Occupational diseases and their consequences - abstract. Basics of occupational health

Occupational diseases can be acute or chronic.

An acute occupational disease (poisoning) is understood as a disease that is, as a rule, the result of a single (for no more than one working day, one work shift) exposure of an employee to a harmful production factor (factors), resulting in temporary or permanent loss of professional ability to work.

A chronic occupational disease (poisoning) is understood as a disease that is the result of prolonged exposure of an employee to a harmful production factor (factors), resulting in temporary or permanent loss of professional ability to work.

An occupational disease can develop over a long period of time after stopping work in contact with harmful, dangerous substances and production factors (phytogenic dusts, carcinogenic substances, etc.).

Occupational diseases can also include diseases in the development of which an occupational disease is a background or fact of risk (for example, lung cancer that develops against the background of asbestosis, silicosis or dust bronchitis).

All persons with identified occupational diseases (poisonings) or deviations from the normal state of health that can be associated with an occupational factor are under dispensary observation by the attending physician or a specialist doctor or by an occupational pathologist.

PROCEDURE FOR ESTABLISHING THE PRESENCE OF AN OCCUPATIONAL DISEASE

Acute occupational disease (poisoning):

Preliminary diagnosis:

The healthcare institution is obliged to send within 24 hours:

emergency notification of an employee’s occupational disease to the Center for State Sanitary and Epidemiological Surveillance (Center for State Sanitary and Epidemiological Surveillance);

message to the employer (in the form established by the Russian Ministry of Health).

Center for State Sanitary and Epidemiological Surveillance:

within 24 hours from the date of receipt of the emergency message, it begins to clarify the circumstances and causes of the disease, upon clarification of which it compiles a sanitary and hygienic description of the employee’s working conditions (in a form approved by the Ministry of Health of Russia) and sends it to the state or municipal health care institution at the place of residence or at the employee’s place of attachment (health care institution).

If the employer (his representative) disagrees with the content of the sanitary and hygienic characteristics of the employee’s working conditions, he has the right to set out his objections in writing and attach them to the characteristics.

Final diagnosis:

A health care institution, based on clinical data of the employee’s health status and sanitary and hygienic characteristics of his working conditions: establishes a final diagnosis and draws up a medical report.

The diagnosis of an acute occupational disease (poisoning) can be established taking into account the conclusion of specialists from the occupational pathology center (Order of the Ministry of Health of Russia No. 405, Appendix 2, paragraph 5).

Chronic occupational disease (poisoning), including one that occurs long after cessation of work in contact with harmful substances or production factors.

Preliminary diagnosis:

If signs of an occupational disease are detected in an employee during a medical examination (when visiting a doctor), the health care institution sends:

notification of an employee’s occupational disease within 3 days to the State Sanitary and Epidemiological Surveillance Center;

the patient to the center of occupational pathology within a month for a special examination in order to clarify the diagnosis and establish a connection between the disease and professional activity;

the patient must have the following documents:

extract from the patient's medical record;

information about the results of preliminary and periodic medical examinations;

sanitary and hygienic characteristics of working conditions;

a copy of the work book.

The Center for State Sanitary and Epidemiological Supervision, within 2 weeks from the date of receipt of a notice of an occupational disease, submits to the health care institution a sanitary and hygienic description of the working conditions of the employee.

Final diagnosis:

Center for Occupational Pathology:

establishes a final diagnosis;

draws up a medical report;

sends a corresponding notice within 3 days:

to the Center for State Sanitary and Epidemiological Surveillance;

employer;

to the insurer;

to the health care institution that referred the patient.

Medical report on the presence of an occupational disease:

issued to the employee against receipt;

sent to the insurer;

sent to the health care institution that referred the patient.

Determining the degree of loss of professional ability to work as a percentage is entrusted to the medical and social expert commissions (MSEC) of the constituent entities of the Russian Federation.

Recognition of a disease as a professional does not always mean a disability. In the case of initial and mild forms of occupational diseases, recommendations on the need to stop working in specific production conditions and rational employment without reducing qualifications and earnings can be given in the conclusion on working capacity.

The established diagnosis - acute or chronic occupational disease (poisoning) can be changed (cancelled) by the center of occupational pathology based on the results of additional studies and examination.

Consideration of particularly difficult cases is entrusted to the Center for Occupational Pathology of the Ministry of Health of Russia.

A notice of change (cancellation) of the diagnosis of an occupational disease is sent by the center of occupational pathology within 7 days after the decision is made:

employer;

to a health care institution;

Working conditions differ at different enterprises. Some officially classify them as dangerous and harmful. However, a person can get an occupational disease at work even if the attestation commission recognized his place as harmless. At the legislative level, benefits and preferences are established for victims.

What is an occupational disease

The definition of an occupational disease is given in the 3rd paragraph of Law No. 125-FZ. This is recognized as an illness caused by exposure of a worker to harmful production factors. Moreover, as a result of the course of the disease, a persistent disorder of the victim’s health occurred, and loss (full or partial) of ability to work.

There are two main types of occupational diseases:

Chronic. It is caused by long-term exposure to harmful industrial factors.
Acute - a fleeting effect on the body with negative consequences.

Attention: each case is subject to a thorough medical investigation. An illness is classified as occupational only after being studied by several specialists.

Damage to the respiratory system of welders is considered chronic. They arise due to constant contact of the respiratory tract with specialized aerosols containing nickel, iron, silicon, aluminum, titanium, copper and others.
Radiation sickness is considered acute. It occurs when a person is exposed to radiation for a short period of time.

For information: the investigation into the circumstances of the occurrence of an occupational illness is entrusted to two parties:

medicine;
employer.

Register of occupational diseases

In 2012, the Ministry of Health and Social Development approved the classifier of occupational diseases (Order No. 417 of April 27). The document lists diseases with the corresponding official characteristics:

disease code;
reasons for occurrence:
- name of the harmful factor;
- his code.

All diseases in the order of the Ministry of Health and Social Development are grouped into four sections. They are associated with the main factor of adverse effects on the human body. Namely:

Chemical influence, including causing various types of poisoning.
Physical working conditions causing potential disability.
Adverse biological effects on humans.
Physical activity leading to persistent changes in the functions of organs and systems of the body.

Hint: the register of occupational diseases is constantly updated and revised. You can get acquainted with the full version for the current date on the official website of the Ministry of Health and Social and Labor Development.

The procedure for classifying a disease as an occupational one is contained in government decree No. 967 of December 15, 2000.

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Classification of occupational illnesses

As such, a complete and unchangeable register of occupational illnesses does not exist. It is customary to use the indicative grouping given in Order 417.

At the same time, doctors divide diseases into two more subgroups:

Actually professional. This includes diseases, the cause of which is not in doubt. It is related to production conditions and the specifics of the patient’s specialty. For example, silicosis is caused by silica dust, and intoxication occurs due to inhalation of industrial poisons.
Common ailments, the clinical picture of which changes for the worse under the influence of the situation at work. For example, health workers can get tuberculosis, this will be recognized as an occupational disease. And rural workers often suffer from bronchial asthma. The disease is caused by chemicals with which the latter have to come into contact.

Based on the factors influencing the disease, they are divided into the following groups:

Nature of harmful impact	Examples
Chemical	Acute and chronic intoxication; skin diseases and allergies; neoplasms
Dust factor	Silicosis; silicatoses; metalloconiosis; anthracosis; pneumoconiosis;
Physical impact	hearing loss; vibration disease; radiation sickness; frostbite
Overstrain of individual organs and systems	Myofasciitis; polyneuritis; radiculoneuritis; asthenopia; myopia
Biological harmful effects (fungi, antibiotics, etc.)	Dysbacteriosis; cutaneous candidiasis; brucellosis; anthrax

Attention: the given classifications are relative. They are used as examples, not guidelines.

Process of investigation of acute occupational illness

Assigning an illness to a professional category is a complex process in which:

a medical facility represented by a local doctor (as a rule);
enterprise administration;
Social Accident Insurance Fund;
others (in some situations).

The patient himself initiates the process. Its tasks include the following:

consult a doctor with health complaints;
explain the possible cause of the disease;
tell in detail about the conditions for performing job duties, including with previous employers.

Further actions depend on the doctor's decision. If factors confirming an occupational illness are identified, the doctor is obliged to notify the state sanitary and epidemiological inspection agency about the incident:

within 24 hours if the form is acute;
three days in advance, if chronic.

Sanitary and epidemiological inspection specialists will organize an inspection of the victim’s place of work. To do this, perform the following actions:

a job evaluation report and other documentation are requested;
the situation is analyzed by visiting the production workshop;
the final analysis is sent to the medical institution.

Hint: the methodology for conducting events is contained in government decree No. 967 of December 15, 2000.

The medical institution analyzes the information received and draws up a final conclusion. The document is issued to the patient against signature, and is also sent to:

to sanitary and epidemiological supervision (for reporting);
to the Accident Insurance Fund;
to the employer.

The investigation into the causes and conditions of occurrence of an occupational illness is carried out on a commission basis. The collegial body, created by an administrative document of an official of the enterprise, is headed by the chief physician of the medical institution in which the patient is being observed (download the order form for the formation of the commission). The responsibilities of the collegial body include:

study of relevant documentation;
examination of the working conditions of the sick person;
interviewing witnesses;
obtaining other necessary information;
preparation of the final act, including:
- identification of perpetrators (if any);
- providing recommendations to eliminate the causes of damage to the body.

Important: the administration of the enterprise is obliged to provide all documentation, including archival documentation, and provide comprehensive assistance to the members of the commission.

To draw up the final act, it is necessary to collect the following documentation:

administrative document of the head of the enterprise on the formation of the commission (order, as a rule);
sanitary and hygienic characteristics of the victim’s place of service, including archival ones;
medical certificate about the condition of the victim’s body;
extracts from occupational safety and health magazines with the signature of the worker stating that he was instructed;
copies of notes on the issuance of safety equipment to the employee;
survey protocols:
- sick;
- witnesses and colleagues;
- responsible persons;
expert opinions of specialized specialists;
medical report on the degree of injury to the worker;
otherwise at the discretion of the commission members.

Important: the listed documents are stitched into a single file. Its shelf life is determined to be 75 years.

The final act must necessarily reflect the commission’s opinion about the guilt of the victim in the situation. This must be agreed upon with representatives of the trade union organization. If it is determined that the sick person is completely at fault, then he is not entitled to benefits and payments from the Social Insurance Fund.

Occupational sickness benefits

The Social Insurance Fund finances the worker’s disability through the employer (paragraph 184 of the Labor Code). A person is entitled to a variety of payments, the types of which are directly related to the condition of his body. The legislation does not provide a specific list of benefits. The regulations establish the boundaries of what is mandatory.

They are shown in the table:

Hint: a person who has been classified as disabled due to an occupational disease can count on pension benefits:

insurance subject to the following conditions:
- having 9 years of work experience (in 2018);
- accumulation in an insurance account (in the Pension Fund) of at least 13.8 points;
social in other situations.

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Determination of an occupational disease after dismissal

Russian legislation takes into account the medical fact that harmful effects can be detected after a long period of time. Therefore, in regulations, the investigation of the causes and conditions of occurrence of occupational illnesses is assigned to the employer in any situation:

if the sick person works;
if you got a job at another enterprise (opened a business);
if you become unemployed.

The procedure for organizing events does not depend on the connection of the sick person with the enterprise at the time of detection of disturbances in the functioning of the body. The patient is obliged to tell the doctor about harmful factors, even if he was exposed to them many years ago.

Attention: an employer’s refusal to organize an investigation based on the dismissal of an employee is a violation of the law.

Benefits for victims

At the legislative level, additional preferences are provided for affected workers. Thus, the employer is obliged:

Provide the victim with another workplace if there are medical indications. This is documented in a separate personnel order.
Provide the worker with additional leave annually in the amount established by the paragraphs of the Labor Code.
As a matter of priority, provide him with a free wellness voucher if there are medical indications.

The voucher is provided at the expense of the Social Insurance Fund. In addition, the victim can count on compensation for travel costs to the place of recovery and back (once a year). Money is allocated through social security authorities upon the initiative application of the beneficiary.

The law does not prohibit the establishment of other measures at the enterprise to support people suffering from occupational illnesses. They are usually included in the collective agreement. An approximate list of additional preferences may look like this:

allocation of additional days of rest;
establishment of shortened working hours while maintaining salary;
payment of financial assistance;
regular compensation of costs for disease prevention and treatment;
payment for the services of a rare or expensive specialist;
provision of food and more.

Hint: large organizations provide sick employees with wellness packages from their own funds.

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Occupational diseases appear as a result of long-term work in hazardous conditions. They involve temporary or permanent loss of ability to work. The employer is obliged to pay compensation to employees at a high risk of occupational diseases.

Concept and types of occupational diseases

The definition of an occupational disease is set out in Federal Law No. 125 of June 24, 1998. This is a disease, the occurrence of which is provoked by harmful working conditions. Occupational diseases are divided into a number of categories:

Acute. Formed as a result of short-term harmful influence. If work-related injuries and illnesses of this kind occur, the employer is responsible for transporting the person to a medical facility. This obligation is stipulated in Article 223 of the Labor Code of the Russian Federation. What are acute occupational diseases? For example, it could be poisoning.
Chronic. Formed due to prolonged exposure to harmful factors. One of the signs of such a disease is its protracted nature.

In the acute form of the disease, it is easier to prove its connection with harmful production factors. For example, there was a release of harmful substances at the enterprise, and an employee was poisoned. The cause-and-effect relationship is obvious. It is a little more difficult to prove a similar connection in a chronic disease.

IMPORTANT! An occupational disease is recognized only as an ailment resulting from exposure to a harmful factor. This is an impact within the framework of production, due to which the employee lost his ability to work (according to Article 209 of the Labor Code of the Russian Federation).

Let's look at examples of occupational diseases:

Varicose veins
Allergic bronchitis.
Asthma.
Eczema.
Gastritis.
Deterioration of visual acuity.

The most common ailments of workers, according to international statistics:

Musculoskeletal deformities (40%).
Cardiovascular diseases (16%).
Airway-related disorders (9%).

Often workers who constantly interact with aggressive substances develop dermatological diseases.

What causes occupational diseases?

The risk of occupational disease arises under the influence of such conditions as:

Mediocre organization of production processes.
Technical backwardness of production.
Ignoring sanitary and hygienic standards.
Features of the climate.
Economic forces.

Almost every negative condition can be reduced.

How to confirm an occupational disease?

In case of occupational diseases, compensation is provided. However, in order to receive them, the employee must confirm that his illness is related specifically to production factors. Finding the appropriate cause-and-effect relationship is the task of the medical authority. This process should be started by the head of the medical institution where the worker is observed. The establishment of an occupational disease is carried out in the following order:

The head of the clinic sends a notification with the primary diagnosis to the sanitary and epidemiological supervision. There are established deadlines for sending notifications: one day for an acute form of the disease, 3 days for a chronic form. All the nuances of filling out the paper are established by order of the Ministry of Health No. 176 of May 28, 2001.
The sanitary and epidemiological supervision must become familiar with the person’s working conditions and characterize them. The document is drawn up in accordance with the standards established by Order of the Ministry of Health No. 176.
If it is an acute illness, the final diagnosis can be made by the clinic. A sanitary and hygienic characteristic is drawn up, after which an appropriate conclusion is issued. If this is a chronic disease, you need to undergo additional examination.
The conclusion can be obtained from the Center for Occupational Pathologies. It is drawn up after examining the person and reviewing the available documents. To apply to the Center, you will need an appropriate referral, work record, characteristics of production factors given by supervision, and an extract from the outpatient card. You will also need the results of regular inspections.

The conclusion is issued urgently if the following circumstances exist:

One-time influence of the production factor.
Sudden onset of acute pathology (for example, severe poisoning).
Symptoms persist throughout the entire shift.
The result of the attack is loss of ability to work.

The FSS Letter dated April 29, 2005 states that the examination process must confirm the direct connection between the disease and working conditions. An insured event occurs only when a pathology occurs due to a contradiction between existing production factors and hygienic standards.

IMPORTANT! To receive insurance, the employee must request benefits within six months from the onset of the pathology.

ATTENTION! The FSS has provided clarification on what is considered an insured event. This is any fact of occupational disease. If an occupational pathology is discovered, but the fund does not pay the insurance, citing the need for additional examinations, you need to contact the judicial authority for an appeal.

What to do if the employer does not issue a certificate?

To obtain insurance, a person must provide an occupational pathology certificate. It is issued by the employer after investigating the circumstances of the illness. If the employer refuses to issue a certificate, the worker can go to court.

Payments to employees for occupational diseases

In case of professional pathologies, the following compensations are provided:

Payments for temporary disability.
One-time payments upon diagnosis of pathology.
Monthly compensation for persons with loss of ability to work.

Payments are made by FSS resources. The amount of compensation can vary significantly. Let's look at the maximum payments recorded in 2016:

About 90,500 rubles (one-time compensation).
Approximately 70,000 rubles (monthly payment).

The maximum amount of payments is set annually by the Social Insurance Fund. In 2017, the maximum monthly benefit is 71,000 rubles, and the one-time benefit is 92,339 rubles. When calculating a specific amount, the employee’s earnings, which he stopped receiving due to pathology, are taken into account.

The Social Insurance Fund also compensates the injured person’s expenses for treatment:

Purchasing medicines.
Payment for paid care, if necessary.
Rehabilitation in sanatorium conditions.
Manufacturing and repair of prostheses.

These payments are made only with the decision of the Social Insurance Fund. They are preceded by checking the necessity of all treatment measures taken.

Compensations are also made in case of death caused by production factors. In the latter situation, the employee’s relatives receive payments.

Accounting entries

Let's look at the entries that are used to reflect payments to persons affected by occupational diseases:

DT20 KT69.1.2. Accounting for contributions to funds for professional pathologies.
DT69.1.2. KT70. Calculation of the amount to pay compensation to the employee.
DT79 KT51. Transfer of the amount for payment of compensation.

All transactions must be confirmed by primary documentation. For example, this could be an accident at work, a payment order.

There are a number of diseases that are in one way or another related to the professional activities of citizens. These include illnesses or accidents that result in a person temporarily or permanently losing their ability to work. Kinds occupational diseases are associated with the influence of harmful occupational factors, such as:

The above factors directly or indirectly affect the health of citizens. In this regard, a law was passed obliging citizens to insure against accidents and employers to pay compensation. Depending on the factors, a general classification of diseases is distinguished.

Types of occupational diseases

Respiratory diseases. These include bronchitis and asthma. Diseases are associated with such professional activities as the production of chemicals, synthetic products, and phytoproducts. Activities in enterprises associated with dust of various types are especially dangerous;
Diseases of the musculoskeletal system, such as chondrosis, spinal curvature. They often occur in people whose activities involve standing on their feet for a long time or, conversely, “sedentary” work, as well as heavy lifting. This category includes hairdressers, office workers, loaders, etc.;
Diseases of the gastrointestinal tract (GIT). The most common gastritis, ulcers, colitis. Associated with eating disorders. Office employees are especially susceptible to these diseases. Often people refuse breakfast, and at work they try to snack on sweets, cookies, and drink coffee. Lack of adequate nutrition to maintain normal metabolism leads to gastrointestinal diseases;
Skin diseases such as dermatitis, eczema. Associated with work where there is contact with substances that damage the skin, fuels and lubricants, medications, dry herbal products;
Workplace injuries. These are burns, frostbite, wounds of varying degrees, fractures, injuries.

Professional diseases can cause disability of citizens. Workplace injuries that result in permanent disability require the business to pay compensation to the employee.

List of occupational diseases

Diseases, associated with chronic intoxication:

acute alcohol poisoning;
petroleum product poisoning;
benzene poisoning;
gas poisoning;
acid poisoning;
alkali poisoning;
metal poisoning.

Diseases, associated with allergic reactions:

allergic rhinitis, sinusitis, laryngitis, etc.;
contact urticaria;
bronchial asthma.

Diseases, associated with effects on the respiratory system:

Chronical bronchitis;
obstructive pulmonary disease;
pneumoconiosis, etc.

Diseases, related to industrial vibration.
Diseases, associated with biological factors.

This is just a small list of occupational diseases. If the diagnosis is confirmed, the employee has the right to receive rehabilitation at the expense of the employer. Due to this the list of occupational diseases is periodically updated.

List of occupational diseases

It includes those diseases that caused by biological, chemical, physical factors, industrial production. Diseases that are obtained as a result of physical exertion and overexertion are also included in this list.

An example could be:

toxic anemia, hepatitis;
radiation sickness, lesions;
radiculitis, diseases of the nervous system.

The list of occupational diseases is a document with which you can confirm the diagnosis. Based on his the commission issues a verdict of incapacity for work.

TO occupational diseases include those diseases that are closely related to the impact of production factors, as well as various other diseases, the course of which is aggravated under the influence of occupational hazards.

Thanks to tireless concern for the health of the people, a large scale of recreational activities, including a whole range of scientific, technical, social, hygienic and medical measures, working and living conditions, and the sanitary state of the environment have significantly improved in our country. However, occupational diseases still remain relevant today.

In modern enterprises occupational diseases develop either due to insufficient or untimely implementation of hygienic measures, or as a result of the impact of unforeseen little-studied factors.

A modern person is faced with occupational diseases not only in the process of work. It is affected by a complex of other negative factors common to all. These include: certain pollution and gas contamination of the surrounding atmosphere, lack of mobility of people, overeating, hidden vitamin deficiency. All of them can be the background for the formation of a pathological condition in which occupational hazards play a leading role.

Some general diseases are more common than usual in certain production conditions. For example, hypertension, coronary heart disease and peptic ulcer disease are observed much more often in people of certain professions. Occupational pathologists were faced with the task of diagnosing subtle manifestations of the disease with layers of nonspecific (general) influences. That is why the work of an occupational pathologist is not always made easier by knowing the possible cause of an occupational disease.

Occupational diseases are part of general clinical disciplines, and their knowledge should be coupled with awareness in other medical disciplines. Physicians of various specialties also have to deal with issues of the impact of industrial environmental factors on the body. In this regard, they need to navigate issues of occupational pathology.

The condition of the workers is closely monitored. Preliminary medical examinations are of great importance. Their purpose is to identify deviations in the state of health of a worker that contribute to an occupational disease. At the same time, it is desirable to pay attention not only to the presence of a disease in a person, but also to a possible predisposition to the negative influence of one or another production factor.

Workers who come into contact with occupational hazards undergo regular medical examinations in order to detect early signs of the disease. Diagnosis is often difficult due to the brightness and specificity lost by occupational diseases. Occupational disease is often diagnosed by microsymptoms, which are difficult to detect.

The classification of occupational diseases is based on their direct relationship with occupational hazards (, chemical, physical factors, etc.).

The most common occupational diseases.