Occupational medical services

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QUESTION: What are the employer’s obligations for employees classified in the 2nd category?
– 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 assessments 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 at 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?
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, an 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?
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? 
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).
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 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 a 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 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 a 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 sink for its pouring and for the washing and decontamination of the devices. If a sink is installed in a preparation room, in 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 in the ambulance.
5. If the ambulance provides ambulatory health care in several specialized sections, must satisfy the requirements for equipment and instrumentation equipment for each specialization section, where is outpatient healthcare provided.
6. When is an ambulance of 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? 
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.
Training organizer ensures that the instructor of the training is only a medical worker with university education with 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?
– 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 workwhich are 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 eligibleor qualifications andcertification 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 preventive medical examination in relation to work for:
a) employee,
1. who performs work in the third category and the fourth category,
2. with 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 into 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?
– 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 form of health surveillance  (STS with authorization, health officer with authorization) for 1. and 2. category of work,
– orby occupational medical services (for 1. – 4. category of work).

QUESTION: What are the requirements for first aid room?
–  in accordance with Act No. 391/2006 Coll., is mandatory to have established a first aid roomif it requires 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 ormust 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?
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?
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?
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 the 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 Educationand then test at the RPHA. In accordance with §16, paragraph 29 of the Act No. 355/2007Coll., update training that is accredited by Ministry of Education is required 1 x per 5 years.



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