Occupational medical services

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QUESTION: What are the legislative requirements regarding medical fitness assessment in relation to updating training?
ANSWER:
– A natural person who is the holder of a license, certificate or document within the meaning of § 16 par. 1, par. b) of Act no. 124/2006 Coll. on Occupational Health and Safety and on amendments to certain acts, as amended (hereinafter the Act), is obliged to comply with § 16 par. 6 of the Act of preventive medical examination in relation to work, which results in the assessment of medical fitness for work to perform this activity within five years of:

  • the issue of the license, certificate or document referred to in par. 1 letter b) of the Act
  • carrying out a previous preventive medical examination in relation to work.

According to § 16 par. 2 letter c) of the Act is assessed on the basis of the result of preventive medical examination in relation to work. It shall be accompanied by a medical opinion which shall not be older than 6 months. 

Pursuant to § 16 par. 7 of the Act for medical preventive examination in relation to work in order to fulfill the requirement laid down in § 16 par. 4 and 6 of the Act also considers a medical examination carried out under a special regulation if the operation of the designated work equipment pursuant to par. 1 requires a driving license. Medical fitness for work according to § 16 par. 4 of the Act is required under § 16 par. 2 letter c) of the Act only for carrying out activities listed in Annex no. 1a of the Act. 

According to § 16 par. 8 of the Act a natural person holding a license, certificate or document pursuant to par. 1 (b) shall be obligatory within five years from the date of issue of the license, certificate or document referred to in par. 1 (b) to receive updating training in a person entitled to an education. It shall undertake further training within five years of the date of completion of the previous updating training. The person entitled to education shall indicate in the license, certificate or document referred to in par. 1 (b) the date of completion of the update training. On the basis of the above, the person entitled to upbringing and education must not indicate in the license the date of completion of the update training without the proof of attendance of the preventive medical examination in relation to the work.

QUESTION: What is the optimum temperature in the workplace?
ANSWER:
– Pursuant to Section 2 of the Ministry of Health Decree No. 99/2016 Coll. it is necessary to distinguish what season it is, the warm season of the year or the cold season of the year. Depending on the period of the year and the type of work/inclusion in the class of work according to the nature of activities, it is characterized in Annex no. 1 of the Ministry of Health Decree No. 99/2016 Coll. / is the optimal and permissible operating temperature determined separately for the warm season of the year and the cold period of the year in Annex no. 2 of the Ministry of Health Decree no. 992016 Coll. E.g. administrative worker: according to Annex no. 1 is assigned to work class 1a, ie. the optimum temperatures for the warm season are according to Annex no. 2: 23-27°C and the permissible operating temperature is 20-28°C.

QUESTION: Does an employee qualify for a break at work at high temperatures in the workplace?
ANSWER:
– Yes, it does. Pursuant to the Labor Code and subsequently also in the sense of Annex no. 3 of the Ministry of Health Decree no. 99/2016. The annex defines the short-term and long-term acceptable time of work divided by sex, clothing and climatic conditions. E.g.: an administrative employee in office without air conditioning: according to Annex no. 3 for the acclimatized man according to Table no. 1 in the annex at room temperature of 36 ° C and more must-have reduced time. The same applies to acclimatized women according to the table no. 4 of Annex no. 3 of the Ministry of Health Decree no. 99/2016 Coll.

QUESTION: Can a sweetened drink be considered a drinking regimen?
ANSWER:
– Pursuant to Section 7 of the Decree of the Ministry of Health of the Slovak Republic no. 99/2016 Coll. and Annex no. 4 of the Ministry of Health Decree no. 99/2016 Coll. is a drinking regime defined as replenishing a sufficient amount of fluids and minerals lost when working into the body. We are talking about water and mineral substitution, so natural water with mineral content is the most appropriate. Any industrially produced replacement is always a compromise. The sweetened drink is not a good compromise, because it contains artificial sweeteners and sugar, which does not necessarily suit all employees, we recommend minerals without added sugar and other substances, eg. stimulating caffeine…

QUESTION: Who must have an occupational health service according to the Act of the National Council of the Slovak Republic no. 355/2007 Coll.?
ANSWER:
– From 1.12.2018 every employer who has employees assigned to the 3rd and 4th category of hazardous work must have a health service. An employer who has employees in categories 1 and 2 must ensure an assessment of the health risk from exposure to occupational and occupational factors at least once every 18 months. Assessment means the qualitative and quantitative detection of health and environmental factors of work under §52 (1) (c), whereby a qualitative and quantitative survey must be carried out by a natural person with competence according to.

QUESTION: Who must have employee records by work categories?
ANSWER:
– On 1 July 2018, § 30 par. 1 (a) k) of Act no. Stipulating the obligation of the employer to annually announce by 15 January in the electronic form to the relevant public health authority data concerning employees performing work in the second category as at 31 December of the previous calendar year; the employer also provides the employee with the data. This provision will apply for the first time in January 2019. The scope of notification of data on employees performing work classified in the second category is determined by law in § 30 paragraph 3 of Act no. 355/2007 Coll.:

  1. workplace name
  2. the name of the professions, indicating the factors of work and the working environment to which the employees are exposed,
  3. the number of employees in the workplace.

QUESTION: Is the registration of employees for category 3 and 4 obligatory?

THE ANSWER:

– Pursuant to Article 30 (1) (m), the employer shall, in cooperation with the occupational health service, produce annually by 31 December information on the results of the health risk assessment and the measures taken to reduce or eliminate them at the workplaces where the work is performed to a third category or a fourth category, including the number of employees performing risky work, and evaluating the health status of employees in relation to work and submitting it to the competent public health authority by 15 January of the following year.

QUESTION: Do I need training when working with toxic and very toxic substances (originally with poisons)? How often must it be repeated?

ANSWER:

Pursuant to Section 15 (3) (a) of Act No. 355/2007 Coll. the employer must have a professionally competent person to work with toxic and very toxic substances. Professional competence is acquired pursuant to Section 16 (2) of Act of the National Council of the Slovak Republic no. 355/2007 Coll., Where before the examination at the Regional Public Health Office, the employee must undergo up-to-date professional training for work with toxic and very toxic substances through an accredited body of the Ministry of Education of the Slovak Republic, followed by an examination at the RPHA. Pursuant to Section 16, paragraph 29 of the Act of the National Council of the Slovak Republic no. 355/2007 Coll. It is required to update the professional training once every 5 years through an accredited body of the Ministry of Education.

QUESTION: Is the employer obliged to ensure the summer drinking regime?
ANSWER:

Pursuant to the Ministry of Health Decree no. Is the employer obligatory drinking regime as follows:

The employer provides for drinking water to the employee at his own costs drinking water at the place of work or at another suitable place determined by the internal regulation of the employer.

In the event of a heat load on an employee carrying out long-term work in Classes 1b to 4, the employer also provides mineral drinks at his own expense to replenish liquids and minerals lost by sweating and breathing.

  1. if the conditions for adjusting the time of work pursuant to Section 4, par. Or if such time adjustment is foreseen; \ tor. \ T
  2. for long-term work in the outdoor workplace during extremely hot days.

QUESTION: What are the employer’s obligations for employees classified in the 2nd category?
ANSWER:
– Ensure a health risk assessment once in 18 months.
– To develop a job categorization in terms of health risks.
– To develop a written record of health risk assessment.
– The copy of the health risk assessment and job categorization must provide to employees’ representatives.
– To develop a risk assessment and operating instructions for the occurring factors of the work environment.
– To have the operating instructions approved if it´s required by a special regulation.
– To keep records of employees.
– Announce annually by January 15th in electronic form data related to employees engaged in the 2nd job category to the competent public health authority as of 31st December of the previous calendar year. The employer will provide the data to employee representatives as well. (Effective date July 1st, 2018)
– Ensure adequate health surveillance for employees.
 
QUESTION: Can the safety technician perform the medical surveillance for the job category 2?
ANSWER:
No. In accordance with the amendment to the Act of the National Council of the Slovak Republic no. 355/2007 Z.z, health surveillance can be provided by a public medic with two years’ experience, occupational health service or a physician with the required specialization. All healthcare providers must have an authorization issued by the Public Health Authority of the Slovak Republic (PHA SR).
 
QUESTION:  Where can I find companies that can provide health surveillance?
ANSWER:
The Public Health Service of the Slovak Republic has a list published on its website under the Information – Labor Health Service.

QUESTION: What are the requirements for an ambulance facility? 
ANSWER:
In accordance with Decree of the Ministry of Health of the Slovak Republic No. 09812/2008-OL on 10 September 2008 on minimum requirements for personnel security and material and technical equipment of individual types of medical facilities (Annex – with full ambulance equipment).
AMBULANCE
1. Basic functional spaces of the outpatient facilities have a minimum room area
a) ambulance 15 m2
b) preparation room (if is established) 12 m2
c) waiting room 8 m2
d) toilet for patients 2 m2
e) toilet for staff 2 m2
f) day room or a cloakroom for staff that may be common for more ambulances,
g) space with a sink for a charwoman.
 
2. Basic and instrumentation equipment of outpatient facilities of general and specialized outpatient health care is:
a) examination deck chair with a minimum height of 60 cm,
b) hand wash basin,
c) sink for washing aids and pouring of biological materials – if is installed in the preparation room, in the ambulance is not necessary,
d) desk, chair,
e) computer with accessories,
f) telephone,
g) chair for the patient,
h) changing table in an ambulance of a general practitioner for children and adolescents and for doctors in specialized clinics,
i) hanger,
j) wall thermometer,
k) waste bin with a pedal – also in the preparation room if is established,
l) emitting bowl,
m) water cups for disposable use,
n) lockable medicine cabinet for medicines and medical devices,
o) cartridge lockable cabinet,
p) refrigerator for pharmaceuticals,
 
10) § 13 par. 4 letter a) Act No. 355/2007 Coll.
Page 236 Journal MH SR 2008 Section 32-51
q) personal weight and altimeter,
r) cabinet for tools and aids,
s) steam sterilizer if the workplace does not have secure sterilization by way of supply separate,
central sterilization or disposable material,
t) dressing sterile material and non-sterile material,
u) disinfectants, antiseptics, means for a higher degree of disinfection of thermolabile tools and devices,
v) aids for the collection of biological material,
w) aids for the administration of medicinal products,
x) infusion stand,
y) barometer, phonendoscope, thermometer,
z) furniture for waiting room – at least three chairs,
aa) pharmaceuticals range and assortments according to the ambulance focus,
ab) washing and disinfection automat for decontamination and disinfection of medical devices if the workplace does not have sterilization in the supplier’s way by separation of the
central sterilization.
3. Ambulances, where biological material is being collected in the context of health care provision, must be equipped with a sink for its pouring and for the washing and decontamination of the devices. If a sink is installed in a preparation room, the ambulance is not necessary.
4. Ambulances using a greater number of repeatable instruments must be equipped with a double sink. If the double sink is installed in the preparation room, is not necessary for the ambulance.
5. If the ambulance provides ambulatory health care in several specialized sections, it must satisfy the requirements for equipment and instrumentation equipment for each specialization section, where is outpatient healthcare provided.
6. When is an ambulance of a general practitioner for adults, which provides a first-aid medical service, mandatory instrumentation is also ECG?
7. Resuscitation set that every ambulance must have forms
a) T – tubus (oral air conduit) in at least three different sizes for men, women, children, and  youth,
b) ambuvak (self-breathing breathing bag) with face semi-masks in two sizes,
c) small oxygen bottle (0,6 l) and reduction valve,
d) oxygen mask,
e) suction and suction catheter in two different sizes.
8. Ambulances are equipped with an anti-shock cabinet containing these medicines and infusion solutions:
I. Drugs for injection
a) sympathomimetic,
b) aqua for injection,
c) parasympatholytics,
d) corticosteroids,
e) minerals,
f) antihistamines,
g) bronchodilators,
h) anesthetics,
i) anti-asthmatics,
j) blood substitutes and perfusion solutions,
k) antiemetics,
l) anxiolytics.
II. Infusion solutions
F1/1 400 ml, F1/1 200 ml, G5% 200 ml.
Section 32-51 Journal MH SR 2008 Page 237
III. Oral drugs 
a) activated carbon,
b) vasodilators.

QUESTION: Who can provide first aid training? 
ANSWER:
Decree No. 398/2010 Coll. on minimum requirements for first aid training and first aid instructor course
In accordance § 4 with Decree No. 398/2010 Coll.: Personnel security of the instructor course.
The training organizer ensures that the instructor of the training is only a medical worker with a university education with a second degree in the medical study by section 27, par. 1 of the Act, who had completed an instructor training accredited by the Ministry.

QUESTION: Must employees have the entry preventive medical examinations?
ANSWER:  
– in accordance with § 6, paragraph 1, letter o) of the Act No. 124/2006 Coll., o) the employer is obliged to assign employees to perform their work with regard to their health status, especially to the result of the assessment of their medical fitness for work, abilities, their age, qualifications and professional competence under the law and other regulations to ensure Occupational Safety and Health at work and not allowing them to perform work which is not suited for their health status, especially to the result of the assessment of their medical fitness for work, for abilities, by their age are not eligible or qualifications and certification of qualification are not under the laws and other regulations to ensure occupational safety and health at work,
– in accordance with §30 letter e) of the Act No. 355/2007 Coll. is required a preventive medical examination in relation to work for:
a) employee,
1. who performs work in the third category and the fourth category,
2. with the repeated occurrence of occupational disease in the same profession at the same workplace,
3. whose the medical fitness for work requires special regulation,
4. who performs work in the second category, third or fourth category and if this work is not carried out over six months for health reasons,
b) individual person – entrepreneur, who does not employ other individual people,
1. who performs work in the third category and the fourth category,
2. whose medical fitness for work requires special regulation,
c) another individual person, who looks for a job
1. for the performance of work included in the third category or the fourth category, or
2. whose medical fitness for work requires special regulation,
d) employee with resources of ionizing radiation A category. 

QUESTION: When does an employer need to have OMS?
ANSWER: 
– in accordance with Act No. 355/2007 Coll. on protection, support and development of public health and on the amendments to certain laws, every employer must have Occupational Medical Services, if he employs at least one employee,
–  it could be by the form of health surveillance  (STS with authorization, health officer with authorization) for 1. and 2. category of work,
– or by occupational medical services (for 1. – 4. category of work).

QUESTION: What are the requirements for first aid room?
ANSWER:
–  in accordance with Act No. 391/2006 Coll. is mandatory to have established a first-aid room if it requires the size of workspaces, type of carried out activities and frequency of accidents occurrence,
– room for first aid shall be equipped with essential facilities and means to provide first aid (i.e. bed, first aid kit). It must be also easily accessible in handling with the stretcher or must be equipped with a sink with running water and ventilated.  

QUESTION: After how many years must be periodic preventive medical examinations for operating motor trucks?
ANSWER:  
In accordance with Annex 1A of the Act No. 124/2006 Coll., the frequency is 1x per five years.

QUESTION: How often do they have to make measurements for lighting and noise?
ANSWER: 
assessment must be done by the accredited person before putting the premises into the operation and at each change (technical, technological, organizational,) in accordance with Act No. 355/2007 Coll.   

QUESTION: Do I need training when I work with toxic and highly toxic substances (originally poisons)? How often do I need retraining?
ANSWER:
In accordance with § 15, paragraph 3, letter a) of Act No. 355/2007 Coll. the employer must have a professionally qualified person to work with toxic and very toxic substances. Professional competence shall be acquired in accordance with § 16, paragraph 2 of Act No. 355/2007 Coll., where before the test an employee must pass an upgrade training for work with toxic and very toxic substances at the Regional Public Health Authority that is accredited by Ministry of Education and then test at the RPHA. In accordance with §16, paragraph 29 of Act No. 355/2007Coll., update training that is accredited by the Ministry of Education is required 1 x per 5 years.

 

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