List of harmful and dangerous production factors by profession - order on medical examinations. List of harmful and dangerous production factors by profession - order on medical examinations Order 302 n harmful factors

Upon hiring, during employment, as well as extraordinary, depending on the state of health. Such workers, in particular, include workers who work in jobs with harmful or dangerous working conditions. They undergo mandatory medical examinations when applying for a job and periodic medical examinations to determine their health status. This is necessary to understand whether the employee can perform his work duties, as well as to timely diagnose the occurrence of occupational diseases.

Harmful and dangerous production factors

Order No. 302n regulates the procedure for conducting inspections and their frequency. However, the list of the harmful and dangerous factors themselves, when working with which it is necessary to undergo examinations, is also approved by this order of the Ministry of Health and Social Development of Russia, adopted on April 12, 2011.

Harmful factors according to order No. 302n

It is the employer's responsibility to organize a pre-employment medical examination or routine examination of employees during their working career. Harmful production factors in Order 302n, which make some types of activities harmful and even hazardous to health, are contained in Appendix 1. The list of factors is presented in the form of a table divided into several columns:

item number;
a group of substances that are harmful to health;
frequency of medical examinations;
specialists who take part in the inspection;
medical procedures and tests that employees need to undergo;
additional medical contraindications.

Appendix 2 approves the directory of factors of order 302n by profession. It is also designed as a table with five columns:

activity, profession for which it is necessary to undergo examination;
frequency of medical examinations;
doctors who take part in the examination;
studies and procedures that need to be completed;
additional contraindications.

The table of harmful factors by profession in Order 302n is very detailed. Harmful factors are divided into chemical (including allergens, carcinogens, natural asbestos, clay and cement, etc.); biological factors including feed, biological toxins (animal or plant poisons), etc.; physical factors, including various types of radiation, industrial noise, etc., as well as labor process factors, in particular, various overloads.

For each factor, it is prescribed how often and which medical specialists should conduct a medical examination of workers who have to work in harmful or dangerous conditions in accordance with the listed factors.

The table of Order No. 302n with harmful production factors by profession from Appendix 1 can be downloaded below.

to the order of the Ministry of Health and Social Development of the Russian Federation

The procedure for conducting mandatory preliminary (upon entry to work) and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions

I. GENERAL PROVISIONS

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

2. Mandatory preliminary medical examinations (examinations) upon entry to work (hereinafter referred to as preliminary examinations) are carried out in order to determine the compliance of the health status of the person entering work with the work assigned to him, as well as for the purpose of early detection and prevention of diseases.

3. Mandatory periodic medical examinations (examinations) (hereinafter referred to as periodic examinations) are carried out for the purposes of:

1) dynamic monitoring of the health status of workers, timely detection of diseases, initial forms of occupational diseases, early signs of the impact of harmful and (or) hazardous production factors on the health of workers, formation of risk groups for the development of occupational diseases;

2) identification of diseases, conditions that are medical contraindications for continuing work associated with exposure to harmful and (or) hazardous production factors, as well as work that requires preliminary and periodic medical examinations (examinations) of workers in order to protect public health , preventing the occurrence and spread of diseases;

3) timely implementation of preventive and rehabilitation measures aimed at maintaining the health and restoration of workers’ ability to work;

5) prevention of accidents at work.

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 current regulations (hereinafter referred to as medical organizations).

5. To conduct a preliminary or periodic examination, a medical organization shall form a permanent medical commission.

The medical commission includes an occupational pathologist, as well as medical specialists who have undergone advanced training in the specialty “occupational pathology” in the prescribed manner or 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 rest with the employer.

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

II. PROCEDURE FOR PRELIMINARY INSPECTIONS

7. Preliminary examinations are carried out upon entry 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 based on the list of contingents approved by the employer and indicates:

- name of the employer;
- type of medical examination (preliminary or periodic)
- last name, first name, patronymic of the person applying for work (employee);
- date of birth of the person applying for work (employee);
- the name of the structural unit of the employer (if any) in which the person applying for work will be employed (employee);
- 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 workers approved by the employer, subject to preliminary (periodic) inspections.

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

The referral is issued to the person applying for work (employee) against signature.

The employer (his representative) is obliged to organize a record of issued directions.

9. To undergo a preliminary examination, a person applying for work submits the following documents to the medical organization:

- direction;
- passport (or other standard document proving his identity);
- employee health passport (if available);
- 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 is issued by a medical organization:

10.1 medical record of an outpatient (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 stored in accordance with the established procedure in the medical organization;

- name of the medical organization, actual address of its location and OGRN code;
- last name, first name, patronymic, date of birth, gender, passport data (series, number, by whom it was issued, date of issue), registration address at the place of residence (stay), telephone number, compulsory medical insurance policy number of the person applying for work (employee);
- 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 applying for work will be employed (employee), the name of the position (profession) or type of work;
- name of the harmful production factor and (or) type of work (indicating the class and subclass of working conditions) and length of contact with them;
- name of the medical organization to which the employee is attached for constant monitoring (name, actual address);
- conclusions of medical specialists who took part in the preliminary or periodic medical examination of the employee, results of laboratory and instrumental studies, conclusions based on the results of the preliminary or periodic medical examination.

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

One health passport is maintained for each employee.

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

During the examination, the health passport is stored in the medical organization. At the end of the examination, a health passport is issued to the employee.

If an employee loses a health passport, the medical organization, upon the employee’s application, issues him a duplicate health passport.

11. A preliminary examination is completed if a person entering work is examined by all medical specialists, as well as the full scope of laboratory and functional tests provided for in the List of harmful and (or) dangerous 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 referred to as the List of Factors) and the List of Works, during the performance of which mandatory preliminary and periodic medical examinations (examinations) of workers are carried out (Appendix No. 2 to the Order) (hereinafter referred to as the List of Works).

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

13. The Conclusion states:

- date of issue of the Conclusion;
- last name, first name, patronymic, date of birth, gender of the person applying for work (employee);
- name of the employer;
- name of the employer’s structural unit (if any), position (profession) or type of work;
- name of the harmful production factor(s) and (or) type of work;
- the result of the medical examination (medical contraindications were identified or 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, is immediately given to the person entering work or who has completed a periodic medical examination, and the second is attached to the medical record of the outpatient.

III. PROCEDURE FOR PERIODIC INSPECTIONS

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

16. Periodic inspections are carried out no less frequently than within the periods 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 name lists developed on the basis of contingents of workers subject to periodic and (or) preliminary inspections (hereinafter referred to as name lists) indicating harmful (hazardous) 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 and name lists:

exposed to harmful production factors specified in the List of Factors, as well as harmful production factors, the presence of which was established based on the results of certification of workplaces for working conditions, carried out in the prescribed manner. As a source of information about the presence of harmful production factors in workplaces, in addition to the results of certification of workplaces for working conditions, the results of laboratory research and tests obtained as part of control and surveillance activities, production laboratory control can be used , and also use operational, technological and other documentation for machines, mechanisms, equipment, raw materials and materials used by the employer in carrying out production activities;

performing work specified in the List of Works;

20. The list of employees subject to preliminary and periodic medical examinations indicates:

- name of the employee’s profession (position) according to the staffing table;
- the name of the harmful production factor according to the List of factors, as well as harmful production factors identified as a result of certification of workplaces for working conditions, as a result of laboratory research and testing obtained as part of control and surveillance 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 carrying out production activities.

21. The list of contingents, 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 an approved list of employees subject to preliminary and periodic medical examinations, which indicates:

- last name, first name, patronymic, profession (position) of the employee subject to periodic medical examination;
- name of the harmful production factor or type of work;
- name of the employer’s structural unit (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 upon 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 give the person sent for a periodic examination a referral for a periodic medical examination, issued in accordance with paragraph 8 of this Procedure.

25. The medical organization, within 10 days from the moment of receiving a list of names from the employer (but no later than 14 days before the start date of the periodic examination agreed with the employer), based on the specified list of names, draws up a calendar plan for conducting a periodic examination (hereinafter referred to as the calendar plan).

The calendar plan is agreed upon 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 the periodic examination with the calendar plan.

27. The medical commission of a medical organization, based on the harmful production factors or work indicated in the list, determines the need for participation in preliminary and periodic examinations of relevant medical specialists, as well as the types and volumes of necessary laboratory and functional tests.

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

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. A periodic examination is completed if the employee is examined by all medical specialists, as well as the full scope of laboratory and functional tests provided for in the List of Factors or the List of Works is completed.

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

32. Based on the results of a periodic examination in the prescribed manner, the employee’s membership in one of the dispensary groups is determined, in accordance with current regulations, with subsequent registration in the medical record and health passport of recommendations for the prevention of diseases, including occupational diseases, and if any medical indications - for further observation, treatment and rehabilitation.

33. Data on medical examinations must be entered into personal medical records and recorded by treatment 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 carrying out preliminary or periodic examinations, the medical record is transferred to the occupational pathology center of the constituent entity of the Russian Federation, on the territory of which 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 entered into an agreement to conduct preliminary and (or) periodic examinations, transfers the medical records of employees to the specified medical organization within 10 days from the date of receipt of the request to the specified medical organization. The request must be accompanied by a copy of the agreement for preliminary and (or) periodic inspections.

36. A medical organization with which the employer has not renewed the contract for conducting preliminary and (or) periodic examinations of employees, at the employer’s written request, must transfer the employees’ medical records according to the inventory to the medical organization with which the employer has currently concluded a corresponding agreement.

37. Participants in emergency situations or incidents, workers engaged in work with harmful and (or) hazardous substances and production factors with a one-time or multiple excess of the maximum permissible concentration (MPC) or maximum permissible level (MAL) for the current factor, workers with ( those who have had a conclusion on a preliminary diagnosis of an occupational disease, persons with persistent consequences of industrial accidents, as well as other workers, if the corresponding decision is made by the medical commission, at least once every five years, undergo periodic examinations in occupational pathology centers and other medical organizations that have the right to carrying out preliminary and periodic examinations, to conduct an examination of professional suitability and an examination of the connection of the disease with the profession.

38. In the event that a psychiatrist and (or) narcologist identifies persons with suspected medical contraindications corresponding to the profile of these specialists, permission to work with harmful and (or) dangerous production factors, as well as to work for which preliminary preparations are required 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 connection of a disease with a profession, when conducting a periodic examination, may involve medical organizations that have the right, in accordance with current regulatory legal acts, to conduct preliminary and periodic examinations and examinations of professional suitability.

40. If there is a suspicion that an employee has an occupational disease during a periodic examination, the medical organization issues the employee a referral 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 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 the federal executive authorities authorized to exercise state control and supervision in the field of ensuring sanitary and epidemiological well-being.

41. In cases where it is difficult to determine the professional suitability of an employee due to his illness and for the purpose of examining professional suitability, the medical organization sends the employee to an occupational pathology center or a specialized medical organization that has the right to conduct an examination of the connection between the disease and 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 workers and, together with the territorial bodies of the federal executive body authorized to exercise state control and supervision in the field of ensuring sanitary and epidemiological well-being of the population and representatives of the employer, draws up the final act.

43. The final act states:

- name of the medical organization that conducted the preliminary examination, address of its location and OGRN code;
- date of drawing up the act;
- name of the employer;
- the total number of workers, including women, workers under the age of 18, workers who have been diagnosed with a permanent degree of disability;
- the number of workers engaged in heavy work and work with harmful and (or) dangerous working conditions;
- the number of workers employed in work that requires periodic medical examinations (examinations), in order to protect public health, prevent the occurrence and spread of diseases, including women, workers under the age of 18, workers who have been diagnosed with a persistent degree of loss of ability to work;
- the number of workers subject to periodic medical examination, including women, workers under the age of 18, workers who have been determined to have a permanent degree of disability;
- the number of workers who have undergone periodic medical examinations, including women, workers under the age of 18, workers who have been diagnosed with a permanent degree of disability;
- percentage of employees covered by 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 workers who have not completed periodic medical examinations, including women, workers under the age of 18, workers who have been determined to have a permanent degree of disability;
- list of employees who have not completed periodic medical examinations;
the number of workers who have not undergone periodic medical examinations, including women, workers under the age of 18, workers who have been determined to have a permanent degree of disability;
- list of employees who have not undergone periodic medical examination;
- the number of employees who do not have medical contraindications to work;
- the number of employees who have temporary medical contraindications to work;
- the number of employees who have permanent medical contraindications to work;
- the number of employees who need additional examination (no conclusion given);
- the number of workers who need examination at the occupational pathology center;
- number of workers in need of outpatient examination and treatment;
- the number of workers in need of inpatient examination and treatment;
- the number of employees in need of sanatorium-resort treatment;
- the number of employees in need of dispensary observation;
- a list of persons with a preliminary diagnosis of an occupational disease, indicating gender and date of birth;
- structural unit (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 referred to as ICD-10);
- a list of newly identified occupational diseases indicating the class of diseases according to ICD-10;
- results of implementation of the recommendations of the previous final act;
- recommendations to the employer on the implementation of a set 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 a constituent entity 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 kept 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 engaged in work with harmful and (or) dangerous working conditions on the territory of a given constituent entity of the Russian Federation and no later than February 15 of the year following the reporting year, sends the summarized information to the Federal Center for Occupational Pathology of the Ministry of Health and Social Development of Russia and the health care 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 periodic examinations of workers engaged 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

48. Employees (persons entering work) are not allowed to perform work with harmful and (or) dangerous working conditions, as well as work that requires preliminary and periodic medical examinations (examinations), in order to protect public health and prevent the occurrence and spread of diseases, in the presence of the following general medical contraindications:

49. Additional medical contraindications are indicated in the List of Factors and the List of Works.

Article 213 of the Labor Code of the Russian Federation.

Article 212 of the Labor Code of the Russian Federation.

Order of the Ministry of Health and Social Development of Russia dated August 31, 2007 No. 569 “On approval of the Procedure for certification of workplaces based on working conditions” (registered by the Ministry of Justice of Russia on November 29, 2007
№ 10577).

Order of the Ministry of Health and Social Development of Russia dated 02/04/2010 No. 55n (as amended on 03/03/2011) “On the procedure for additional medical examination of working citizens” (together with the “Procedure and scope of additional medical examination of working citizens”) (registered by the Ministry of Justice of Russia on 03/04/2010 No. 16550).

In cases of severe 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 medical specialists corresponding to the profile of the disease, with the participation of an occupational pathologist.

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

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

Order No. 302n on medical examinations establishes not only the categories of employees who must undergo them, but also the procedure for conducting them. In March 2018, changes were made to this regulatory act. We'll tell you which ones.

Read our article:

Order of the Ministry of Health 302n with amendments and additions of 2018

The order approved the rules for undergoing medical examinations. The list of professions and jobs for which an employee undergoes an examination upon entry is determined based on working conditions. It must be compiled by the employer.

If an employee performs work included in the list, he will be required to first undergo this procedure. Appendix 2 is a table that is used not only by the employer, but also by the medical institution. Columns 3 to 5 contain:

lists of specialists who will need to be visited;
a list of studies, both laboratory tests and functional measurements;
additional health contraindications.

It is worth noting that if several types of work are performed during production, it is necessary to take into account the need to conduct medical examinations for these types of work simultaneously. Example: maintenance and repair of existing electrical installations.

Changes to Order 302n in 2018 were made in March. They affected Appendix 2. The list of workers who were sent for medical examinations was expanded. Instead of employees of social shelters and nursing homes, employees of social service organizations providing social services should be sent for a medical examination:

in stationary form of social services;
semi-stationary form of social services;
in the form of social services at home.

Harmful factors for medical examination by profession in Appendix 1

During the work process, an employee is constantly or periodically exposed to various production factors.

They can be:

optimal;
acceptable;
harmful;
dangerous.

This gradation of production environment factors has been established. The presence of a production factor of a particular group is determined in the process of a special assessment of working conditions.

The application concerns only groups 3 and 4 - harmful and dangerous factors.

Harmful working conditions are understood as those in which the impact of harmful and (or) dangerous factors exceeds hygienic standards and can lead to varying degrees of damage to health.

The 3rd group is divided into 3 subgroups depending on the expected.

Dangerous factors are considered to be those that during a working day or shift can lead to a threat to the life of a citizen, and their prolonged exposure inevitably leads to acute occupational diseases.

Order 302n on medical examinations does not contain a gradation according to the “harmfulness” of a particular exposure. It provides a gradation depending on the operating factor (chemical, biological, physical, labor process). This classification allows you to quickly navigate the list.

Procedure for conducting medical examinations 302n

Occupational medical examinations can be carried out both during employment and during work. Their main purpose is to identify health problems that prevent an employee from performing work. The procedure is set out in Appendix 3.

Preliminary medical examinations must be carried out before the candidate goes to work. In the human resources department of the organization, the future employee is given a referral for a medical examination, and it is possible to undergo the medical examination at the place of residence or in any medical institution convenient for him.

The cost of the applicant undergoing a medical examination must be reimbursed by the employer.

The direction is drawn up on the organization's letterhead. It must contain the name of the company, as well as its details. The text of the document itself contains the candidate's full name, date of birth, position and department, production factors and types of work in accordance with Appendices 2 and 1. The direction is signed by an authorized person and the company seal is affixed.

At the clinic, the employee must present a referral, a passport, a psychiatrist’s report and a health passport, if available. Health workers make a list of necessary specialists and tests that need to be completed. After completing all procedures, the employee is given a certificate of completion of a medical examination. He must provide this conclusion to the employer.

Final act on medical examinations 302n (sample)

The final act is issued to the employer upon completion of the medical examination as a whole, as established by paragraph 42. It is a summary table for the entire staff of the enterprise or part of it.

Download the final act form>>>

The final act contains information about the employer and the number of personnel. Based on the results of the inspections, summary tables 1 and 2 are filled out by name. The employer is given suggestions for health-improving activities and... The act is filled out in 4 copies.

The completed final report on medical examinations must be kept for 50 years in the medical organization that conducted the examinations.

Since the date of its original publication, Order 302n itself on undergoing medical examinations has never been changed or supplemented, but in 2013 and 2015 changes were made to its annexes.

Compared to the original edition, the following changes have been made to the applications:

The list of hazardous and harmful production factors has been expanded, for example:
- welding aerosols with manganese and silicon-containing compounds have been added to the chemical factors;
- in biological ones, the number of allergens and infected material has been significantly expanded and hepatitis B, C and AIDS viruses have been added, etc.;
- in physics, a new section has been added on ionizing radiation and increased gravitational overloads, etc.;
the number of medical specialists performing medical examinations has increased (dentists, allergists, and endocrinologists have been added to sections where they were not originally present);
the number of additional contraindications for work 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) has increased;
a completely new section of substances and compounds united by a chemical structure that cause various types of diseases has been added (section 1.2 chemical factors), and the list of pesticides has also been significantly expanded (section 1.3.2).

List of contingents by order 302n

The contingent of employees who, in accordance with the order of the Ministry of Health and Social Development dated April 12, 2011 No. 302n, must be sent for a medical examination, is formed from the list of positions and professions for which employees are subject to being sent for a medical examination upon employment.

Everyone who is employed 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);
on a certain type of work (at height, under water, underground, etc., the full list is given in Appendix No. 2).

The contingent list is a mandatory document and must contain:

names of positions and professions, during employment for which mandatory and periodic medical examinations are carried out in accordance with current legislation (Appendix No. 2);
harmful and dangerous working conditions (Appendix No. 1). Necessary clarification: 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 approved by law, it can be made in the form of a list; Order 302n with the amendment of 2019 on medical examination allows this.

Harmful production factors by profession

Each profession has its own harmful working conditions, but Order 302 of the Ministry of Health does not provide for referral for a medical examination by profession. 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 decreased physical activity of the computer operator.

According to Order 302n, harmful production factors by profession are:

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

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 dated December 28, 2013. Comprehensive lists of harmful factors are set out in Appendix No. 1 to Order 302n on medical examinations.

Name list of employees according to order 302n

A list of employees by name according to Order 302 is compiled every time employees are sent for periodic medical examinations.

This document is drawn up on the basis of the “Contingent...” (302n dated 04/12/11 of the Ministry of Health and Social Development, referral for a medical examination) and includes:

FULL NAME. employee, his profession or position.
Name of the harmful or dangerous production factor.
Name of the structural unit.

How to get a referral for a medical examination using Form 302n

According to the norm, which was approved by Order 302n dated April 12, 2011 of the Ministry of Health and Social Development, a referral for a medical examination is issued during an employment interview, and the candidate must sign for receipt of the referral in a special journal. The referral is issued by the employee who documents the hiring and dismissal of employees.

In the direction according to order 302n the following must be indicated:

Name of the organization that issued the referral.
Form of ownership and eight-digit code of economic activity according to OKVED.
Name of the medical organization, actual address of its location and OGRN code.
Type of medical examination (preliminary or periodic).
FULL NAME. a person entering or working as an employee.
Date of birth of the person entering the job (employee).
The name of the structural unit (if any) in which the job candidate (or current employee) will be employed.
Name of position (profession) or type of activity.
Harmful and dangerous production factors, as well as the type of work in accordance with the approved “Staff of Workers”.

The referral is signed by the employee who issued the referral, indicating his position, surname, and initials.

Final medical examination report

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

Date of preparation;
employer's name;
name of the medical organization;
percentage of employees covered by periodic medical examinations;
a list of newly diagnosed chronic somatic diseases indicating the class of diseases;
results of implementation of recommendations of the previous final act;
recommendations for the implementation of a set of health-improving measures;
lists of workers who have not completed or undergone periodic medical examinations, as well as those who have been diagnosed with a permanent 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.