Nahorna A. M.1 , Kononova I. G.1, Grechkovskaya N. V.2
1SI «Institute for Occupational Health of NAMS of Ukraine», Kyiv
2National Medical Academy for Post-graduate Education named after P. L. Shupik, Kyiv
Introduction. Medical examinations of workers, working in harmful and dangerous conditions, in particular, is a significant part of the system of occupational care, directed at detection and prevention of occupational and work-related diseases. The reform of the health system as the whole and the State sanitary-epidemiological service (SSES) in particular, has negatively affected the quality of medical care of workers. The SESS was practically removed from the control of organization and qual-ity of medical examinations, which resulted in infringement of the established interrelations with occupational pathologists. Purpose. To define the role and place of SESS of Ukraine in organization and control of medical examinations of workers, involved in harmful and dangerous conditions, and to specify ways of improving the system of conduction of medical exami-nations of workers of selected categories in the modern period.
Material and methods. The process of conduction preventive medical examinations of workers of selected categories in Ukraine according to the «Operating data on the results of periodic medical examinations», regulated by the Order of Ministry of Health of Ukraine № 246-07 and the information of the territorial administrations of SSES, proposals for making changes and amendments to the acting procedure, applied to SSES of Ukraine. The presented materials is the result of the analysis of legislative, regulative acts on reforming SSES in Ukraine, reports and information-analytical materials on organizing the supervision, directed at detection of peculiarities and problems in organization and conducting medical examinations at sub-jects of the supervision in the modern period in comparison with the previous 2009—2013 years.
Results. At the present time, when industrial medicine in the country has been almost destroyed, the procedure of medical care of workers, involved in harmful and dangerous conditions, is not preciously identified. Such categories of workers are available not only at industrial enterprises, but, also, in food, communal facilities, medical establishments, etc. In 2013 medical examinations were performed by 1091 medical commissions, from which almost 90 % act on the base of state medi-cal institutions. 253 checks on the assessment of their activity, due to their keeping to the Order of Ministry of Health № 246-07 have been made (23,2 % of them with participation of SSES and occupational pathologists — 52 commissions). Conclusion. The part and place of SSES of Ukraine in the modern period have been changed, resulting in the reduction of the number of workers in SSES, in the change of organization of its activity, dis-coordination with occupational pathologists and employers. The results of the analysis of periodical medical examinations of individuals, working in harmful and dangerous conditions in 2013, showed the infringement in the system of the control on the part of the SSES by medical commissions and, also, organization of medical examinations and execution of medical recommendations in facilities.
Key words: medical examinations, workers, harmful and dangerous work conditions, medical commissions, prevention, occupational pathologists