Sanitary and medical care for workers in accordance with labor protection requirements is assigned to the employer (Part 1 of Article 223 of the Labor Code of the Russian Federation).

The organization of sanitary services for workers is regulated by "SP 44.13330.2011. Code of rules. Administrative and domestic buildings. Updated edition of SNiP 2.09.04-87" (approved by Order of the Ministry of Regional Development of Russia dated December 27, 2010 N 782) and includes the following equipment:

Sanitary facilities;

Premises for eating;

Premises for medical care;

Rest rooms in work time and psychological relief.

At each first aid post there must be a first aid kit (Part 1 of Article 223 of the Labor Code of the Russian Federation). Its composition is determined by Order of the Ministry of Health and Social Development of Russia dated March 5, 2011 N 169n. In particular, according to the Order, the first aid kit must be equipped with means for temporarily stopping bleeding and dressing wounds, and products for performing cardiopulmonary resuscitation.

Important! The list of medical products that should be included in a first aid kit is given in the Appendix to the said Order and is exhaustive. The employer does not have the right to replace any product independently (clause 1 of the notes to the Appendix).

A practical situation. Should a medical organization have a first aid kit to provide first aid to employees?

All employers, regardless of organizational and legal forms and forms of ownership, are required to follow the provisions Labor Code RF (Part 3, Article 11 of the Labor Code of the Russian Federation).

According to Part 1 of Art. 223 of the Labor Code of the Russian Federation, each employer must organize a sanitary post with a first aid kit. At the same time, the norms of the Labor Code of the Russian Federation do not contain exceptions in relation to specific types of activities of employers.

Thus, medical organizations are required to have first aid kits for providing first aid to employees, equipped in accordance with Order of the Ministry of Health and Social Development of Russia dated March 5, 2011 N 169n.

The employer must also provide workers in hot shops and areas with carbonated salt water. The standards for such provision are provided for in the Instructions for the sanitary maintenance of premises and equipment manufacturing enterprises(approved by the USSR Ministry of Health on December 31, 1966 N 658-66). According to paragraph 118 of the said instructions, these standards are set at the rate of 4 - 5 liters per person per shift, while the salt content in water is up to 0.5 percent.

The employer is obliged to provide, at his own expense or in his own vehicle, transportation to medical organizations or to the place of residence of employees who have suffered from industrial accidents and occupational diseases, as well as for other medical reasons.

Medical care for workers includes the organization of mandatory medical examinations (Article 213.330.3 of the Labor Code of the Russian Federation), provision of free milk (or other equivalent food products) and therapeutic and preventive nutrition to persons engaged in work with harmful and especially harmful working conditions.

Do you think you are Russian? Were you born in the USSR and think that you are Russian, Ukrainian, Belarusian? No. This is wrong.

Are you actually Russian, Ukrainian or Belarusian? But do you think that you are a Jew?

Game? Wrong word. The correct word is “imprinting”.

The newborn associates himself with those facial features that he observes immediately after birth. This natural mechanism is characteristic of most living creatures with vision.

Newborns in the USSR saw their mother for a minimum of feeding time during the first few days, and most time we saw the faces of the maternity hospital staff. By a strange coincidence, they were (and still are) mostly Jewish. The technique is wild in its essence and effectiveness.

Throughout your childhood, you wondered why you lived surrounded by strangers. The rare Jews on your way could do whatever they wanted with you, because you were drawn to them, and pushed others away. Yes, even now they can.

You cannot fix this - imprinting is one-time and for life. It’s difficult to understand; the instinct took shape when you were still very far from being able to formulate it. From that moment, no words or details were preserved. Only facial features remained in the depths of memory. Those traits that you consider to be your own.

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System and observer

Let's define a system as an object whose existence is beyond doubt.

An observer of a system is an object that is not part of the system it observes, that is, it determines its existence through factors independent of the system.

The observer, from the point of view of the system, is a source of chaos - both control actions and the consequences of observational measurements that do not have a cause-and-effect relationship with the system.

An internal observer is an object potentially accessible to the system in relation to which inversion of observation and control channels is possible.

An external observer is an object, even potentially unattainable for the system, located beyond the system’s event horizon (spatial and temporal).

Hypothesis No. 1. All-seeing eye

Let's assume that our universe is a system and it has an external observer. Then observational measurements can occur, for example, with the help of “gravitational radiation” penetrating the universe from all sides from the outside. The cross section of the capture of “gravitational radiation” is proportional to the mass of the object, and the projection of the “shadow” from this capture onto another object is perceived as an attractive force. It will be proportional to the product of the masses of the objects and inversely proportional to the distance between them, which determines the density of the “shadow”.

The capture of “gravitational radiation” by an object increases its chaos and is perceived by us as the passage of time. An object opaque to “gravitational radiation”, the capture cross section of which is larger than its geometric size, looks like a black hole inside the universe.

Hypothesis No. 2. Inner Observer

It is possible that our universe is observing itself. For example, using pairs of quantum entangled particles separated in space as standards. Then the space between them is saturated with the probability of the existence of the process that generated these particles, reaching its maximum density at the intersection of the trajectories of these particles. The existence of these particles also means that there is no capture cross section on the trajectories of objects that is large enough to absorb these particles. The remaining assumptions remain the same as for the first hypothesis, except:

Time flow

An outside observation of an object approaching the event horizon of a black hole, if the determining factor of time in the universe is an “external observer,” will slow down exactly twice - the shadow of the black hole will block exactly half of the possible trajectories of “gravitational radiation.” If the determining factor is the “internal observer,” then the shadow will block the entire trajectory of interaction and the flow of time for an object falling into a black hole will completely stop for a view from the outside.

It is also possible that these hypotheses can be combined in one proportion or another.

Responsibilities legal entities and individual entrepreneurs to comply with the requirements of sanitary legislation

According to Art. eleven Federal Law“On the sanitary and epidemiological well-being of the population” individual entrepreneurs and legal entities, in accordance with the activities they carry out, are obliged to:
- comply with the requirements of sanitary legislation, as well as regulations, instructions and sanitary and epidemiological conclusions of officials carrying out state sanitary and epidemiological supervision;
- develop and carry out sanitary and anti-epidemic (preventive) measures;
- ensure the safety for human health of the work performed and services provided, as well as products for industrial and technical purposes, food products and goods for personal and household needs during their production, transportation, storage, and sale to the public;
- carry out production control, including through laboratory research and testing, for compliance with sanitary rules and carrying out sanitary and anti-epidemic (preventive) measures when performing work and providing services, as well as during the production, transportation, storage and sale of products;
- carry out work to substantiate the safety for humans of new types of products and their production technology, criteria for the safety and (or) harmlessness of environmental factors and develop methods for monitoring environmental factors;
- promptly inform the population, local government bodies, bodies exercising state sanitary and epidemiological supervision about emergency situations, production stoppages, and violations technological processes posing a threat to the sanitary and epidemiological well-being of the population;
- have officially published sanitary rules, methods and techniques for monitoring environmental factors;
- carry out hygienic training of workers.

Responsibilities of the employer to ensure sanitary rules and regulations

In accordance with Article 2 of the Federal Law “On Sanitary and Epidemiological Services to the Population”, the sanitary and epidemiological well-being of the population is ensured through: control over the implementation of sanitary and anti-epidemic (preventive) measures and mandatory compliance by citizens, individual entrepreneurs and legal entities with sanitary rules as an integral part of the activities carried out by them activities.
Organs state power and local governments, organizations of all forms of ownership, individual entrepreneurs, citizens ensure compliance with legal requirements Russian Federation in the field of ensuring the sanitary and epidemiological well-being of the population at its own expense.
In accordance with Art. 24 of the same law, when operating industrial, public premises, buildings, structures, equipment and transport, sanitary and anti-epidemic (preventive) measures must be carried out and safe working, living and recreational conditions for humans must be ensured in accordance with sanitary rules and other regulatory legal acts of the Russian Federation .
According to Art. 223 of the Labor Code of the Russian Federation, the provision of sanitary, medical and preventive services to employees of organizations in accordance with labor protection requirements is assigned to the employer. For these purposes, the organization is equipped with the following according to established standards:
- sanitary facilities;
- premises for eating;
- premises for medical care;
- rooms for rest during working hours and psychological relief;
- sanitary posts with first aid kits equipped with a set of medicines and preparations for first aid are being created;
- apparatus (devices) are installed to provide workers in hot shops and areas with carbonated salt water.

Requirements for sanitary premises

Sanitary services for workers are part of a set of labor protection measures. It should ensure protection of a person’s skin and mucous membranes from the action of harmful production factors during the shift and cease their effect after its end. These basic requirements determine the set and composition of sanitary premises and devices. Their layout, set and composition depend on their membership in the production process groups defined by SNiP 05/31/2003 " Public buildings and administrative buildings." In accordance with clause 8.1 of the said SNiP, during the design and construction of buildings, measures established by these norms and rules must be provided to ensure compliance with sanitary and epidemiological requirements for the protection of human health and the environment.
In accordance with clause 5.1 of SNiP 31-05-2003, premises in administrative buildings, as a rule, comprise the following main functional groups:
a) management offices;
b) work premises structural divisions institutions and organizations;
c) meeting rooms and (or) conference rooms;
d) premises for information and technical purposes, including: technical libraries, design rooms, archives, premises for information and computer technology, etc., depending on the design assignment;
e) entrance group of premises, including: lobby, outer vestibule, cloakroom, pass office, security room;
f) premises of social services, including: premises of enterprises Catering, medical services, sanitary facilities, living quarters for service and operational personnel, sports and fitness facilities, etc.
Sanitary premises include: dressing rooms; showers; washrooms; toilets; rest areas during working hours; rooms for washing, dry cleaning, drying, dust removal, neutralization of special clothing and shoes.
The capacity of sanitary facilities and facilities depends on the number of workers.
The composition, equipment, including the number of plumbing fixtures and the area of ​​premises of functional groups D and E, are determined taking into account the standards established in SNiP 2.08.02-89 “Public buildings and structures”.
Sanitary premises must be disinfected in accordance with established requirements.
In accordance with clause 2.5. SNiP 2.09.04-87 sanitary facilities for workers involved directly in production should be designed depending on the groups of production processes. The group of production processes is determined depending on the hazard class of the pollutants, the degree of pollution and the volume (area) of pollution (for example, only hands, or the body and work clothes).
In accordance with the following paragraphs of SNiP 2.09.04-87:
clause 2.6. In dressing rooms, the number of compartments in closets or hanger hooks for home and special clothing should be taken equal to the payroll number of workers, for street clothes - the number in two adjacent shifts;
clause 2.12. In cases where cleaning or neutralization of workwear must be carried out after each shift, instead of dressing rooms, dispensing workwear should be provided;
clause 2.13. The number of showers, washbasins and special household devices provided for by SNiP 2.09.04-87 should be taken according to the number of workers in a shift or part of this shift, simultaneously finishing work;
clause 2.14*. Showers are equipped with open shower cabins. Up to 20% of shower stalls may be closed. Shower cabins with a through passage are provided when production processes groups 1c, 3b, as well as in cases established by departmental regulatory documents;
clause 2.15*. Lavatories in multi-storey residential, administrative and industrial buildings must be on each floor. If the number of workers on two adjacent floors is 30 people or less, restrooms should be located on one of the floors with the largest number of people.
If the number of workers on three floors is less than 10 people, it is allowed to provide one restroom on three floors.
If there are disabled people with musculoskeletal disorders among the workers, restrooms should be located on each floor, regardless of the number of workers on the floors;
clause 2.16*. In latrines with more than four sanitary fixtures, one stall should be provided for the elderly and disabled. If there are disabled people with musculoskeletal disorders among the workers, a cabin for disabled people should be provided regardless of the number of sanitary fixtures in the restrooms;
clause 2.17*. A common restroom for men and women may be provided if the number of workers per shift is no more than 15 people. In those enterprises where it is possible to employ blind people, restrooms for men and women must be separate;
clause 2.18*. The entrance to the restroom should be through a vestibule with a self-closing door.
In men's restrooms, in accordance with departmental standards, it is allowed to use tray urinals with wall-mounted flushes instead of individual ones.
If there are disabled people using wheelchairs among the workers, one of the urinals in the restrooms should be located at a height of no more than 0.4 m from the floor;
clause 2.19*. The distance from workplaces in industrial buildings to restrooms, smoking rooms, rooms for heating or cooling, half-showers, drinking water supply devices should be no more than 75 m, for people with disabilities with musculoskeletal disorders and the blind - no more than 60 m, and from workers places on the enterprise site - no more than 150 m;
clause 2.20. For washing workwear, production enterprises or a group of enterprises must provide laundries with dry cleaning departments. In justified cases, the use of city laundries is allowed, provided that special departments (process lines) are installed in them for processing workwear.
The composition and area of ​​the premises for laundry, dry cleaning, restoration of impregnation and neutralization of work clothes should be established in the technological part of the project, taking into account the sanitary requirements of its processing;
clause 2.21. To neutralize workwear contaminated with non-volatile substances, it is allowed to use a separate technological line in laundries;
clause 2.22. Walls and partitions of dressing rooms for workwear, showers, pre-shower rooms, washrooms, restrooms, rooms for drying, dust removal and neutralization of workwear must be made to a height of 2 m from materials that allow them to be washed hot water using detergents. The walls and partitions of the specified premises above the 2 m mark, as well as the ceilings, must have a waterproof coating;
clause 2.23. In laundries, rooms should be provided for the repair of workwear at the rate of 9 m2 per workplace. The number of jobs should be taken at the rate of one shoe repair job and two clothing repair jobs per 1000 payroll people;
clause 2.24. In agreement with local councils trade unions it is allowed to provide a centralized warehouse of special clothing and equipment personal protection.

Requirements for drinking water supply

Water for drinking purposes must comply with the requirements of sanitary rules and regulations 2.1.4.1074-01 “Drinking water”. For workplaces remote from distribution points drinking water installed on a centralized water supply, water vessels must be provided (individual flasks or collective ones). They must undergo daily cleaning and disinfection using established methods.

Responsibility for violation of sanitary legislation requirements

According to Art. 6.3. Code of the Russian Federation “On Administrative Offenses”, violation of legislation in the field of ensuring the sanitary and epidemiological well-being of the population, expressed in violation of existing sanitary rules and hygienic standards, failure to comply with sanitary, hygienic and anti-epidemic measures, entails a warning or the imposition of an administrative fine:
- for officials - from five hundred to one thousand rubles;
- on persons carrying out entrepreneurial activity without forming a legal entity - from one hundred to five hundred rubles or administrative suspension of activities for a period of up to ninety days;
- for legal entities - from ten thousand to twenty thousand rubles or administrative suspension of activities for a period of up to ninety days.
According to Art. 6.4. Code of the Russian Federation “On Administrative Offences”, violation of sanitary and epidemiological requirements for the operation of residential premises and public premises, buildings, structures and transport entails the imposition of an administrative fine:
- for citizens - in the amount of one hundred to five hundred rubles;
- for officials - from ten to twenty minimum sizes wages;
- for persons carrying out entrepreneurial activities without forming a legal entity - from one thousand to two thousand rubles or administrative suspension of activities for a period of up to ninety days;
- for legal entities - from ten thousand to twenty thousand rubles or administrative suspension of activities for a period of up to ninety days.

New edition of Art. 223 Labor Code of the Russian Federation

Sanitary services and medical support for workers in accordance with labor protection requirements are the responsibility of the employer. For these purposes, the employer, in accordance with established standards, equips sanitary premises, premises for eating, premises for providing medical care, rooms for rest during working hours and psychological relief; first aid stations are organized, equipped with first aid kits; apparatus (devices) are installed to provide workers in hot shops and areas with carbonated salt water, and more.

Transportation to medical organizations or to the place of residence of employees affected by industrial accidents and occupational diseases, as well as for other medical reasons, is carried out using the employer’s vehicles or at his expense.

Commentary on Article 223 of the Labor Code of the Russian Federation

According to Article 223 of the Labor Code of the Russian Federation, the employer must provide sanitary, medical and preventive conditions for employees in accordance with labor protection requirements.

What does this mean? The article explains that the organization must equip sanitary facilities, premises for eating, and premises for providing medical care according to established standards. As well as rooms for relaxation during working hours and psychological relief. In addition, the enterprise creates sanitary posts with first aid kits stocked with a set of medicines, supplies and medical supplies for providing first aid.

The standards for equipping sanitary facilities and premises for providing medical care are established by the Construction Norms and Rules "Administrative and Domestic Buildings" SNiP 2.09.04-87 (approved by Decree of the USSR State Construction Committee dated December 30, 1987 N 313). So, the area of ​​the room where employees will eat is determined at the rate of 1 square. m for each visitor or 1.65 sq. m for a disabled person using a wheelchair, but not less than 12 sq. m. You also need to install a washbasin, a stationary boiler, electric stove and a refrigerator. If the number of employees of the organization is small, then it is allowed to provide an additional space of 6 square meters instead of a separate room. m to install a table for eating.

Let us add that the standards stipulate that a room for meals is equipped when the number of people working in one shift is no more than 30 people. If your organization has a larger number of employees, then a canteen is provided. If there is already a dining room, a room for meals is not equipped at the same time.

For rest rooms and psychological relief, devices for preparing and distributing special tonic drinks are provided. It's easier to say electric kettles for tea or coffee.

Many organizations also purchase heating appliances, air conditioners and fans, vacuum cleaners, etc. All this is justified, since it is fully consistent with the norms of the commented article - it helps to ensure normal conditions labor. Another question is that in order to take such costs into account when taxing profits, it is important to correctly draw up supporting documents. Therefore, buying household appliances, you need to get a cash register and sales receipts, as well as an invoice.

Let us add that a medical center can be equipped in any organization, and not where working conditions are harmful or difficult. The fact is that the requirements of the commented article must be observed regardless of the working conditions in the organization. This interpretation is also confirmed by the Resolution of the Federal Antimonopoly Service of the Volga District dated December 2, 2004 in case No. A55-5119/04-31.

Part one of Article 223 also sets out a rule according to which, in order to provide workers in hot shops and areas, apparatus (devices) with carbonated salt water are installed in the specified places. Currently, the Instruction on the sanitary maintenance of premises and equipment of industrial enterprises is still in force (approved by the Deputy Chief Sanitary Inspector of the USSR on December 31, 1966 N 658-66). It is applied to the extent that does not contradict current labor legislation (Article 423 of the Labor Code of the Russian Federation). According to the provisions of the mentioned Instructions, in hot shops, workers must receive sparkling water with a salt content of up to 0.5% and at the rate of 4 - 5 liters per person per shift. And if carbonated salt water is given to the employee in bottles, then it is not necessary to install apparatus or devices.

Another comment on Art. 223 Labor Code of the Russian Federation

1. Sanitary rules and hygienic standards are approved by the State Sanitary and Epidemiological Service of Russia and the Ministry of Health and Social Development of Russia. Organizations must be equipped with sanitary facilities, rooms for eating and providing medical care, rooms for rest during working hours and psychological relief, sanitary posts with first aid kits stocked with a set of medicines and preparations for first aid.

2. The standards for the equipment of such premises are provided by SNiP 2.09.87 “Administrative and domestic buildings”, approved by Resolution of the State Construction Committee of Russia dated March 31, 1994 N 18-23 (Labor Safety. M., 2002. P. 106 - 107). The sanitary facilities include: dressing rooms, showers, washrooms, latrines, smoking rooms, places for placing half-showers, drinking water supply devices, rooms for heating or cooling, processing, storing and issuing workwear.

Sanitary, medical and preventive services for workers must be organized by the employer in accordance with labor protection requirements. The organization of sanitary services for workers includes the construction, expansion, reconstruction and equipment of sanitary facilities, dressing rooms, showers, washrooms, toilets, smoking rooms, places for half-showers, rooms for personal hygiene of women, drinking water supply devices, rooms for heating or cooling, processing, storage and distribution of special clothing. Read more about this in the presented material.

The organization of medical and preventive services covers the construction and equipment of health care facilities for providing medical care to employees and conducting health procedures: health, first-aid posts, women's personal hygiene rooms, steam rooms, saunas, inhalators, fotariums, as well as rooms for hand and foot baths, for relaxation during working hours.

Large organizations may envisage the construction of clinics (outpatient clinics, hospitals, sanatoriums, ambulance stations and other medical care services), as well as sports and recreational buildings and facilities and equipping them with the latest equipment.

Providing sanitary, household, medical and preventive services to workers is carried out in the manner established by regulatory legal acts, collective agreements or agreements (see Articles 40 and 45 of the Labor Code of the Russian Federation).

For these purposes, the employer, in accordance with established standards must:

– provide workers with sanitary facilities, rooms for eating, providing medical care, rooms for rest during working hours and psychological relief;

– create sanitary posts with first aid kits stocked with a set of medicines and preparations for first aid;

– install apparatus (devices) to provide workers in hot shops and areas with carbonated salt water.

Standards for equipping sanitary premises and premises for providing medical care are established by the Building Codes and Rules "Administrative and Domestic Buildings" - SNiP 2.09.04-87 as amended (I-1-94, I-2-95) (hereinafter - SNiP 2.09.04-87).

According to paragraph 2.4 of SNiP 2.09.04-87, sanitary premises include dressing rooms, showers, washrooms, latrines, smoking rooms, places for half-showers, drinking water supply devices, rooms for heating or cooling, processing, storage and distribution of workwear.

In dressing rooms, storage of work clothes and home clothes can be shared or separate, in cabinets with two compartments. In multi-story buildings, toilets should be on each floor.

Premises for dry cleaning, deodorization and storage of workwear must be equipped with mechanical (forced) ventilation. Ventilation systems must be designed to capture harmful and hazardous substances before releasing them into the atmosphere.

Premises for drying workwear must ensure fire safety.

Laundries must provide washing of contaminated work clothes.

The area of ​​the room for eating is determined at the rate of 1 square. m for each visitor, but not less than 1.65 sq. m for a disabled person using a wheelchair, but not less than 12 sq. m. You also need to install a washbasin, a stationary boiler, an electric stove and a refrigerator in this room. If the number of employees of the organization is small, then it is allowed to provide an additional space of 6 square meters instead of a separate room. m to install a table for eating.

Clause 2.49 of SNiP 2.09.04-87 stipulates that a room for meals is equipped when the number of people working in one shift is no more than 30 people. If the organization employs a larger number of employees, then in this case the presence of a canteen is provided. If there is already a dining room, a room for meals is not equipped at the same time.

When designing an organization, it is necessary to provide health centers, first-aid posts, rooms for personal hygiene of women, steam rooms (sauna), and according to departmental standards - rooms for inhalations, fotariums, hand and foot baths, as well as rooms for rest during working hours and psychological relief (clause 2.26 of SNiP 2.09.04-87).

If the number of people working in an organization is from 50 to 300, a medical station must be provided.

The area of ​​the medical station should be: 12 square meters. m – with a payroll of 50 to 150 employees, 18 sq. m – from 151 to 300.

In organizations that provide for the possibility of using the labor of disabled people, the area of ​​the medical station may be increased by 3 square meters. m.

The medical center must have equipment in agreement with local health authorities.

In organizations with payroll If more than 300 people are employed, paramedic health centers should be provided.

If the number of employees in an organization is more than 300 people, paramedic health centers with an area of ​​at least 18 square meters must be organized. m.

If the employer has road transport he is obliged to organize pre-trip medical examinations of drivers under an agreement with a health care organization. In this case, the employer is required to allocate a special room consisting of at least two rooms: a room for inspections and a room for collecting biological media. The premises must be equipped with the necessary medical devices, equipment and furniture (paragraph 4 of the letter of the Ministry of Health of the Russian Federation dated August 21, 2003 No. 2510/9468-03-32 “On pre-trip medical examinations of vehicle drivers”).

For workers employed in hot shops, such a measure of medical and preventive care should be provided as the supply of carbonated salt water.

This measure is intended to restore the water balance in the body of workers working in hot shops. To do this, the employer must install machines with carbonated salt water in the above-mentioned workshops based on the consumption of 4-5 liters per shift per employee. If carbonated salt water is provided to the employee in bottles, then it is not necessary to install apparatus or devices.

Transportation of employees who fall ill at work or suffer from industrial accidents and occupational diseases to medical institutions or to their place of residence is carried out by the employer's vehicles or at the expense of the organization where the sick or injured person works.