In adult patients, the need for fluorography is a concern due to the presence of a certain dose of radiation.
The Federal Law of November 21, 2011 “On the fundamentals of protecting the health of citizens in the Russian Federation” prescribes the need for working citizens to undergo FLG in order to prevent and control dangerous infectious diseases. Therefore, you need to clearly understand when to do fluorography according to the law, and when you can refuse it.
Law of the Russian Federation on the need for fluorography
Law No. 77 of 2001 “On the Prevention of Tuberculosis in the Russian Federation” is often mistakenly considered to be a regulatory document.
In fact, the document does not contain information about undergoing fluorographic examination for the purpose of preventing respiratory tract diseases. In the Russian Federation, since 2012, another regulatory act has been in force under number 1011N “Procedure for conducting a medical examination.” The law is aimed at diagnosing respiratory pathologies as early as possible and prescribes testing for persons over 18 years of age, 1 rad (10 mSV) every two years.
When to get diagnosed
The legislation of the Russian Federation requires the passage of fluorography as a mandatory diagnostic measure during a preventive medical examination.
Patients who have documentary evidence of completing the study within the last 12 months are exempt from the study.
Fluorography may not be necessary if you have up-to-date information about pulmonary fluoroscopy, pulmonary radiography, or MRI.
The safest diagnostic method
The requirements specified in the regulatory act may be changed individually or in the event of the development of an extremely unfavorable epidemiological situation. In addition, fluorography is a mandatory health insurance procedure.
Today, another regulatory act is being developed, which will provide for the procedure and timing of medical examinations for the timely detection of tuberculosis. Presumably, the law will come into force in 2021 and will replace document No. 77 of 2001.
Why do people want to refuse fluorography?
Regular chest examination is due to concern for both your own health and the health of others. But more and more often people are wondering whether the procedure is mandatory, and whether it is possible to refuse fluorography.
The most common reason for failure is the radiation dose received during the procedure. We receive small doses of radiation every day, even from air, water, buildings and structures, lighting fixtures, vehicles, household appliances, electronics and air travel. The majority of those who wrote a refusal from fluorography consider additional radiation dangerous.
Opponents argue that the impact of harmful radiation during fluorography is minimal and does not affect human health in any way, and its effect is equivalent to a week-long vacation spent in a warm country.
Frequency of fluorographic examination
According to the law of the Russian Federation, the working population is required to undergo a study at least once a year.
Based on the results, a conclusion is issued, which is required upon admission to an educational institution and military service, upon employment, and treatment in an inpatient department.
There is another category of the population that is required to undergo fluorographic diagnostics in an intensive mode, usually every six months. This group includes:
- medical personnel;
- mining workers;
- employees of hazardous production.
Undergoing fluorography several times a year is considered a justified preventive measure, since the chance of developing pulmonary pathologies in this group is high.
Refusal of fluorography - is it possible in principle?
According to Russian legislation, every citizen has the right to medical care and to work. At the same time, every citizen has the right to independently make decisions about how and when he wants to use the services of medical institutions. And every employer is obliged to comply with labor protection requirements, as well as sanitary and epidemiological safety. In principle, each of these theses sounds quite logical, unambiguous and understandable.
However, trying to combine them at the same time can lead to a bit of conflict. Imagine the situation - the employer is obliged to ensure sanitary and epidemiological safety, including by guaranteeing visitors and clients that its employees have been vaccinated. And employees themselves have the right to write a refusal to be vaccinated at work. This is one of the most common problem cases, about which you can read in more detail in a separate article. But such ambiguous situations occur not only in matters related to vaccinations.
Thus, an employer may often require employees to undergo a medical examination, and almost always such an examination also includes the employee undergoing a fluorography or chest x-ray. This requirement is provided for by the need to primarily prevent tuberculosis, but it also makes it possible to identify malignant tumors and a number of other respiratory diseases in the early stages.
At the same time, each employee has the right to independently manage his own health and decide what kind of medical services he wants to receive and when. Now many people consider fluorography to be harmful - after all, during it, a person receives a certain dose of radiation, which can be fraught with various other health problems if exposure standards are exceeded. This is why fluorography is not performed too often.
How to refuse examination legally
If you wish to refuse to undergo a fluorographic examination, you must write an application addressed to the head physician of the medical institution and obtain permission.
If desired, diagnostics can be voluntarily replaced by digital fluorography, which reduces radiation exposure. Thus, film fluorography involves exposure to 0.3-0.5 mSV per session, and digital fluorography - up to 0.05 mSV.
For comparison: the natural background of Moscow is 0.02 mSV. Therefore, diagnostics using a digital device is harmless.
How to refuse a test if your employer forces you to take it? Only certain groups of people are required to undergo the study. When starting a job, the employer may require a report from a radiologist for safety reasons. In this case, fluorography can be replaced with gentle diagnostic methods.
Tuberculosis used to be a terrible disease that could not be cured even in the first half of the twentieth century. Today, disease control is possible with the help of fluorography, the diagnostic benefits of which are obvious. Diagnostics are recommended once a year, however, this is not true.
Annual examination is prescribed only to certain groups of people. Therefore, when undergoing a routine examination, find out in detail from your doctor about the importance of diagnostics, specifically in your case. But you shouldn’t refuse the prescribed fluorography. The specialist knows better whether an examination is necessary in this case or not.
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LLC "NTVP "Kedr - Consultant" » Services » Legal consultations » Labor disputes » Can the lack of FLG examination data (fluorography) be a basis for removal from work?
Questions
Can the lack of FLG examination data (fluorography) be grounds for removal from work?
When applying for a job, is it sufficient for the applicant to provide only a conclusion based on the results of a preliminary medical examination, or does the employer have the right to demand a copy of his personal medical record?
Lawyer's answer
The employer is obliged to remove anyone who has not passed a medical examination or has contraindications to work. Practice shows that it is also possible to exclude an employee from work who:
— refused a medical examination due to the fact that the harmful working conditions identified as a result of a special assessment were not recorded in the employment contract;
— did not complete the examination (for example, passed all the tests except fluorography);
— underwent a medical examination in a medical organization other than the one with which the employer entered into an agreement.
An employee should not be suspended if:
- he did not undergo a medical examination due to the fact that he was not given a referral;
— there are errors in the medical report (for example, there is no signature of the chairman of the medical commission);
— the identified contraindications do not interfere with the performance of the job.
Review: “Practice to help: what to consider when organizing medical examinations of employees” (ConsultantPlus, 2019) {ConsultantPlus}
Article 65 of the Labor Code of the Russian Federation contains a list of documents presented when concluding an employment contract.
In some cases, taking into account the specifics of the work, when concluding an employment contract, it is necessary to present additional documents, in particular (Parts 3, 4 of Article 63, Articles 213, 283, 324, 327.3 of the Labor Code of the Russian Federation; Article 2, paragraph 4 of Art. 13, paragraph 1 of Article 13.3 of the Law of July 25, 2002 N 115-FZ; Order of the Ministry of Health and Social Development of Russia of April 12, 2011 N 302n; Decree of the Government of the Russian Federation of July 22, 2013 N 613):
1) a medical report upon entry to work, during which mandatory medical examinations (examinations) of employees are carried out;
Situation: What documents may be required when applying for a job? (“Electronic magazine “ABC of Law”, 2020) {ConsultantPlus}
The form of the document that is issued based on the results of a preliminary medical examination depends on the category of citizens sent for this examination. For example, for people entering work at the age of 15-17 years, such a document is a certificate in form N 086/u, which is approved by Order of the Ministry of Health of Russia dated December 15, 2014 N 834n. This follows from clauses 1, 2.4, 2.5 of the Procedure for filling out accounting form N 086/у, approved by the said Order. Upon completion of the preliminary examination by the persons specified in clause 1 of the Procedure for conducting medical examinations (approved by Order of the Ministry of Health and Social Development of Russia dated April 12, 2011 N 302n), a medical report is issued, drawn up in accordance with clauses 12 - 14 of this Procedure.
Data on medical examinations are reflected in the personal medical record. This follows from paragraph 5 of Art. 34 of the Federal Law of March 30, 1999 N 52-FZ.
Personal medical records are issued, in particular, to persons who enter work related to the production, storage, transportation and sale of food and drinking water, raising and educating children, public utilities and consumer services. This conclusion follows from the analysis of clause 1.1 of Rospotrebnadzor Order No. 402 dated May 20, 2005 and the contents of the personal medical record form, which is approved by the said Order.
When applying for a job, these persons must present a personal medical record to the employer. This conclusion was made on the basis of the data contained on page 30 of the said form of the personal medical record book, according to which such a record book is subject to storage by the employer. Additional clarifications about the personal medical record are contained in the letter of Rospotrebnadzor dated November 10, 2015 N 01/13734-15-32.
Guide to HR issues. How to hire {ConsultantPlus}
Based on the above, we believe that it is possible not to allow an employee to work who has not passed the examination completely (for example, he has passed all the tests except fluorography). Also, the employee is obliged to provide the employer with a medical report upon starting a job, during which mandatory medical examinations (examinations) of employees and a personal medical record are carried out.
Selection of documents (see appendix):
Question: ...The applicant for the position underwent an examination a month before employment and presented a medical record to the employer with a record of passing all the necessary doctors for this category of workers. Does the employer have the right not to send for a preliminary examination? Is a medical record a basis for employment? (“Website “Onlineinspection.RF”, 2019) {ConsultantPlus}
The explanation was given by Igor Borisovich Makshakov, legal consultant of LLC NTVP Kedr-Consultant, July 2020.
When preparing the answer, SPS ConsultantPlus was used
This clarification is not official and does not entail legal consequences; it is provided in accordance with the Regulations of the CONSULTATION LINE ().
