ORDER OF THE MINISTRY OF HEALTH OF THE REPUBLIC OF TAJIKISTAN

of October 31, 2012 No. 536

About approval "Procedure and frequency of performing obligatory preliminary and periodic medical examinations"

For the purpose of safety of work, health protection, the prevention of origin and spread of infectious (parasitic) diseases, mass noninfectious diseases (poisonings), occupational diseases and accidents, decrease in level of diseases, improvement of quality of performing medical examinations and their regulation based on article 31 of the Law of the Republic of Tajikistan "About ensuring sanitary and epidemiologic safety of the population" according to Item 6 of the Regulations on the Ministry of Health of the Republic of Tajikistan approved by the order of the Government of the Republic of Tajikistan of December 28, 2006 No. 603,

I dispose:

1. Approve the Procedure and frequency of performing obligatory preliminary and periodic medical examinations. It (is applied)

2. To heads of department of health care of the Gorno-Badakhshan Autonomous Region, Khatlon and Sughd areas and city of Dushanbe, chief physicians of the central hospitals of the cities and areas of republican subordination:

a) organize performing obligatory preliminary and periodic medical examinations according to this procedure in specialized state treatment and prevention facilities;

b) based on the analysis of results of medical examinations for the purpose of improvement and public health care to take adequate measures for labor safety, preventions of origin and spread of infectious (parasitic) diseases, mass noninfectious diseases (poisonings), occupational diseases, and also recovery of working ability of workers.

3. To the head of Service of the state sanitary and epidemiological surveillance of the Ministry of Health of the Republic of Tajikistan (Aliyev S. P.), to directors of the centers of the state sanitary and epidemiological surveillance of the Gorno-Badakhshan Autonomous Region, Sughd and Khatlon areas, city of Dushanbe, cities and areas of republican subordination:

a) strengthen sanitary and epidemiological surveillance behind timeliness, quality and completeness of performing obligatory preliminary and periodic medical examinations, especially medical examinations performed for the purpose of the prevention of origin and spread of infectious (parasitic) diseases to take adequate measures on the relation of persons, the companies and organizations which staff evade from passing of medical examinations according to the current legislation of the Republic of Tajikistan;

b) strengthen supervision of accomplishment of regulations of occupational health, especially in the companies where working conditions of workers are connected with hazardous substances and adverse production factors; develop methodical recommendations about improvement of working conditions, decrease in impact of hazardous substances and adverse production factors and to control their accomplishment.

4. To the director of Republican clinical center of occupational diseases (Amirshoyev Sh. T.):

a) according to regulatory legal acts of the Republic of Tajikistan and this order together with organizations of industry of health care of the republic to provide the organization of performing obligatory preliminary and periodic medical examinations of workers which labor activity is connected with hazardous substances and adverse production factors;

b) give organizational and methodical help to organizations of industry of health care of the republic on the organization and performing obligatory preliminary and periodic medical examinations of workers which labor activity is connected with hazardous substances and adverse production factors;

c) in Republican clinical center of occupational diseases to organize carrying out research works on implementation of new methods of diagnostics and treatment of occupational diseases and recovery of working ability of patients.

5. To rectors of the Tajik state medical university of Abuali ibn Sino (Urbonov U. A.) and Tajik institute of postdegree preparation of medical personnel (Akhmedov A. A.): assist in passing of cycles of advanced training and special preparation to specialists of treatment and prevention facilities who perform medical examinations

6. The conclusion about occupational disease in compliance of the operating procedure to assign the right of establishment of the diagnosis and issue to Republican clinical center of occupational diseases.

7. This order to provide in accordance with the established procedure on state registration to the Ministry of Justice of the Republic of Tajikistan.

8. This order to enact after state registration and official publication.

9. Declare invalid the order of the Minister of Health of the Republic of Tajikistan of 30.07.2011 No. 422 "About performing obligatory preliminary and periodic medical examinations".

10. Control of execution of this order to assign to the first deputy (Dzhobirov S. B.) and deputy ministers of health care (Rakhmonov S. B., Mirzoyev A. S.).

Approved by the Order of the Minister of Health of the Republic of Tajikistan of October 31, 2012, No. 536

Procedure and frequency of performing obligatory preliminary and periodic medical examinations

1. General provisions

1. This procedure is developed based on article 31 of the Law of the Republic of Tajikistan "About ensuring sanitary and epidemiologic safety of the population" and determines procedure, frequency, the organization and performing obligatory preliminary and periodic medical examinations.

Obligatory medical examinations are complex of the treatment-and-prophylactic events held for the purpose of health protection, the prevention of origin and spread of infectious (parasitic) diseases, mass noninfectious diseases (poisonings), occupational diseases and accidents and also for the purpose of determination of compliance, condition, health of the worker of the work charged to it.

2. Obligatory medical examinations consists:

a) preliminary medical examinations (in case of revenues to work). Preliminary medical examinations in case of revenues to work are performed for the purpose of determination of compliance of the state of health of the worker (osvidetelstvuyemy) of the work charged to it;

b) periodic medical examinations. Periodic medical examinations include frequency (frequency rate) of medical examinations of workers taking into account the performed work and the circle connected with its accomplishment. Frequency (frequency rate) of medical examination depends on time necessary for observation of change of the state of health of the worker and on the survey purpose.

Periodic medical examinations are performed in the course of labor activity of the worker on purpose:

- determinations of compliance of the state of health of the worker of the work performed by it (job responsibilities);

- dynamic observation of the state of health of workers, timely identification of initial forms of professional (poisonings) and infectious (parasitic) diseases, early signs of impacts of harmful and dangerous production factors on the state of health of the worker;

- detection of the general diseases which are medical contraindications for further work, connected with impact of harmful and dangerous production factors and the having medical contraindications for accomplishment of job responsibilities;

- timely holding the preventive and rehabilitation actions directed to preserving health and recovery of working ability of workers.

c) Extraordinary medical examinations:

- if the worker considers that deterioration in state of his health is connected with working conditions he has the right to demand performing extraordinary medical examination.

d) Drivers of automotive vehicles are exposed pretrip, routine and posttrip medical examinations.

3. Medical examinations of workers are subdivided into two groups:

a) I group. The medical examinations performed for the purpose of determination of compliance of health of the worker to the performed work and preventions of occupational diseases. Are subject to such surveys the workers occupied on hard work and at works with harmful and dangerous working conditions, including at underground, night works and working at vehicles. The list of workers whose activities it is connected with harmful production factors it is determined by the Government of the Republic of Tajikistan. (The order of the Government of the Republic of Tajikistan No. 702 of December 31, 2010).

b) II group. The medical examinations performed for the purpose of health protection of the prevention of origin and spread of infectious (parasitic) diseases. Such medical surveys the workers of industries of the food industry, public catering, trade, medicine, educations, municipal services and other industries who are directly servicing the population are exposed.

2. The organization and performing obligatory preliminary and periodic medical examinations of the workers connected with hazardous substances and adverse production factors

4. According to the Labor code of the Republic of Tajikistan the employer shall organize carrying out preliminary, in case of execution of an employment agreement (contract), and obligatory medical examinations of the workers, periodic in the course of work, occupied on hard work with harmful or dangerous working conditions including at underground and night works, and also at the works connected with movement of vehicles for the purpose of determination of compliance to the performed work of condition of their health and the prevention of occupational diseases.

5. Preliminary medical examinations in case of revenues to work to be performed for determination of compliance of the state of health of the worker (osvidetelstvuyemy) of the work charged to it, and also for the purpose of the prevention of occupational diseases, accidents and safety of work.

6. Periodic medical examinations of the workers connected with hazardous substances and adverse production factors to be carried out on purpose:

a) dynamic observation of the state of health of workers, timely identification of initial forms of occupational diseases, early signs of impacts of harmful and dangerous production factors on the state of health of workers, forming of risk groups;

b) detection of the general diseases which are medical contraindications for further work connected with impact of harmful and dangerous production factors;

c) timely carrying out preventive and rehabilitation action, directed to preserving health and recovery of working ability of workers.

7. Preliminary and periodic medical examinations to be performed by the state medical organizations workers of which took specialization courses on occupational diseases and having the license for the specified type of activity. For the purpose of ensuring availability of medical attendance and not derivation of workers from production:

- the working schedule of medical institutions which perform obligatory medical examinations to be provided according to the working schedule of the organization and the worker time of workers;

- when providing the corresponding sanitary and epidemiologic conditions on mutual approval obligatory periodic medical examinations to be carried out based on the company of workers from mobile team of medical institution.

8. Preliminary (in case of revenues to work, transfer into other work) to be subject to medical examinations persons who in the future execution of their obligations will be connected with impact of harmful and adverse factors of productions.

9. The administration of educational institutions and rates on professional training of cases if after their termination person by the nature of sovy activities is affected by harmful and adverse conditions of work, shall send the specified contingent for performing preliminary medical examinations prior to training.

10. If by results of preliminary medical examination medical contraindications to performance of work connected with impact by hazardous substances and adverse production factors are determined, osvidetelstvuyemy it is not allowed to work.

11. In case of transfer of the worker into other work of which it is characteristic similar with former to work of impact harmful and adverse condition of work preliminary medical examinations not to be carried out.

12. For passing of preliminary medical examination (in case of revenues to work, transfer into other work) the administration of the companies issues osvidetelstvuyemy according to appendix of 1 this procedure the direction for the appeal to the treatment and prevention facility performing medical examinations. In the direction the surname, name, middle name, year of birth, profession osvidetelstvuyemy harmful factors and adverse working condition is entered.

13. The administration of the company provides persons directed to preliminary medical examinations, forms of the directions.

14. Is exposed to periodic medical examinations all workers whose activities are connected with impact of hazardous substances and adverse production factors.

15. Frequency of medical examinations - this frequency (frequency rate) of performing medical examinations. Frequency and amount of performing obligatory preliminary and periodic medical examinations of accomplishment of some works connected with hazardous substances and adverse conditions of work is given in appendix 2 presents of procedure.

16. In compliance of the article 31 Law of the Republic of Tajikistan "About ensuring sanitary and epidemiologic safety of the population" in case of need, based on offers of bodies and organizations of the public sanitary and epidemiologic service of the Ministry of Health of the Republic of Tajikistan, municipal authorities, in the separate organizations (workshops, laboratories and other structural divisions) additional indications to performing medical examinations of workers can be entered.

17. In compliance of "The labor code of the Republic of Tajikistan" the worker has the right to demand performing extraordinary medical examination if he considers that deterioration in state of his health is connected with working conditions.

18. Periodic medical examinations of workers ahead of schedule to be performed based on the medical certificate or the reasonable conclusion of bodies of Service of the state sanitary and epidemiological surveillance.

19. The center of the state sanitary and epidemiological surveillance, administration of the companies and medical institution have the right to direct the worker ahead of schedule to medical examinations (after the postponed disease, injury and other). In this case in the direction the reasons of the early direction are specified medical examination.

20. Periodic medical examinations of shift workers can be performed in territorial medical organizations of the place performance of work.

21. The administration of the companies together with the representative of the Center of the state sanitary and epidemiological surveillance for the purpose of planning of performing medical examinations the next year no later than December 1 of the current year constitutes the list of workers of subjects to periodic medical examinations. In the list surname, the name, middle name, year of birth, post, length of service, the worker's address, communication of labor activity with hazardous substances and adverse conditions of work shall be entered completely. The list is approved with the Center of the state sanitary and epidemiological surveillance and is provided to medical institution which performs medical examinations.

22. The administration of the companies publishes the order about performing medical examinations and shall according to the order, provide passing of medical examinations of workers timely and in full.

23. The administration of the companies has the right not to allow to work of workers who evade from passing of medical examinations or does not implement the recommendation about their results.

24. The administration of medical institution which performs periodic medical examinations based on the provided list of administration of the companies constitutes the schedule of performing medical examinations. The plan is approved with administration of the company in part time of carrying out survey and about the Center of the state sanitary and epidemiological surveillance regarding accounting of all workers.

25. The head of the medical organization performing preliminary and periodic medical examinations approves structure of medical commission. The commission chairman are appointed the pathologist or other specialty having special preparation on professional pathology. The commissions shall the specialists who had within the specialties training on professional pathology will be included. If the medical institution is specialized in the direction of performing medical examinations, then the order on statement of structure of medical commission is not issued.

26. The head of medical institution shall organize qualitatively and in full performing medical examinations. For this purpose it shall provide passing of workers of advanced training and special training courses, and also carrying out all necessary laboratory inspections and to provide organization with necessary oborudovaniye and stock.

27. The main person, performing preliminary and periodic medical examinations, the therapist is. In preliminary medical examinations participation of all specialists (the neuropathologist, the ophthalmologist, the otorhinolaryngologist, the dermatovenerologist, the surgeon, etc. or the family doctor) to procedure is obligatory.

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