, which we will conditionally divide into 3 groups and consider in more detail.

Paragraph 27 consists of 16 subparagraphs depending on the category of ground vehicles. It must be borne in mind that the classification of vehicles used in the order adopted by the State Duma RF 10/19/2011, not yet put into effect. According to the new classification, 9 categories and 6 subcategories of vehicles will now appear in Russia (previously there were 5 categories).

Categories of vehicles (project):

Subcategory A1	moped, scooter with an engine capacity of less than 50 cc
Category A	motorcycle with an engine capacity of more than 50 cc.
Subcategory IN 1	motorcycle with a sidecar with an engine capacity of more than 50 cm3.
Category IN	a car with a gross weight of up to 3.5 tons.
Subcategory C1	truck with a gross weight of up to 3.5 tons.
Category WITH	a truck with a gross weight of more than 3.5 tons.
Subcategory D1	minibus with up to 9 seats
Category D	with more than 9 seats
Category BE	car with trailer
Subcategory C1E	Category C1 truck with trailer
Category CE	category C truck with trailer
Subcategory D1E	minibus category D1 with a trailer
Category DE	category D bus with trailer
Category Tm	trams
Category Tb	trolleybuses

Appendix No. 3 to the order of the Ministry of Health and Social Development of the Russian Federation No. 302N

This annex defines the organization and procedure for conducting mandatory medical examinations: preliminary (when applying for a job) and periodic medical examinations (examinations) of workers employed in hard work and in work with harmful and (or) dangerous working conditions.

In this section of the order, point by point, the main issues related to the preparation and passage of medical examinations, the necessary documentation, the specifics of issuing medical reports and final acts based on the results of a medical examination, etc. are considered in detail. It makes sense for labor protection engineers, personnel managers and everyone who, by the nature of their activity, to carry out medical examinations at enterprises, study Appendix No. 3 in detail, considering it as a regulatory framework for organizing mandatory preliminary (when applying for a job) and periodic medical examinations (surveys) of workers.

It is necessary to pay attention to section 3, paragraph 17, according to which employees under 21 years of age undergo periodic examinations annually. This provision also applies to inspections of drivers, so. a driver's medical certificate for persons under 21 is issued for a period of 1 year.
Appendix 3 section p.48 contains a list of general medical contraindications, on the basis of which, in conjunction with additional medical contraindications, the occupational pathologist decides on the employee's professional suitability to perform this type of activity.