The translation of this document is outdated.
Translation validity: 01.07.2015.–06.05.2022.
Amendments not included: 03.05.2022.
Text consolidated by Valsts valodas centrs (State
Language Centre) with amending regulations of:
14 September 2010 [shall
come into force from 23 September 2010];
8 January 2013 [shall come into force from 11 January
2013];
16 June 2015 [shall come into force from 1 July
2015].
If a whole or part of a paragraph has been amended,
the date of the amending regulation appears in square
brackets at the end of the paragraph. If a whole
paragraph or sub-paragraph has been deleted, the date of
the deletion appears in square brackets beside the
deleted paragraph or sub-paragraph.
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Republic of Latvia
Cabinet
Regulation No. 219
Adopted 10 March 2009
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Procedures for the Performance of
Mandatory Health Examinations
Issued pursuant to
Section 15, Paragraph one of the Labour Protection Law
I. General Provisions
1. This Regulation prescribes the procedures for the
performance of mandatory health examinations (hereinafter - the
health examination) for those employees whose state of health is
affected by or may be affected by factors of the working
environment harmful to health, and those employees who have
special conditions at work.
2. This Regulation shall not apply to health examinations
which are to be performed for seafarers, soldiers, aircraft
flight crew, and air-traffic controllers, as well as the
officials with special service ranks in the institutions of the
Ministry of the Interior system and in the Prison
Administration.
3. The health examination shall be performed for the following
persons:
3.1. who are employed or who are due to be employed in work in
which their state of health is affected by factors of the working
environment harmful to health (Annex 1);
3.2. who are employed or are due to be employed in work with
special conditions - dangerous work with a high risk of accidents
for the employee himself or herself or those around him or her
(Annex 2).
4. The following persons shall be sent for the health
examination in the cases referred to in Paragraph 3 of this
Regulation:
4.1. persons prior to commencing employment legal
relationships or State civil service legal relationships for the
performance of the initial health examination;
4.2. employed persons:
4.2.1. for the performance of periodic health examinations -
in accordance with the procedures laid down in this
Regulation;
4.2.2. for the performance of extraordinary (additional)
health examinations:
4.2.2.1. if factors of the working environment harmful to
health or special conditions change;
4.2.2.2. upon instruction of a doctor of occupational diseases
or a doctor of occupational health and occupational diseases
(hereinafter - the doctor of occupational diseases), those
employees who work under similar working conditions as an
employee for which the doctor of occupational diseases has
determined the characteristics of an occupational disease which
have developed as a result of exposure to the factors of the
working environment harmful to health at his or her
workplace;
4.2.2.3. if the doctor of occupational diseases has indicated
the deadline for the next extraordinary (additional) health
examination under the special notes and recommendations in Part
II, Paragraph 12 of the mandatory health examination card (Annex
3) (hereinafter - the health examination card);
4.2.2.4. upon request of an employee or a trusted
representative thereof, if there is a reason to believe that
factors of the working environment harmful to health are
adversely affecting the health of the employee;
4.2.2.5. upon initiative of an employer in any other time
period, in order to ascertain that the state of health of an
employee conforms with the work to be performed, including in
case of lasting or regular incapacity to work.
[8 January 2013]
5. The health examination shall be performed by the following
persons:
5.1. the doctor of occupational diseases, except for if a
person is employed or is due to be employed in work with sources
of ionising radiation which conform to category A in accordance
with the laws and regulations regarding protection against
ionising radiation;
5.2. the doctor of occupational diseases from the Occupational
and Radiological Medicine Centre of valsts sabiedrība ar
ierobežotu atbildību "Paula Stradiņa klīniskā universitātes
slimnīca" [State limited liability company Pauls Stradins
Clinical University Hospital] (hereinafter - the Occupational and
Radiation Medicine Centre), if a person is employed or is due to
be employed in work involving sources of ionising radiation.
[8 January 2013]
6. If the health examination has been performed for a person
prior to the commencement of employment legal relationships or
State civil service legal relationships, a repeat health
examination shall not be necessary and the health examination
card issued shall also be valid for submission to another
employer throughout the time period specified in this Regulation
in relation to the performance of the next periodic health
examination, if the factors of the working environment or working
conditions are similar.
7. If an employee is transferred to another job or an employee
starts working for another employer in a workplace in which the
factors of the working environment harmful to health or working
conditions are similar to the factors of the former working
environment or working conditions, the next periodic health
examination appropriate to this job shall be performed in the
previously specified time period, if a copy of the health
examination card performed at the previous workplace is
submitted.
8. An employer for which an employee is working in a
supplementary work shall accept a copy of the health examination
card of the health examination performed in the primary
employment approved by the employer as a confirmation of the
conformity of the employee with the work to be performed if the
factors of the working environment harmful to health and working
conditions are the same as in the primary employment of the
employee.
9. If the health examination has been performed for an
employee according to the factors existing in the working
environment harmful to health in the workplace in another
European Union Member State, the employee shall not be sent for
the health examination and an opinion on the conformity of the
state of health of the person with the work to be performed shall
be valid throughout the whole time period specified in this
Regulation in relation to the performance of the next periodic
health examination according to the factors of the working
environment or working conditions. Upon request of the State
Labour Inspectorate an employer shall ensure that the opinion of
a doctor on the conformity of the state of health of the person
with the work to be performed be translated into the official
language.
10. The State Labour Inspectorate shall monitor and control
the conformity with this Regulation by employers, and the Health
Inspectorate shall monitor and control the professional
activities of healthcare practitioners.
II. Referral for a Mandatory
Health Examination
11. An employer shall send employees and persons prior to the
commencement of employment legal relationships or State civil
service legal relationships for the health examination to one of
the doctors of occupational diseases referred to in Paragraph 5
of this Regulation according to the factors of the working
environment harmful to health and the special conditions
specified in a risk assessment of the working environment.
12. Prior to sending an employee to the doctor of occupational
diseases for the performance of the health examination, an
employer may send the employee for the performance of laboratory
and functional investigations indicated in Annexes 1 and 2 to
this Regulation according to the factors of the working
environment harmful to health and special conditions specified
and to the specialists referred to in Annexes 1 and 2 to this
Regulation, whose examination is mandatory according to the
factors of the working environment harmful to health and special
conditions, or another additional investigation and for the
performance of investigations which are regarded as essential. In
such case the employee shall be sent for the performance of the
health examination to the doctor of occupational diseases
following the receipt of the results of these investigations. The
employee shall submit the results of the investigations to the
doctor of occupational diseases during the health
examination.
13. All persons referred to in Paragraph 3 of this Regulation
shall be sent for an initial health examination prior to the
commencement of employment legal relationships or State civil
service legal relationships.
14. If no other period is indicated in Annex 1 or 2 to this
Regulation according to the factors of the working environment
harmful to health or special conditions of work, employees shall
be sent for periodic health examinations as follows:
14.1. once every three years, if:
14.1.1. the exposure index of chemical substances is greater
than 0.5 but less than 0.75;
14.1.2. an employee is exposed to the effects of such noise
which exceeds the lowest values of the noise exposure level but
does not exceed the highest values of the noise exposure level
(in the boundaries from 80 to 85 dB(A));
14.1.3. an employee is exposed to the effects of such other
physical factors of the working environment exposure action
values of which exceed the action values specified for the
corresponding physical factor, not exceeding the limit values of
exposure;
14.1.4. the health of employees in the working environment is
affected by optical radiation which does not exceed the specified
limit values of exposure;
14.1.5. the health of employees in the working environment is
affected by the factors of the working environment harmful to
health referred to in Annex 1 to this Regulation which do not
have specified limit values;
14.2. once every two years, if:
14.2.1. the exposure index of chemical substances is greater
than 0.75, but less than 1.0:
14.2.2. several chemical substances with similar (synergic)
properties have an effect on an employee in the workplace and the
amount of the exposure index of these substances is greater than
0.75, but less than 1.0;
14.2.3. employees are employed in work in special conditions -
dangerous work where a high risk of accidents exists for an
employee or those around him or her (Annex 2);
14.3. once a year, if:
14.3.1. the state of health of an employee is affected by a
factor of the working environment harmful to health for which a
limit value of exposure and the need for measurements has been
specified, but the measurement of exposure of this factor has not
been performed in the working environment;
14.3.2. the exposure index of chemical substances is greater
than 1.0;
14.3.3. an employee is exposed to the effects of such noise
which exceeds the highest action value of noise exposure (85
dB(A)), or to the effects of other such physical factors of the
working environment for which the specified limit values of
exposure exceed the limit values of exposure specified for the
physical factors;
14.3.4. several chemical substances with similar (synergic)
properties have an effect on an employee in the workplace and the
sum of the exposure index of these substances is greater than
1.0;
14.3.5. the state of health of an employee at work is affected
by carcinogenic substances.
15. When determining the frequency of periodic health
examinations, the exposure to the factors in the working
environment harmful to health and the specified limit values
thereof shall be taken into account, in conformity the following
principles:
15.1. when evaluating exposure to noise and other physical
factors which have specified exposure values, the exposure time
of this factor shall be taken into account, by re-calculating the
exposure to an employee if the exposure time of a factor exceeds
eight hours per day and 40 hours per week;
15.2. if an employee is subjected to exposure of more than one
chemical substance or chemical product (simultaneously or
gradually), the potential mutual and common exposure of all the
chemical substances and chemical products used at work shall be
taken into account, as the sum of chemical substances with a
similar (synergic) exposure effect.
16. If the exposure index of chemical substances is less than
0.5 and the effect on an employee of the physical factor of the
working environment, which has specified exposure level values,
does not exceed the value of any specified exposure level value
and, moreover, it is possible to prove that these levels conform
with long-term conditions of the working environment, it shall be
allowed not to send the employee for periodic health
examinations.
17. If employees are not sent for the health examinations in
accordance with Paragraph 16 of this Regulation, but it is
established in the current risk assessment that the risks of the
working environment have changed, causing a greater risk to the
health of employees, and the working conditions no longer conform
with those specified in Paragraph 16 of this Regulation,
employees shall be sent for the health examinations in accordance
with Paragraph 14 of this Regulation.
18. If the chemical risk factor with which employees come into
contact at the workplace is a metal which is not absorbed by the
organism through undamaged skin, does not cause an allergic
reaction upon contact or the development of a tumour in a local
contact point and is present in work tools or equipment in a
connected manner, it shall be allowed not to send employees and
persons for the health examinations prior to the commencement of
employment legal relationships or State civil service
relationships.
19. An employer shall determine a specific time for the
performance of periodic and extraordinary (additional) health
examinations of not less than four weeks and not more than three
months.
[8 January 2013]
20. On referral for the health examination, an employer shall
issue the health examination card (Annex 3) in two copies to an
employee and person prior to the commencement of employment legal
relationships or State civil service legal relationships,
completing Part I of the health examination card "Referral for a
Mandatory Health Examination" beforehand.
21. Upon referral of an employee for an extraordinary
(additional) health examination, an employer shall issue a new
health examination card and attach a copy of the previously
performed health examination card, except for the case referred
to in Sub-paragraph 4.2.2.3 of this Regulation.
22. Upon referral of an employee for an extraordinary
(additional) health examination in accordance with that specified
in Sub-paragraph 4.2.2.3 of this Regulation, the specific medical
treatment institution to which the employee is being referred
shall be additionally indicated in parenthesis under the words
"Referral for a Mandatory Health Examination" in Part I of the
health examination card, providing that the health examination
shall be performed in the medical treatment institution the
doctor of which has indicated a deadline for the performance of
an extraordinary health examination. If the relevant medical
treatment institution has terminated activities or the doctor who
has indicated the deadline for the performance of an
extraordinary health examination has ceased employment legal
relationships with the medical treatment institution, the
employee shall perform the extraordinary health examination in a
different medical treatment institution indicated by the
employer.
23. Paragraphs 6 and 7 of the health examination card shall be
completed by an employer indicating (in words) the current factor
of the working environment harmful to health in the working
environment or the special conditions of work in accordance with
Annexes 1 and 2 to this Regulation. Following the indication
regarding the current factors of the working environment harmful
to health in the working environment, it shall be indicated in
brackets when the next health examination is due, or, if the time
of the next health examination is different depending on several
factors of the working environment harmful to health, it shall be
indicated after each indication regarding the current factors of
the working environment harmful to health in the working
environment.
23.1 If an employee is sent for the performance of
the mandatory health examination:
23.1 1. in accordance with Sub-paragraphs 1.1, 1.2,
1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 1.10, 1.11, 1.12, 1.13 and
Paragraph 2 of Annex 1 to this Regulation, the health examination
card shall indicate in Paragraph 6 the specific chemical
substance to which the employee is exposed or will be exposed, as
well as the nature of the chemical substance, the duration and
concentration in the air of the working environment;
23.1 2 in accordance with Sub-paragraph 3.2 of
Annex 1 to this Regulation, the biological agent to which the
employee is exposed or will be exposed shall be indicated in
Paragraph 6 of the health examination card.
[8 January 2013]
24. When indicating the length of service, the period worked
for a specific employer shall be indicated in Paragraphs 8 and 9
of the health examination card, upon existence of factors of the
working environment harmful to health or when performing work in
special conditions.
25. If an employee is sent for an extraordinary (additional)
health examination, the reason for the need for an extraordinary
health examination shall be indicated in Sub-paragraph 10.2 of
the health examination card.
26. If an employer has not received the health examination
card completed by a doctor of occupational diseases, he or she is
entitled to suspend an employee from work, until the employee
submits the health examination card to the employer in which it
is noted that the state of health thereof conforms with the work
to be performed. An employee may not be suspended from work if he
or she has not performed a mandatory health examination within
the specified deadline due to circumstances beyond his or her
control, on the entry of which the employee shall inform his or
her employer.
III. Performance of Health
Examinations
27. Upon performing the health examination, the doctor of
occupational diseases shall ask the person whose state of health
is to be examined for conformity with the work to be performed
(hereinafter - the person to be examined) and fill out the
questionnaire regarding the state of health of the person
(hereinafter - the questionnaire) (Annex 4). The questionnaire
shall be signed by the person to be examined when he or she has
ascertained that the information on the questionnaire corresponds
with that stated by him or her. The doctor of occupational
diseases shall include the questionnaire in the medical
documentation of the person.
[8 January 2013]
28. The doctor of occupational diseases may request additional
information from the family doctor of the person to be examined
in order to clarify the information provided in the
questionnaire.
29. If the doctor of occupational diseases feels it is
necessary, he or she may request the results of the risk
assessment of the working environment from an employer which
relates to the workplace of the person to be examined.
30. If precise information regarding the factors of the
working environment harmful to health or special conditions of
work are not indicated in the health examination card and,
therefore, it is not possible to perform a qualitative health
examination, the doctor of occupational diseases may request
additional information from an employer regarding the current
factors of the working environment harmful to health in the
working environment and special conditions to which an employee
is subjected, and, if necessary, request clarification from the
employer of information indicated in the health examination card,
without providing an opinion on the conformity of the state of
health of the employee with the work to be performed. The doctor
of occupational diseases shall make an entry regarding this in
Paragraph 12 of the health examination card.
31. The doctor of occupational diseases may not make
corrections to the information indicated by an employer in the
health examination card.
32. An employer, upon receipt of the request from the doctor
of occupational diseases referred to in Paragraph 30 of this
Regulation, shall issue a new health examination card, clarifying
the information indicated in the health examination card
accordingly.
33. In order to ascertain the working conditions in which an
employee performs work, the doctor of occupational diseases has
the right, by previous agreement with an employer, to visit the
workplace of the employee whose health he or she is
examining.
34. The doctor of occupational diseases shall send persons to
be examined for the performance of laboratory investigations and
to other specialists for mandatory purposeful assessment and
investigation in accordance with Annexes 1 and 2 to this
Regulation.
35. If the results obtained by specialist assessment and
laboratory investigations are not sufficient for determination of
the conformity of the state of health with the work to be
performed, the doctor of occupational diseases shall send the
person to be examined to specialists for the performance of
additional assessment and investigations in accordance with
Annexes 1 and 2 to this Regulation.
36. If the doctor of occupational diseases has an
appropriately confirmed qualification and apparatus for the
performance of any of the assessments or investigations referred
to in Annexes 1 and 2 to this Regulation, he or she may perform
them himself or herself without sending the person to be examined
to the relevant specialists or for investigations in accordance
with Annexes 1 and 2 to this Regulation.
37. If the results of the specialist assessment and
investigations received confirm that additional assessment,
laboratory or functional investigations of the person to be
examined are necessary (which are not referred to in Annexes 1
and 2 to this Regulation), in order to clarify the conformity of
the state of health with the work to be performed, the doctor of
occupational diseases shall send the person to be examined for
the performance thereof in accordance with the indications. The
doctor of occupational diseases shall indicate the justification
for the additional assessment or investigation in the medical
documentation of the person to be examined.
38. If assessment, investigation, and analysis of the state of
health of the person to be examined has been performed within the
last year, and certifying documents are submitted to the doctor
of occupational diseases (results of investigations or analyses,
opinions of specialists, statements, including a statement of the
health of a driver), the doctor of occupational diseases shall
take these into account, when investigating the relevant person
and when providing an opinion on the conformity of the state of
health of the person with the work to be performed. In such case
the person to be examined shall not be sent for performance of
such investigations, analyses, or consultations again the results
of which for the previous year are available and may be used for
determination and evaluation of the state of health thereof.
39. If the doctor of occupational diseases, when evaluating
the state of health of the person to be examined, establishes
that any of the specialist assessments or investigations referred
to in Annex 1 or 2 to this Regulation are not necessary in order
to evaluate the conformity of the state of health of the person
to be examined with the work to be performed, it shall be allowed
not to send the person to be examined for such assessments or
investigations, indicating the justification in the medical
documentation of the person to be examined.
40. If indications of an occupational disease are established
in the person to be examined during health examination, the
doctor of occupational diseases shall issue a consultant opinion
to the person to be examined and attach the results of the
necessary investigations for submission to the family doctor
thereof. The family doctor shall refer the person to be examined
to the Doctors' Council of Occupational Diseases.
41. If during the health examination a disease not connected
with work is established which has not been diagnosed until then
and is not being treated, an additional statement shall be issued
to the person to be examined regarding deviations from the
accepted levels of the established norms or regarding the disease
diagnosed and the person to be examined shall be sent to the
family doctor thereof for further assessment and treatment or for
prescribing a course of rehabilitation. A note regarding diseases
which are not connected with work shall not be made in the health
examination card.
IV. Opinion on the Conformity of
the State of Health of the Person with the Work to be
Performed
42. After receipt of the results of investigations and
specialist assessments and when the performance of an
investigation of a person has taken place, the doctor of
occupational diseases shall provide an opinion on the conformity
of the state of health of the person with the work to be
performed by completing Part II "Opinion on the Conformity of the
State of Health of a Person with the Work to be Performed" of
both copies of the health examination card.
43. For the persons to be examined who are employed and who
are due to be employed in work with sources of ionising
radiation, an opinion on the conformity of the state of health of
the person with the work to be performed shall be provided by the
doctor of occupational diseases, except for persons who, in
accordance with the laws and regulations regarding protection
against ionising radiation, comply with category A, or the doctor
of occupational diseases of the Occupational and Radiation
Medicine Centre.
[8 January 2013]
43.1 The doctor of occupational diseases shall
provide the Centre with information regarding the health
examinations performed in the previous year and the restrictions
determined for persons who are employed and who are due to be
employed in work with sources of ionising radiation which comply
with category B, in accordance with the laws and regulations
regarding protection against ionising radiation, by 15 February
each year in conformity with the form placed on the website of
the Occupational and Radiation Medicine Centre.
[8 January 2013]
44. It shall be indicated in the health examination card that
the state of health of the person to be examined conforms with
the work to be performed, if:
44.1. the person to be examined is recognised as practically
healthy;
44.2. in the case of health disorders established in the
person to be examined, contact with the factors of the working
environment harmful to health indicated is not connected with the
deterioration of the current state of health thereof;
44.3. due to the health disorders established in the person to
be examined who is employed or is due to be employed in work in
special conditions, a risk of accidents at work to himself or
herself or those around him or her may not arise;
44.4 the health disorders caused to the person to be examined
by factors of the working environment harmful to health are
evaluated as mild (insignificantly affecting the quality of life)
or simply preventable, by using means of protection, and the
continuation of work in the working conditions indicated is not
connected with significant irreversible health disorders
(significantly affecting the quality of life) or the development
of complications.
45. If it is indicated in the health examination card that the
state of health of a person conforms to the work to be performed
in accordance with Sub-paragraph 44.4 of this Regulation:
45.1. the doctor of occupational diseases shall indicate
recommendations in the health examination card on a compulsory
basis for the protection of health of the employee at the
workplace (collective and individual means of protection, special
measures of health protection aimed towards the particular
person, including optical corrective appliances necessary for
work with a computer);
45.2. an employer shall ensure the conformity with the
abovementioned recommendations for the protection of the health
of the employee in the working environment.
46. It shall be indicated in the health examination card that
the state of health of the person to be examined does not conform
to the work to be performed:
46.1. if the person to be examined who is exposed or due to be
exposed to the effects of factors of the working environment
harmful to health at work:
46.1.1. has been established with serious health disorders or
an occupational disease caused by factors of the working
environment harmful to health and further contact with the factor
of the working environment harmful to health is connected with
the deterioration of the state of health thereof;
46.1.2. has been established with health disorders which may
be significantly deteriorated by the particular factor of the
working environment harmful to health and affect the course of a
current disease not connected with work;
46.2. if the person to be examined who performs or will
perform work in special conditions:
46.2.1. has been established with the absolute medical
contra-indications indicated in Annex 2 to this Regulation for
the work to be performed;
46.2.2. has been established with the medical
contra-indications to be evaluated indicated in Annex 2 to this
Regulation which according to the evaluation of the doctor of
occupational diseases are such which create the risk of accidents
for the employee or those around him or her, when performing work
in special conditions;
46.2.3. has been established with other health disorders not
referred to in Annex 2 to this Regulation which the doctor of
occupational diseases evaluates as such which cause a risk of
accidents to the employee or people around him or her, when
performing work in the special conditions indicated. In such case
justification for the decision shall be indicated in the medical
documentation;
46.3. for a specific period while treatment takes place
(indicating to an employer, in Paragraph 12 of the health
examination card by the special notes and recommendations, that
it applies for the period of treatment, and a period of
extraordinary health examination after the course of treatment),
if:
46.3.1. a factor of the working environment harmful to health
has caused reversible health disorders to the employee where
treatment and renewal of capacity to work is possible;
46.3.2. the health disorders established for the employee who
performs work in special conditions which may cause a risk of
accidents, are curable and reversible.
47. If, in accordance with Sub-paragraph 46.3 of this
Regulation, it is indicated in the health examination card that
the state of health of an employee does not conform to the work
to be performed, the doctor of occupational diseases shall do as
follows:
47.1. provide recommendations regarding treatment and
rehabilitation measures, if necessary, sends a person to be
examined with the opinion of a consultant to the family doctor
for outpatient treatment;
47.2. indicate the recommended measures of labour
protection;
47.3. indicate the period for extraordinary (additional)
health examination following completion of a course of treatment,
in order to assess whether the health disorders caused by factors
of the working environment harmful to health and health disorders
which caused a risk of accidents, have been eliminated and the
state of health conforms with the work to be performed.
48. If, when performing a health examination of an employee,
reversible health disorders caused by a specific factor of the
working environment harmful to health are disclosed which may be
eliminated by measures of medical treatment in a short period of
time, the doctor of occupational diseases may issue a sick-leave
certificate to an employee, prescribing treatment, and delay the
completion of Part II of the health examination card until the
end of the treatment.
49. If, when performing a health examination, the doctor of
occupational diseases or a physician specialist establishes that
medicinal products, corrective measures, including optical
corrective appliances, or medical treatment procedures are
required by the person to be examined, he or she shall issue the
necessary prescriptions and referrals to the person to be
examined or send the relevant person to the family doctor
thereof.
V. Health Examinations of
Employees for a Specific Period of Time
50. If the person to be examined is due to be employed with an
employer for a specific period of time which is less than one
year, prior to the commencement of employment legal relationships
or State civil service legal relationships the person to be
examined shall be sent for the performance of a health
examination, if the work is due to be performed in special
conditions (Annex 2) or if the conditions of the working
environment conform to those indicated in Sub-paragraph 14.3 of
this Regulation.
51. If the person to be examined is due to be employed for
less than a year with an employer with which this person was
employed previously, and less than one year has passed since the
previous employment, periodic health examinations shall be
performed in accordance with Paragraph 14 of this Regulation.
52. If an employer employs a person who is younger than 18
years and who is acquiring an education in an educational
establishment (during holidays in the educational establishment)
for a specific period of time, not longer than three months, it
shall be allowed not to perform a health examination in
accordance with the procedures laid down in this Regulation, if
the employer requests and receives an opinion of a family doctor
regarding the state of health of the abovementioned person.
VI. Storage of Health Examination
Cards and Measures to be Performed by an Employer
53. The first copy of the health examination card with an
opinion on the conformity of the state of health of a person for
the work to be performed shall be submitted to an employer by an
employee or person prior to the commencement of employment legal
relationships or State civil service legal relationships and the
second copy shall remain in the medical documentation of the
person to be examined, with the doctor of occupational diseases
who performed the health examination.
54. Following the receipt of a health examination card, an
employer or authorised person thereof shall complete Part III of
the health examination card "Measures Performed by an Employer in
Accordance with that Indicated in the Opinion of the Mandatory
Health Examination".
55. If the doctor of occupational disease has indicated
recommendations in the health examination card for the protection
of health of an employee in the workplace, the employer shall
comply with the indicated recommendations in relation to
arrangement of the working environment and shall complete Part
III of the health examination card accordingly.
56. If the doctor of occupational diseases has only indicated
the conformity of the state of health of the person to be
examined with the work to be performed in the health examination
card and Paragraph 12 of the health examination card has not been
completed, the employer shall be allowed not to make notes in the
health examination card.
57. If in accordance with Sub-paragraph 46.3 of this
Regulation it is indicated in the health examination card that
the state of health of an employee does not conform to the work
to be performed for the period of time while treatment takes
place, but the employee may work in another job, without using a
sick-leave certificate, an employer shall do as follows:
57.1. ensure the employee with working conditions without the
effects of the particular factor of the working environment
harmful to health;
57.2. ensure that the employee does not perform work in the
particular special conditions;
57.3. comply with the recommendations indicated in relation to
arrangement of the working environment;
57.4. send the employee for an extraordinary (additional)
health examination within the period of time indicated in the
health examination card.
58. If it is indicated in the health examination card that the
state of health of an employee does not conform to the work to be
performed, an employer shall do as follows:
58.1. ensure the employee with working conditions without the
effects of the particular factor of the working environment
harmful to health;
58.2. ensure that the employee does not perform work in the
particular special conditions.
59. An employer shall keep health examination cards for not
less than 10 years. Afterwards they shall be deposited in the
archives in accordance with the requirements laid down in the
laws and regulations regarding document storage and depositing
thereof to the archives.
60. An employer shall issue a copy of the health examination
card of an employee approved by the employer upon the request of
the employee.
VII. Closing Provisions
61. Cabinet Regulation No. 527 of 8 June 2004, Procedures on
Carrying Out Mandatory Health Examinations (Latvijas
Vēstnesis, 2004, No. 96; 2005, No. 4; 2008, No. 63), is
repealed.
62. This Regulation shall come into force on 1 April 2009.
Informative Reference to European
Union Directives
[14 September
2010; 8 January 2013; 16 June 2015]
This Regulation contains legal norms arising from:
1) Council Directive 89/391/EEC of 12 June 1989 on the
introduction of measures to encourage improvements in the safety
and health of workers at work;
2) Directive 2007/59/EC of the European Parliament and of the
Council of 23 October 2007 on the certification of train drivers
operating locomotives and trains on the railway system in the
Community;
3) Council Directive 90/641/Euratom of 4 December 1990 on the
operational protection of outside workers exposed to the risk of
ionizing radiation during their activities in controlled
areas;
4) Council Directive 96/29/Euratom of 13 May 1996 laying down
basic safety standards for the protection of the health of
workers and the general public against the dangers arising from
ionizing radiation;
5) Commission Directive 2014/82/EU of 24 June 2014 amending
Directive 2007/59/EC of the European Parliament and of the
Council as regards general professional knowledge and medical and
licence requirements.
Prime Minister I. Godmanis
Acting for the Minister for
Welfare,
Minister for Education and Science T. Koķe
In Revised
Version Submitted by the Ministry of Welfare
Annex 1
Cabinet
Regulation No. 219
10 March 2009
Factors of the Working Environment
Harmful to Health
[8 January
2013]
|
No.
|
Harmful factors of the
working environment
|
Notes
|
Physician - specialist
assessments
|
Laboratory and functional
investigations
|
|
Mandatory specialist
assessments required
|
Additional specialist
assessments required
|
Initial health
examination
|
Periodic health
examination
|
Determination of a chemical
in biological environments * - shall be carried out as
necessary, if possible to be determined and evaluated
|
|
1.
|
2.
|
3.
|
4.
|
5.
|
6.
|
7.
|
8.
|
| 1. |
Chemical factors |
|
|
|
|
|
|
| 1.1. |
Metals and metalloids |
|
|
|
|
|
|
| 1.1.1. |
Aluminium and its compounds |
|
doctor of occupational
diseases |
otorhinolaryngologist |
Full blood count (hereinafter -
FBC); evaluation of external respiratory functions
(hereinafter - ERF); X-ray investigation of lungs
(hereinafter - lung x-ray). |
FBC; ERF. |
aluminium in blood or in
urine |
| 1.1.2. |
Antimony and its compounds |
|
doctor of occupational
diseases |
|
FBC;
lung X-ray.
|
FBC |
antimony or its metabolites in
blood or in urine |
| 1.1.3. |
Arsenic and its compounds |
Passes through placental
membrane; may cause genetic pathology. |
doctor of occupational diseases,
neurologist
|
dermatologist,
otorhinolaryngologist
|
FBC; level of bilirubin in the blood (hereinafter -
bilirubin); level of aspartate aminotransferase in the
blood (hereinafter - AST), level of alanine
aminotransferase in the blood (hereinafter - ALT);
lung X-ray.
|
FBC; bilirubin; AST; ALT;
lung X-ray.
|
arsenic or its metabolites in
blood or in urine |
| 1.1.4. |
barium and its compounds |
|
doctor of occupational
diseases |
|
FBC; lung x-ray; potassium in
the blood. |
FBC; potassium in the
blood. |
barium in blood or in urine |
| 1.1.5. |
Beryllium and its compounds |
Once a year if poorly soluble or insoluble beryllium
compounds (metallic beryllium, beryllium oxide, beryllium
hydroxide) are in the air of the working environment.
Passes through placental membrane, secretes through
breast milk.
|
doctor of occupational
diseases |
|
FBC, ERF, lung x-ray |
FBC; lung x-ray |
beryllium in urine |
| 1.1.6. |
Zinc and its compounds |
|
doctor of occupational
diseases |
dermatologist |
FBC; lung x-ray |
FBC |
zinc or its metabolites in blood
or in urine |
| 1.1.7. |
Mercury and its compounds |
Easily crosses the placenta and
toxically affects the embryo, secretes through breast
milk. |
doctor of occupational diseases,
neurologist |
dental practitioner |
FBC |
FBC |
mercury in blood, mercury in
urine |
| 1.1.8. |
Phosphorus and its
compounds |
|
|
|
|
|
|
| 1.1.8.1. |
Yellow phosphorus and its
compounds |
Passes through the placental
membrane, affects the reproductive function of women. |
doctor of occupational diseases,
neurologist |
dental practitioner |
FBC; bilirubin; AST; ALT |
FBC; bilirubin; AST; ALT; jaw
x-ray - once every three years if length of service exceeds
five years |
not determined |
| 1.1.8. |
Red phosphorus and its
compounds |
Passes through the placental
membrane, affects the reproductive function of women. |
doctor of occupational diseases,
neurologist |
dental practitioner |
FBC; bilirubin; AST; ALT |
FBC; bilirubin; AST; ALT |
not determined |
| 1.1.9. |
Chrome and chromic acid. their
compounds and alloys |
Passes through the placental
membrane, accumulates in the embryo. |
doctor of occupational diseases,
otorhinolaryngologist; |
dermatologist |
FBC; lung x-ray |
FBC; lung x-ray |
chrome in blood or in urine |
| 1.1.10. |
Cadmium and its compounds |
Passes through the placental
membrane, may delay embryonic development, secretes through
breast milk. |
doctor of occupational
diseases |
otorhinolaryngologist |
FBC; urine analysis; ERF;
lung X-ray
|
FBC; urine analysis;
lung X-ray
|
cadmium in blood or in
urine |
| 1.1.11. |
Cobalt and its compounds;
analogues |
|
|
|
|
|
|
| 1.1.11.1. |
Cobalt and its compounds |
|
doctor of occupational
diseases |
dermatologist |
FBC; lung x-ray |
FBC |
cobalt or its metabolites in
blood or in urine |
| 1.1.11.2. |
zirconium and its compounds |
|
doctor of occupational
diseases |
dermatologist |
FBC; lung x-ray |
FBC |
zirconium or its metabolites in
blood |
| 1.1.11.3. |
molybdenum and its
compounds |
|
doctor of occupational
diseases |
dermatologist |
FBC; lung x-ray |
FBC |
molybdenum or its metabolites in
blood or in urine |
| 1.1.11.4. |
titanium and its compounds |
|
doctor of occupational
diseases |
|
FBC; lung x-ray |
FBC |
not determined |
| 1.1.11.5. |
vanadium and its compounds |
|
doctor of occupational
diseases |
dermatologist |
FBC; lung x-ray |
FBC |
vanadium or its metabolites in
blood or in urine |
| 1.1.11.6. |
tungsten and its compounds |
|
doctor of occupational
diseases |
|
FBC; lung x-ray |
FBC |
not determined |
| 1.1.12. |
Lithium and its compounds |
|
doctor of occupational diseases,
neurologist |
|
FBC; urine analysis; serum
creatinine |
FBC; urine analysis; serum
creatinine |
lithium in blood.
lithium or its metabolites in urine
|
| 1.1.13. |
Manganese and its compounds |
Clinical symptoms of poisoning
may also progress if work with manganese has been
discontinued. |
doctor of occupational diseases,
neurologist |
|
Clinical blood count (haemoglobin, leucocytes, erythrocyte
sedimentation rate) (hereinafter - CBC),
lung X-ray
|
CBC |
not determined |
| 1.1.14. |
Magnesium and its compounds |
|
doctor of occupational
diseases |
|
FBC |
FBC |
magnesium in blood |
| 1.1.15. |
Nickel and its compounds |
Passes through the placental
membrane. |
doctor of occupational diseases,
otorhinolaryngologist |
dermatologist |
FBC; lung x-ray |
FBC; lung x-ray |
nickel or its metabolites in
blood or in urine |
| 1.1.16. |
Platinum group metals, silver,
gold, the compounds and alloys thereof |
|
doctor of occupational
diseases |
|
FBC; lung x-ray |
FBC |
platinum, silver or its
metabolites in blood or in urine |
| 1.1.17. |
Rare earth elements: lanthanum;
caesium |
|
doctor of occupational
diseases |
|
FBC; lung x-ray |
FBC |
not determined |
| 1.1.18. |
Selenium, tellurium and their
compounds |
Passes through placental
membrane, secretes through breast milk |
doctor of occupational
diseases |
dermatologist,
ophthalmologist
|
FBC; lung x-ray |
FBC |
selenium or its metabolites in
blood or in urine |
| 1.1.19. |
sulphur and its compounds,
including carbon disulphide |
|
doctor of occupational
diseases |
neurologist |
FBC; lung x-ray |
FBC |
sulphur or its metabolites in
the exhaled air, in blood or in urine |
| 1.1.20. |
Lead, its non-organic and
organic compounds, including tetraethyl lead |
If lead in the blood >60µg/100ml - repeated analysis
after 2 weeks
If lead in the blood 40-60 µg/100ml - repeated analysis
after 2 months
Adolescents, pregnant women and women breastfeeding and
after giving birth shall not be allowed to do work
involving lead and its compounds
|
doctor of occupational diseases,
neurologist |
|
FBC, erythrocytes with granular
basophils, reticulocytes, coproporphyrin and delta
aminolevulinic acid in urine |
FBC, erythrocytes with granular
basophils, reticulocytes, coproporphyrin and delta
aminolevulinic acid in urine |
lead or its metabolites in blood
or in urine. |
| 1.1.21. |
Thallium and its compounds |
|
doctor of occupational
diseases |
|
FBC |
FBC |
thallium or its metabolites in
blood or in urine |
| 1.1.22. |
Copper and its compounds |
|
doctor of occupational
diseases |
otorhinolaryngologist |
FBC, lung x-ray, bilirubin; AST,
ALT |
FBC; bilirubin; AST; ALT |
copper or its metabolites in
blood or in urine |
| 1.2. |
Inorganic halogen compounds |
|
|
|
|
|
|
| 1.2.1. |
Bromide and its compounds |
|
doctor of occupational
diseases |
otorhinolaryngologist,
dermatologist, neurologist |
FBC; lung x-ray |
FBC |
bromide or its metabolites in
blood or in urine |
| 1.2.2. |
Fluorine and its compounds |
|
doctor of occupational diseases,
otorhinolaryngologist |
dermatologist, neurologist |
FBC; lung x-ray |
FBC |
fluoride or its metabolites in
blood or in urine |
| 1.2.3. |
Chlorine and its compounds,
mixtures containing chlorine |
|
doctor of occupational
diseases |
otorhinolaryngologist,
dermatologist |
CBC; lung x-ray |
CBC |
not determined |
| 1.2.4. |
Iodine and its compounds |
Iodides pass through the
placental membrane, may cause hypothyroidism in newborn
infants and their death due to breathing distress |
doctor of occupational
diseases |
otorhinolaryngologist,
dermatologist |
FBC; lung x-ray |
FBC |
not determined |
| 1.3. |
Cyanide compounds |
|
|
|
|
|
|
| 1.3.1. |
Hydrogen cyanide, cyanide (metal
cyanides and other cyanides), other cyanide compounds |
Once a year |
doctor of occupational diseases,
neurologist |
dermatologist |
FBC |
FBC |
cyanides in blood or
carboxyhaemoglobin |
| 1.3.2. |
Isocyanates |
Once a year |
doctor of occupational
diseases |
dermatologist,
otorhinolaryngologist
|
FBC |
FBC |
not determined |
| 1.4. |
Inorganic gases |
|
|
|
|
|
|
| 1.4.1. |
Nitrogen and its inorganic
compounds, including oxides, ammonia. |
|
doctor of occupational
diseases |
otorhinolaryngologist |
FBC; lung x-ray |
FBC |
not determined |
| 1.4.2. |
Phosgene (COCl2) |
|
doctor of occupational
diseases |
otorhinolaryngologist,
dermatologist |
FBC; lung x-ray |
FBC |
not determined |
| 1.4.3. |
Ozone |
|
doctor of occupational
diseases |
otorhinolaryngologist |
CBC; lung x-ray |
CBC |
not determined |
| 1.4.4. |
Carbon monoxide |
|
doctor of occupational diseases,
neurologist |
|
FBC |
FBC |
CO in blood or
carboxyhaemoglobin |
| 1.5. |
Other substances irritating to
the respiratory tract |
|
|
|
|
|
|
| 1.5.1. |
Acids, including hydrochloric
acid, phosphoric acid, nitric acid |
|
doctor of occupational
diseases |
otorhinolaryngologist,
dermatologist |
CBC; lung x-ray |
CBC |
not determined |
| 1.5.2. |
Hydroxides, including potassium
hydroxide, sodium hydroxide |
|
doctor of occupational
diseases |
otorhinolaryngologist,
dermatologist |
FBC; lung x-ray |
FBC |
not determined |
| 1.5.3. |
Hydrogen peroxide |
|
doctor of occupational
diseases |
otorhinolaryngologist,
dermatologist |
FBC; ERF |
FBC |
not determined |
| 1.6. |
Hydrocarbons and derivative
compounds |
|
|
|
|
|
|
| 1.6.1. |
Aliphatic hydrocarbons,
including methane, ethane, ethene (ethylene), ethine
(acetylene), propane, butane, pentane, hexane, heptane,
octane, nonane, decane, paraffin wax, alicyclic hydrocarbons,
including cyclopropane, cyclohexane, terpenes (including
turpentine) |
|
doctor of occupational diseases,
neurologist |
otorhinolaryngologist,
dermatologist |
FBC; bilirubin; AST; ALT |
FBC; bilirubin; AST; ALT |
2-hexanole and/or 2,5
hexanedione in urine or n-hexane in blood (if contact with
hexane or methyl-n-butyl ketone) |
| 1.6.2. |
Aromatic hydrocarbons |
|
|
|
|
|
|
| 1.6.2.1. |
benzene |
|
doctor of occupational diseases,
neurologist |
dermatologist |
FBC |
FBC |
Benzene metabolites in blood,
urine or exhaled air, or phenol in urine (at the end of a
shift) |
| 1.6.2.2. |
toluene |
|
doctor of occupational diseases,
neurologist |
dermatologist |
FBC |
FBC |
Toluene in blood or hippuric
acid in urine (at the end of a shift) |
| 1.6.2.3. |
styrene |
|
doctor of occupational diseases,
neurologist |
dermatologist |
FBC |
FBC |
Styrene in blood or mandelic
acid in urine (at the end of a shift) |
| 1.6.2.4. |
other benzene homologues,
including xylene, ethylbenzene, cumene |
|
doctor of occupational diseases,
neurologist |
dermatologist |
FBC |
FBC |
Benzene homologue metabolites in
blood or in urine |
| 1.6.3. |
Furans, their derivatives,
including furfural, tetrahydrofuran |
|
doctor of occupational
diseases |
neurologist,
otorhinolaryngologist, dermatologist |
FBC |
FBC |
not determined |
| 1.6.4. |
Naphthalene and its derivatives,
including chloronaphthalenes |
|
doctor of occupational
diseases |
neurologist,
otorhinolaryngologist, dermatologist |
FBC; bilirubin; AST; ALT |
FBC; bilirubin; AST; ALT |
not determined |
| 1.6.5. |
Halogenic hydrocarbons |
|
|
|
|
|
|
| 1.6.5.1. |
chloroform, tetrachloromethane,
dichloroethane |
chloroform, embryo toxic;
dichloroethane - secretes through breast milk |
doctor of occupational diseases,
neurologist |
dermatologist |
FBC; bilirubin; AST; ALT |
FBC; bilirubin; AST; ALT |
not determined |
| 1.6.5.2. |
trichloroetheylene,
tetrachloroethylene |
Absorbed through healthy
skin |
doctor of occupational diseases,
neurologist |
dermatologist |
FBC; bilirubin; AST; ALT |
FBC; bilirubin; AST; ALT |
trichloroethylene in blood >
5mg/l, trichloroacetic acid in urine > 100 mg/l;
tetrachloroethylene in blood >1 mg/l |
| 1.6.5.3. |
methylene chloride |
|
doctor of occupational diseases,
neurologist |
dermatologist |
FBC; bilirubin; AST; ALT |
FBC; bilirubin; AST; ALT |
not determined |
| 1.6.5.4. |
vinyl chloride |
|
doctor of occupational diseases,
neurologist |
dermatologist |
FBC, bilirubin, AST, ALT, lung
x-ray |
FBC, bilirubin, AST, ALT, lung
x-ray |
not determined |
| 1.6.5.5. |
polychlorinated byphenils |
mutagenic, teratogenic, pass
through the placental membrane, secrete through breast
milk |
doctor of occupational diseases,
neurologist |
dermatologist |
FBC; bilirubin; AST; ALT |
FBC; bilirubin; AST; ALT |
not determined |
| 1.6.5.6. |
other halogenic hydrocarbons,
including ethylene chloride, methyl bromide, fluorine
containing hydrocarbons - freons |
methyl bromide - also absorbs
through clothing and rubber |
doctor of occupational diseases,
neurologist |
dermatologist |
FBC; bilirubin; AST; ALT |
FBC; bilirubin; AST; ALT |
not determined |
| 1.6.6. |
Nitro compounds and amino
compounds |
|
|
|
|
|
|
| 1.6.6.1. |
Aliphatic amino compounds,
including methylamine, dimethylamine, triethylamine,
ethylenediamine, ethylenamine, chlorethylamine, ethanolamines
(including triethanolamine) |
|
doctor of occupational
diseases |
dermatologist, neurologist,
otorhinolaryngologist |
FBC; ERF |
FBC |
not determined |
| 1.6.6.2. |
Aromatic amines, including
aniline, toluidine, benzidine, naphthylamine, auramine |
|
doctor of occupational
diseases |
dermatologist, neurologist |
FBC |
FBC |
tryptophan-3-oxiantranil acid in
urine or in blood |
| 1.6.6.3. |
Aromatic nitrocompounds and
nitrozone compounds, including dinitro-benzene,
dinitrophenol, trinitrotoluene |
|
doctor of occupational
diseases |
neurologist, dermatologist,
ophthalmologist |
FBC; bilirubin; AST; ALT |
FBC; bilirubin; AST; ALT |
not determined |
| 1.7. |
Hydrazine and its
derivatives |
|
doctor of occupational
diseases |
dermatologist |
FBC; ERF |
FBC |
not determined |
| 1.8. |
Phenols and their
derivatives |
|
doctor of occupational
diseases |
dermatologist |
FBC |
FBC |
phenol in urine (>80mg/l -
serious poisoning) |
| 1.9. |
Alcohols, glycols |
|
|
|
|
|
|
| 1.9.1. |
Methanol |
|
doctor of occupational diseases,
neurologist |
ophthalmologist,
narcologist |
FBC |
FBC |
not determined |
| 1.9.2. |
Butanols, ethanol, propanols,
pentanols (amyl-alcohols) |
|
doctor of occupational diseases,
neurologist |
dermatologist |
FBC |
FBC |
not determined |
| 1.9.3. |
Ethylene glycole
(ethanediol) |
|
doctor of occupational
diseases |
neurologist, dermatologist |
FBC |
FBC |
not determined |
| 1.10. |
Ethers, esters, epoxide
compounds |
|
|
|
|
|
|
| 1.10.1. |
Diethyl ether, ethylene glycol
ethers, (cellosolves) including ethyl cellosolve, methyl
cellosolve |
|
doctor of occupational
diseases |
neurologist, dermatologist |
FBC |
FBC |
not determined |
| 1.10.2. |
Esters, including ethyl acetate,
butyl acetate |
|
doctor of occupational
diseases |
neurologist, dermatologist |
FBC |
FBC |
not determined |
| 1.10.3. |
Epoxides, including
ephylchlorhydrin |
|
doctor of occupational
diseases |
neurologist, dermatologist,
ophthalmologist |
FBC; ERF |
FBC |
not determined |
| 1.11. |
Aldehydes and ketones |
|
|
|
|
|
|
| 1.11.1. |
Formaldehyde and other aliphatic
aldehydes |
|
doctor of occupational diseases,
neurologist |
dermatologist, ophthalmologist,
otorhinolaryngologist |
FBC; ERF |
FBC |
not determined |
| 1.11.2. |
Acetone, methylehtylketone,
methyl isobutyl ketone, other ketones |
|
doctor of occupational diseases,
neurologist |
dermatologist |
CBC |
CBC |
not determined |
| 1.12. |
Organic acids, their derivatives
(amides, acid anhydrides) |
|
|
|
|
|
|
| 1.12.1. |
Formic acid, acetic acid, oxalic
acid |
|
doctor of occupational
diseases |
dermatologist,
otorhinolaryngologist |
FBC |
FBC |
not determined |
| 1.12.2. |
Acrylic acid and metacrylic
acid, their esters, nitriles |
|
doctor of occupational
diseases |
otorhinolaryngologist,
dermatologist, neurologist |
FBC |
FBC |
not determined |
| 1.12.3. |
Acetic acid and other organic
acid anhydrides |
|
doctor of occupational
diseases |
otorhinolaryngologist,
dermatologist, ophthalmologist |
FBC; ERF |
FBC |
not determined |
| 1.12.4. |
Phthalic acid and phthalic acid
anhydride, their derivatives |
|
doctor of occupational
diseases |
otorhinolaryngologist,
ophthalmologist, neurologist |
FBC; ERF |
FBC |
not determined |
| 1.12.5. |
Acid amides, including
dimethylformamide, dimethylacetamide |
Absorbs through healthy skin,
dimethylacetamide adversely affects the reproductive system
of women |
doctor of occupational
diseases |
neurologist,
otorhinolaryngologist, dermatologist, gynaecologist,
obstetrician |
FBC; bilirubin; AST; ALT |
FBC; bilirubin; AST; ALT |
not determined |
| 1.13. |
Different chemical
substances |
|
|
|
|
|
|
| 1.13.1. |
Chemical plant protection
products |
Passes through the placental
membrane, embryo toxic, affects the reproductive function of
women. |
doctor of occupational diseases,
neurologist |
otorhinolaryngologist,
dermatologist, ophthalmologist |
FBC, ERF, bilirubin; AST,
ALT |
FBC; bilirubin; AST; ALT |
Activity of cholinesterase in
the blood plasma - working with phosphororganic compounds or
carbamic acid compounds |
| 1.13.2. |
Means of medical treatment
(except antibiotics, enzyme preparations and
bio-stimulators) |
|
doctor of occupational
diseases |
dermatologist, neurologist |
FBC, the prothrombin index (for
those working with anticoagulants), activated partial
thromboplastin time (hereinafter - APTT) (for those working
with anticoagulants) |
FBC, the prothrombin index (for
those working with anticoagulants), APTT (for those working
with anticoagulants) |
not determined |
| 1.13.2.1. |
Antibiotics |
|
doctor of occupational
diseases |
dermatologist |
FBC |
FBC |
not determined |
| 1.13.2.2. |
Enzyme preparations and
bio-stimulators |
|
doctor of occupational
diseases |
dermatologist |
FBC |
FBC |
not determined |
| 1.13.3. |
Organic colouring agents: azo
colouring agent, antrahinon colouring agent, phthalocyan and
paraphenylenediamine (ursola) colouring agents |
|
doctor of occupational
diseases |
dermatologist,
otorhinolaryngologist, ophthalmologist |
FBC |
FBC |
not determined |
| 1.13.4. |
Plastic, synthetic resins |
|
|
|
|
|
|
| 1.13.4.1. |
Acrylic materials |
|
doctor of occupational
diseases |
dermatologist |
FBC |
FBC |
not determined |
| 1.13.4.2. |
Epoxide materials |
|
doctor of occupational
diseases |
dermatologist,
otorhinolaryngologist, neurologist |
FBC, piramidon reaction |
FBC, piramidon reaction |
not determined |
| 1.13.4.3. |
Formaldehyde resins, phenol -
formaldehyde materials |
|
doctor of occupational
diseases |
dermatologist,
otorhinolaryngologist, neurologist |
FBC; ERF |
FBC |
not determined |
| 1.13.4.4. |
Fluoroplasts (polymers on the
basis of fluororganic compounds) |
|
doctor of occupational diseases,
neurologist |
dermatologist |
FBC |
FBC |
not determined |
| 1.13.4.5. |
Polyamides (polymers on the
basis of amino acids and diamines) |
|
doctor of occupational
diseases |
dermatologist, neurologist |
FBC |
FBC |
not determined |
| 1.13.4.6. |
Polyesters (dicarbonacid and
polyhydric alcohol polymer - derivatives) |
|
doctor of occupational
diseases |
dermatologist |
FBC |
FBC |
not determined |
| 1.13.4.7. |
Polyethylene, polypropylene |
|
doctor of occupational
diseases |
dermatologist |
FBC |
FBC |
not determined |
| 1.13.4.8. |
Polystyrenes (polymers on the
basis of styrene and its derivatives) |
|
doctor of occupational diseases,
neurologist |
dermatologist |
FBC |
FBC |
not determined |
| 1.13.4.9. |
Polyurethanes (polymers on the
basis of isocyanates) |
|
doctor of occupational
diseases |
dermatologist, neurologist |
FBC |
FBC |
not determined |
| 1.13.4.10. |
Polyvinyl chloride (polymers on
the basis of vinyl chloride and vinylidene chloride) |
|
doctor of occupational diseases,
neurologist |
dermatologist |
FBC; lung x-ray |
FBC; lung x-ray |
not determined |
| 1.13.4.11. |
Synthetic rubber |
|
doctor of occupational diseases,
neurologist |
dermatologist |
FBC |
FBC |
not determined |
| 1.13.4.12. |
Silicon organic compounds and
oiling agents on their base |
|
doctor of occupational
diseases |
dermatologist |
FBC |
FBC |
not determined |
| 1.14. |
Synthetic detergents |
|
doctor of occupational
diseases |
dermatologist |
FBC |
FBC |
not determined |
| 2. |
Dust |
In the mandatory health
examination card, indicating the harmful factor by
Sub-paragraph 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7.1, and 2.7.2
of this Annex, it shall be indicated in addition to the dust
of which particular substance the employee is exposed |
|
|
|
|
|
| 2.1. |
Abrasive dust and dust
containing abrasives |
|
doctor of occupational diseases,
otorhinolaryngologist |
dermatologist,
ophthalmologist |
CBC, ERF, lung x-ray |
CBC; lung x-ray |
- |
| 2.2. |
Dust of plant origin, including
sugar, flour, coffee, chocolate, and of animal origin
including animal and bird feathers, and other dust of organic
origin |
|
doctor of occupational diseases,
otorhinolaryngologist |
ophthalmologist |
CBC, ERF, lung x-ray |
CBC, ERF |
- |
| 2.3. |
Dust of metals and their alloys
- if work includes contact with metal powders |
See also the relevant chemical
substances in Paragraph 1 of this Annex |
doctor of occupational diseases,
otorhinolaryngologist |
ophthalmologist |
CBC, ERF, lung x-ray |
CBC, ERF |
- |
| 2.4. |
Welding aerosols, gas cutting
aerosols |
See also the relevant chemical
substances which are in the composition of the welding
aerosol, in Paragraph 1 of this Annex |
doctor of occupational diseases,
otorhinolaryngologist, neurologist |
ophthalmologist |
CBC, ERF, lung x-ray |
CBC, ERF |
- |
| 2.5. |
Lime and chalk dust |
|
doctor of occupational diseases,
otorhinolaryngologist |
dermatologist,
ophthalmologist
|
CBC, ERF, lung x-ray |
CBC, ERF |
- |
| 2.6. |
Dust containing carbon and its
inorganic compounds, including coal, graphite, soot, diamond
dust |
|
doctor of occupational diseases,
otorhinolaryngologist |
dermatologist,
ophthalmologist
|
CBC, ERF, lung x-ray |
CBC, ERF |
- |
| 2.7. |
Dust containing silicon dioxide
and silicates |
|
|
|
|
|
|
| 2.7.1. |
Dust containing silicon
dioxide |
|
doctor of occupational diseases,
otorhinolaryngologist |
dermatologist,
ophthalmologist
|
CBC, ERF, lung x-ray |
CBC, ERF |
- |
| 2.7.2. |
Dust containing silicates,
including glass fibres, glass and rock wool dust, except
asbestos |
|
doctor of occupational diseases,
otorhinolaryngologist |
dermatologist,
ophthalmologist
|
CBC, ERF, lung x-ray |
CBC, ERF |
- |
| 2.7.3. |
Asbestos |
Examinations shall also be
performed after discontinuance of the exposure to
asbestos |
doctor of occupational diseases,
otorhinolaryngologist |
|
FBC, ERF, lung x-ray |
FBC; lung x-ray |
- |
| 3. |
Biological factors |
|
|
|
|
|
|
| 3.1. |
Biological factors with allergen
properties, including allergens for treatment and diagnosis,
blood preparations and immunobiological preparations |
|
doctor of occupational
diseases |
otorhinolaryngologist,
ophthalmologist
|
FBC, ERF, lung x-ray |
FBC; ERF |
- |
| 3.2. |
Biological agents which may
cause infection, including biological agents of Group 2, 3
and 4 (bacteria, viruses, fungi and parasites) |
If health examination has been
performed in accordance with the regulatory enactments
regarding health examinations for employees who perform work
related to a potential risk to the health of other people,
mandatory health examination need not be performed in
accordance with this Paragraph |
doctor of occupational
diseases |
dermatologist, doctor of
infectious diseases |
FBC, other laboratory
investigations according to potential infection |
FBC, other laboratory
investigations according to potential infection |
- |
| 3.3. |
Latex products, including work
using latex gloves |
|
doctor of occupational
diseases |
dermatologist |
FBC |
FBC |
- |
| 4. |
Physical factors |
|
|
|
|
|
|
| 4.1. |
Ionising radiation (x-ray
radiation and gamma radiation); radioactive substances and
sources of ionising radiation |
Health examinations shall be
carried out annually for employees falling within category A;
health examinations shall be carried out every two years for
employees falling within category B |
doctor of occupational
diseases |
neurologist, haematologist,
dermatologist, ophthalmologist |
FBC, leucocyte formula |
FBC, leucocyte formula |
- |
| 4.2. |
Non-ionising radiation |
|
|
|
|
|
|
| 4.2.1. |
Artificial optical
radiation |
|
|
|
|
|
|
| 4.2.1.1. |
Artificial ultraviolet radiation
(UV), including UV radiation which radiates during the
welding process |
|
doctor of occupational diseases,
ophthalmologist |
dermatologist |
CBC |
CBC |
- |
| 4.2.1.2. |
Laser radiation |
|
doctor of occupational diseases,
ophthalmologist |
dermatologist, neurologist |
CBC |
CBC |
- |
| 4.2.1.3. |
Other artificial optical
radiation |
|
doctor of occupational
diseases |
ophthalmologist |
CBC |
CBC |
- |
| 4.2.2. |
Natural radiation if work takes
place under the influence of direct sunlight for more than
50% of the working time |
|
doctor of occupational
diseases |
dermatologist,
opthalmologist |
CBC |
CBC |
- |
| 4.2.3. |
Electromagnetic fields: radio
frequency and microwave radiation, low frequency electric and
magnetic fields |
|
doctor of occupational diseases,
neurologist |
|
CBC |
CBC |
- |
| 4.3. |
Changes in atmospheric
pressure |
|
|
|
|
|
|
| 4.3.1. |
Increased atmospheric pressure
in work which is connected with diving under water up to a
depth of 12 metres. |
Once a year |
doctor of occupational diseases,
otorhinolaryngologist, neurologist |
opthalmologist,
dermatologist |
FBC, electrocardiogram |
FBC, electrocardiogram |
- |
| 4.3.2. |
Increased atmospheric pressure
in work which is connected with diving under water to a depth
of 12 to 60 metres. |
Once a year |
doctor of occupational diseases,
otorhinolaryngologist, neurologist |
ophthalmologist, gynaecologist,
obstetrician |
FBC, electrocardiogram, glucose
in blood |
FBC, electrocardiogram, glucose
in blood |
- |
| 4.3.3. |
Increased atmospheric pressure
in work which is connected with diving under water to a depth
of more than 60 metres. |
Twice a year |
doctor of occupational diseases,
otorhinolaryngologist, neurologist |
ophthalmologist, gynaecologist,
obstetrician |
FBC, electrocardiogram, glucose
in blood |
FBC, electrocardiogram, glucose
in blood |
- |
| 4.3.4. |
Decreased atmospheric pressure
which is similar to the atmospheric pressure at 3000 m above
the sea level or lower. |
Once a year |
doctor of occupational diseases,
otorhinolaryngologist, neurologist |
ophthalmologist |
FBC; lung x-ray |
FBC |
- |
| 4.4. |
Temperature changes |
|
|
|
|
|
|
| 4.4.1. |
Decreased temperature which is
lower than the recommended temperatures for a specific
workplace but above + 50 C |
Send for mandatory health
examinations if work in the indicated conditions is performed
for more than 50 % of the working time |
doctor of occupational
diseases |
neurologist |
CBC, cold test |
CBC |
- |
| 4.4.2. |
Decreased temperature below +
50 C |
Send for mandatory health
examinations if work in the indicated conditions is performed
for more than 50% of the working time |
doctor of occupational diseases,
neurologist |
|
CBC, cold test |
CBC, cold test |
- |
| 4.4.3. |
Increased temperature which is
higher than the recommended temperatures for a specific
workplace but below +39° C |
Send for mandatory health
examinations if work in the indicated conditions is performed
for more than 50% of the working time |
doctor of occupational
diseases |
neurologist |
CBC |
CBC |
- |
| 4.4.4. |
Increased temperature above +
390 C |
Send for mandatory health
examinations if work in the indicated conditions is performed
for more than 50% of the working time |
doctor of occupational diseases,
neurologist |
|
FBC |
FBC |
- |
| 4.4.5. |
Intensive heat radiation, if
work is connected with being under the influence of direct
heat radiation, including work in hot workshops |
|
doctor of occupational diseases,
neurologist, ophthalmologist |
dermatologist |
FBC |
FBC |
- |
| 4.5. |
Noise |
Audiometry need not be performed
if there is a complete bilateral loss of hearing |
doctor of occupational diseases,
otorhinolaryngologist |
|
CBC, audiometry |
CBC, audiometry |
- |
| 4.6. |
Contact transmission of
ultrasound to hands |
health examination is performed
if the ultrasound intensity is above 1,5
W/cm2 |
doctor of occupational diseases,
neurologist |
|
CBC |
CBC |
- |
| 4.7. |
Vibration |
|
|
|
|
|
|
| 4.7.1. |
Hands - palm vibration |
|
doctor of occupational diseases,
neurologist |
|
CBC, cold test, vibration
sensations |
CBC, cold test, vibration
sensations |
- |
| 4.7.2. |
Whole body vibration |
|
doctor of occupational diseases,
neurologist |
|
CBC, cold test, vibration
sensations |
CBC, cold test, vibration
sensations |
- |
| 4.8. |
Overload of vocal cords, if work
is connected with prolonged periods of talking in a raised or
modified voice or singing |
|
doctor of occupational diseases,
otorhinolaryngologist |
|
CBC |
CBC |
- |
| 4.9. |
Physical overload |
|
|
|
|
|
|
| 4.9.1. |
Moving heavy objects without
mechanical aids, lifting and holding heavy objects |
Periodic holding of heavy objects with both hands (with one
hand):
for men - more than 10 kg (5 kg);
for women - more than 7 kg (3 kg)
|
doctor of occupational diseases,
neurologist |
Gynaecologist, birth
attendant |
FBC, electrocardiogram
(after 40 years of age)
|
CBC, electrocardiogram (after 40
years of age) |
- |
| 4.9.2. |
Being positioned in a compulsory
position for longer than 50 % of the working time, local
muscular tension, including work while standing |
In accordance with this
Paragraph, employees who perform work with a computer need
not be sent for a health examination |
doctor of occupational diseases,
neurologist |
|
CBC |
CBC |
- |
| 4.9.3. |
Frequent motions, quick movement
which requires marked physical activities for longer than 50
% of the working time, including walking, running,
cycling |
|
doctor of occupational diseases,
neurologist |
|
CBC |
CBC |
- |
| 4.9.4. |
Frequent, periodic bending down
for more than 50 % of the working time |
|
doctor of occupational diseases,
neurologist |
|
CBC |
CBC |
- |
| 4.9.5. |
Frequent, monotonous, repeated
motions; work which is connected with prolonged and intense
local muscular tension, including working with hands and hand
tools for more than 50 % of the working time |
|
doctor of occupational diseases,
neurologist |
|
CBC |
CBC |
- |
| 4.10. |
Increased visual strain,
including work with a microscope, discerning of fine
details |
Employer may send an employee
more than once every three years for just a vision test with
an opthalmologist or optometrist, ensuring that once every
three years a health examination of the employee is performed
by a doctor of occupational diseases in accordance with the
procedures laid down in this Regulation.** |
doctor of occupational diseases,
ophthalmologist |
neurologist, optometrist |
|
|
- |
| 4.11. |
Work with a computer (work with
displays and workstations) |
Employer may send an employee
more than once every three years for just a vision test with
an opthalmologist or optometrist, ensuring that once every
three years a health examination of the employee is performed
by a doctor of occupational diseases in accordance with the
procedures laid down in this Regulation.** |
doctor of occupational diseases,
ophthalmologist |
neurologist, optometrist |
CBC |
CBC |
- |
| 5. |
Psycho-emotional factors |
|
|
|
|
|
|
| 5.1. |
Night Work |
|
doctor of occupational
diseases |
|
CBC, electrocardiogram (after 40
years of age) |
CBC, electrocardiogram (after 40
years of age) |
- |
| 5.2. |
Increased responsibility,
frequent taking of such decisions which may significantly
affect the life or health of a human being, or the quality of
life of many people, responsibility for significant material
values |
|
doctor of occupational diseases,
neurologist |
psychiatrist,
psychotherapist |
CBC,
electrocardiogram
(after 40 years of age)
|
CBC,
electrocardiogram
(after 40 years of age)
|
- |
| 5.3. |
Other high psycho-emotional
stress at work, including psycho-emotional overload |
|
doctor of occupational
diseases |
neurologist, psychiatrist,
psychotherapist |
CBC,
electrocardiogram
(after 40 years of age)
|
CBC,
electrocardiogram
(after 40 years of age)
|
- |
| 6. |
Other risk factors of the
working environment |
|
|
|
|
|
|
| 6.1. |
Work which is connected with
strained hearing, when the sound is transmitted directly into
the ear (the use of audio headphones) |
|
doctor of occupational diseases,
otorhinolaryngologist |
|
CBC, audiometry |
CBC |
- |
| 6.2. |
Work which is connected with the
influence of sweet and sour food products on tooth enamel,
including tasting of wines and sweets |
Once a year |
doctor of occupational diseases,
dental practitioner |
|
CBC |
CBC |
- |
| 6.3. |
Other previously unmentioned
harmful factors of the working environment |
Indicate in the mandatory health
examination card the particular harmful factor to which an
employee is subjected |
doctor of occupational
diseases |
|
CBC |
CBC |
- |
* Determination of the concentration of chemical substances in
the organism, performed by accredited laboratories.
** After this assessment, an oculist or an optometrist shall
provide a conclusion only regarding the conformity of the
eyesight of an employee with the work to be performed, if
necessary writing a prescription for the purchase of visual
corrective appliance.
Acting for the Minister for
Welfare,
Minister for Education and Science T. Koķe
In Revised
Version Submitted by the Ministry of Welfare
Annex 2
Cabinet
Regulation No. 219
10 March 2009
Work in Special Conditions
[14 September
2010; 16 June 2015]
|
No.
|
General description of the
work to be performed
|
Notes
|
Physician - specialist
assessments
|
Mandatory laboratory and
functional investigations to be performed
|
Medical contra-indications
for the work to be performed (health disorders, in case of
which there is greater risk of the development of
situations at work which cause the risk of accidents to the
employee himself or herself, or those around him or her
|
|
Mandatory specialist
assessments required
|
Additional specialist
assessments required
|
Initial health
examination
|
Periodic health
examination
|
Abolute*
|
To be evaluated
|
|
1.
|
2.
|
3.
|
4.
|
5.
|
6.
|
7.
|
8.
|
9.
|
| 1. |
Work which is performed at more
than 1.5 m but less than 5 m above ground, covering or
support platform, if these constructions do not have a
protective enclosure, or it is necessary to go outside the
protective enclosure for the performance of work. |
|
doctor of occupational diseases,
neurologist
|
ophthalmologist,
otorhinolaryngologist |
|
|
Epilepsy.
Severe encephalopathy.
|
Eye diseases with a pronounced reduction in visual
functions (visual acuity with correction is less than 0.5
in one eye and less than 0.2 in the other eye).
Coronary heart disease.
Addiction to alcohol or psychotropic substances.
Chronic diseases of the central nervous system or mental
illnesses.
Disorders of the vestibular system, including Meniere's
disease.
|
| 2. |
Work which is performed at more
than 5 m above ground, covering or support platforms, if
these constructions do not have a protective enclosure, or it
is necessary to go outside the protective enclosure for the
performance of work |
|
doctor of occupational diseases, neurologist,
ophthalmologist,
otorhinolaryngologist
|
|
|
|
Disorders of the vestibular system, including Meniere's
disease which increase the risk of accident.
Epilepsy.
Severe encephalopathy.
|
Coronary heart disease. Cardiovascular diseases. Hypertonic
disease.
Addiction to alcohol or psychotropic substances.
Hernias affecting work and having a tendency to
strangulate (there are no limitations after a successful
surgery).
Chronic diseases of the central nervous system or mental
illnesses.
Eye diseases with a pronounced reduction in visual
functions, including visual acuity with correction less
than 0.5 in one eye and less than 0.2 in the other eye.
Permanent unilateral or bilateral reduction in any
aetiological hearing (in a whispered voice at a distance of
less than 3 m), if such reduction in hearing may cause the
risk of accidents and it is not possible to ensure adequate
communication by other means, if necessary.
|
| 3. |
Operators of different cargo
cranes, servicing of different installations which are meant
for lifting of people higher than 1.5 m above the
ground. |
|
doctor of occupational diseases,
neurologist, ophthalmologist, otorhinolaryngologist |
narcologist |
|
|
Epilepsy.
Eye diseases with a pronounced reduction in visual
functions, including visual acuity with correction less
than 0.5 in one eye and less than 0.2 in the other eye,
where such reduction in sight does not cause a risk of
accident.
Severe encephalopathy.
|
Coronary heart disease.
Addiction to alcohol or psychotropic substances.
Hernias affecting work and having a tendency to
strangulate (there are no limitations after a successful
surgery).
Disorders of the vestibular system, including Meniere's
disease.
Chronic diseases of the central nervous system or mental
illnesses.
Permanent unilateral or bilateral reduction in any
aetiological hearing (in a whispered voice at a distance of
less than 3 m), if such reduction in hearing may cause the
risk of accidents and it is not possible to ensure adequate
communication by other means.
|
| 4. |
Slinging work |
|
doctor of occupational diseases,
neurologist, ophthalmologist, otorhinolaryngologist |
|
|
|
Epilepsy.
Severe encephalopathy.
|
Coronary heart disease. Cardiovascular diseases. Hypertonic
disease.
Eye diseases with a pronounced reduction in visual
functions, including visual acuity with correction less
than 0.5 in one eye and less than 0.2 in the other eye.
Chronic diseases of the central nervous system or mental
illnesses.
Addiction to alcohol or psychotropic substances.
Hernias affecting work and having a tendency to
strangulate (there are no limitations after a successful
surgery).
Disorders of the vestibular system, including Meniere's
disease. Permanent unilateral or bilateral reduction in any
aetiological hearing (in a whispered voice at a distance of
less than 3 m), if such reduction in hearing may cause the
risk of accidents and it is not possible to ensure adequate
communication by other means.
|
| 5. |
Work on portable ladders, if it
involves climbing higher than 1.5 m |
If employee has been sent for
health examination in accordance with Paragraph 1 or 2 of
this Annex, this Paragraph need not be indicated |
doctor of occupational diseases,
neurologist |
ophthalmologist,
otorhinolaryngologist |
|
|
Epilepsy.
Severe encephalopathy.
|
Coronary heart disease. Cardiovascular diseases. Hypertonic
disease.
Addiction to alcohol or psychotropic substances.
Hernias affecting work and having a tendency to
strangulate (there are no limitations after a successful
surgery).
Eye diseases with a pronounced reduction in visual
functions, including visual acuity with correction less
than 0.5 in one eye and less than 0.2 in the other eye.
Permanent unilateral or bilateral reduction in any
aetiological hearing (in a whispered voice at a distance of
less than 3 m), if such reduction in hearing may cause the
risk of accident and it is not possible to ensure adequate
communication.
Disorders of the vestibular system, including Meniere's
disease.
|
| 6. |
Work in electrical installations
in operation with a voltage of 50 V and more |
|
doctor of occupational diseases,
neurologist, ophthalmologist |
otorhinolaryngologist |
Clinical blood count
(haemoglobin, leucocytes, erythrocyte sedimentation rate)
(hereinafter - CBC) |
CBC |
Severe encephalopathy. |
Permanent unilateral or bilateral reduction in any
aetiological hearing (in a whispered voice at a distance of
less than 3 m), if such reduction in hearing may cause the
risk of accidents and it is not possible to ensure adequate
communication by other means.
Disorders of the vestibular system, including Meniere's
disease which increase the risk of accident.
Addiction to alcohol or psychotropic substances.
Chronic diseases of the central nervous system or mental
illnesses.
Cardiovascular diseases.
Eye diseases with a pronounced reduction in visual
functions, including visual acuity with correction less
than 0.5 in one eye and less than 0.2 in the other eye,
persistent eye watering which does not respond to
treatment, limited field of vision greater than 20°.
|
| 7. |
Work which is performed in closed
underground premises, shafts, closed tanks |
|
doctor of occupational diseases,
neurologist, ophthalmologist |
otorhinolaryngologist,
ophthalmologist
|
Full blood count (hereinafter -
FBC) |
FBC |
Claustrophobia.
Severe encephalopathy.
|
Coronary heart disease.
Chronic diseases of the central nervous system or mental
illnesses.
Addiction to alcohol or psychotropic substances.
Eye diseases with a pronounced reduction in visual
functions, including visual acuity with correction less
than 0.5 in one eye and less than 0.2 in the other eye.
|
| 8. |
Work with dangerous equipment
which is under pressure, including servicing of boiler
equipment |
|
doctor of occupational diseases,
neurologist |
psychiatrist,
otorhinolaryngologist,
oftalmologs,
narcologist
|
CBC |
CBC |
Eye diseases with a reduction in visual functions,
including visual acuity with correction less than
0,5 in one eye and less than 0,2 in the other eye, if
such visual reduction causes the risk of accident.
|
Coronary heart disease.
Permanent unilateral or bilateral reduction in any
aetiological hearing (in a whispered voice at a distance of
less than 3 m), if such reduction in hearing may cause the
risk of accident and it is not possible to ensure adequate
communication.
Chronic diseases of the central nervous system or mental
illnesses.
Addiction to alcohol or psychotropic substances.
|
| 9. |
Blasting work, including
pyrotechnic blasting work |
|
doctor of occupational diseases,
neurologist |
psychiatrist,
otorhinolaryngologist,
oftalmologs,
narcologist
|
FBC |
FBC |
Eye diseases with a pronounced
reduction in visual functions, including visual acuity with
correction less than 0.5 in one eye and less than 0.2 in the
other eye, where such reduction in sight causes a risk of
accident. |
Coronary heart disease.
Permanent unilateral or bilateral reduction in any
aetiological hearing (in a whispered voice at a distance of
less than 3 m), if such reduction in hearing may cause the
risk of accident and it is not possible to ensure adequate
communication.
Chronic diseases of the central nervous system or mental
illnesses.
Addiction to alcohol or psychotropic substances.
|
| 10. |
Work, performance of which
requires wearing gas masks |
Once a year |
doctor of occupational diseases, neurologist,
ophthalmologist
|
otorhinolaryngologist,
surgeon,
narcologist, psychiatrist
|
FBC, X-ray of lungs (hereinafter
- lung x-ray), evaluation of the external respiratory
function (hereinafter - ERF), electrocardiogram (hereinafter
- ECG) |
FBC, ERF, ECG |
Epilepsy.
Severe psychosis, neurosis, encephalopathy.
Stress stenocardia.
Chronic lung diseases with disorders of respiratory
function.
Chest deformity which hinders breathing and working in a
gas mask or individual protective clothing.
Reduction in visual acuity below 0,8 in one eye and
below 0,5 in the other eye (without correction).
Permanent unilateral or bilateral reduction in any
aetiological hearing (in a whispered voice in a distance of
less than 3 m).
Pregnancy.
|
Addiction to alcohol or psychotropic substances.
Chronic diseases of the central or peripheral nervous
system or mental illnesses.
Cardiovascular diseases, peripheral arterial
diseases.
Acquired or genetic heart rhythm disorders.
Chronic diseases of the respiratory system.
Nasal septum deviation, which hinders working in a gas
mask.
Disorders in the development of locomotor apparatus.
Bone, joint, ligament diseases.
Tumours which hinder working in a gas mask.
Acute or chronic recurring inflammation of internal ear
or otitis media.
Disorders of the vestibular system, including Meniere's
disease.
Endocrine diseases, diabetes mellitus.
Eye diseases with a reduction in visual functions.
Gastro-intestinal tract diseases with functional
disorders and abdominal cavity diseases hindering the
performance of physical work.
Hernias affecting work and having a tendency to
strangulate (there are no limitations after a successful
surgery).
|
| 11. |
Industrial truck and motor cart
driving |
Up to 60 years of age - once every five years;
from 60 years of age - once every three years.
If an employee concurrently has a driving licence, this
health examination need not be performed.
|
doctor of occupational diseases,
ophthalmologist, otorhinolaryngologist |
neurologist |
CBC |
CBC |
Eye diseases with a pronounced reduction in visual
functions, including visual acuity with correction less
than 0.5 in one eye and less than 0.2 in the other eye,
where such reduction in sight causes a risk of accident.
Epilepsy.
|
Coronary heart disease.
Permanent unilateral or bilateral reduction in any
aetiological hearing (in a whispered voice at a distance of
less than 3 m), if such reduction in hearing may cause the
risk of accidents and it is not possible to ensure adequate
communication.
Chronic diseases of the central nervous system or mental
illnesses.
Addiction to alcohol or psychotropic substances.
|
| 12. |
Train driving |
|
|
|
|
|
|
|
| 12.1. |
Rail traction vehicle
driving |
|
|
|
|
|
|
|
| 12.1.1. |
Traction
vehicle driver
(operator)
|
Up to 55 years of age - once every three years, from 55
years of age - once a year
Extraordinary (additional) periodic health examination
shall be performed:
1. if there is reason to believe that an employee has
one of the contra-indications referred to in this
Regulation;
2. if the doctor of occupational diseases considers that
such health examination is necessary following a period of
at least 30 days of incapacity for work of an employee due
to sickness;
3. if an accident at work has occurred;
4. if an employee has been withdrawn from the
performance of duties for safety reasons;
5. by a doctor of occupational diseases and an
ophthalmologist once a year or within another period of
time specified by a doctor, if the person to be examined
uses contact lenses or glasses or has lens implants, has
had a keratotomy or keratectomy;
6. if the doctor of occupational diseases considers that
due to the state of health of the employee it is necessary
to increase the frequency of examinations
|
the doctor of occupational
diseases, ophthalmologist, otorhinolaryngologist, surgeon,
neurologist, psychiatrist, psychologist **, narcologist,
gynaecologist-birth specialist |
speech therapist |
1. a general medical examination (including general
testing, determining blood pressure, etc.);
2. eyesight test, including determination of colour
perception (use a recognised test, e.g. Ishihara colour
perception test, as well as, if necessary, other recognised
tests), determination of the identification of colour
signals (the test is based solely on colour, not comparable
differences), a contrast test, measurement of the eye's
inner pressure, determination of field of vision,
examination of the bottom of the eye, testing of binocular
vision;
3. hearing test, audiometry;
4. examination of vestibular apparatus;
5. CBC;
6. urine analysis (hereinafter - UA);
7. blood sugars (using blood glucose meter);
8. ECG at rest;
9. test for determining the presence of psychotropic
substances (narcotics, psychotropic medicines, or alcohol)
in the organism***;
10. testing of cognitive abilities (attention, ability
to concentrate, memory, perception and judgement),
communication abilities and psychometric reactions
(response rate, manual coordination) as part of the
examination by a neurologist, psychologist, and
psychiatrist;
11. an additional examination by an ophtalmologist and
an eyesight test once a year or within another period of
time specified by an optician, if the person to be examined
uses contact lenses or glasses or has lens implants, has
had a keratotomy or keratectomy;
|
1. a general medical examination (including general
testing, determining blood pressure, etc.);
2. eyesight test, including determination of colour
perception (use a recognised test, e.g. Ishihara colour
perception test, as well as, if necessary, another
recognised test), determination of the identification of
colour signals (the test is based solely on colour, not
comparable differences), a contrast test, measurement of
the eye's inner pressure, determination of field of vision,
examination of the bottom of the eye, testing of binocular
vision;
3. hearing test, audiometry;
4. examination of vestibular apparatus;
5. CBC;
6. UA;
7. blood sugars (using blood glucose meter);
8. ECG at rest (over the age of 40 years);
9. test for determining the presence of psychotropic
substances (narcotics, psychotropic medicines, or alcohol)
in the organism***;
10. an additional examination by an optician and an
eyesight test once a year or within another period of time
specified by an optician, if the person to be examined uses
contact lenses or glasses or has lens implants, has had a
keratotomy or keratectomy
|
1. Any kind of health disorder or use of medicines,
narcotics or substances that could lead to sudden loss of
consciousness, loss of attention or concentration, sudden
incapacity for work, loss of balance or coordination,
significant restrictions on mobility (movement):
1.1. any genetic and aetiological dementia or defects
with chronic or progressive development and disorders of
higher cortical function, medium severe or pronounced
mental retardation and acute, sub-chronic or chronic
psychotonic disorders;
1.2. registered with the State Addiction Service;
1.3. various aetiological pronounced vestibular
vegetative disorders, confirmed by health care
institutions;
1.4. upper or lower limb deficiency or deficiency of
part thereof;
1.5. internal diseases;
1.5.1. malignant new growths: diseases of the
haematopoietic system; haemorrhagic diathesis (in case of a
benign process for employees - an individual approach);
1.5.2. organic heart muscle and valve damages (heart
disease, atherosclerotic cardiosclerosis, post-infarction
cardiosclerosis, myocarditis, etc) with permanent level
II-III circulatory deficiency;
1.5.3. chronic coronary heart disease with frequent pain
attacks. Condition after repeated myocardial infarction or
infarction causing aneurysm;
1.5.4. heart rhythm disorders with level II-III
cardiovascular insufficiency or symptoms of cerebral blood
flow disorders;
1.5.5. severe hypertonic disease with pronounced damage
to blood vessels;
1.5.6. chronic processes of lung infection (chronic
obstructive pulmonary disease, abscess, bronchiectases)
with frequent aggravations and symptoms of lung-heart
insufficiency;
1.5.7. persistent bronchial asthma;
1.5.8. chronic disease of gastro-intestinal tract,
pancreas, the liver and biliary tract with a pronounced
insufficiency of organ functions;
1.5.9. chronic diseases of kidneys and ureter with
symptoms of renal deficiency;
1.5.10. severe form of endocrine disease with a
pronounced functional insufficiency;
1.5.11. various aetiological damages of joints with
permanent mobility disorders, which may be an obstacle in
the fulfilment of duties of service in the relevant
profession;
1.5.12. active tuberculosis of all organs and all types
requiring treatment during medical examination;
1.6. gynaecological diseases:
1.6.1. pronounced (complete, partial) prolapse or
falling of uterus and vagina. Massively bleeding uterine
cervical erosions;
1.6.2. malignant or symptomatically benign uterine
tumours. All appendageal tumours;
1.6.3. genitourinary and rectal fistulas;
1.6.4. severe disorders of ovarian and menstrual
function. Pathological climax;
1.6.5. chronic inflammation processes of the uterus and
appendages thereof, with frequent aggravations and
functional disorders of surrounding organs;
1.7. surgical diseases:
1.7.1. consequences of various traumas, surgical
operations, chronic bone, cartilage, joint diseases
(deforming arthritis, meniscitis, spondylosis,
spondyloarthritis), genetic and acquired bone deformities
(scoliosis, kyphosis, kyphoscoliosis, spondylolisthesis,
etc), with permanent recurrent pain and permanent
functional disorders of the damaged organ;
1.7.2. thrombophlebitis with frequent aggravations;
pronounced varicose veins of the lower limbs with trophic
ulcers, not responding to treatment;
1.7.3. all forms of obliterating endarteritis is a
contra-indication when taking up employment. Employees may
remain within their speciality, if the disease does not
affect the performance of service duties;
1.7.4. pronounced hand deformities, restricted finger
mobility (immobility) which significantly affects the
holding function of the hand;
1.7.5. faecal and urinal fistulas, rectal development
disorders; urinary tract and bladder diseases and
development disorders resulting in incontinence;
1.7.6. all forms of malignant tumours are a
contra-indication when taking up employment. If employees
have a benign course of the disease, the approach shall be
individual;
1.8. pregnancy:
1.8.1. intolerance (pre-eclampsia);
1.8.2. pathology in pregnancy****.
2. Visual impairments in the form of:
2.1. visual acuity with or without correction is less
than: 1.0; less than 0.5 in the eye with reduced visual
acuity;
2.2. corrective lens capacity more than +5 - for
hypermetropia, more than -8 for myopia*****;
2.3. insufficient vision at close distance and in the
middle distance with or without means of visual
correction;
2.4. changed colour vision;
2.5. non-recognition of colour signals;
2.6. changed field of vision;
2.7. ineffective binocular vision;
2.8. ineffective vision in both eyes******;
2.9. poor contrast sensitivity;
2.10. inability to endure bright lights;
2.11. advanced eye disease with visual impairment;
2.12. use of coloured contact lenses and photochromatic
lenses (excluding lenses with UV protection).
3. Hearing disorders in the form of:
3.1. insufficient hearing to be able to talk on the
telephone, as well as to hear warning sounds and radio
messages;
3.2. hearing deficiency exceeding 40 dB at frequencies
500 and 1000 Hz;
3.3. hearing deficiency exceeding 45 dB at a frequency
of 2000 Hz for the ear with reduced sound flow
conductivity;
3.4. the use of hearing aids*******.
4. Chronic hearing defect (unable to communicate in a
loud and clear voice).
5. Anomalies of the vestibular apparatus
|
|
| 12.1.2. |
Means of traction driver
(engine driver) instructor
Means of traction
driver's (engine driver's) assistant
|
Up to 62 years of age - once every three years, from 62
years of age - once a year. Extraordinary (additional)
periodic health examinations shall be performed:
1. if there is reason to believe that an employee has
one of the contra-indications referred to in this
Regulation;
2. if the doctor of occupational diseases considers that
such health examination is necessary following a period of
at least 30 days of incapacity for work of an employee due
to sickness;
3. if an employee has been withdrawn from the
performance of duties for safety reasons (after an accident
or incident caused by a personal error of such
employee);
4. by a doctor of occupational diseases and an
ophthalmologist once a year or within another period of
time specified by a doctor, if the person to be examined
uses contact lenses or glasses or has lens implants, has
had a keratotomy or keratectomy;
5. if the doctor of occupational diseases considers that
due to the state of health of the employee it is necessary
to increase the frequency of examinations
|
a doctor of occupational
diseases, ophthalmologist, otorhinolaryngologist, surgeon,
neurologist, psychiatrist, narcologist |
|
1. a general medical examination;
2. eyesight test, including determination of colour
perception (use a recognised test, e.g. Ishihara colour
perception test, as well as, if necessary, another
recognised test), a contrast test, measurement of the eye's
inner pressure, determination of field of vision,
examination of the bottom of the eye, testing of binocular
vision;
3. hearing test, audiometry;
4. CBC;
5. UA;
6. blood sugars (using blood glucose meter);
7. test for determining the presence of psychotropic
substances (narcotics, psychotropic medicines, or alcohol)
in the organism***;
8. an additional examination by an ophtalmologist and an
eyesight test once a year or within another period of time
specified by an optician, if the person to be examined uses
contact lenses or glasses or has lens implants, has had a
keratotomy or keratectomy
|
1. a general medical examination;
2. eyesight test, including determination of colour
perception (use a recognised test, e.g. Ishihara colour
perception test, as well as, if necessary, another
recognised test), a contrast test, measurement of the eye's
inner pressure, determination of field of vision,
examination of the bottom of the eye, testing of binocular
vision;
3. hearing test, audiometry;
4. CBC;
5. UA;
6. blood sugars (using blood glucose meter);
7. test for determining the presence of psychotropic
substances (narcotics, psychotropic medicines, or alcohol)
in the organism***;
8. an additional examination by an ophtalmologist and an
eyesight test once a year or within another period of time
specified by an optician, if the person to be examined uses
contact lenses or glasses or has lens implants, has had a
keratotomy or keratectomy;
|
1. Any kind of health disorder or use of medicines,
narcotics or substances that could lead to sudden loss of
consciousness, loss of attention or concentration, sudden
incapacity for work, loss of balance or coordination,
significant restrictions on mobility (movement):
1.1. any genetic and aetiological dementia or defects
with chronic or progressive development and disorders of
higher cortical function, medium severe or pronounced
mental retardation and acute, sub-chronic or chronic
psychotonic disorders;
1.2. registered with the State Addiction Service;
1.3. various aetiological pronounced vestibular
vegetative disorders, confirmed by health care
institutions;
1.4. upper or lower limb deficiency or deficiency of
part thereof;
1.5. internal diseases;
1.5.1. malignant new growths: diseases of the
haematopoietic system; haemorrhagic diathesis (in case of a
benign process for employees - an individual approach);
1.5.2. organic heart muscle and valve damages (heart
disease, atherosclerotic cardiosclerosis, post-infarction
cardiosclerosis, myocarditis, etc) with permanent level
II-III circulatory deficiency;
1.5.3. chronic coronary heart disease with frequent pain
attacks. Condition after repeated myocardial infarction or
infarction causing aneurysm;
1.5.4. heart rhythm disorders with level II-III
cardiovascular insufficiency or symptoms of cerebral blood
flow disorders;
1.5.5. severe hypertonic disease with pronounced damage
to blood vessels;
1.5.6. chronic processes of lung infection (chronic
obstructive pulmonary disease, abscess, bronchiectases)
with frequent aggravations and symptoms of lung-heart
insufficiency;
1.5.7. persistent bronchial asthma;
1.5.8. chronic disease of gastro-intestinal tract,
pancreas, the liver and biliary tract with a pronounced
insufficiency of organ functions;
1.5.9. chronic diseases of kidneys and ureter with
symptoms of renal deficiency;
1.5.10. severe form of endocrine disease with a
pronounced functional insufficiency;
1.5.11. various aetiological damages of joints with
permanent mobility disorders, which may be an obstacle in
the fulfilment of duties of service in the relevant
profession;
1.5.12. active tuberculosis of all organs and all types
requiring treatment during medical examination;
1.6. gynaecological diseases:
1.6.1. pronounced (complete, partial) prolapse or
falling of uterus and vagina. Massively bleeding uterine
cervical erosions;
1.6.2. malignant or symptomatically benign uterine
tumours. All appendageal tumours;
1.6.3. genitourinary and rectal fistulas;
1.6.4. severe disorders of ovarian and menstrual
function. Pathological climax;
1.6.5. chronic inflammation processes of the uterus and
appendages thereof, with frequent aggravations and
functional disorders of surrounding organs;
1.7. surgical diseases:
1.7.1. consequences of various traumas, surgical
operations, chronic bone, cartilage, joint diseases
(deforming arthritis, meniscitis, spondylosis,
spondyloarthritis), genetic and acquired bone deformities
(scoliosis, kyphosis, kyphoscoliosis, spondylolisthesis,
etc), with permanent recurrent pain and permanent
functional disorders of the damaged organ;
1.7.2. thrombophlebitis with frequent aggravations;
pronounced varicose veins of the lower limbs with trophic
ulcers, not responding to treatment;
1.7.3. all forms of obliterating endarteritis is a
contra-indication when taking up employment. Employees may
remain within their speciality, if the disease does not
affect the performance of service duties;
1.7.4. pronounced hand deformities, restricted finger
mobility (immobility) which significantly affects the
holding function of the hand;
1.7.5. faecal and urinal fistulas, rectal development
disorders; urinary tract and bladder diseases and
development disorders resulting in incontinence;
1.7.6. all forms of malignant tumours are a
contra-indication when taking up employment. If employees
have a benign course of the disease, the approach shall be
individual;
1.8. pregnancy:
1.8.1. intolerance (pre-eclampsia);
1.8.2. pathology in pregnancy****.
2. Visual impairments in the form of:
2.1. visual acuity with or without means of visual
correction less than 1.0; less than 0.5 in the eye with
reduced vision;
2.2. corrective lens capacity more than +5 - for
hypermetropia, more than -8 for myopia*****;
2.3. insufficient vision at close distance and in the
middle distance with or without means of visual
correction;
2.4. changed colour vision;
2.5. non-recognition of colour signals;
2.6. changed field of vision;
2.7. ineffective binocular vision;
2.8. ineffective vision in both eyes******;
2.9. poor contrast sensitivity;
2.10. inability to endure bright lights;
2.11. advanced eye disease with visual impairment;
2.12. use of coloured contact lenses and photochromatic
lenses (excluding lenses with UV protection).
3. Hearing disorders in the form of:
3.1. insufficient hearing to be able to talk on the
telephone, as well as to hear warning sounds and radio
messages;
3.2. hearing deficiency exceeding 40 dB at frequencies
500 and 1000 Hz;
3.3. hearing deficiency exceeding 45 dB at a frequency
of 2000 Hz for the ear with reduced sound flow
conductivity;
3.4. the use of hearing aids*******.
4. Chronic hearing defect (unable to communicate in a
loud and clear voice).
5. Anomalies of the vestibular apparatus
|
|
| 12.2. |
Train traffic management:
train traffic, senior dispatchers
dispatchers, power dispatchers,
persons on duty, railway station operators,
sorting hump, park masters-on-duty and operators,
manoeuvre dispatchers, centralisation and switch point
operators
freight train chief conductors, conductors, train
assemblers and
their assistants, speed regulators of car movement,
signalmen, train
and freight receiving employees.
|
Once every three
years
|
doctor of occupational diseases,
neurologist,
ophthalmologist,
otorhinolaryngologist,
gynaecologist, birth attendant
surgeon,
psychiatrist,
narcologist
|
psychologist |
Clinical blood analysis, UA, ECG, lung x-ray audiogram,
examination of vestibular apparatus,
colour awareness test,
measurements of internal eye pressure,
determination of visual field,
examination of the bottom of the eye, Rh-factor
test,
rectosigmoid examination (for men after 40 years of
age), gynaecological examination (bacteriological,
cytological) and rectosigmoid examination (for women after
40 years of age)
|
Clinical blood analysis, UA, ECG, lung x-ray audiogram,
examination of vestibular apparatus,
colour awareness test,
measurements of internal eye pressure,
determination of visual field,
examination of the bottom of the eye,
rectosigmoid examination (for men after 40 years of
age), gynaecological examination (bacteriological,
cytological) and rectosigmoid examination (for women after
40 years of age)
|
|
Any genetic and aetiological dementia or defects with
chronic or progressive development and disorders of higher
cortical function, medium severe or pronounced mental
retardation and acute, sub-chronic or chronic psychotonic
disorders.
Registered with the State Addiction Service.
Visual impairment.
Changes in eye refraction exceeding ± 3.5 dioptres.
Changes in the retina or the optic nerve, which impair
visual functions.
Eyelid paresis or paralysis.
Colour vision anomaly of type A or B.
Deafness in one or both ears.
For persons who are taken into employment - if whispered
speech is heard at a distance of not less than one metre
(for each ear), for employees- if whispered speech is heard
at a distance of not less than 0.5 metres (for each
ear).
Various aetiological pronounced vestibular vegetative
disorders, confirmed by health care institutions.
Upper or lower limb deficiency or deficiency of part
thereof.
Internal diseases:
1. malignant new growths: statement of the hematopoietic
system.
illnesses; haemorrhagic diathesis (in case of a benign
process for employees- an individual approach);
2. organic heart muscle and valve damages (heart
disease, atherosclerotic cardiosclerosis, post-infarction
cardiosclerosis, myocarditis . etc) with permanent level
II-III circulatory deficiency;
3. chronic coronary heart disease with frequent pain
attacks. Condition after repeated myocardial infarction or
infarction causing aneurysm;
4. heart rhythm disorders with level II-III
cardiovascular insufficiency or symptoms of cerebral blood
flow disorders;
5. severe hypertonic disease with pronounced damage to
blood vessels;
6. chronic processes of lung infection (chronic
obstructive pulmonary disease, abscess, bronchiectases)
with frequent aggravations and symptoms of lung-heart
insufficiency;
7. persistent bronchial asthma;
8. chronic disease of gastro-intestinal tract, pancreas,
the liver and biliary tract with a pronounced insufficiency
of organ functions;
9. chronic diseases of kidneys and ureter with symptoms
of renal deficiency;
10. severe form of endocrine disease with a pronounced
functional insufficiency;
11. various aetiological damages of joints with
permanent mobility disorders, which may be an obstacle in
the fulfilment of duties of service in the relevant
profession;
12. active tuberculosis of all organs and all types
requiring treatment during medical examination.
Gynaecological diseases:
1. pronounced (complete, partial) prolapse or falling of
uterus and vagina. Massively bleeding uterine cervical
erosions;
2. malignant or symptomatically benign uterine tumours.
All appendageal tumours;
3. genitourinary and rectal fistulas;
4. severe disorders of ovarian and menstrual function.
Pathological climax;
5. chronic inflammation processes of the uterus and
appendages thereof, with frequent aggravations and
functional disorders of surrounding organs.
Surgical diseases:
1. consequences of various traumas, surgical operations,
chronic bone, cartilage, joint diseases (deforming
arthritis, meniscitis, spondylosis, spondyloarthritis),
genetic and acquired bone deformities (scoliosis, kyphosis,
kyphoscoliosis, spondylolisthesis, etc), with permanent
recurrent pain and permanent functional disorders of the
damaged organ;
2. thrombophlebitis with frequent aggravations;
pronounced varicose veins of the lower limbs with trophic
ulcers, not responding to treatment;
3. all forms of obliterating endarteritis is a
contra-indication when taking up employment. Employees may
remain within their speciality, if the disease does not
affect the performance of service duties;
4. pronounced hand deformities, restricted finger
mobility (immobility), which significantly affects the
holding function of hand;
5. faecal and urinal fistulas, rectal development
disorders; urinary tract and bladder diseases and
development disorders resulting in incontinence;
6. all forms of malignant tumours are a
contra-indication when taking up employment. If employees
have a benign course of the disease, the approach shall be
individual.
|
| 12.3. |
Maintenance of rail infrastructure:
senior masters of rail tracks, road masters, foremen,
assemblers and track walkers persons on duty at level
crossings senior electrical engineers of signalling,
central control and interlocking installations, electrical
engineers and electrical assemblers
senior electrical engineers of catenaries and
electricity supply districts, electrical engineers and
electric assemblers.
|
|
doctor of occupational diseases,
neurologist, ophthalmologist, otorhinolaryngologist,
gynaecologist, birth attendant surgeon, psychiatrist,
narcologist |
psychologist |
Clinical blood analysis, UA,
ECG, lung x-ray audiogram, examination of vestibular
apparatus, colour awareness test, measurements of internal
eye pressure, determination of visual field, examination of
the bottom of the eye, Rh-factor test, rectosigmoid
examination (for men after 40 years of age), gynaecological
examination (bacteriological, cytological) and rectosigmoid
examination (for women after 40 years of age) |
Clinical blood analysis, UA,
ECG, lung x-ray, audiogram, examination of vestibular
apparatus, colour awareness test, measurements of internal
eye pressure, determination of visual field, examination of
the bottom of the eye, rectosigmoid examination (for men
after 40 years of age), gynaecological examination
(bacteriological, cytological) and rectosigmoid examination
(for women after 40 years of age) |
|
Any genetic and aetiological dementia or defects with
chronic or progressive development and disorders of higher
cortical function, medium severe or pronounced mental
retardation and acute, sub-chronic or chronic psychotonic
disorders.
Registered with the State Addiction Service.
Visual impairment.
Changes in eye refraction exceeding ± 3.5 dioptres.
Changes in the retina or the optic nerve, which impair
visual functions.
Eyelid paresis or paralysis.
Colour vision anomaly of type A or B.
Deafness in one or both ears.
For persons who are taken into employment - if whispered
speech is heard at a distance of not less than one metre
(for each ear), for employees- if whispered speech is heard
at a distance of not less than 0.5 metres (for each
ear).
Various aetiological pronounced vestibular vegetative
disorders, confirmed by health care institutions.
Upper or lower limb deficiency or deficiency of part
thereof.
Internal diseases:
1. malignant new growths: statement of the hematopoietic
system.
illnesses; haemorrhagic diathesis (in case of a benign
process for employees- an individual approach);
2. organic heart muscle and valve damages (heart
disease, atherosclerotic cardiosclerosis, post-infarction
cardiosclerosis, myocarditis . etc) with permanent level
II-III circulatory deficiency;
3. chronic coronary heart disease with frequent pain
attacks. Condition after repeated myocardial infarction or
infarction causing aneurysm;
4. heart rhythm disorders with level II-III
cardiovascular insufficiency or symptoms of cerebral blood
flow disorders;
5. severe hypertonic disease with pronounced damage to
blood vessels;
6. chronic processes of lung infection (chronic
obstructive pulmonary disease, abscess, bronchiectases)
with frequent aggravations and symptoms of lung-heart
insufficiency;
7. persistent bronchial asthma;
8. chronic disease of gastro-intestinal tract, pancreas,
the liver and biliary tract with a pronounced insufficiency
of organ functions;
9. chronic diseases of kidneys and ureter with symptoms
of renal deficiency;
10. severe form of endocrine disease with a pronounced
functional insufficiency;
11. various aetiological damages of joints with
permanent mobility disorders which may be an obstacle in
the fulfilment of duties of service in the relevant
profession;
12. active tuberculosis of all organs and all types
requiring treatment during medical examination.
Gynaecological diseases:
1. pronounced (complete, partial) prolapse or falling of
uterus and vagina. Massively bleeding uterine cervical
erosions;
2. malignant or symptomatically benign uterine tumours.
All appendageal tumours;
3. genitourinary and rectal fistulas;
4. severe disorders of ovarian and menstrual function.
Pathological climax;
5. chronic inflammation processes of the uterus and
appendages thereof, with frequent aggravations and
functional disorders of surrounding organs.
Surgical diseases:
1. consequences of various traumas, surgical operations,
chronic bone, cartilage, joint diseases (deforming
arthritis, meniscitis, spondylosis, spondyloarthritis),
genetic and acquired bone deformities (scoliosis, kyphosis,
kyphoscoliosis, spondylolisthesis, etc), with permanent
recurrent pain and permanent functional disorders of the
damaged organ;
2. thrombophlebitis with frequent aggravations;
pronounced varicose veins of the lower limbs with trophic
ulcers, not responding to treatment;
3. all forms of obliterating endarteritis is a
contra-indication when taking up employment. Employees may
remain within their speciality, if the disease does not
affect the performance of service duties;
4. pronounced hand deformities, restricted finger
mobility (immobility), which significantly affects the
holding function of hand;
5. faecal and urinal fistulas, rectal development
disorders; urinary tract and bladder diseases and
development disorders resulting in incontinence;
6. all forms of malignant tumours are a
contra-indication when taking up employment. If employees
have a benign course of the disease, the approach shall be
individual.
|
| 12.4. |
Maintenance of rolling stock:
(senior railroad car inspectors (repairers)
for technical maintenance points of cars,
railroad car inspectors (repairers),
operators).
|
Once every three years |
doctor of occupational diseases,
neurologist,
ophthalmologist,
otorhinolaryngologist,
gynaecologist, birth attendant
surgeon,
psychiatrist,
narcologist
|
psychologist |
Clinical blood analysis, UA, ECG, lung x-ray audiogram,
examination of vestibular apparatus,
colour awareness test,
measurements of internal eye pressure,
determination of visual field,
examination of the bottom of the eye, Rh-factor
test,
rectosigmoid examination (for men after 40 years of
age), gynaecological examination (bacteriological,
cytological) and rectosigmoid examination (for women after
40 years of age)
|
Clinical blood analysis, UA, ECG, lung x-ray audiogram,
examination of vestibular apparatus,
colour awareness test,
measurements of internal eye pressure,
determination of visual field,
examination of the bottom of the eye,
rectosigmoid examination (for men after 40 years of
age), gynaecological examination (bacteriological,
cytological) and rectosigmoid examination (for women after
40 years of age)
|
|
Any genetic and aetiological dementia or defects with
chronic or progressive development and disorders of higher
cortical function, medium severe or pronounced mental
retardation and acute, sub-chronic or chronic psychotonic
disorders.
Registered with the State Addiction Service.
Visual impairment.
Changes in eye refraction exceeding ± 3.5 dioptres.
Changes in the retina or the optic nerve, which impair
visual functions.
Eyelid paresis or paralysis.
Colour vision anomaly of type A or B.
Deafness in one or both ears.
For persons who are taken into employment - if whispered
speech is heard at a distance of not less than one metre
(for each ear), for employees- if whispered speech is heard
at a distance of not less than 0.5 metres (for each
ear).
Various aetiological pronounced vestibular vegetative
disorders, confirmed by health care institutions.
Upper or lower limb deficiency or deficiency of part
thereof.
Internal diseases:
1. malignant new growths: statement of the hematopoietic
system.
illnesses; haemorrhagic diathesis (in case of a benign
process for employees- an individual approach);
2. organic heart muscle and valve damages (heart
disease, atherosclerotic cardiosclerosis, post-infarction
cardiosclerosis, myocarditis . etc) with permanent level
II-III circulatory deficiency;
3. chronic coronary heart disease with frequent pain
attacks. Condition after repeated myocardial infarction or
infarction causing aneurysm;
4. heart rhythm disorders with level II-III
cardiovascular insufficiency or symptoms of cerebral blood
flow disorders;
5. severe hypertonic disease with pronounced damage to
blood vessels;
6. chronic processes of lung infection (chronic
obstructive pulmonary disease, abscess, bronchiectases)
with frequent aggravations and symptoms of lung-heart
insufficiency;
7. persistent bronchial asthma;
8. chronic disease of gastro-intestinal tract, pancreas,
the liver and biliary tract with a pronounced insufficiency
of organ functions;
9. chronic diseases of kidneys and ureter with symptoms
of renal deficiency;
10. severe form of endocrine disease with a pronounced
functional insufficiency;
11. various aetiological damages of joints with
permanent mobility disorders which may be an obstacle in
the fulfilment of duties of service in the relevant
profession;
12. active tuberculosis of all organs and all types
requiring treatment during medical examination.
Gynaecological diseases:
1. pronounced (complete, partial) prolapse or falling of
uterus and vagina. Massively bleeding uterine cervical
erosions;
2. malignant or symptomatically benign uterine tumours.
All appendageal tumours;
3. genitourinary and rectal fistulas;
4. severe disorders of ovarian and menstrual function.
Pathological climax;
5. chronic inflammation processes of the uterus and
appendages thereof, with frequent aggravations and
functional disorders of surrounding organs.
Surgical diseases:
1. consequences of various traumas, surgical operations,
chronic bone, cartilage, joint diseases (deforming
arthritis, meniscitis, spondylosis, spondyloarthritis),
genetic and acquired bone deformities (scoliosis, kyphosis,
kyphoscoliosis, spondylolisthesis, etc), with permanent
recurrent pain and permanent functional disorders of the
damaged organ;
2. thrombophlebitis with frequent aggravations;
pronounced varicose veins of the lower limbs with trophic
ulcers, not responding to treatment;
3. all forms of obliterating endarteritis is a
contra-indication when taking up employment. Employees may
remain within their speciality, if the disease does not
affect the performance of service duties;
4. pronounced hand deformities, restricted finger
mobility (immobility), which significantly affects the
holding function of hand;
5. faecal and urinal fistulas, rectal development
disorders; urinary tract and bladder diseases and
development disorders resulting in incontinence;
6. all forms of malignant tumours are a
contra-indication when taking up employment. If employees
have a benign course of the disease, the approach shall be
individual.
|
| 12.5. |
Provision of passenger traffic:
passenger trainmasters,
auditors-controllers, conductors-controllers
passenger car attendants.
|
Once every three years |
doctor of occupational diseases,
neurologist, ophthalmologist, otorhinolaryngologist,
gynaecologist, birth attendant surgeon, psychiatrist,
narcologist |
psychologist |
Clinical blood analysis, UA, ECG, lung x-ray audiogram,
examination of vestibular apparatus,
colour awareness test,
measurements of internal eye pressure,
determination of visual field,
examination of the bottom of the eye, Rh-factor test,
rectosigmoid examination (for men after 40 years of age),
gynaecological examination (bacteriological, cytological)
and rectosigmoid examination (for women after 40 years of
age)
|
Clinical blood analysis, UA, ECG, lung x-ray audiogram,
examination of vestibular apparatus,
colour awareness test,
measurements of internal eye pressure,
determination of visual field,
examination of the bottom of the eye,
rectosigmoid examination (for men after 40 years of
age), gynaecological examination (bacteriological,
cytological) and rectosigmoid examination (for women after
40 years of age)
|
|
Any genetic and aetiological dementia or defects with
chronic or progressive development and disorders of higher
cortical function, medium severe or pronounced mental
retardation and acute, sub-chronic or chronic psychotonic
disorders.
Registered with the State Addiction Service.
Visual impairment.
Changes in eye refraction exceeding ± 3.5 dioptres.
Changes in the retina or the optic nerve, which impair
visual functions.
Eyelid paresis or paralysis.
Colour vision anomaly of type A or B.
Deafness in one or both ears.
For persons who are taken into employment - if whispered
speech is heard at a distance of not less than one metre
(for each ear), for employees- if whispered speech is heard
at a distance of not less than 0.5 metres (for each
ear).
Various aetiological pronounced vestibular vegetative
disorders, confirmed by health care institutions.
Upper or lower limb deficiency or deficiency of part
thereof.
Internal diseases:
1. malignant new growths: statement of the hematopoietic
system.
illnesses; haemorrhagic diathesis (in case of a benign
process for employees- an individual approach);
2. organic heart muscle and valve damages (heart
disease, atherosclerotic cardiosclerosis, post-infarction
cardiosclerosis, myocarditis . etc) with permanent level
II-III circulatory deficiency;
3. chronic coronary heart disease with frequent pain
attacks. Condition after repeated myocardial infarction or
infarction causing aneurysm;
4. heart rhythm disorders with level II-III
cardiovascular insufficiency or symptoms of cerebral blood
flow disorders;
5. severe hypertonic disease with pronounced damage to
blood vessels;
6. chronic processes of lung infection (chronic
obstructive pulmonary disease, abscess, bronchiectases)
with frequent aggravations and symptoms of lung-heart
insufficiency;
7. persistent bronchial asthma;
8. chronic disease of gastro-intestinal tract, pancreas,
the liver and biliary tract with a pronounced insufficiency
of organ functions;
9. chronic diseases of kidneys and ureter with symptoms
of renal deficiency;
10. severe form of endocrine disease with a pronounced
functional insufficiency;
11. various aetiological damages of joints with
permanent mobility disorders which may be an obstacle in
the fulfilment of duties of service in the relevant
profession;
12. active tuberculosis of all organs and all types
requiring treatment during medical examination.
Gynaecological diseases:
1. pronounced (complete, partial) prolapse or falling of
uterus and vagina. Massively bleeding uterine cervical
erosions;
2. malignant or symptomatically benign uterine tumours.
All appendageal tumours;
3. genitourinary and rectal fistulas;
4. severe disorders of ovarian and menstrual function.
Pathological climax;
5. chronic inflammation processes of the uterus and
appendages thereof, with frequent aggravations and
functional disorders of surrounding organs.
Surgical diseases:
1. consequences of various traumas, surgical operations,
chronic bone, cartilage, joint diseases (deforming
arthritis, meniscitis, spondylosis, spondyloarthritis),
genetic and acquired bone deformities (scoliosis, kyphosis,
kyphoscoliosis, spondylolisthesis, etc), with permanent
recurrent pain and permanent functional disorders of the
damaged organ;
2. thrombophlebitis with frequent aggravations;
pronounced varicose veins of the lower limbs with trophic
ulcers, not responding to treatment;
3. all forms of obliterating endarteritis is a
contra-indication when taking up employment. Employees may
remain within their speciality, if the disease does not
affect the performance of service duties;
4. pronounced hand deformities, restricted finger
mobility (immobility) which significantly affects the
holding function of hand;
5. faecal and urinal fistulas, rectal development
disorders; urinary tract and bladder diseases and
development disorders resulting in incontinence;
6. all forms of malignant tumours are a
contra-indication when taking up employment. If employees
have a benign course of the disease, the approach shall be
individual.
|
| 13. |
Owners of aircraft technical
maintenance certificates and candidates for the receipt of
the certificate. |
Once a year after 40 years of
age |
doctor of occupational diseases,
internist, ophthalmologist, otorhinolaryngologist,
neurologist, surgeon, psychiatrist (upon performing initial
examination), narcologist (upon performing initial
examination) |
|
Clinical blood analysis, UA,
ECG, lung x-ray, tonal audiogram |
Clinical blood analysis, UA,
ECG, lung x-ray, tonal audiogram |
Addiction to alcohol or psychotropic substances.
Epilepsy.
Psychosis, neurosis.
Requirements for vision:
a) eyeballs and adnexa thereof within normal limits
without acute or chronic diseases;
b) normal field of vision;
c) visual acuity may not be less than 0.7 with or
without correction for each eye separately. If acuity of
0.7 is only with correction, then vision of each eye
without correction shall not be less than 0.1. Refraction
shall not exceed + 5.0/-6.0 dioptres, including the
cylinder in the largest axis.
Hearing requirements:
a) tonal audiogram once every five years up to 40 years
of age;
b) tonal audiogram once every two years after 40 years
of age;
c) if the loss of hearing established by audiogram for
each ear separately does not exceed 35 DB on frequencies of
500, 1000 and 2000 Hz or more than 50 DB on a frequency of
3000 Hz or 40 DB on frequencies of 4000-8000 Hz, the
applicant complies with the health requirements.
|
Cardiovascular diseases.
Acquired or genetic heart rhythm disorders.
Chronic lung diseases.
Acute lung tuberculosis.
Diseases of the gastro-intestinal tract with functional
disorders.
Endocrinological diseases.
Kidney, urinary tract diseases and diseases of
genitals.
Pregnancy.
Bone, joint, ligament diseases. Cases of losing
consciousness with an unsatisfactory or unclear reason from
a medical point of view.
Acute or chronic recurring inflammation of internal ear
or otitis media.
Disorders of the vestibular apparatus.
Speech defects and stuttering.
|
Notes.
1. * Such health disorders, upon existence of which work in
specific special conditions is connected with the risk of
accidents to the employee himself or herself or those around him
or her.
2. ** In the course of the examination it shall be verified
that the applicant has no identified psychological shortcomings,
particularly in terms of capacity to act, or other relevant
personal factors which may impede the full and safe performance
of his or her duties.
3. *** If necessary, according to the instructions of the
narcologist.
4. **** In cases of intolerance or pathology, pregnancy shall
be considered as a reason for temporary exemption from the
performance of duties and legal provisions shall apply to protect
pregnant female drivers of a rail traction vehicle.
5. ***** In the event of deviations an optician may indicate
in the opinion that the state of vision corresponds to the work
to be done if visual corrective measures are used. In such case
the doctor of occupational diseases shall take a decision on the
conformity of the state of health with the work to be
performed.
6. ****** Except for a case where a person has lost binocular
vision after starting work and has adapted sufficiently, as well
as has sufficient compensatory capacity. Such an exception shall
not apply to a person who from 1 January 2016 acquires a
certificate of competence of a driver of a traction vehicle
(train driver) in accordance with Cabinet Regulation No. 873 of
14 September 2010, Regulations Regarding Obtaining a Train
Driver's Qualification and Licence to Drive a Traction
Vehicle.
7. ******* An otolaryngologist states in the opinion that the
state of hearing corresponds to the work to be performed when a
hearing aid is used. In such case the doctor of occupational
diseases shall take a decision on the conformity of the state of
health with the work to be performed.
Acting for the Minister for
Welfare,
Minister for Education and Science T. Koķe
Annex 3
Cabinet
Regulation No. 219
10 March 2009
Mandatory Health Examination
Card
Referral for a Mandatory Health
Examination
| |
|
(name of the medical
treatment institution) (indicated, if necessary)
|
|
1. Employer (name, address, telephone number) |
|
|
2. Given name, surname of the person |
|
|
3. Personal identification number |
|
|
6. Factors of the working environment harmful to health |
|
|
|
| (in
accordance with Annex 1, Paragraph… of Cabinet Regulation No.
219 of 10 March 2009, Procedures for Performance of Mandatory
Health Examinations) |
|
7. Special working conditions |
|
|
|
|
| (in
accordance with Annex 2, Paragraph… of Cabinet Regulation No.
219 of 10 March 2009, Procedures for Performance of Mandatory
Health Examinations) |
| 8. Length of service in the
conditions of the working environment harmful to health
referred to in Paragraph 6 of this card |
|
|
(years, months)
|
| 9. Length of service in the
special working conditions referred to in Paragraph 7 of this
card |
|
|
(years, months)
|
|
10. |
|
is referred for the following mandatory |
| |
(given name, surname)
|
|
| health examination (underline as
appropriate): |
| 10.1. initial
health examination; |
| 10.2.
extraordinary health examination (reason: |
|
); |
| 10.3. periodic
health examination. |
Employer or authorised person thereof
Date_____________________________
Seal
II. Opinion on the Conformity of the
State of Health of the Person with the Work to be Performed
11. Evaluation of the state of health of the person (underline
as appropriate):
11.1. the state of health conforms with the work to be
performed;
11.2. the state of health does not conform with the work to be
performed;
11.3. symptoms of an occupational disease have been
detected.
|
12. Special notes and recommendations to the employer
|
|
|
|
|
|
|
|
|
Doctor certified in occupational diseases |
|
|
Date_____________________________
|
|
|
Seal of the medical treatment institution
|
|
III. Measures Performed by the
Employer in Accordance with that Indicated in the Opinion of the
Mandatory Health Examination
Employer or authorised person thereof
Date_____________________________
Seal
Acting for the Minister for
Welfare,
Minister for Education and Science T. Koķe
Annex 4
Cabinet
Regulation No. 219
10 March 2009
Questionnaire Regarding the State
of Health
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Personal
identification number |
|
|
|
|
|
|
- |
|
|
|
|
|
|
|
Medical history |
|
Illnesses during the last three years |
|
|
|
|
Frequently used medicinal products |
|
Health disorders:
Traumas no ___ yes_____ types_____________________
Epileptic seizures no____ yes_____
Surgeries performed ___ not performed_____
types_____________________
Visual impairments no___ yes____ types_________________
Hearing impairments no___ yes____ types_________________
Diabetes mellitus no ____ yes ____ type
________________________________
Changes in the blood composition no ___ yes ___
types____________
Cardiovascular diseases no ____yes __________ types
____________
Arterial hypertension no ____yes_____ how
recent________________
Arterial pressure is usually___________________
Crises: none_____ are present ______how often_________
Respiratory tract diseases no ____yes __________ types
____________
Digestive system diseases no ____ yes __________ types
____________
Diseases of locomotor system no____yes __________ types
____________
Allergic reactions no ____yes____ to
what_______________________
Nervous system diseases no ____yes __________ types
____________
Mental illnesses no ___ yes_____
types_____________________
Tumours no_____yes______types________________
Occupational disease determined no ____ yes ____
|
If an occupational disease is determined, indicate type |
|
Disability determined no ____ yes ____
|
If disability is determined, indicate disability group |
|
|
Family doctor of the person |
|
| |
(the given
name, surname of the family doctor shall be indicated) |
I hereby confirm with my signature that the information
provided is true.
Acting for the Minister for
Welfare,
Minister for Education and Science T. Koķe
Translation © 2019 Valsts valodas centrs (State
Language Centre)
|
|
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-
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