Questions of special assessment of working conditions of medical workers

Introduction. Before the entry into force of the Federal law of the Russian Federation of December 28, 2013 No. 426-FZ "On special assessment of working conditions" one of the available and effective elements of occupational risk assessment in the workplace was workplace certification (WPC) for working conditions, which allows to identify harmful and/or dangerous factors of the production environment, assess the risk levels in the workplace and determine the main areas of employee protection from the adverse effects of harmful production factors. The results of a special assessment of working conditions (SAWC) can be used not only to develop and implement measures aimed at improving the working conditions of employees, informing employees about working conditions and the existing risk of damage to their health, but also to establish guarantees and compensation provided for by the Labor code of the Russian Federation (RF) for employees engaged in work with harmful and (or) dangerous working conditions.

The aim of the study is to identify problematic issues during the implementation of SAWC at the workplaces of medical workers to prevent possible errors in its further implementation.

Materials and methods. We used data obtained from the results of WPC and SAWC of medical workers of various medical organizations of the Republic of Tatarstan (RT). A retrospective analysis of cases of occupational diseases was applied according to the data of the Department of Rospotrebnadzor for the Republic of Tatarstan and the register of patients of the Republican Center of Occupational Pathology.

Results. In the RT medical organizations according to the results of SAWC marked decrease in the number of jobs with hazardous working conditions from 92.2% to 78.2% due to the fact that the methodology of the SAWC will not assess the intensity of the work process in all workplaces health workers, and identification and evaluation of biological factors do not always reflect the actual microbiological status of the environment. As a result, working conditions are assessed as acceptable, which deprives medical workers of previously established guarantees and compensation. In addition, during periodic medical examinations (PME), studies on the biological factor are not fully carried out, which makes it difficult to diagnose viral hepatitis, which occupies the second place in the structure of occupational morbidity of medical workers.

Conclusions. For high-quality implementation of SAWC in medical organizations, it is necessary to assess the intensity of the labor process of medical workers, taking into account intellectual, sensory, emotional loads, monotony of loads and working hours, and for the correct assessment of the biological factor, it is recommended to introduce an epidemiologist to the commission.

1. Order of the Ministry of Health and Social Development of the Russian Federation of April 12, 2011 № 302n "On approval of lists of harmful and(or) hazardous production factors and work, during which mandatory preliminary and periodic medical examinations (examinations) are conducted, and the Procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of workers engaged in hard work and in work with harmful and(or) dangerous working conditions" (in Russian).

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3. Federal law from 28.12.2013 № 426-FZ "On special assessment of working conditions"(in Russian).

4. On state of sanitary epidemiologic well-being of population in Repablic of Tatarstan in 2015: Governmental report. Federalnaya sluzhba po nadzoru v sfere zashity prav potrebitelej i blagopoluchiya cheloveka. 2016 (in Russian).

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9. Order of the Ministry of Labor and Social Protection of the Russian Federation of January 20, 2015 № 24n "On amendments to the Methodology for the special assessment of working conditions and the Classifier of harmful and (or) dangerous production factors, approved by order of the Ministry of Labor and Social Protection of the Russian Federation of January 24, 2014 № 33n"(in Russian).

10. Order of the Ministry of Labor and Social Protection of the Russian Federation of January 24, 2014 № 33n “On approval of the Methodology for the special assessment of working conditions, the Classifier of harmful and (or) hazardous production factors, the form of the report on the special assessment of working conditions and instructions for its completion” (in Russian).

11. Guideon Hygienic Assessment of Factors of Working Environment and Work Load. Criteria and Classification of Working Conditions (in Russian).

12. Order of the Ministry of Labor and Social Protection of the Russian Federation of April 24, 2015 № 250n "On approval of the features of a special assessment of working conditions at workplaces of certain categories of medical workers and a list of medical equipment (apparatus, instruments, equipment), the normal functioning of which may be affected by measuring instruments used in the course of a special assessment of working conditions” (in Russian).

13. Order of the Ministry of Labor and Social Protection of the Russian Federation of June 30, 2017 № 544н “On Amendments to the Order of the Ministry of Labor and Social Protection of the Russian Federation of April 24, 2015 № 250n“ On the approval of the features of a special assessment of working conditions at individual workplaces categories of medical workers and a list of medical equipment (apparatus, instruments, equipment), the normal functioning of which may be affected by measuring instruments used in the course of a special assessment of working conditions” (in Russian).

14. "Labor Code of the Russian Federation" dated 30.12.2001 № 197-FZ (in Russian).

15. Order of the Ministry of Health and Social Development of the Russian Federation of April 12, 2011 № 302n "On approval of lists of harmful and(or) hazardous production factors and work, during which mandatory preliminary and periodic medical examinations (examinations) are conducted, and the Procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of workers engaged in hard work and in work with harmful and(or) dangerous working conditions" (in Russian).