Download Amendment of Decree No 33 of the Minister of Welfare in

THE 5th ENWHP CONFERENCE - 19th-20th June 2006 - Healthy Work in an Ageing Europe
Amendment of Decree No 33 of
the Minister of Welfare in 1998
on fitness-for-job examination in
2000
concerning vulnerable groups
National Institute of Occupational Health,
Hungary
Director: Antal Tettinger MD
Speaker: Ferenc Kudász MD
Occupational Health and Safety
Constitution
Rule No 33 of 1993 on Occupational
Health and Safety (Labour Safety Act)
Everyone in organised work:
cca. 2.3 million employees
Decree No 33 of the Minister of Welfare in
1998 on fitness-for-job examination
Harmonised to Council
Directive 89/391 EEC on the
introduction of measures to
encourage improvements in
the safety and health of
workers at work
Over 2 million medical
examinations in 2004
Amendment made in 2000
concerning vulnerable groups
Addition: protection of
ageing people at work
Harmonised to Council
Directive 92/85/EEC on
…safety and health at work of
pregnant workers and workers
who have recently given birth
or are breastfeeding and
Directive 94/33/EC on the
protection of young people at
work
Annual medical health checks for
ageing workers
• The pre-employment medical examination is obligatory
for every employee in every age-group
• The periodic medical examination is obligatory for certain
employees (e.g. working with carcinogenic substances)
• The amendation concerned stipulates at least annual
fitness-for-job examination for all ageing workers
• Ageing workers:
above the retirement age limit relative to the worker
Special attention to females:
groups under and over 45 are distinct
Fitness-for-job examination
• Employer obliged to run or hire
occupational medical service
• Employer sends employees to preemployment, periodical, fitness-for-duty
and termination examinations with brief
description of hazards of workplace
• Occupational physician has to know
thoroughly real-life on-site workplace
conditions
Scope of occupational medical
examination
Diseases
Social
environment
Workplace conditions, hazards
Properties of
work
Personal
capabilities
Workload
Work
stress
Optimal
Underload
Overload
Adaptation of
work to employee
Ageing of the body
• The ageing of the human body results
couple of changes that alter body
reactions, capacities
• Physical working capacity is usually
decreasing
• Sensorial functions and reactions are
weakening and slowing
• Metabolism is slowing
Legal provisions
• In case of employing ageing workers
• 10/B. § declares
– Special attention is to be made at the fitness-for-job
examination concerning that ageing workers are not
fit or fit with restrictions to work in certain workplaces
with hazards and conditions listed in appendix No 8 of
the amendment of Decree No 33 of the Minister of
Welfare in 1998 on fitness-for-job examination in
2000
– The adaptation of work to the capabilities of the
employee has to be accentuated even stronger
Appendix No 8 of decree No 33 of
the Minister of Welfare in 1998
• The table is divided for the vulnerable
groups concerned and for hazards
Females
Males
Pregnant Young <45 >45-x >x Young >x
• ‘x’ stands for retirement age limit relative to
the worker (currently standard is 62 years)
Types of occupational medical
inhibitions and restriction to ageing
workers
• Inhibition of employment
• Restriction of load to 70%
• Detailed load-stress analysis based on the
fitness-for-job examination, workplace
ergonomic inspection
• Inhibition - except for research scuba diving like
archeologists
• Underground mining and petrol drilling
workplaces are prohibited for females except for
non-physical jobs and training sessions
Conditions and hazards
• Physical work conditions: Heavy work, Lifting > 10 kg, Work in
adverse ergonomic postures, Risk of cumulative trauma disorder
of the hands
• Mental load: Working in time press if the time for the periodic
repeating action does not excess 3 minutes and there is no
organized shift in actions, Actions with increased mental
information load or with need for special attention if it exceeds
the half of the working time
• High risk of accident: Increased health risk of the worker or
others
• Physical hazards: Heavy and medium work in heat exposition,
Alternating heat and cold workplaces, Working in wet locations,
Hand-arm vibration exceeding, Whole body vibration, Working
under hyperbaric conditions
• Chemical hazards: Production, neutralization, packing and use
of category 2.8. pesticides (including every organic phosphor
pesticides), organic solvents, quicksilver and its derivates, Indium
and its derivates, hexavalent chromium and its derivates,
antibiotics, hormones and hormone derivates
Personal decision
• In the following slides we would like to
highlight the importance of case-by-case
personal decision making that helps to
protect the health of ageing workers
meanwhile not limiting or segregating due
to their chronological age
• The aforementioned appendix helps to
identify hazards to ageing workers
Case I. Tyre manufacture
• The enterprise is owned by the multinational
tyre-maker Michelin. Before it was the biggest
Hungarian tyre and rubber manufacturer called
Taurus. Currently employing around 2000
workers in Hungary.
• The privatisation of the former state company
with the change of the Hungarian legislation
resulted more strict environmental and
occupational hygienic standards, austere
financial control and workforce downsizing with
forced retirement programmes
Repairman fit to work
• Born in 1938
• Started work in 1957 as electrician,
operational repairman (on-site repair of
machines,
heavy
physical
work,
ergonomic hazards)
• Term locksmith in job description also
appears
68 years in healthy working
• Annual medical health checks resulted ‘fit’
to work
• Last examination in March 2006 ‘fit with
glasses’
• Reasons:
healthy
expertise is highly valued
better occupational hygiene
shift from on-site to shop work
Case II. Pharmaceutical company
• Richter Gedeon is the biggest Hungarian
pharmaceutical enterprise with generic
and original products, high research
activity and factories outside Hungary too
• Renowned in steroid science, steroid
molecule supplier for many companies
around the world
Pharmaceutical manufacturer I
• Born in 1944
• Works for the company from 1960
• Intermediary substance production:
hormone exposure
• Three-monthly medical examinations
include laboratory and sex hormone level
checks
46 years in hormone exposition
• Health checks showed no significant
pathology
• After reaching retirement-age continued to
work in the same job
• Retired this year in full health
Pharmaceutical manufacturer II
• Born in 1940
• Works in the company from 1981
• Intermediary substance production
from 2000
• Three-monthly medical examinations
include laboratory and sex hormone level
checks
65 year old committed to work on
• From 2002 testosterone levels fall below
natural limits
• Treated with hypertension, type II. diabetes
mellitus
• As he felt healthy and there was no change
in other laboratory values continued to
work after reaching retirement age
• Vacancy in other plant helped to move him
to a workplace with no steroid exposure as
he is committed to work on
Conclusion
• Occupational health services are beach-heads
of health promotion in workplaces
– Regular examinations – early recognition
– Adaptation of work
– Personal case-by-case decision making
• The Appendix gives guidelines for the services
in order to help ageing workers healthy and
productive
• All these efforts are in vain unless workers are
trained lifelong in order to their experience
should be indispensable for the enterprises
• Special thanks to colleagues at the
occupational health services providing the
case studies:
– Hedvig Bajor MD
– Ádám Lénárd MD
Thank you for your attention