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Boiler room operator undergoing medical examination according to order 302. Occupational safety instructions for boiler room operator

— production instructions for the operation of main and auxiliary equipment;

— labor protection instructions for the boiler room operator and other labor protection instructions;

1.4.3. Repeated training on labor safety for the operator is carried out at least once every three months.

1.4.4. Unscheduled briefing is carried out when:

— upon the introduction of new or amended legislative and other regulatory legal acts containing labor protection requirements, as well as labor protection instructions;

— when changing technological processes, replacing or upgrading equipment, devices, tools and other factors affecting labor safety;

— if employees violate labor safety requirements, if these violations create a real threat of serious consequences (industrial accident, accident, etc.);

— at the request of officials of state supervision and control bodies;

- during breaks in work (for work with harmful and (or) dangerous conditions - more than 30 calendar days, and for other work - more than two months);

- by decision of the employer (or a person authorized by him).

1.4.5. Targeted briefings are carried out for the employee when performing one-time work, during liquidation of the consequences of accidents, natural disasters and work for which a permit, permit or other special documents are issued, as well as when holding mass events in the organization.

1.5. The operator is obliged to comply with the internal labor regulations:

- do not smoke in the workplace;

- do not allow drinking alcoholic beverages during working or non-working hours in the boiler room;

- comply with duty schedules approved by the site manager.

1.6. Operators' scheduled working hours are no more than 12 hours. Eating is allowed in the workplace.

1.7. Periodic medical examinations of operators are carried out once every 2 years.

1.8. When performing work, the operator may be exposed to dangerous and harmful production factors:

- hazardous production factors - factors the impact of which on a worker under certain conditions can lead to injury or a sudden deterioration in health;

- harmful - to decreased performance or to diseases.

1.9. The boiler room operator must be aware of possible exposure to harmful and hazardous production factors.

Physical factors:

— dangerous voltage level in the electrical circuit on the control panels (units) of thermal power plants;

- falling from height;

— roughness, burrs, sharp edges on equipment surfaces;

— gas contamination of the working area air (in case of gas leaks, leaks in gas ducts, boiler lining, lack of ventilation);

— increased temperature of the surface of the equipment (in the absence or damage to the insulation of the equipment);

— increased vibration during equipment operation;

— indoor microclimate;

— increased noise (if you do not use anti-noise headphones);

Psychophysiological – labor intensity.

1.10. There are 4 classes of working conditions and nature according to the degree of harmfulness and danger: optimal, acceptable, harmful and dangerous.

Optimal working conditions (class 1) are conditions under which the employee’s health is maintained and the prerequisites are created for maintaining a high level of performance.

Acceptable working conditions (class 2) are characterized by such levels of environmental factors and the labor process that do not exceed established hygienic standards for workplaces, and possible changes in the functional state of the body are restored during regulated rest or by the beginning of the next shift and do not have an adverse effect in the immediate and future. in the long term on the health of workers and their offspring. Acceptable working conditions are conditionally classified as safe.

Harmful working conditions (class 3) are characterized by the presence of harmful factors, the levels of which exceed hygienic standards and have an adverse effect on the worker’s body and/or his offspring.

1.11. When performing work in accordance with the type of dangerous and harmful production factors, the boiler room operator is obliged to use personal protective equipment (working clothing, safety shoes and safety devices: goggles, respirator, headphones, etc.).

1.12. According to the “Standard for providing personal protective equipment to workers, the operator must use:

— Cotton suit for protection against general industrial pollution and mechanical influences — 1 per year.

— Leather boots — 1 pair per year.

— Combined mittens or knitted gloves with polymer coating - 4 pairs per year.

- Safety glasses - until worn out.

In winter additionally:

— Jacket with insulating lining — 1 for 3 years.

— Insulated leather boots — 1 pair for 3 years.

1.13. The operator must report equipment malfunctions to the site manager and dispatcher before starting work or during the working day after detecting a malfunction and make an entry in the equipment defects and malfunctions log.

1.14. In the event of an accident, the boiler room operator can provide first aid to the victim, report the incident to management and the dispatcher, call a doctor and, if possible, maintain the situation at the scene of the incident for investigation.

1.15. Along with these requirements, the boiler room operator must comply with:

— requirements set out in the tariff and qualification characteristics for the level of theoretical and practical knowledge of the operator of the corresponding category;

— requirements of the Production Instructions for the operation of boilers;

— rules for the technical operation of equipment, devices, tools with which it works or which it services;

— internal labor regulations.

1.16. Labor protection requirements are mandatory for the employee. Failure to comply with these requirements is considered a violation of labor discipline.

2. Labor protection requirements before starting work

2.1. Before accepting a shift, the boiler room operator must:

- put work clothes in order. Sleeves and tails of overalls should be fastened with all buttons, and hair should be tucked under the helmet. Clothes must be tucked in so that there are no dangling ends or flapping parts. Shoes must be closed. IT IS PROHIBITED to roll up the sleeves of workwear;

— walk around the equipment being serviced along a specific route, check the safe condition of the equipment, fences, rotating mechanisms, the presence of numbers on the equipment and pipeline fittings;

— check the availability and serviceability of tools and devices and their compliance with the expiration date, as well as the presence of emergency lighting, fire extinguishing equipment, posters or safety signs;

— check in the service area that there are no unnecessary objects blocking the passages, that there is sufficient lighting in the work area and on the equipment being serviced (the absence of burnt out lamps);

— report to the ODS dispatcher about all identified comments and obtain permission to ignite the boiler.

— lean and stand on site barriers, walk on pipelines, as well as on structures and ceilings not intended for passage through them;

— start-up and short-term operation of mechanisms or devices in the absence or malfunction of fencing devices;

— clean near mechanisms without safety guards or with poorly secured guards;

— operate faulty equipment, as well as equipment with faulty or disabled emergency shutdown devices, interlocks, protections and alarms;

— repair equipment without taking technical measures to prevent it from being put into operation by mistake (starting the engine, supplying steam or water, etc.), spontaneous movement or movement;

- come to shift drunk or drink alcohol during working hours.

3. Labor protection requirements during work

3.1. During operation, the boiler room operator is obliged to:

- do not leave operating boilers unattended, both during operation of the boiler and after it is stopped (until combustion in the furnace completely stops and the coolant temperature drops to 45 degrees C),

- do not block passages and approaches to devices, fittings and fire shields,

- do not allow unauthorized persons into the boiler room without a representative of the enterprise administration,

- do not allow untrained and uncertified persons to operate,

- if your health worsens, stop working, make the workplace safe, notify your immediate supervisor, or go to a medical facility,

- during accidents, take part in eliminating the consequences and not handing over and accepting shifts until they are completely eliminated.

3.2. Operate the boiler in accordance with the “boiler operating schedule”.

3.4. The boiler should be purged in accordance with the regime map and production instructions for boiler operation at least once per shift.

3.5. Check the proper operation of pressure gauges and safety valves at least once per shift.

3.6. To increase the boost of the boiler, it is necessary to increase the gas pressure, then the air, and when decreasing, vice versa.

3.7. In case of deviations in the boiler operating mode from the norm, act in accordance with the “Plan for localization and elimination of emergency situations in the boiler room”, “Production instructions for the operation of the boiler”.

3.8. Permit repair personnel to repair work according to the permit, prepare the workplace, and provide targeted instructions.

3.9. When there is a break in the operation of equipment for troubleshooting, replacement of working parts, etc. display safety posters.

3.10. Wear overalls and safety shoes.

3.11. During boiler operation, the boiler room operator is prohibited from:

- leave boilers unattended until combustion in the furnace completely stops, residual fuel is removed from it and the pressure is reduced to zero;

— commissioning of boilers with faulty fittings, feeding devices, automatic safety systems, emergency protection and alarm systems;

- ignite extinguished gas in the firebox without prior ventilation of the firebox and flues;

— light a gas torch from a nearby burner;

— jam the safety valves or additionally load them;

— carry out purging when the purge valves are faulty, open and close the valves with blows of a hammer or other objects;

— lubricate the bearings and tighten the seals while the pumps are operating;

- use boxes and other temporary devices and devices instead of stairs and platforms;

- lengthen the wrenches (put pipes on them, etc.), and also hit the wrench to avoid breaking the bolts and damaging the threads.

4. Occupational safety requirements in emergency situations

4.1. The boiler room operator is obliged to emergency stop the boiler in accordance with the Production Instructions for the operation of boilers and.

4.2. To provide medical care to victims of injury, poisoning and sudden illness, act in accordance with the “Instructions for first aid in case of an accident at work.”

4.3. In case of accidents:

— Immediately organize first aid for the victim and, if necessary, transport him to a medical organization;

— Take urgent measures to prevent the development of an emergency or other emergency situation and the impact of traumatic factors on other persons;

— Before the investigation of the accident begins, preserve the situation as it was at the time of the incident, if this does not threaten the life and health of other persons and does not lead to a catastrophe, accident or other emergency circumstances, and if it is impossible to preserve it, record the current situation (compile schemes, carry out other activities);

5. Labor protection requirements upon completion of work

5.1. When the boiler room operates around the clock, the boiler room operator is obliged to:

— pass the shift in accordance with the “Production Instructions for the Operation of Boilers”;

- sign in the operational log about the shift, if the shift worker fails to show up, inform the DS dispatcher; it is prohibited to leave the boiler room without supervision.

5.2. Notify your immediate supervisor of any deficiencies in the operation of the equipment.

Put the protective clothing in a specially designated place, wash your hands with soap, and if possible, take a shower.

The boiler room operator is obliged to comply with the requirements of the labor protection instructions for the boiler room operator.

Every year during the heating season we receive boiler house operators. They undergo medical examinations when hired. According to 302 n and a special assessment of harmfulness, a medical examination must be carried out once every 2 years. Tell me, can we use last year’s medical examination when hiring operators or not?

Answer

Answer to the question:

No, in this situation, before hiring, employees must be sent for a preliminary medical examination again. This is due to the fact that there was a dismissal. During the time that employees did not work, they could develop contraindications to work. Moreover, the requirement for preliminary medical inspection is a mandatory requirement that must be met with every hire.

Consequently, workers can be hired only after undergoing a preliminary medical examination.

Details in the materials of the Personnel System:

1.Answer: Is it necessary to conduct a mandatory medical examination if an employee is hired for a short period of time to temporarily replace an absent employee (for a period of illness, vacation, etc.). The position for which an employee is hired requires a medical examination.

N.Z. Kovyazina

Yes need.

The need for a medical examination is caused by the presence of dangerous and (or) harmful factors and work in the labor process (Appendices No. 1, 2 to the order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n). Since such factors objectively exist for the temporarily filled position, the temporary employee is subject to all medical examinations provided for by law in the general manner (Article 213 of the Labor Code of the Russian Federation). The term of the contract with the conscript does not matter.

With respect and wishes for comfortable work, Ekaterina Zaitseva,

HR System expert

In recent years, a large number of regulations have been issued defining the responsibilities of employers and health care institutions to provide medical care to workers in hazardous industries. However, in a number of cases, the employer’s legally established obligations to protect the health of workers in hazardous industries are not fulfilled and their function is transferred to the territorial health authorities.

Currently, a system of stepwise provision of medical care to workers in hazardous industries is being implemented. This system includes three links: 1) outpatient clinic, 2) inpatient (therapeutic and diagnostic, treatment and rehabilitation /I stage of rehabilitation/, 3) sanatorium-resort /II stage of rehabilitation/.

The main objectives of the outpatient clinic of the Center are the prevention of occupational and work-related diseases, as well as medical and social rehabilitation of workers who have initial signs of occupational diseases that are not accompanied by loss of ability to work. The only effective way to accomplish these tasks is to effectively (high-quality) carry out preventive medical examinations of these contingents. However, creating a truly effective system for conducting medical examinations is associated with certain organizational difficulties.

Currently, periodic medical examinations are carried out by territorial medical institutions and are of a screening nature. According to the annual reports of health care facilities, the percentage of coverage of workers with periodic medical examinations in the region is 88-90% annually. At the same time, it should be noted that the effectiveness of periodic medical examinations by healthcare facility specialists is extremely low. The reasons for the low efficiency of primary care are that the local therapist does not have special knowledge regarding the clinical manifestations of diseases arising from exposure to harmful factors of modern industrial and agricultural production, does not have data on the intensity of harmful factors in a specific workplace, and does not have information on the prevalence of occupational diseases in specific production conditions, and is also not focused on identifying early signs of occupational diseases.

In order to overcome the difficulties that inevitably arise when organizing and conducting preliminary and periodic medical

The following approach is convenient for inspections:

Familiarity with the legal framework necessary for conducting medical examinations

General requirements for organizing medical examinations

The procedure for conducting medical examinations

Legal basis for conducting medical examinations

The legal basis for conducting medical examinations is based primarily on Article 254 of the Labor Code of the Russian Federation, which states that workers engaged in heavy work and work with harmful or dangerous working conditions undergo mandatory preliminary upon entry to work and periodic medical examinations to determine their suitability for the assigned work. and prevention of occupational diseases.

181 Federal Law of the Russian Federation dated June 23, 1999 establishes the following types of medical activities at the employer’s own expense: mandatory preliminary upon employment and periodic medical examinations (examinations) of employees, extraordinary medical examinations (examinations) of employees at their requests in accordance with medical recommendations with retention of their place of work (position) and average earnings for the duration of the specified medical examinations; as well as exclusion (by employers) of workers; to perform their job duties without undergoing mandatory medical examinations and in case of medical contraindications. Comments to Ch. X Labor Code of the Russian Federation (2000) states:

Employers and officials guilty of violating legislative and other regulations on labor protection, failure to fulfill obligations established by collective agreements or agreements on labor protection, or interfering with the activities of representatives of state supervision and control bodies, as well as public control, are subject to administrative, disciplinary or criminal liability in the manner established by the legislation of the Russian Federation and its constituent republics. Russian Federation. For violation of the requirements of legislative and other regulations on labor protection, enterprise employees are subject to disciplinary and, in appropriate cases, financial and criminal liability.

In cases where the production activities of enterprises pose a danger to the life and health of workers and the population, their activities may be suspended by order of the head of the Center for State Sanitary and Epidemiological Surveillance or state labor protection inspectors

The main document according to which preliminary and periodic medical examinations are carried out is order of the Ministry of Health of the Russian Federation No. 405 dated December 10, 1996, due to the fact that it is the one that has approval from the Ministry of Justice of the Russian Federation. According to Order No. 405, the scope of medical examinations is carried out in accordance with Order No. 90 dated March 14, 1996. Below we will talk about the order (August 2004 No. 83.)

General requirements for organizing preliminary and periodic medical examinations:

General requirements include

Availability of a full package of regulations on the protection of workers' health; on conducting preliminary and periodic medical examinations of workers;

Possibility of interaction with social protection authorities, social insurance and employers in this area of ​​activity.

Providing the opportunity for specialists of a medical institution taking part in the organization and conduct of preliminary and periodic medical examinations to familiarize themselves with these documents,

Compliance with the requirements of the Government of the Russian Federation No. 967 dated December 5, 2000, order of the Ministry of Health of the Russian Federation No. 405, order of the Ministry of Health of the Russian Federation No. 90,

Participation in the examination of the attending physician,

Sufficient technical equipment of health care facilities,

Availability of specialists (our own or external ones) who have a document (certificate, identification) indicating special training in occupational pathology issues no more than five years old.

Preliminary and periodic medical examinations, as well as examination of professional suitability, can be carried out by medical institutions of any organizational and legal forms that provide primary medical care to the population and have a license for the specified type of activity. Medical examinations can be carried out by Centers and departments of occupational pathology, subject to the availability of an appropriate license with the issuance of a conclusion on the results of the examination and suitability for professional activities. Certain aspects of the examination of professional suitability are allowed to be carried out by some specialized health care facilities (dermatovenerological, drug addiction, psychoneurological dispensaries).

The main person conducting medical examinations is the attending physician.

In accordance with Article 58 of the Fundamentals of the Legislation of the Russian Federation on the protection of the health of citizens, the attending physician is a doctor who provides medical care to the patient during the period of his observation and treatment in an outpatient clinic or hospital institution. The attending physician can be a general practitioner at a health center, workshop or territorial site, a general practitioner working in a medical and preventive organization, or a doctor at a Trade Union center who carries out a medical examination using all current medical documentation necessary to assess the employee’s health status over time.

Without the involvement of the attending physician, conducting preliminary and periodic medical examinations is methodologically incorrect. As experience shows, it is during medical examinations carried out by permanent medical examination commissions, prevention departments, medical examination clinics or other medical and preventive institutions without the participation of the attending physician that numerous errors arise related to the admission to professional activities of persons who have contraindications to work with harmful production factors . Procedure for medical examinations

As Order 405 states, the contingents subject to preliminary and periodic medical examinations are determined by the State Sanitary and Epidemiological Supervision centers of the constituent entities of the Russian Federation together with the employer (by workshop, profession, hazardous, harmful substances and production factors) no later than December 1 of the previous year. The timing of inspections must correspond to the established frequency.

Preliminary and periodic medical examinations of workers working on a rotational basis are carried out by medical and preventive organizations / institutions / at the place of permanent medical care or at the location of the shifts, when the administration of the rotational organizations decides on their financing.

Measures to prepare the institution for preliminary and periodic medical examinations.

To the heads of health care facilities:

1. Study the list of harmful substances and production factors affecting employees of supervised enterprises (according to the lists of contingents subject to periodic medical examinations approved by the State Sanitary Inspectorate).

2. Determine the composition of the medical team for conducting preliminary and periodic medical examinations, taking into account the list of harmful substances and production factors at the supervised enterprises (Appendix No. 1, 2 of the order of the Ministry of Health of the Russian Federation No. 90).

3. Determine the set of necessary laboratory research methods, taking into account the list of harmful substances and production factors at supervised enterprises (Appendix No. 1, 2 of Order No. 90 of the Ministry of Health of the Russian Federation).

4. Determine a set of necessary functional research methods, taking into account the list of harmful substances and production factors at supervised enterprises (Appendix No. 1 and 2 of Order No. 90 of the Ministry of Health of the Russian Federation).

5. Ensure the availability of research equipment, chemical reagents, X-ray film and other components in health care facilities for carrying out appropriate laboratory and functional research methods.

6. Draw up a schedule for sending doctors of all specialties involved in preliminary and periodic medical examinations to special training in occupational pathology.

7. Provide training to laboratory doctors on how to conduct special laboratory tests.

Planning.

To the heads of health care facilities:

1. Conclude an agreement with the employer to conduct preliminary and periodic medical examinations.

2. Receive, by December 1 of the year preceding the periodic medical examination, the named lists of contingents subject to periodic medical examinations. The lists must be certified by the State Sanitary and Epidemiological Supervision Center and contain information on the number of occupations examined by workshop, hazardous substances and production factors (in accordance with Appendices No. 1.2 of Order No. 90 of the Ministry of Health of the Russian Federation), length of service, frequency of medical examinations and the date of the last medical examination.

3. Issue an order to conduct preliminary and periodic medical examinations of employees of supervised enterprises in health care facilities. Appoint someone responsible for conducting preliminary and periodic medical examinations at health care facilities, indicate the composition of the medical team performing medical examinations, and determine the working hours of the medical team. The person responsible for conducting preliminary and periodic medical examinations in health care facilities must have a certificate in the specialty "Occupational Pathology".

4. Create a work schedule for the medical team.

5. Create a work schedule for laboratory doctors.

6. Create a work schedule for functionalist doctors.

7. If there is no specialist doctor in the health care facility, enter into an agreement with another health care facility to attract a specialist of this profile to conduct preliminary and periodic medical examinations. The timing of employee examinations must coincide with the work schedule of the main medical team.

8. Ensure that every medical specialist participating in periodic medical examinations of contingents subject to periodic medical examinations in the current year is available. The lists must include 3 additional columns: diagnosis, conclusion (pass, fail), treatment and health measures.

9. Draw up a work schedule for the clinical expert commission (CEC) to make an opinion on contraindications to continuing work in hazardous conditions and resolve conflict situations.

Conducting preliminary medical examinations.

Under an agreement with the employer (head of the organization), the health care facility is obliged to ensure a preliminary medical examination of the employee.

Scheme of preliminary medical examination in health care facilities:

Registration of the employee’s attendance at the health care facility to undergo a preliminary medical examination.

Registration of an employee in a health care facility for a preliminary medical examination is carried out in a special register. The registration form must include the date of application, passport data, the name of the company that sent the employee, harmful production factors at the future place of work and a conclusion about the suitability of the health status for the proposed job.

During the registration of an employee, the documents required to undergo a preliminary medical examination are checked:

A referral from the personnel department of the enterprise (organization), which contains a list of harmful substances and production factors at the future place of work in accordance with Appendices No. 1 and 2 of Order No. 90 of the Ministry of Health of the Russian Federation,

Passport or other identification document, military ID,

Outpatient medical record from the place of regular medical care. If documents are missing or do not fully comply with the requirements (for example, there is no outpatient card, the referral does not indicate harmful substances and production factors), a medical examination is not carried out.

Filling out the employee’s professional route sheet in the outpatient card.

The employee’s professional route sheet indicates the name of the enterprise, workshop, site, profession, length of service at this place of work,

harmful substances and production factors at a given place of work, a final conclusion on the suitability of the state of health for the work assigned. In free form, data on the composition of the medical team performing the medical examination in accordance with Order No. 90 of the Ministry of Health of the Russian Federation and the volume of necessary laboratory and functional tests are entered on the professional route sheet.

Examination by medical specialists. Each doctor enters the data of an objective examination into the employee’s outpatient record and gives his opinion on the suitability of the state of health for the work assigned. On the referral sheet for a preliminary medical examination, the main medical specialist issues a final conclusion on the suitability of the health status for the proposed job. The conclusion, signed by the main medical specialist, is sealed by the health care facility. In the professional route sheet, the main medical specialist duplicates the final conclusion on the suitability of the health status for the intended job.

The main person conducting the preliminary medical examination is the general practitioner, indicated in first place in the medical team, according to column 5 (“participation of medical specialists”) of appendices No. 1 and 2 of order No. 90 of the Ministry of Health of the Russian Federation. During the physical examination, the primary physician must complete the physical examination. The doctor makes his conclusion taking into account the data from laboratory and functional examination methods of the employee, which are pasted into the outpatient card. In the referral sheet for a preliminary medical examination, the conclusion signed by the doctor is sealed by the health care facility.

We remind you that, regardless of the place of work, the person being examined is required to undergo a blood test (hemoglobin, leukocytes, ESR), an X-ray of the chest organs in a direct projection, women are examined by an obstetrician-gynecologist with a bacteriological (for flora) and cytological (for atypical cells) examination .

If the health status does not correspond to the work assigned, the employee is sent to a meeting of the clinical expert commission of the health care facility. Based on the results of the employee’s examination, the clinical expert commission makes a conclusion that he is unfit to work in hazardous working conditions. The first copy of the report is handed over to the employee; a copy of the report is sent to the employer who issued the referral within three days.

Registration of preliminary medical examination results

The result of the preliminary medical examination is entered into the register of preliminary medical examinations.

When transferring an employee to another place of work with similar working conditions and production factors, documents are drawn up by the attending physician based on the data of the previous preliminary or periodic medical examination. The referral specifies the date for the second medical examination.

When an employee is transferred to another place of work with other harmful working conditions and production factors, a preliminary medical examination is carried out on a general basis in accordance with the list of harmful production factors at the new place of work

Conducting periodic medical examinations.

Periodic medical examinations are carried out in accordance with the schedule approved by the chief physician of the healthcare facility and agreed with the employer.

Registration of employees' attendance for periodic medical examinations.

The attendance of employees for periodic medical examinations is ensured by the employer in accordance with the approved plan. Registration is carried out in order to verify the necessary documents for conducting a periodic medical examination: a referral from the employer to undergo a periodic medical examination, a passport or other identification document, a military ID, an outpatient medical card from the place of permanent medical care. If documents are missing or do not fully comply with the requirements, a medical examination will not be carried out.

During registration, the order of examination by medical specialists and the time of taking tests, undergoing functional examination methods, and x-ray examination are determined. Note! Order No. 90 of the Ministry of Health of the Russian Federation specifies chest radiography as a mandatory examination method, and not fluorographic examination.

Filling out the professional route sheet.

Entering into the sheet the date of inspection, work experience, and in case of a change of place of work - information about the name of the enterprise, workshop, site, profession, work experience at the new place of work, harmful substances and production factors at the new place of work. The data on the composition of the medical team performing the medical examination in accordance with the order of the Ministry of Health of the Russian Federation No. 90, and the volume of necessary laboratory and functional studies are adjusted.

Examination by medical specialists.

Each doctor enters the data of an objective examination into the employee’s outpatient record and gives his opinion on the suitability of the health status. If an employee is diagnosed with a disease that prevents them from continuing to work in harmful conditions, a decision is made to send the patient to a meeting of the clinical expert commission of the health care facility. The list of general medical contraindications for work involving hazardous substances and production factors is indicated in Appendix 4 of Order No. 90 of the Ministry of Health of the Russian Federation. A list of additional medical contraindications depending on the specific harmful factor is given in column 7 of Appendix No. 1.2 of Order No. 90 of the Ministry of Health of the Russian Federation.

If an employee detects signs of a general disease that prevents continued contact with harmful substances and production factors, a set of treatment and preventive measures is developed. (If medical examinations are not carried out in a medical facility for continuous observation, notifications of all cases of newly diagnosed general diseases are transferred to the medical facility at the place of permanent medical care of the employee. Notification forms are prepared at the expense of the employer).

If an employee detects abnormalities in individual organs and systems of the body, the doctor prescribes a set of additional diagnostic measures. The examination plan is entered into the patient’s outpatient record for further in-depth examination of the employee at the place of permanent medical care (the employer does not pay for the range of additional medical services not included in appendices No. 1 and 2 of Order No. 90 of the Ministry of Health of the Russian Federation). The final diagnosis is established by specialists from continuous medical care facilities and included in the list of updated diagnoses.

The primary person conducting the periodic medical examination. is the doctor indicated in the first place in the medical team, according to column 5 (“participation of medical specialists”) of appendices No. 1 and 2 of the order of the Ministry of Health of the Russian Federation No. 90. During the medical examination, the main doctor must complete the medical examination. The doctor makes his conclusion taking into account the data from laboratory and functional examination methods of the employee, which are pasted into the outpatient card.

If an employee detects signs of an occupational disease, he is sent to a meeting of the clinical expert commission of a medical institution, which conducts a periodic medical examination in order to decide on further examination at the Trade Center. Further actions of doctors are regulated by Decree of the Government of the Russian Federation of December 15, 2000 No. 967 “On approval of the Regulations on the investigation and recording of occupational diseases.”

For each person with health problems, the doctor conducting a medical examination prescribes therapeutic and health measures: diet, referral to outpatient treatment, inpatient treatment, sanatorium treatment, in a sanatorium, rest home.

Work of the clinical expert commission.

Based on the results of the employee’s examination, the clinical expert commission makes a conclusion about his suitability to work in hazardous working conditions. All conclusions of the commission are recorded in the journal of KEC meetings. The first copy of the conclusion is given to the employee, a copy of the conclusion is sent to the employer who issued the referral within three days. The period for examining an employee at a meeting of the clinical expert commission should not exceed 3 days relative to the schedule for conducting a periodic medical examination of the employee.

By decision of the CEC, an employee can be removed from continuing to work in hazardous working conditions (the presence of general and additional medical contraindications), transferred to work in easier working conditions, or referred to MSEC due to a general illness.

If an employee has signs of an occupational disease, by decision of the CEC, he is sent to the regional center for occupational diseases. The doctor responsible for conducting preliminary and periodic medical examinations at the health care facility sends an emergency notification to the Center for State Sanitary and Epidemiological Surveillance to compile a sanitary and hygienic description of the employee’s working conditions.

Making a final conclusion about the suitability of the health status for the work performed.

On the referral sheet for periodic medical examination (referral forms for periodic medical examination are prepared at the expense of the employer), the main medical specialist makes a final conclusion on the suitability of the health status for the proposed job. The conclusion signed by the main medical specialist is sealed by the health care facility.

Registration of the final act

The results of periodic medical examinations of employees are summarized in the form of final reports. The final report is drawn up within 2 weeks from the date of completion of the periodic medical examination. Upon completion of the periodic inspection, the person responsible for its conduct is provided with information for drawing up a final report. The official form of the final act, specified in the notes to appendices No. 1 and 2 of order No. 555 of the USSR Ministry of Health, has been legally canceled, although a new one has not been developed.

The final act must contain the following data;

Composition of the commission for drawing up the final act;

The composition of the medical team examining workers. For each medical specialist, the date of the last improvement in occupational pathology is indicated;

The number of persons subject to periodic medical examination in the current year, including women;

Number of people examined (percentage of examination coverage), including women;

Number of uninspected (indicating the reason);

Number of people with newly diagnosed general disease;

The number of persons included in dispensary observation groups in connection with chronic general diseases (according to examination data and outpatient records);

- (the number of persons with health problems who require further examination at their place of residence;

The number of persons referred to KEK health care facilities,

The number of people who need temporary transfer to another job for health reasons (general diseases, occupational diseases);

The number of people who need permanent transfer to another job for health reasons (general diseases, occupational diseases);

Number of persons referred to MSEC (general diseases);

Number of identified persons suspected of having an occupational disease (including women), list of names;

Number of persons sent to the regional center of occupational diseases, list of names;

Number of persons to be referred for outpatient treatment.

Number of persons subject to referral for inpatient treatment;

Number of persons subject to referral for sanatorium treatment;

The number of persons to be sent to a sanatorium;

Number of people in need of diet and special nutrition;

The final act is drawn up in 4 copies and submitted to the TsGSEN, adm. enterprises, trade union committees, health care facilities.

Health care facilities bear full legal responsibility for the quality of medical examinations, as extra-budgetary activities, on the basis of existing legislation.

Control over the quality of preliminary and periodic medical examinations is entrusted to the bodies of the SSES and the Trade Union Center.

Order No. 90

Unfortunately, Order No. 90 contains a number of defects that significantly complicate the work.

Order No. 90 does not contain requirements for the preparation of medical certificates and the final act.

Compared to Order 555, there is no third column: previously - the nature of the work being carried out, which makes it difficult to select contingents for conducting PMO. Example - work in contact with ultrasound - in order 555, work with medical equipment was indicated as workplaces, in order No. 90 there are no instructions, as a result of which workplaces in health care facilities are not submitted to the SSES bodies and are not subject to preliminary and preliminary medical examinations in the scope of the order .

In the column “participation of medical specialists” the term appears: “according to indications”. Indications can be either a long work experience or the presence of clinical signs of the disease. The indications must be determined by a general practitioner. It is known that chronic occupational diseases in the early stages have an asymptomatic course and cannot be identified based on complaints. Consequently, the order itself provides for the possibility of diagnosing these occupational diseases only in the later stages. Example: exposure to high temperature includes cataracts and the participation of an ophthalmologist according to indications. But the first 3 stages of thermal cataract are not accompanied by a decrease in visual acuity. , patient complaints.

In addition to the optional participation of some medical specialists in PME (according to indications), in column 7 there are references to medical contraindications in addition to general medical. contraindications. In particular, in column No. 7, when contacting fluoroplastics (p. 30), chronic diseases of the nervous system are indicated as contraindications to work, but the participation of a neurologist in the commission is not provided. A similar situation is observed with contact with cyanide compounds (p. 22): diseases of the anterior segment of the eyes are indicated as contraindications, and there is no ophthalmologist on the commission. Contraindications to working with acrylic nitrile (p. 22) are allergic skin diseases, dystrophic changes in the V.D.P., diseases of the peripheral nervous system, but an ENT doctor does not participate in the commission. dermatologist and neurologist. For vibration disease, high and complicated myopia are indicated as contraindications, but there is no ophthalmologist on the commission (in Order No. 555, an ophthalmologist was a mandatory medical specialist).

For a number of harmful factors, in the same column No. 7 of Order No. 90 there are no contraindications previously approved by Order No. 555. Such inconsistencies complicate the work of medical specialists and lead to the development of injuries and occupational diseases in the workplace, despite the fact that medical examinations are carried out in a high-quality manner.

Column No. 6 indicates laboratory and functional studies carried out during the PME. But here, too, there are inaccuracies. It is mandatory to conduct a blood test with the number of red blood cells, white blood cells, and ESR. Some of the tables provide a link to a general blood test (page 22, chromium), and some to the leukocyte formula (page 22, acrylonitrile). If in the first case a study on the number of reticulocytes and platelets was meant, then the indications of study data on contact with aromatic hydrocarbons are unclear (p. 16). with lead (page 12). Even more incomprehensible is the indication to conduct a study of the leukocyte formula according to indications (page 9, copper), and a general blood test according to indications (page 10, lithium). In order No. 555, contact with welding aerosol containing Mn, Mg. Ti, Zn, Cu, implied a study of the leukocyte formula, this study is not specified in order No. 90.

In case of contact with abrasive dusts, the period for performing Rg-graphy of the lungs (p. 36) is not indicated for people with more than 15 years of experience, although in the future this paragraph is referred to repeatedly.

Special attention should be paid to conducting periodic medical examinations of workers in occupational pathology centers. These medical examinations are regulated by Order No. 90 of the Ministry of Health of the Russian Federation once every 3-5 years, depending on the harmful and hazardous substances and production factors involved, but are not carried out almost everywhere. Medical examinations should be carried out in a consultative clinic or inpatient occupational pathology center.

Previously, there were standard objections from employers to conducting these medical examinations. As a rule, they relied on clause 2.9. order No. 405: ""... inspections can carried out in the conditions of the PC...", implying that it is not necessary to fulfill the requirements of column No. 4 of Order No. 90 of the Ministry of Health of the Russian Federation. However, since the adoption of Order No. 83, the situation has changed radically. Employees with more than 5 years of experience will be examined at the Trade Union Center once every 5 years .

Carrying out medical examinations at enterprises by on-site personnelbrigades

This approach significantly reduces the costs of enterprises, avoids labor loss and the associated lost profits of enterprises, while maintaining the quality of surveys.

One mobile team per year is capable of conducting more than 5,000 examinations. At the same time, the benefits are obvious not only for enterprises, but also for the Trade Union Center.

Team composition:

1. Mobile fluorograph (Large-frame 100 mm or, better, digital, allowing you to obtain images of 38 * 38 cm, 41 * 41 cm)

2. Car for the medical team

3. A UAZ vehicle equipped with the following equipment:

1. spiro analyzer (Chest, Microspiro, etc.)

2. ECG machine

3. vibration tester

4. tuning forks,

5. laboratory assistant’s kit: hemoglobinometer, binocular microscope, ca-lillaries, test tubes, glasses, ESR meters, stands, scarifiers, Goryaev chambers, reagents, automatic micropipettes, bins, packing suitcase

6. ophthalmologist’s kit: straight ophthalmoscope, Govin-Sivtsev table, trial set of glasses, set of trial spectacle frames, arc perimeter, Maklakov tonometers, or IOP indicator, Rabkin tables;

7. otorhinolaryngologist kit: audiometer, ear specula, nasal speculum, spatulas, intralaryngeal speculum, nasopharyngeal speculum, kidney-shaped trays, ear tweezers, Janet syringe (reusable),

8. tonometers, stethophonendoscopes, thermometers.

The average daily workload of a medical team, staffed by doctors and paramedical personnel, is at least 50-60 people with a guarantee of maintaining the quality of work. The detection of signs of occupational diseases in comparison with medical examinations carried out by medical institutions at the place of residence increases by 10-12 times, and reaches 1.1% of the number of those examined (when medical examinations are carried out by medical institutions at the place of residence, it is only 0.1% or less) . At the same time, the initial incidence of disability due to occupational diseases is significantly reduced due to the fact that they are detected at a functionally reversible stage and can be effectively treated with the use of sick leave.

Attention should be paid to the fact that with this approach, the employer actually pays for the detection of general somatic diseases, which reduces the costs of healthcare budgets.

If signs of deviation in health status are detected, workers are sent to the Center for Occupational Pathology to undergo a medical examination in accordance with column “4” of Order No. 90 of the Ministry of Health of the Russian Federation (inpatient examination).

The above system for organizing medical care for workers in hazardous industries allows for the following to be carried out at the outpatient clinic stage:

* high-quality periodic medical examinations,

* detection of occupational diseases in a functionally reversible phase

* early detection of general somatic diseases among workers in hazardous industries

* identification of individuals with individual signs of exposure to harmful production factors (control group) and dynamic monitoring of them in the Trade Union Center

* development for each patient of an individual scheme of treatment and rehabilitation measures aimed at maintaining health in hazardous working conditions,

* if necessary, timely removal from exposure to harmful factors.

Thus, the modern concept of l

List of doctors for periodic medical examinations depends on what position the employee being surveyed occupies, as well as his gender. In our article you will find information about the standard list of doctors who will need to see you to confirm that your health status meets the stated requirements, and about the procedure for undergoing medical examinations.

Which categories of workers are required to undergo periodic medical examinations?

Caring for the health of employees is one of the most important responsibilities of an employer. In accordance with Art. 213 of the Labor Code of the Russian Federation, are required to undergo a medical examination (both before entering work and subsequently, at certain intervals):

  • workers engaged in work characterized by the presence of harmful and/or hazardous production factors;
  • specialists working in the field related to transport traffic;
  • workers working in the field of public catering, medical and child care institutions, as well as some other organizations closely related to the provision of services to the population;
  • employees who are under 21 years of age;
  • other categories of workers, the list of which is established by federal and local legislation.

In accordance with Part 3 of Art. 5.27.1 of the Code of Administrative Offenses of the Russian Federation, failure by the employer to comply with this requirement entails a fine, the amount of which can reach 130,000 rubles.

The procedure for preparing for mandatory periodic medical examination

The sequence of actions of the employer aimed at organizing and conducting periodic medical examinations is as follows:


What documents are drawn up during a periodic medical examination, who pays for it?

Unlike the initial medical examination, which an employee undergoes before concluding an employment agreement with the employer, when undergoing a periodic medical examination, a certificate drawn up in form No. 086/u or No. 001-GS/u is not required. Based on the results of a periodic examination of an employee in a medical organization, a conclusion is drawn up containing the following information:

  • date of issue of the document;
  • Full name of the person who underwent the inspection;
  • name of the employing organization;
  • the name of the structural unit in which the employee works, as well as the exact name of his position;
  • a list of harmful and dangerous production factors that have a direct impact on his health;
  • the result of the examination and the doctor’s conclusion based on its results, indicating the presence or absence of contraindications for the employee to perform the declared type of work.

This document must be signed by the chairman of the medical commission and certified by the seal of the health care institution. Also, the results of the completed medical examination are indicated in the health passport, which is kept by the employer.

Don't know your rights?

All costs for employees undergoing examinations by doctors, as well as conducting laboratory and functional tests, in accordance with the provisions of Art. 213 of the Labor Code fall on the employer. Regardless of which medical institution (public or private) the medical examination will be carried out, the employer must enter into an agreement with it for the provision of relevant services, the cost of which depends on the number of workers examined and the prices established by the management of the clinic.

Passing a medical examination under order 302n - which doctors need to be visited

The procedure for conducting periodic medical examinations of enterprise employees is determined by the provisions of the order of the Ministry of Health and Social Development of the Russian Federation “On approval of lists...” dated April 12, 2011 No. 302n. In accordance with Art. 5 of Section I of the said normative act, the medical examination must be carried out by members of a permanent medical commission, which includes:

  • occupational pathologist;
  • medical specialists who have completed an advanced training course in the specialty “occupational pathology”, or doctors who have a valid certificate in this specialty.

The composition of this commission is approved by order of the chief physician of the health care institution that provides medical examination services for employees of the enterprise.

Wherein list of doctors for medical examination depending also on the sphere in which the employee works and the conditions for his labor activity. Appendix No. 1 to Order No. 302n lists a list of harmful and dangerous production factors, in the presence of which an employee must have his health checked by medical specialists. The same appendix contains a list of doctors who must examine workers working in certain conditions, as well as the frequency of such examinations. In addition, in the document you can find an exact list of laboratory and functional studies, the conduct of which allows you to make the most objective and accurate conclusion about the employee’s state of health.

List of doctors for repeated medical examination at work

A list of doctors who must be visited by an employee of an enterprise when undergoing a medical examination is provided to him directly at the enterprise by the person responsible for carrying out the medical examination and coordinating the process of its implementation. Depending on the worker’s position, this list may include:

  • otorhinolaryngologist;
  • dermatovenerologist;
  • ophthalmologist;
  • allergist;
  • oncologist;
  • urologist;
  • gynecologist;
  • surgeon;
  • endocrinologist;
  • neurologist;
  • orthopedist;
  • dentist;
  • infectious disease specialist;
  • mammologist (for women over 40 years of age), although in some cases a visit to this specialist is replaced by a mandatory mammography procedure followed by presentation to a gynecologist.

IMPORTANT! The link to the 3rd list, specified in Appendix 1 to Order No. 302n, establishes the employee’s obligation to undergo examination by a therapist, psychiatrist and narcologist. The legality of this norm is confirmed by the decision of the Supreme Court of the Russian Federation “On refusal to recognize...” dated December 18, 2012 No. AKPI12-1363.

The list of mandatory tests that every employee undergoing a medical examination must undergo includes:

  • general analysis of urine and blood;
  • fluorography.

Note: this list may be supplemented with other types of examinations and analyzes (depending on the position held by the employee).

Who conducts a medical examination before starting a working day or shift?

In accordance with clause 4, part 2, art. 46 of the Law “On the Fundamentals of Health Protection...” dated November 21, 2011 No. 323 in order to identify the impact of hazardous and harmful production factors, as well as the presence of diseases that interfere with the normal performance of work, certain categories of workers (for example, drivers of vehicles transporting passengers ) are required to undergo daily inspection before going to work. Unlike periodic medical examinations, this event does not take much time. It is carried out, in accordance with part 8 of the appendix to the order of the Ministry of Health of the Russian Federation “On approval of the procedure...” dated December 15, 2014 No. 835n, by a health worker with a higher or secondary medical education, or a health care institution that has a license to provide medical services (including conducting medical examinations).

So, some categories of workers are required to undergo both initial and periodic medical examinations, during which their health status is checked by both general practitioners and highly specialized specialists. The list of doctors whose examination is a mandatory condition for the employee to carry out further work activities, laboratory tests and other studies, as well as a description of working conditions, the influence of which entails the need for regular examinations, are established by the provisions of Order of the Ministry of Health and Social Development No. 302n. Based on this document, a list of doctors is formed for each position who must be visited by the employees occupying it.

Here is an article on this topic

Scroll: What is order 302n

Interview with the director of the science department of the Klin Institute of Safety and Working Conditions, Nadezhda Ivanovna Simonova.

Order N 302n changes the requirements for creating a list of persons who are subject to inspection: this list is now formed based on workplace certification data. Two new specialists are being introduced who are required to take part in the medical examination in accordance with Order No. 302n - a narcologist and a psychiatrist. State labor inspectorates have the right to control everything related to labor protection and health of workers. Partially, these functions in terms of health protection and compliance with working conditions are carried out by Rospotrebnadzor and its “industrial hygiene department”. The employer is obliged to conduct a medical examination at his own expense, and during working hours and during the medical examination to pay the employee his average salary.

What is Order No. 302n on mandatory medical examination of employees at the employer’s expense? What categories of employees are covered by it?
- The requirement for mandatory medical examination of workers has existed and been implemented for the last twenty years. Previously, it was based on several disparate orders, which led to confusion. The main current order was Order No. 83, in parallel with it, Orders No. N 90 and 555, which were adopted back in the Soviet period, were partially in effect. Order N 302n combined all the requirements for periodic and preliminary medical examinations for workers engaged in hazardous working conditions, and slightly changed the regulations, bringing them to a more modern state. New methods and organizations for conducting inspections have emerged.
- Medical examinations will be carried out by new categories of doctors. Who are we talking about?
- Two new specialists are being introduced who are required to take part in the medical examination in accordance with Order No. 302n - a narcologist and a psychiatrist. Almost never before have these doctors been used to conduct examinations of workers engaged in hazardous working conditions.
- What is the reason for the need for drug and psychiatric examinations of employees?
- It is no secret that in our country there is not the most favorable situation with the use of narcotic and psychotropic drugs among people of working age. The number of drug addicts is growing, including among workers working in hazardous conditions. Diagnosis of such problems among this category of specialists is especially relevant, because often the lives of other people depend on them. On the other hand, countries in Europe and America are concerned about the deterioration of the mental state of the working-age population, which is expressed in an increase in depression and neurotic conditions. Moreover, in the 21st century. This problem is seen especially clearly, since in a number of developed countries it is mental disorders that cause more than 40% of temporary disability. We hope that the participation of a psychiatrist in conducting periodic medical examinations will be a timely step for monitoring people with such defective, neurotic disorders, and will allow for a more rational organization of their prevention in the future.
- What are the most common mental problems among workers?
- Problems begin with a banal disorder, which is often mixed with social stress caused by fierce competition in the labor market and fear of losing a job. Extremely high employer demands on personnel, competition within the team between employees, constant overtime, and a high pace of work also play a negative role. All these factors lead a person to a depressed state. People who have no prospects for career growth, as well as representatives of so-called “communicative professions”, such as cashiers-controllers in supermarkets, especially suffer from this. This category of employees does not have the right to make complaints to customers and express dissatisfaction, while customers constantly take advantage of this and try to start a conflict. As a result, a lot of negative emotions accumulate, while you have to smile and be very correct. This may cause neurotic effects.
- Which authorities will monitor the execution of the Order?
- To be fair, it must be said that there have always been many employers who took compliance with such requirements very seriously. First of all, we are talking about industrial, mining and transport enterprises that were previously state-owned. This type of employer seriously risks the technological process if it ignores the requirements of medical regulations. Of course, any job can be done poorly: this applies not only to the employer, but also to medical organizations that conduct examinations. However, their mistakes should not discredit the system itself, since it is being developed purposefully. And even if there are critical comments to this Order, it must be said that, compared to previous orders, it is a step forward. State labor inspectorates have the right to control everything related to labor protection and health of workers. Partially, these functions in terms of health protection and compliance with working conditions are carried out by Rospotrebnadzor and its “industrial hygiene department”. In addition, the employer is obliged to provide complete information about the results of the inspection to trade unions.
- If the employer ignores the medical examination, what regulatory documents should the employee refer to?
- The main legislative act in this area is the Labor Code. The Labor Code very clearly states that the employer is obliged to conduct a medical examination at his own expense, and during working hours and during the medical examination to pay the employee his average salary. These provisions are recorded in the Labor Code of the Russian Federation. Violation of the Labor Code of the Russian Federation leads to administrative liability. But if a poorly conducted medical examination or its absence leads to fatal consequences, then the employer may also fall under criminal liability. In any case, an employee can always contact the state labor inspectorate, the industry trade union, and Rospotrebnadzor, if we are talking about an occupational disease or health impairment.
- How soon should we expect positive results from this innovation?
- I think that the situation will not change at large industrial and mining enterprises: medical examinations have been carried out and will continue to be carried out. Some problems may arise in small and medium-sized businesses. It should be borne in mind that until today these standards have worked very poorly in small and medium-sized businesses. It is no secret that a significant proportion of employees of small companies are outside the scope of social insurance and often do not work under employment contracts. All this requires the improvement of labor legislation and regulations, which will relate to the organization of all events depending on the different volume of property and the number of employees.
- What is the current cost of a medical examination per employee?
- Amounts may vary. This service is provided by organizations licensed to conduct medical examinations. Let’s say, a year or two ago across the country you could find a range from 1.5 thousand to 10 thousand rubles. and more. The new Order introduces new specialists into the medical examination, which will lead to a slight increase in the cost of its implementation. However, at the same time, Order N 302n changes the requirements for creating a list of persons who are subject to inspection: this list is now formed based on workplace certification data. It includes those employees who obviously work in hazardous working conditions, that is, in the presence of factors in the workplace that exceed hygiene standards. In this case, with the right approach and competent consultation of organizations specializing in these issues, the employer can benefit by reducing the number of people inspected. In addition, today the Ministry of Justice is discussing an order that provides for the possibility for employers to use funds from the compulsory health insurance fund for periodic medical examinations. This is a fairly good reserve that allows the employer to reduce the amount of its own funds spent on inspection. It is possible that in some organizations it will even be possible to conduct a medical examination entirely at the expense of funds allocated by the Social Insurance Fund.
- What legislative acts, also related to health protection at the workplace, should be expected in the near future?
- The Ministry of Labor and Social Development has been actively developing the paradigm of using the idea of ​​assessing and managing professional risks in the process of managing labor activity over the past few years. The concept of professional risk was introduced into the Labor Code of the Russian Federation, whereas previously it was mentioned only in Federal Law N 125-FZ. Today, already in the Labor Code of the Russian Federation, we have initial ideas about the professional risk management system, and in the near future we will receive a procedure for assessing and managing professional risks. This document is already under consideration by the Ministry of Health. The results of periodic medical examinations are the second of two components (the first is workplace certification) that are used in assessing occupational risks. One of the expected innovations will be the automation of the results of periodic medical examinations, that is, unified registration forms will be introduced, which will allow the creation of databases based on the results of examinations. The latter, combined with a workplace certification database, provide the values ​​of individual occupational risks. Thanks to this technique, it will be possible to see which factor most influences the risk - working conditions, health status or the high risk of injury from equipment. Based on this, the employer will be able to choose primary actions to manage occupational risks, both to reduce the level of exposure to harmful factors and to preserve and strengthen the health of workers. This will reduce professional risk at the enterprise, as well as reduce the volume of insurance payments.

Signed for seal
14.05.2012

As far as I know, operators of gas boiler houses are entitled to additional vacation 6 working (7 calendar) days.