Methodology for setting standards for the work of an occupational pathologist

Introduction. In 2012, the system of providing medical care to employees in various industries, construction, transport, and communications underwent major changes. As part of the reorganization, specialists have developed a new structure that includes a network of treatment centers at various levels designed to provide specialized medical care to those who work in harmful and dangerous working conditions. These changes were implemented on the basis of the order of the Ministry of Health of the Russian Federation dated November 13, 2012. No. 911n "On approval of the procedure for providing medical care for acute and chronic occupational diseases". Labor rationing plays a key role in healthcare management, especially in the context of the introduction of the latest medical care technologies. Currently, the basis for rationing the work of occupational pathologists is the "Methodology for calculating labor rationing in the system of occupational pathology centers", approved by the Decree of the Ministry of Health of the Russian Federation dated March 11, 1999, No. 99/40.

The study aims to explore existing approaches to rationing the work of occupational pathologists during mandatory preliminary and periodic medical examinations, when providing medical care in the field of "Occupational pathology" and conducting an examination of professional suitability and studying the relationship of the disease with the profession.

Materials and methods. The authors analyzed the legislative acts regulating the rationing of occupational pathologists, as well as the results of scientific research, statistical reports (including form No. 30 "Information about a medical organization", timekeeping charts and information on the labor costs of an occupational pathologist in the performance of his functional duties, calculated according to Methodology No. 99/40 (based on data from the centers of occupational pathology of subjects of the Russian Federation for the period from 2021 to 2023).

Results. According to the time-keeping charts of occupational pathologists, the doctor's expenses for the main type of activity (expert, advisory, professional examinations, expert work at the request of judicial authorities, conducting correspondence consultations) amounted to 154.9 minutes, or 70.5%, of the total activity time in occupational pathology centers, and 45.9 minutes (20.9%), for personal time — 19 minutes (8.6%). For comparison, in medical organizations, the doctor's expenses for the main type of activity amounted to 152.7 minutes (78.3%), for additional — 31.8 minutes, (16.3%) and for personal time — 12.1 minutes (6.2%). According to the timekeeping charts of the inpatient department, occupational pathologists at the occupational pathology center spend 56.6 minutes (or 67.7% of the total working time) on their main activities, additional (expert work at the request of judicial authorities, educational activities, development of new techniques) — 19.8 minutes (23.7%), personal time — 7.2 minutes (8.6%). In medical organizations, labor costs for an additional type of activity prevailed — 47.4 minutes (63%), while the main type of activity took 2 times less time, 25.5 minutes, or 33.9%, and personal time costs — 5.1 minutes (6.8%). The research results highlight the peculiarities of the professional activities of occupational pathologists. In outpatient settings, the share of expert work among occupational pathologists reaches 38%, while in inpatient settings this figure is at least 55.1%. This is due to the fact that more than 60% of patients are referred to specialized occupational pathology centers to resolve expert issues.

Limitations. The study examined the results of a limited number of time-lapse charts (14 time-lapse charts of an outpatient occupational pathologist and 7 time-lapse charts of an inpatient department for the period 2021–2023).

Conclusion. The methodology for rationing the work of specialists in the field of occupational pathology needs to be revised and improved based on current legislative documents regulating the Rules for developing standard labor standards, the duties of occupational pathologist, providing medical care in the field of «Occupational Pathology», as well as conducting mandatory preliminary and periodic medical examinations, assessing professional suitability and studying the relationship between diseases and professional activities.

Ethics. In carrying out the work, the authors adhered to the Ethical Principles of medical research described in the Helsinki Declaration of the World Medical Association "Ethical Principles of conducting medical research with human participation as an object" of the latest edition (October 2024).

Contributions:
Kobyakova O.S. — editing, making fundamental changes, approving the final version of the article;
Chernov O.E. — data analysis and interpretation, text writing;
Panova I.V. — data collection, analysis and interpretation, text writing;
Zemlyakova S.S. — data analysis and interpretation, text writing.
All authors — are responsible for the concept and design of the study.

Funding. The study had no funding.

Conflict of interest. The authors declare no conflict of interest.

Received: 01.04.2025 / Accepted: 30.05.2025 / Published: 05.07.2025

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