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Order 302 paragraphs. How to write an order for a periodic medical examination. What medical examinations do workers undergo?

Involving employees under employment contracts, the company's administration is responsible for their health. Therefore, it must prevent and minimize the impact of harmful conditions on the health of workers. To this end, when hiring, the employer sends employees to undergo medical examinations, and for some categories of employees, periodic medical examinations are mandatory. All these points are considered by Order 302n dated 04/12/11 of the Ministry of Health and Social Development with changes in 2018.

The main legislative act that regulates the procedure for employees of organizations to undergo medical examinations is Order No. 302 approved by the Ministry of Health. Its norms were adopted back in 2011. Three times the provisions of this normative act were supplemented. This happened in 2013, 2015, 2018.

This order establishes not only the basic concepts and procedures, but also the cases when a medical examination is mandatory for the company's management.

Changes and additions to the order dated April 12, 2011 No. 302n 2018

Currently, the following changes and additions to the Order of the Ministry of Health Development can be distinguished:

  • The new edition of the order provides for a wider list of factors that have a harmful and dangerous effect on the health of an employee, in the presence of which a periodic medical examination and other types of it are mandatory. For example, welding aerosols with manganese-containing and silicon-containing compounds are added to the factors with a chemical effect; more allergens, infected material, as well as AIDS, hepatitis B, C viruses were added to the factors that can have a biological effect; the list of physical impact factors – ionizing radiation and increased gravitational overloads – has been expanded.
  • The list of doctors by specialization who examine employees during medical examinations has been significantly expanded. Now it has endocrinologists, dentists, allergists.
  • For cases where an employee is employed in jobs where there is an impact of certain factors, the list of additional contraindications (for example, exposure to electromagnetic fields) has been expanded, just like for certain jobs, for example, in geographically remote areas, when working on machines.
  • A new section has been introduced into the order, which defines substances and compounds that have a common chemical structure and lead to various diseases, and the list of hazardous pesticides has been expanded.

Download (as amended on 02/06/2018).

For whom a medical examination under order 302 is mandatory

The order establishes a list of employees who must undergo a medical examination.

This includes workers:

  • In which working conditions involve the impact of dangerous and harmful factors. These include chemical, physical, biological. A complete list of these factors is defined in Appendix No. 1 to the Order of the Ministry of Health Development 302.
  • Employed in the types of work listed by law. These include work underground, under water, at height, etc. They are listed in Appendix No. 2 to the Order of the Ministry of Health 302.

To assign the status of harmful or dangerous to working conditions, it is necessary. Only after the assessment, the hazard class of the factor and the need for a medical examination are established.

Important! Do not forget about the need to undergo a medical examination in accordance with the Labor Code of the Russian Federation. This regulation defines employees who must undergo a medical examination before they are allowed to work.

This includes:

  • Employees who have not reached the age of majority (18 years).
  • Entering a company where jobs are exposed to hazardous and harmful factors.
  • Applicants for work in the organization of the food industry, public catering, trade, working at water utilities, medical and children's institutions.
  • When working on a watch.
  • Underground employees.
  • When you have to work in the regions of the Far North, as well as areas equated to them.

Procedure for referral for a medical examination

For the preliminary

In order for an employee to pass, a referral must be issued to him. This form, along with an identity document, must be presented at the medical facility. If the employee is not being examined for the first time, then he must have a health passport in his hands, which must also be presented.

The medical institution opens a card for this employee, and if there is no health passport, it draws up such a document.

All those specialists whose opinion must be taken into account for examination according to labor standards should take part in the medical examination.

As the examination progresses, doctors will put down the results of the examination on the card, as well as the results of the laboratory analysis. Based on the results of the examination, the card reflects its result, after which this document remains in storage at the medical facility.

The employee is issued a conclusion in which it is necessary to reflect whether there are any contraindications for working in the desired position. The conclusion is drawn up in two copies, one must be stored in a medical institution, and the second is transferred to the employer.

Attention! A health passport must be opened for each employee who undergoes a preliminary medical examination or a periodic one in a medical institution. Initially, this form is stored together with the employee's card. After the inspection is completed, data is entered into the passport, and then it is handed over to the employee.

On periodic

This kind of medical examination is carried out on the basis of lists that are compiled by the responsible person of the business entity. They must include all employees who are employed in workplaces with harmful or dangerous factors. The list of employees must be formed at least 2 months before the start date of the medical examination.

One of the innovations was the fact that even during a periodic inspection, a company representative must hand over a referral to the employee. It is done in a standard way.

The medical organization with which the contract for the medical examination has been concluded, prepare lists of specialists and establish the procedure for conducting it. It must transfer all the necessary papers to the employer no later than 14 days before the start of the medical examination.

The procedure for examining employees takes place according to the usual scheme and ends with the issuance of a medical report. After that, the organization draws up a final report on the inspection.

A fully completed referral is signed by the person responsible for this with personal data. In the case when a newly arriving employee is sent for a mandatory inspection, the referral must be issued to him against signature. To record this fact, it is necessary to have a special journal or sheet in the company.

Attention! The type of direction is not established by law. Each business entity develops it himself, taking into account the needs, but using the required details.

Responsibility of the employer for the admission of the employee to work without a medical examination

The law establishes liability for those employers who allow their employees to start work without carrying out the necessary medical examination. This responsibility is established in the Code of Administrative Offenses.

According to this legislative act, liability for violation is:

  • For an official - 15-25 thousand rubles;
  • Entrepreneurs - 15-25 thousand rubles;
  • For a company - 110-130 thousand rubles.

The amount of the fine imposed will be determined based on the number of employees allowed to work in this way.

In the event that the health of an employee who has not passed a medical examination is damaged or his death occurs, then non-compliance with the norms of the law will be considered from the perspective of the Criminal Code.

Important! In turn, if the employee refuses to undergo a medical examination, then the Labor Code provides for his removal from work in this case. This measure is introduced after the written acquaintance of the employee against signature.

It will be valid until he provides the administration of the company with a document confirming his suitability for work. The employee will not be paid for the period of such temporary suspension.

;
III. PROCEDURE FOR PERIODIC INSPECTIONS (P.P. 15 - 47);
IV. MEDICAL CONTRAINDICATIONS FOR ADMISSION TO WORK (P.P. 48 - 49);

Preliminary and periodic medical examinations: affordable prices at the "Clinic of Occupational Medicine" in Moscow

An obligatory condition for the interaction between employers and employees is the organization by the enterprise of preliminary and periodic medical examinations for personnel. The difference between these types of professional examination according to the provisions of Order 302n is that a preliminary examination is carried out upon admission to work and can be carried out on an individual basis.

At the same time, periodic medical examinations are aimed at a dynamic study of the health status of personnel, early detection of occupational diseases, as well as symptoms / pathologies that are incompatible with working conditions. This examination may be carried out collectively.

According to the Order of the Ministry of Health and Social Development 302n dated April 12, 2011, periodic examinations must be carried out at least once a year. Moreover, if there are no hazardous production factors at the enterprise, an examination of employees can be organized in any medical institution that has a license to carry out this type of activity.

Order of the Ministry of Health and Social Development of Russia 302n dated April 12, 2011 also determines the procedure for organizing professional examinations at enterprises where factors harmful and dangerous for specialists are observed. The personnel of such companies for at least 5 years must be examined in specialized Occupational Pathology Centers or medical institutions licensed for professional suitability examination.

The preparation of lists for periodic medical examinations, as well as the approval of their calendar plan, is carried out by the employer together with the medical organization. By contacting our clinic, you can arrange a professional examination at any convenient time at an affordable price.

Registration of a driver's medical certificate and EEG

The procedure for obtaining a driver's license or opening a new category changes regularly. However, for some categories, in particular:

  • C, C1, CE, C1E;
  • D, D1, DE, D1E;
  • Tm, Tb,

A prerequisite is the passage of the electroencephalogram of the brain.

If you have a question: “Where can I get a daily EEG in Moscow at an affordable price?” Our clinic offers to sign up for diagnostics. Here you can get fast and inexpensive results of the daily electroencephalogram.

ORDER 302 N dated April 12, 2011 OF THE MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION (MINISTRY OF HEALTH AND DEVELOPMENT OF RUSSIA) MOSCOW

"On approval of the lists of harmful and (or) hazardous production factors and work, during the performance of which mandatory preliminary and periodic medical examinations (examinations) are carried out, and the Procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions. with changes from dated May 15, 2013 N 296n.

Published: October 28, 2011 at"RG" - Federal issue No. 5619
Effective: November 8, 2011

Registered with the Ministry of Justice of the Russian Federation on October 21, 2011.Registration N 22111

In accordance with Article 213 of the Labor Code of the Russian Federation (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2002, N 1 (part 1), Art. 3; 2004, N 35, Art. 3607; 2006, N 27, Art. 2878; 2008, N 30 (part 2), art. 3616) and clause 5.2.100.55 of the Regulations on the Ministry of Health and Social Development of the Russian Federation, approved by Decree of the Government of the Russian Federation of June 30, 2004 N 321 (Collected Legislation of the Russian Federation, 2004, N 28, article 2898; 2009, N 3; article 378), I order:

1. Approve:

a list of harmful and (or) hazardous production factors, in the presence of which mandatory preliminary and periodic medical examinations (examinations) are carried out, in accordance with Appendix No. 1;

a list of works during the performance of which mandatory preliminary and periodic medical examinations (examinations) of employees are carried out, in accordance with Appendix No. 2;

The procedure for conducting mandatory preliminary (when applying for a job) and periodic medical examinations (examinations) of employees engaged in hard work and work with harmful and (or) dangerous working conditions, in accordance with Appendix No. 3.

2. To put into effect the lists of harmful and (or) hazardous production factors and work, during the performance of which preliminary and periodic medical examinations (examinations) are carried out, and the Procedure for conducting preliminary and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions, from January 1, 2012.

order of the Ministry of Health and Medical Industry of the Russian Federation of March 14, 1996 N 90 "On the procedure for conducting preliminary and periodic medical examinations of workers and medical regulations for admission to the profession" (according to the conclusion of the Ministry of Justice of Russia, the document does not need state registration, letter dated December 30, 1996 Mr. N 07-02-1376-96);

order of the Ministry of Health and Social Development of the Russian Federation of August 16, 2004 N 83 "On approval of the lists of harmful and (or) hazardous production factors and work, during the performance of which preliminary and periodic medical examinations (examinations) are carried out, and the procedure for conducting these examinations ( examinations)" (registered by the Ministry of Justice of the Russian Federation on September 10, 2004 N 6015);

Order of the Ministry of Health and Social Development of the Russian Federation of May 16, 2005 N 338 "On Amendments to Appendix No. 2 to the Order of the Ministry of Health and Social Development of Russia of August 16, 2004 N 83" On Approval of Lists of Harmful and (or) Hazardous Production Factors and Works during which preliminary and periodic medical examinations (examinations) are carried out, and the procedure for conducting these examinations (examinations)" (registered by the Ministry of Justice of the Russian Federation on June 3, 2005 N 6677).

4. Establish that from January 1, 2012, subparagraphs 11, 12 (with the exception of subparagraphs 12.2, 12.11, 12.12), 13 of Appendix N 2 to the order of the Ministry of Health of the USSR of September 29, 1989 N 555 "O" do not apply on the territory of the Russian Federation improvement of the system of medical examinations of workers and drivers of individual vehicles.

Minister

T. Golikova

ORDER MINISTRIES OF HEALTH OF THE RUSSIAN FEDERATIONdated May 15, 2013 N 296 n

"On amendments to Appendix No. 2 to Order No. 302 n dated April 12, 2011. Ministry of Health and Social Development of the Russian Federation "On approval of the lists of harmful and (or) hazardous production factors and work, during the performance of which mandatory preliminary and periodic medical examinations (examinations) are carried out, and the Procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of workers, employed in heavy work and in work with harmful and (or) dangerous working conditions"

Registered with the Ministry of Justice of Russia on July 3, 2013. Registration N 28970

I order:

Amend Appendix No. 2 to Order No. 302n of April 12, 2011 of the Ministry of Health and Social Development of the Russian Federation "On Approval of Lists of Harmful and (or) Hazardous Production Factors and Works, During the Performance of Which Mandatory Preliminary and Periodic Medical Examinations (Examinations) Are Conducted ), and the Procedure for Conducting Mandatory Preliminary and Periodic Medical Examinations (Examinations) of Employees Engaged in Heavy Work and Work with Harmful and (or) Dangerous Working Conditions" (registered by the Ministry of Justice of the Russian Federation on October 21, 2011, registration N 22111) according to application.

Minister

V.I. Skvortsova

Paragraph 19 shall be stated in the following wording:

19. Works in children and adolescents

seasonal wellness

organizations

1 time per year

Dermatovenereologist,

Otorhinolaryngologist,

*Infectionist

Fluorography of the lungs
Blood test for
syphilis
smears for gonorrhea
upon admission to
work
Research on
carriage
intestinal pathogens
infections and
serological
examination for
typhoid fever in
applying for a job
and further on
epidemiological indications
Research on
helminthiases with
applying for a job
and in the future - not
less than once a year
either by
epidemiological indications

Diseases and bacterial carriage:
1) typhoid fever, paratyphoid,
salmonellosis, dysentery;
2) helminthiases;
3) syphilis in the infectious period;
4) leprosy;
5) contagious skin diseases:
scabies, trichophytosis, microsporia,
scab, actinomycosis with ulceration
or fistulas on exposed parts of the body;
6) infectious and destructive forms
pulmonary tuberculosis, extrapulmonary
tuberculosis with fistulas,
bacteriuria, lupus erythematosus
face and hands;
7) gonorrhea (all forms) for a period
treatment with antibiotics
and getting negative results
first control;
8) ozena

Application No. 3
to the Order of the Ministry
health and social
development of the Russian Federation
dated April 12, 2011 No. 302 n

PROCEDURE FOR COMPULSORY PRELIMINARY (WHEN ENTRY TO WORK) AND PERIODIC MEDICAL EXAMINATIONS (EXAMINATIONS) FOR EMPLOYEES ENGAGED IN HARD WORK AND WORK WITH HARMFUL AND (OR) DANGEROUS LABOR CONDITIONS

I. General provisions

1. The procedure for conducting mandatory preliminary (when applying for a job) and periodic medical examinations (examinations) of employees engaged in hard work and work with harmful and (or) dangerous working conditions (hereinafter referred to as the Procedure), establishes the rules for conducting mandatory preliminary (when employment) and periodic medical examinations (examinations) of persons employed in heavy work and in work with harmful and (or) dangerous working conditions (including underground work), in work related to traffic, as well as in work , during which it is mandatory to conduct preliminary and periodic medical examinations (examinations) in order to protect public health, prevent the occurrence and spread of diseases 1 .

2. Mandatory preliminary medical examinations (examinations) upon admission to work (hereinafter referred to as preliminary examinations) are carried out in order to determine whether the state of health of a person entering a job is in line with the work assigned to him, as well as for the purpose of early detection and prevention of diseases.

4. Preliminary and periodic examinations are carried out by medical organizations of any form of ownership that have the right to conduct preliminary and periodic examinations, as well as to examine professional suitability in accordance with the current regulatory legal acts (hereinafter referred to as medical organizations).

5. To conduct a preliminary or periodic examination by a medical organization, a permanent medical commission is formed.

The composition of the medical commission includes an occupational pathologist, as well as specialist doctors who have completed advanced training in the specialty "occupational pathology" in the prescribed manner or who have a valid certificate in the specialty "occupational pathology".

The medical commission is headed by an occupational pathologist.

The composition of the medical commission is approved by order (instruction) of the head of the medical organization.

6. Responsibilities for organizing preliminary and periodic examinations of employees are assigned to the employer 2 .

Responsibility for the quality of preliminary and periodic examinations of employees rests with the medical organization.

II. The procedure for conducting preliminary inspections

7. Preliminary examinations are carried out upon admission to work on the basis of a referral for a medical examination (hereinafter referred to as the referral) issued to the person applying for work by the employer.

8. The direction is filled out on the basis of the list of contingents approved by the employer and it indicates:

  • the name of the employer;
  • type of medical examination (preliminary or periodic),
  • surname, name, patronymic of the person entering the work (employee);
  • date of birth of the person entering the work (employee);
  • the name of the structural unit of the employer (if any), in which the person entering the work will be employed (the employee is employed);
  • the name of the position (profession) or type of work;
  • harmful and (or) dangerous production factors, as well as the type of work in accordance with the contingent of employees approved by the employer, subject to preliminary (periodic) inspections.

The direction is signed by an authorized representative of the employer indicating his position, surname, initials.

The direction is issued to the person entering the work (employee), against signature.

The employer (his representative) is obliged to organize the registration of issued referrals.

9. To undergo a preliminary examination, a person entering a job submits the following documents to a medical organization:

  • direction;
  • passport (or other document of the established form proving his identity);
  • employee health passport (if available);
  • the decision of the medical commission that conducted the mandatory psychiatric examination (in cases provided for by the legislation of the Russian Federation).

10. For a person undergoing a preliminary examination, the following are issued in a medical organization:

10.1 outpatient medical record (registration form No. 025/u-04, approved by order of the Ministry of Health and Social Development of Russia dated November 22, 2004 No. 255) (registered by the Ministry of Justice of Russia on December 14, 2004 No. 6188) (hereinafter referred to as the medical record), which reflects conclusions of medical specialists, results of laboratory and instrumental studies, conclusions based on the results of a preliminary or periodic medical examination.

The medical record is kept in accordance with the established procedure in a medical organization;

  • the name of the medical organization, the actual address of its location and the OGRN code;
  • last name, first name, patronymic, date of birth, gender, passport data (series, number, issued by whom, date of issue), address of registration at the place of residence (stay), telephone number, number of the compulsory medical insurance policy of the person entering work (employee);
  • the name of the employer;
  • form of ownership and type of economic activity of the employer according to OKVED;
  • the name of the structural unit of the employer (if any), in which the person entering the work will be employed (the employee is employed), the name of the position (profession) or type of work;
  • the name of the harmful production factor and (or) type of work (indicating the class and subclass of working conditions) and the length of contact with them;
  • the name of the medical organization to which the employee is assigned for permanent monitoring (name, actual location address);
  • conclusions of medical specialists who took part in the preliminary or periodic medical examination of the employee, the results of laboratory and instrumental studies, the conclusion on the results of the preliminary or periodic medical examination.

Each health passport is assigned a number and the date it was completed.

One health passport is maintained for each employee.

For persons attached to the FMBA of Russia for medical care, an employee's health passport is not issued.

During the examination, the health passport is kept in a medical organization. Upon completion of the examination, the health passport is issued to the employee in his hands.

If an employee loses a health passport, the medical organization, at the request of the employee, issues a duplicate of the health passport to him.

11. The preliminary examination is completed in case of examination of the person entering the work by all medical specialists, as well as the completion of the full scope of laboratory and functional studies provided for by the List of harmful and (or) hazardous production factors, in the presence of which mandatory preliminary and periodic medical examinations are carried out. examinations (examinations) of factors (Appendix No. 1 to the order (hereinafter - the List of factors) and the List of works, during the performance of which mandatory preliminary and periodic medical examinations (examinations) of employees are carried out (Appendix No. 2 to the order) (hereinafter - the List of works).

12. Upon completion of the preliminary examination by a person entering the job, a medical organization draws up a conclusion based on the results of a preliminary (periodic) medical examination (hereinafter referred to as the Conclusion).

13. The conclusion states:

  • date of issue of the Conclusion;
  • surname, name, patronymic, date of birth, gender of the person entering the work (employee);
  • the name of the employer;
  • the name of the structural unit of the employer (if any), position (profession) or type of work;
  • name of the harmful production factor(s) and (or) type of work;
  • the result of a medical examination (medical contraindications identified, not identified).

The conclusion is signed by the chairman of the medical commission indicating the surname and initials and certified by the seal of the medical organization that conducted the medical examination.

14. The conclusion is drawn up in two copies, one of which, based on the results of the medical examination, immediately after the completion of the examination, is issued to the person entering the job, or who has completed the periodic medical examination, in his hands, and the second is attached to the medical record of the outpatient.

III. The procedure for conducting periodic inspections

15. The frequency of periodic inspections is determined by the types of harmful and (or) dangerous production factors affecting the employee, or the types of work performed.

16. Periodic inspections are carried out at least within the terms specified in the List of Factors and the List of Works.

17. Employees under the age of 21 undergo periodic examinations annually.

18. Extraordinary medical examinations (examinations) are carried out on the basis of medical recommendations specified in the final act, drawn up in accordance with paragraph 43 of this Procedure.

19. Periodic inspections are carried out on the basis of lists of names developed on the basis of contingents of workers subject to periodic and (or) preliminary inspections (hereinafter - lists of names) indicating harmful (dangerous) production factors, as well as the type of work in accordance with the List of factors and the List works.

The following employees are subject to inclusion in the contingent lists and name lists:

  • exposed to harmful production factors specified in the List of factors, as well as harmful production factors, the presence of which is established by the results of attestation of workplaces for working conditions, carried out in the prescribed manner 3 . As a source of information about the presence of harmful production factors at workplaces, in addition to the results of attestation of workplaces for working conditions, the results of laboratory research and testing obtained as part of control and supervision activities, production laboratory control, as well as operational, technological and other documentation for machines, mechanisms, equipment, raw materials and materials used by the employer in the implementation of production activities;
  • performing the work provided for by the List of Works.

20. The list of the contingent of employees subject to preliminary and periodic medical examination shall indicate:

  • the name of the profession (position) of the employee according to the staffing table;
  • the name of a harmful production factor according to the List of factors, as well as harmful production factors established as a result of certification of workplaces for working conditions, as a result of laboratory research and tests obtained as part of control and supervision activities, production laboratory control, as well as using operational, technological and other documentation for machines, mechanisms, equipment, raw materials and materials used by the employer in the course of production activities.

21. The list of the contingent, developed and approved by the employer, is sent within 10 days to the territorial body of the federal executive body authorized to carry out federal state sanitary and epidemiological supervision at the actual location of the employer.

22. Name lists are compiled on the basis of the approved list of the contingent of employees subject to preliminary and periodic medical examination, which indicates:

  • surname, name, patronymic, profession (position) of the employee subject to periodic medical examination;
  • the name of the harmful production factor or type of work;
  • name of the structural unit of the employer (if any).

23. Name lists are compiled and approved by the employer (his authorized representative) and no later than 2 months before the start date of the periodic examination agreed with the medical organization, they are sent by the employer to the specified medical organization.

24. Before conducting a periodic examination, the employer (his authorized representative) is obliged to hand over to the person sent for a periodic examination a referral for a periodic medical examination, drawn up in accordance with paragraph 8 of this Procedure.

25. The medical organization, within 10 days from the date of receipt of the list of names from the employer (but not later than 14 days before the start date of the periodic examination agreed with the employer), on the basis of the specified list of names, draws up a calendar plan for conducting a periodic examination (hereinafter - the schedule ).

The calendar plan is coordinated by the medical organization with the employer (his representative) and approved by the head of the medical organization.

26. The employer, no later than 10 days before the start date of the periodic examination agreed with the medical organization, is obliged to familiarize the employees subject to periodic examination with the calendar plan.

27. The medical commission of a medical organization, on the basis of the hazardous production factors or work specified in the list of names, determines the need for participation in preliminary and periodic examinations of the relevant specialist doctors, as well as the types and volumes of necessary laboratory and functional studies.

28. To undergo a periodic examination, the employee is obliged to arrive at the medical organization on the day established by the calendar plan and present the documents specified in paragraph 10 of this Procedure at the medical organization.

29. For an employee undergoing a periodic examination, the medical organization draws up the documents established by paragraph 10 of this Procedure (if not available).

30. Periodic examination is completed in case of examination of the employee by all medical specialists, as well as the completion of the full scope of laboratory and functional studies provided for in the List of Factors or the List of Works.

31. Upon completion of the employee's periodic examination by a medical organization, a medical report is issued in the manner prescribed by paragraphs 12 and 13 of this Procedure.

32. Based on the results of the periodic examination in accordance with the established procedure 4, the employee’s belonging to one of the dispensary groups is determined in accordance with the current regulatory legal acts, with subsequent registration in the medical record and health passport of recommendations for the prevention of diseases, including occupational diseases, and if available medical indications - for further observation, treatment and rehabilitation.

33. Data on the passage of medical examinations shall be entered into personal medical books and recorded by medical and preventive organizations of the state and municipal health care systems, as well as by bodies exercising federal state sanitary and epidemiological supervision.

34. In the event of liquidation or change of a medical organization that performs preliminary or periodic examinations, the medical record is transferred to the occupational pathology center of the constituent entity of the Russian Federation, on whose territory it is located, or in cases provided for by the legislation of the Russian Federation, to the occupational pathology centers of the FMBA of Russia, where it is stored in for 50 years.

35. The Center for Occupational Pathology, on the basis of a written request from a medical organization with which the employer has concluded an agreement for preliminary and (or) periodic examinations, transfers medical records of employees within 10 days from the date of receipt of the request from the specified medical organization. A copy of the contract for preliminary and (or) periodic inspections must be attached to the request.

36. A medical organization with which the employer has not renewed the contract for conducting preliminary and (or) periodic examinations of employees, at the written request of the employer, must transfer the medical records of employees according to the inventory to the medical organization with which the employer has currently entered into an appropriate contract.

37. Participants in emergencies or incidents, workers employed in work with harmful and (or) hazardous substances and production factors with a single or multiple excess of the maximum allowable concentration (MPC) or maximum allowable level (MPL) for the current factor, employees with ( who had) a conclusion on a preliminary diagnosis of an occupational disease, persons with persistent consequences of accidents at work, as well as other employees, if the relevant decision is made by the medical commission, at least once every five years, undergo periodic examinations at occupational pathology centers and other medical organizations that have the right to conducting preliminary and periodic examinations, to conduct an examination of professional suitability and examination of the connection of the disease with the profession.

38. If a psychiatrist and (or) narcologist identifies persons suspected of having medical contraindications corresponding to the profile of these specialists, to be admitted to work with harmful and (or) dangerous production factors, as well as to work, during the performance of which it is necessary to carry out preliminary and periodic medical examinations (examinations) of employees, these persons, in cases provided for by the legislation of the Russian Federation, are sent for examination by a medical commission authorized by the health authority.

39. Occupational pathology centers and other medical organizations that have the right to conduct periodic examinations, to conduct an examination of professional suitability and an examination of the relationship of a disease with a profession, during a periodic examination, may involve medical organizations that have the right, in accordance with the current regulatory legal acts, to conduct preliminary and periodic examinations and examinations of professional suitability.

40. If it is suspected that an employee has an occupational disease during a periodic examination, a medical organization issues a referral to an occupational pathology center or a specialized medical organization that has the right to conduct an examination of the relationship of the disease with the profession, and also draws up and sends, in the prescribed manner, a notice of the establishment of a preliminary diagnosis of an occupational disease to the territorial body of federal executive bodies authorized to exercise state control and supervision in the field of ensuring sanitary and epidemiological well-being.

41. In cases of difficulty in determining the professional suitability of an employee due to his illness and for the purpose of examination of professional suitability, a medical organization sends an employee to an occupational pathology center or a specialized medical organization that has the right to conduct an examination of the connection of the disease with the profession and professional suitability, in accordance with the current legislation of the Russian Federation.

42. Based on the results of the examinations, the medical organization, no later than 30 days after the completion of the periodic medical examination, summarizes the results of the periodic examinations of employees and, together with the territorial bodies of the federal executive body authorized to exercise state control and supervision in the field of ensuring the sanitary and epidemiological welfare of the population and representatives of the employer, draws up the final act.

43. The final act states:

  • the name of the medical organization that conducted the preliminary examination, the address of its location and the OGRN code;
  • date of drawing up the act;
  • the name of the employer;
  • the total number of employees, including women, employees under the age of 18, employees who have a persistent degree of disability;
  • the number of employees engaged in heavy work and work with harmful and (or) dangerous working conditions;
  • the number of employees employed in jobs that require periodic medical examinations (surveys), in order to protect public health, prevent the occurrence and spread of diseases, including women, workers under the age of 18, workers who have established a persistent degree of loss ability to work;
  • the number of employees subject to periodic medical examination, including women, employees under the age of 18, employees who have a persistent degree of disability;
  • the number of employees who have undergone a periodic medical examination, including women, employees under the age of 18, employees who have been diagnosed with a persistent degree of disability;
  • the percentage of coverage of employees with periodic medical examinations;
  • a list of persons who have undergone a periodic medical examination, indicating gender, date of birth, structural unit (if any), conclusion of the medical commission;
  • the number of employees who have not completed a periodic medical examination, including women, employees under the age of 18, employees who have a persistent degree of disability;
  • a list of employees who have not completed a periodic medical examination;
  • the number of employees who have not undergone a periodic medical examination, including women, employees under the age of 18, employees who have been diagnosed with a persistent degree of disability;
  • a list of employees who have not undergone a periodic medical examination;
  • the number of employees who do not have medical contraindications to work;
  • the number of employees with temporary medical contraindications to work;
  • the number of employees with permanent medical contraindications to work;
  • the number of employees in need of an additional examination (conclusion not given);
  • the number of employees who need to be examined in the center of occupational pathology;
  • the number of employees requiring outpatient examination and treatment;
  • the number of employees in need of inpatient examination and treatment;
  • the number of employees in need of sanatorium treatment;
  • the number of employees in need of dispensary observation;
  • a list of persons with a preliminary diagnosis of an occupational disease, indicating gender, date of birth; structural subdivision (if any), profession (position), harmful and (or) hazardous production factors and work;
  • a list of newly established chronic somatic diseases indicating the class of diseases according to the International Classification of Diseases - 10 (hereinafter - ICD-10);
  • a list of newly established occupational diseases with an indication of the class of diseases according to ICD-10;
  • the results of the implementation of the recommendations of the previous final act;
  • recommendations to the employer on the implementation of a complex of health-improving measures, including preventive and other measures.

44. The final act is approved by the chairman of the medical commission and certified by the seal of the medical organization.

45. The final act is drawn up in four copies, which are sent by the medical organization within 5 working days from the date of approval of the act to the employer, to the center of occupational pathology of the subject of the Russian Federation, the territorial body of the federal executive body authorized to exercise state control and supervision in the field of ensuring sanitary epidemiological well-being of the population.

One copy of the final act is stored in the medical organization that conducted periodic examinations for 50 years.

46. ​​The Center for Occupational Pathology of a constituent entity of the Russian Federation summarizes and analyzes the results of periodic medical examinations of workers employed in work with harmful and (or) dangerous working conditions on the territory of this constituent entity of the Russian Federation, and no later than February 15 of the year following the reporting one, sends summarized information to Federal Center for Occupational Pathology of the Ministry of Health and Social Development of Russia and to the health management body of this constituent entity of the Russian Federation.

47. The Federal Center for Occupational Pathology of the Ministry of Health and Social Development of Russia, no later than April 1 of the year following the reporting year, submits information on the conduct of periodic examinations of workers employed in work with harmful and (or) dangerous working conditions to the Ministry of Health and Social Development of Russia.

IV. Medical contraindications for admission to work

49. Additional medical contraindications are specified in the List of factors and the List of works.

1 Article 213 of the Labor Code of the Russian Federation.

2 Article 212 of the Labor Code of the Russian Federation.

3 Order of the Ministry of Health and Social Development of Russia dated August 31, 2007 N 569 "On approval of the Procedure for attestation of workplaces in terms of working conditions" (registered by the Ministry of Justice of Russia on November 29, 2007 N 10577).

4 Order of the Ministry of Health and Social Development of Russia dated February 4, 2010 N 55n (as amended on March 3, 2011) "On the procedure for additional medical examination of working citizens" (together with the "Procedure and volume of additional medical examination of working citizens") (registered by the Ministry of Justice of Russia on March 4, 2010 No. 16550).

5 In cases of pronounced forms of mood disorders, neurotic, stress-related, somatoform, behavioral and personality disorders, the issue of professional suitability for the relevant work is decided individually by a commission of specialist doctors corresponding to the profile of the disease, with the participation of a professional pathologist.

6 After the treatment, the issue is resolved individually by a commission of medical specialists, an occupational pathologist, an oncologist.

7 Only for persons working in contact with harmful and (or) dangerous production factors specified in the List of Factors.

APPENDICES TO APPENDIX No. 3 "PROCEDURE FOR CARRYING OUT ..." ORDER No. 302N OF THE MINISTRY OF HEALTH OF RUSSIA DATED 12.04.11

The applications listed below have not been registered with the Ministry of Justice of the Russian Federation and are provided for review. The reliability of the materials is confirmed by their presence in the bases of legal documents "Garant" and "Consultant Plus".

Download: "Appendix No. 1. Referral for a preliminary (periodic) medical examination (examination), form."

In 2012, the Order of the Ministry of Health and Social Development No. 302n came into force, regulating the conduct of mandatory medical examinations for persons employed in hazardous and hazardous industries. According to the requirements of this document, the employer is obliged to send employees to primary and periodic medical commissions. All regulatory provisions of the order and the procedure for sending for a medical examination in 2019 should be taken into account by employers with jobs certified as harmful and dangerous.

General information

Labor legislation establishes the obligation of employers with hazardous industries to conduct regular medical examinations for their employees (Article 213 of the Labor Code of the Russian Federation). Payment for diagnostic procedures and the cost of analyzes is made by the employer.

The purpose of the initial medical examination when applying for a job is to establish the professional suitability of the applicant for the job. Periodic measures are aimed at early detection of health problems, prevention of diseases of general and related to production factors.

Passing the examination is the responsibility of the employees. If they refuse, they cannot be allowed to work in accordance with the requirement of Federal Law No. 52-FZ of March 30, 1999.

The procedure and factors that determine the need for medical examinations are enshrined in the provisions of the Order of the Ministry of Health and Social Development of April 12, 2011 No. 302n. It consists of three applications, each of which contains:

  • in Annex 1 - factors considered potentially hazardous to health;
  • in Appendix 2 - types of work, admission to which can be carried out only with permission from narrow specialists;
  • Annex 3 - the procedure for organizing and conducting medical examinations with the forms of the documents necessary for this.

Order of the Ministry of Health 302n: changes and additions in 2019

The document underwent the last changes on February 6, 2018 in connection with the issuance of orders from new ministries ( affecting only application 2):

  • Ministry of Labor - Order No. 62n,
  • Ministry of Health - Order No. 49n.

More fundamental changes to the document were made earlier - by order of the Ministry of Health dated December 5, 2014 No. 801n.

Annex 1: Harmful and dangerous factors

In a tabular version, the application contains all the information about the production factors that require medical examinations, their frequency and a list of doctors. The table is divided into four sections according to the factors of the negative impact of production factors:

  • chemical;
  • biological;
  • physical;
  • labor process.

Each section is divided into subsections, where harmful and dangerous effects on human health are specified even more precisely. For each of them, the threat is established on the basis of the SUT.

  • the frequency of medical examinations;
  • a list of specialists in narrow areas that should be in the medical commission;
  • a list of analyzes and studies that need to be carried out by the employee during the inspection;
  • contraindications that are the reason for the removal of the employee from the performance of duties at this workplace.

Annex 2: Harmful and dangerous working conditions

In this appendix, the table contains the types of work that require primary and periodic medical examinations for those who are employed in them. These include:

  • work associated with a risk to life and health, including climbing, under water, land, as well as security and collection services;
  • work in production, classified as harmful and dangerous factors;
  • associated with the timber industry, in particular for the harvesting, processing, alloying of wood;
  • in special climatic and geographical zones;
  • associated with man-made and natural hazards;
  • work in direct contact with the mass presence of people (in educational, medical institutions, transport, consumer services, catering and trade).

Here, as well as in the first appendix, the frequency of medical examinations, a list of doctors, studies and contraindications for work is established.

Annex 3: The procedure for conducting medical examinations

In Appendix 3, Order 302n establishes the rules for conducting primary and periodic medical examinations.

Primary is required to organize the admission of a newly hired employee to perform work duties. For this, the applicant is given the appropriate direction.

Periodic must be carried out within the time limits established by Appendix 1 or 2 to order 302n, for personnel working for a certain time (for persons under 21 years of age, they are held annually). For their organization, the personnel service must:

  • data of employees subject to medical examination, enter in the list, indicating their full name, position and harmful production factors at the workplace;
  • the agreed list must be sent to the territorial body of sanitary and epidemiological control within 10 days;
  • transfer the list to a medical institution that has undertaken to conduct a medical commission in accordance with the concluded agreement. The transfer period is regulated by order 302n - no later than two months before the date of the scheduled inspection;
  • no later than 10 days before the start of the event, familiarize the personnel subject to the medical examination with the plan for its passage and hand over the referral.

The calendar plan for medical examinations must be developed by a medical institution and agreed with the employer. The duty of the personnel declared in the lists to appear on the appointed dates at the medical organization.

A medical examination is considered completed only if all laboratory tests, examination by narrow specialist doctors and a formalized conclusion are available.

Obtaining a referral for a medical examination in the form 302n

The employer has the right not to allow personnel who have not passed the mandatory medical examination to the workplace. For its passage, a citizen is issued a referral, with which it is necessary to come to a medical institution. The passage of doctors is a free procedure, since the employer has a contract for the provision of medical services.

The referral form does not have a unified form, but the following details are mandatory:

  • name of the employing organization indicating the form of ownership and OKVED;
  • the name of the medical institution where the employee is sent for an examination, with the address of his location and the PSRN code;
  • type of medical examination (periodic or preliminary);
  • personal data of the employee: full name, date of birth;
  • if the employer has structural units, the name of the place where the citizen works or plans to work should be indicated;
  • an indication of the position, profession or type of work, employee or applicant;
  • a list of harmful and dangerous factors of production, in connection with the work on which a medical examination is required.

The direction is filled in by an employee of the personnel service or other authorized person of the organization. Issued against signature to the employee.


Failure to comply with the requirements of labor legislation in the obligatoryness of passing medical examinations and order 302n entails the administrative responsibility of the employer:

  • a fine in the amount of 15-25 thousand rubles for individual entrepreneurs and officials;
  • a fine of 110-130 thousand rubles for legal entities.

The document was developed and approved by the Ministry of Health on April 10, 2011, registered with the Ministry of Justice on October 21, 2011 under No. 22111. Since the date of the original publication, the text has never been changed or supplemented, but there have been changes in the applications in Order 302 n of April 12, 2011 for medical examinations - in 2013 and 2015 years.

Compared to the original version, the document now includes:

  • a new list of dangerous and harmful production factors, for example:
    • welding aerosols with manganese- and silicon-containing compounds were added to the chemical factors;
    • in biological, the number of allergens, infected material has been significantly expanded and viruses of hepatitis B, C and AIDS, etc. have been added;
    • in physics, a new section of ionizing radiation and increased gravitational overloads, etc., has been added;
  • an increased number of specialist doctors performing medical examinations (dentists, allergists, endocrinologists have been added to sections where they were not originally there);
  • an increased number of additional contraindications for labor activity in certain conditions (for example, in electromagnetic fields) and for certain types of work (for example, for work in remote geographical areas and for working with machines);
  • a new section of substances and compounds united by a chemical structure that cause various kinds of diseases (section 1.2 of chemical factors);
  • updated list of pesticides (section 1.3.2).

There are repeated reports in the media that the Order of the Ministry of Health 302n with amendments and additions is again planned to be changed and even canceled. As part of the regulatory guillotine, officials included this document in the list of regulations that are recommended to be recognized as invalid. But it is still unknown whether the relevant decision will be approved and in what time frame. Follow the news.

List of contingent by Order 302n

The contingent of employees who are sent for control by the Order of the Ministry of Health 302n on professional examinations with changes for 2019 is formed from the list of positions and professions, when employed, for which employees are subject to a medical examination.

Everyone who is busy is sent for inspection:

  • in harmful and dangerous working conditions (chemical production, ionizing radiation, etc., a complete list of factors is indicated in Appendix No. 1);
  • in a certain type of work (at height, under water, underground, etc., a complete list is indicated in Appendix No. 2).

For an employer, a list of specialists for a periodic medical examination according to Order 302n is a mandatory document that contains:

  • names of positions and professions, upon employment for which mandatory and periodic medical examinations are carried out in accordance with applicable law (Appendix No. 2);
  • harmful and dangerous working conditions (Appendix No. 1). Necessary explanation: all working conditions are determined based on the results of a special assessment of working conditions.

Due to the fact that the form of the document is not legally approved, it is made in the form of a list, the law allows this.

Harmful production factors by profession

Each profession has harmful working conditions, but Order 302 of the Ministry of Health does not provide for referral to a medical examination by profession as such. But it provides for the presence or absence of harmful and dangerous production factors, such as, for example, an increased level of electromagnetic radiation and reduced physical activity of a computer operator.

By order 302n, harmful production factors by profession are:

  • chemical;
  • biological;
  • physical;
  • conditions of the labor process associated with the performance of work in certain conditions and with certain substances that can cause harm to health or cause death to a person.

The presence or absence of specific hazardous working conditions is determined based on the results of a special assessment of working conditions carried out in accordance with Federal Law No. 426-FZ of December 28, 2013. An exhaustive list of harmful factors is set out in Appendix No. 1 to Order 302n on passing medical examinations.

Name list of employees according to Order 302n

A list of names of employees according to Order 302 is compiled each time employees are sent for periodic medical examinations.

This document is compiled on the basis of the "Contingent ..." (302n dated 12.04.11 of the Ministry of Health and Social Development, referral for a medical examination) and includes:

  1. FULL NAME. employee, his profession or position.
  2. The name of a harmful or dangerous production factor.
  3. Name of the structural unit.

How to get a referral for a medical examination in the form 302n

According to the norms, a referral for a medical examination by profession according to Order of the Ministry of Health 302 in 2019 is issued during an employment interview, and the candidate signs for receiving the referral in a special journal. The referral is issued by an employee who documents the hiring and dismissal of employees.

Here is the information contained in a sample referral for a periodic medical examination by Order 302n in 2019:

  1. The name of the organization that issued the referral.
  2. Form of ownership and eight-digit code of economic activity according to OKVED.
  3. The name of the medical organization, the actual address of its location and the code according to the OGRN.
  4. Type of medical examination (preliminary medical examination when applying for a job - Order 302n - or periodic).
  5. FULL NAME. an incoming or working employee.
  6. Date of birth of the person entering the job (employee).
  7. The name of the structural unit (if any) in which the job candidate (or current employee) is employed.
  8. The name of the position (profession) or type of activity.
  9. Harmful and dangerous production factors and type of work in accordance with the approved "Contingent of workers".

The direction is signed by the employee who issued it, indicating the position, surname, initials.

The final act of the medical examination

In accordance with Order 302n, a medical organization, upon completion of a periodic medical examination by employees, together with representatives of the employer and Rospotrebnadzor, draws up a final act, which indicates:

  • Date of preparation;
  • the name of the employer;
  • name of the medical organization;
  • the percentage of coverage of employees with periodic medical examinations;
  • a list of newly diagnosed chronic somatic diseases with an indication of the class of diseases;
  • the results of the implementation of the recommendations of the previous final act;
  • recommendations for the implementation of a complex of recreational activities;
  • lists of employees who have not completed, have not undergone a periodic medical examination, and those who have a persistent degree of disability and other indicators (the full list is in paragraph 43 of the procedure for conducting preliminary medical examinations under Order 302n).

The final act under Order 302 is approved by the chairman of the commission, who certifies it with the seal of the medical organization. But Order 302n with the 2019 change on medical examinations in 2020 requires that the act be drawn up in four copies:

  1. Employer.
  2. In the center of occupational pathology of the subject of the Russian Federation.
  3. In the territorial division of Rospotrebnadzor.
  4. For a medical organization where it is stored for 50 years.