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 MDSpeaker: Ferenc Kudász MD

THE 5th ENWHP CONFERENCE - 19th-20th June 2006 - Healthy Work in an Ageing Europe

Occupational Health and SafetyConstitutionRule No 33 of 1993 on Occupational Health and Safety (Labour Safety Act)

Decree No 33 of the Minister of Welfare in 1998 on fitness-for-job examination

Amendment made in 2000 concerning vulnerable groups

Harmonised to Council Directive 89/391 EEC on the introduction of measures to encourage improvements in the safety and health of workers at work

Everyone in organised work: cca. 2.3 million employees

Over 2 million medical examinations in 2004

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

Addition: protection of ageing 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

workerSpecial 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 pre-employment, 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

Personal capabilities

Workplace conditions, hazards

Workload

Diseases Social environment

Properties of work

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