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LEGAL ACTS OF THE REPUBLIC OF LATVIA
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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.

 

Republic of Latvia

Cabinet
Regulation No. 219
Adopted 10 March 2009

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  
4. Place of residence  
5. Profession  
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

Position

 

Signature and full name

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  
Signature and full name  
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

Position

 
Signature and full name  

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

Given name

  Surname  
Personal identification number             -            
Address  
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.

(date) Signature

Acting for the Minister for Welfare,
Minister for Education and Science T. Koķe


Translation © 2019 Valsts valodas centrs (State Language Centre)

 
Document information
Title: Kārtība, kādā veicama obligātā veselības pārbaude Status:
In force
in force
Issuer: Cabinet of Ministers Type: regulation Document number: 219Adoption: 10.03.2009.Entry into force: 01.04.2009.Publication: Latvijas Vēstnesis, 41, 13.03.2009.
Language:
LVEN
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