Thông tư 28/2016/TT-BYT hướng dẫn quản lý bệnh nghề nghiệp

CIRCULAR

MANAGEMENT OF OCCUPATIONAL DISEASES

Pursuant to the Labor Code No. 10/2012/QH13 dated June 18, 2012;

Pursuant to the Law on Social insurance No. 58/2014/QH13 dated November 20, 2014;

Pursuant to the Law on Occupational hygiene and safety No. 84/2015/QH13 dated June 25, 2015;

Pursuant to the Government's Decree No. 63/2012/NĐ-CP dated August 31, 2012 defining the functions, tasks, powers and organizational structure of the Ministry of Health;

At the request of Director of Health Environment Management Agency;

The Minister of Health promulgates a Circular on management of occupational diseases,

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GENERAL PROVISIONS

Article 1. Scope

This Circular provides for documents and contents of pre-employment health checkup, screening for occupational diseases, provision of periodic examination for workers having occupational diseases, occupational disease investigation and reporting.

Article 2. Regulated entities

1. Workers who are exposed to harmful elements and likely to catch occupational diseases, doing arduous, toxic or dangerous works, including apprentices and interns, workers who have retired or resigned from jobs having the risk of occupational diseases, workers participating in social insurance specified in Clause 1 and Clause 4 Article 2 of the Law on Social insurance No. 58/2014/QH13 whose social insurance payment period is reserved or have resigned pending provision of pension or monthly benefits.

2. Enterprises, organizations, cooperatives, household businesses, individuals hiring workers specified in Clause 1 of this Article (hereinafter referred to as employers).

3. Health facilities capable of providing occupational disease examination in accordance with regulations of law on medical examination and treatment that provide pre-employment health checkup, screening for occupational diseases, periodic examinations for workers having occupational diseases (hereinafter referred to as examining facilities)

Chapter II

PRE-EMPLOYMENT HEALTH CHECKUP

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1. Subjects of pre-employment health checkup are specified in Clause 3 Article 21 of the Law on Occupational hygiene and safety.

2. Health checkups shall be provided for workers before they are assigned to do harmful works.

Article 4. Pre-employment health checkup documents

1. A letter of introduction prepared by the employer according to the template in Appendix 1 enclosed herewith. If there are more than one worker have to undergo pre-employment health checkup, the employer shall enclose with the letter of introduction a list of workers which specify their jobs and harmful elements.

2. The health checkup sheet template is provided in Appendix 2 enclosed herewith.

Article 5. Health checkup contents

1. Pre-employment health checkup shall be carried out in accordance with the health checkup sheet in Appendix 2 enclosed herewith.

2. Apart from complying with provisions of Clause 1 of this Article, the chief physician shall prescribe specialist consultation suitable for the workers’ positions.

3. The physicians that directly give health checkup may prescribe subclinical testing (testing, medical imaging, function probing) suitable for the workers’ positions.

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Chapter III

EXAMINATION FOR OCCUPATIONAL DISEASES

Article 6. Subjects of screening

1. Workers specified in Clause 1 Article 2 of this Circular.

2. Workers that are not specified in Clause 1 of this Article must be reassigned to jobs posing a risk of occupational diseases.

Article 7. Screening time

1. The screening time is specified in Clause 1 Article 21 of the Law on Occupational hygiene and safety.

2. In cases of suspicion of acute occupational diseases or at the request of the employer or workers, the screening time shall be decided by the requester.

Article 8. Screening documents

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2. The health checkup book according to the template provided in Appendix 3 enclosed herewith.

3. Valid copies of any of the following documents:

a) Working environment monitoring result. If the worker is exposed to microorganisms and working environment monitoring is carried out before the effective date of Decree No. 44/2016/NĐ-CP, the document shall be enclosed with a microorganism exposure assessment sheet issued by a competent authority before July 01, 2016;

b) A confirmation of exposure to acute occupational disease elements according to the template provided in Appendix 5 enclosed herewith in case of an acute occupational disease is acquired before the level of exposure to harmful elements is determined;

4. A valid copy of the discharge note or medical record summary related to the occupational disease (if any).

Article 9. Occupational disease screening procedures and contents

1. Screening examination procedures:

a) Before starting the examination, the employer or worker shall send the documents specified in Article 8 of this Circular to the examining facility;

b) After adequate documents are received, the examining facility shall inform the employer or worker of the time, location and contents of the examination;

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d) At the end of the examination, the examining facility shall write sufficient information on the health checkup books and aggregate result of the examination according to the template in Appendix 10 enclosed herewith;

dd) Where a worker is diagnosed with an occupational disease, the examining facility shall compile a occupational disease dossier according to the template in Appendix 7 enclosed herewith and prepare a occupational disease report according to the template in Appendix 9 enclosed herewith;

e) After the examination is done, the examining facility shall return the documents mentioned in Point d and dd Clause 1 of this Article to the employer or worker within 20 working days.

2. Screening examination contents

a) Obtain personal information, health status, medical history of the worker and his/her family, duration of exposure to harmful elements;

b) Carry out the examination in accordance with Appendix 4 enclosed herewith to discover the occupational diseases on the List of occupational diseases covered by insurance specified in Circular No. 15/2016/TT-BYT;

c) Female workers shall be provided with pelvic examination;

d) Carry out other examinations related to harmful elements of the working environment where necessary;

dd) Where workers have been provided with periodic health checkup in accordance with Circular No. 14/2013/TT-BYT, the health checkup result shall be used together with other contents specified in Point b and d Clause 2 of this Article;

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Article 10. Consultations for occupational disease diagnosis

1. A consultation shall be held for diagnosis of asbestosis, bronchus disease, disease caused by exposure to vibration and the cases beyond the capacity of the physicians.

2. Consultation council:

The head of the examining facility shall issue a decision on establishment of a consultation council which consists of:

a) 01 representative of the examining facility as the chairperson;

b) 01 physician specialized in occupational diseases;

c) 01 physician whose specialty is related to the occupational disease that needs consulting;

d) 01 secretary appointed by the chairperson;

e) Where necessary, the chairperson shall decide whether to invite other specialists.

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4. Where a case is beyond the professional capacity of the examining facility, the consultation record and occupational disease dossier shall be transferred to an upper-level facility for diagnosis.

Chapter IV

PROVISION OF PERIODIC EXAMINATION FOR WORKERS HAVING OCCUPATIONAL DISEASES

Article 11. Subjects and time of periodic examinations

1. Workers diagnosed with occupational diseases.

2. Times of periodic examinations are specified in Appendix 6 enclosed herewith.

Article 12. Periodic examination documents

1. The employer shall prepare the following documents:

a) A letter of introduction according to the template in Appendix 1 enclosed herewith;

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2. A worker who has resigned or retired shall prepare the occupational disease dossier himself/herself.

Article 13. Procedures and contents of periodic examination

1. Procedures:

a) Before carrying out a periodic examination, the employer or worker shall send the documents specified in Article 12 of this Circular to the examining facility;

b) After adequate documents are received, the examining facility shall inform the employer or worker of the time, location and contents of the examination;

c) The examining facility shall examine workers having occupational diseases;

d) At the end of the examination, the examining facility shall write the result in each occupational disease dossier, aggregate the results of periodic examination according to the template in Appendix 11 enclosed herewith, and send the results to the workers within 20 working days.

2. Periodic examination contents:

a) Follow instructions in Point a, b and d Clause 2 Article 9 of this Circular and Appendix 6 enclosed herewith;

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Chapter V

OCCUPATIONAL DISEASE INVESTIGATION

Article 14. Cases of occupational disease investigation

1. First occupational disease investigation shall be carried out in the following cases:

a) The investigation is requested by a worker who has not received occupational disease benefits according to regulations of law on occupational hygiene and safety;

b) The investigation is requested by the employer;

c) There are many cases of acute occupational diseases or many people having a disease at the same time in the same workplace;

d) The working environment monitoring result exceeds the permissible limits but no workers are diagnosed with occupational diseases, or working environment monitoring and health checkup for workers are not carried out;

dd) The investigation is requested by a social insurance authority;

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a) The occupational disease investigation result is appealed against;

b) The reinvestigation is requested by a competent authority;

3. Final occupational disease investigation shall be carried out where the result of reinvestigation is appealed against.

Article 15. The power to establish an investigation team

1. First investigation team:

a) Director of the Provincial Department of Health, heads of regulatory bodies who establish the investigation team at the request of inspectors of Provincial Department of Health or heads of health authorities in the cases specified in Clause 1 Article 14 of this Circular;

b) Director of Health Environment Management Agency – the Ministry of Health shall establish an investigation team in the cases specified in Point c and Point d Clause 1 of this Article or the cases beyond the capacity of the investigation team mentioned in Point a of this Clause.

2. Director of Health Environment Management Agency shall establish a reinvestigation team in the cases specified in Clause 2 Article 14 of this Circular.

3. The Ministry of Health shall establish a final investigation team in the cases specified in Clause 3 Article 14 of this Circular.

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1. A first investigation team consists of:

a) A chief who is a senior inspector of Provincial Department of Health or head of a health authority of a Ministry;

b) 01 secretary who is a physician who has a degree in occupational diseases;

c) 01 physician whose specialty is related to the occupational disease under investigation;

d) 01 representative of the Department of Labor, War Invalids and Social Affairs;

dd) 01 representative of the Provincial Confederation of Labor;

e) 01 representative of the social insurance authority of the province or a Ministry;

g) Other members decided by the chief.

2. A first investigation team specified in Point b Clause 1 and reinvestigation team specified in Clause 2 Article 15 of this Circular consists of:

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b) 01 secretary who is a physician who has a degree in occupational diseases;

c) 01 physician whose specialty is related to the occupational disease under investigation;

d) 01 representative of the Legal Department – the Ministry of Health;

dd) 01 representative of the Department of Labor, War Invalids and Social Affairs of the province where the investigation takes place;

e) Other members decided by the chief.

3. The Minister of Health shall establish a final investigation team at the request of the chief inspector of the Ministry of Health or Director of Health Environment Management Agency. Such final investigation team consists of:

a) A chief who is a senior inspector of the Ministry of Health;

b) 01 secretary who is a physician specialized in occupational diseases of an institution which belongs to the defensive medicine system;

c) 01 physician whose specialty is related to the occupational disease under investigation;

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dd) 01 representative of Social Security Administration of Vietnam;

e) Other members decided by the chief.

Article 17. Responsibilities of investigation team members

1. The chief of an investigation team has the responsibility to:

a) Organize activities of the investigation team and assign tasks to its members;

b) Hold discussions to reach consensus among the members. If such consensus cannot be reached, the chief shall make a decision and take responsibility for it;

c) Disclose the investigation record.

2. Investigation team members have the responsibility to:

a) Perform the tasks given by the chief and take responsibility for their performance;

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3. Not reveal information and documents obtained during the investigation before the investigation record is disclosed.

Article 18. Time limit and procedures for investigation and disclosing investigation records

1. Time limit: 45 days from the effective date of the decision to establish an investigation team.

2. Investigation procedures:

a) Examine the workplace;

b) Collect evidence and documents about the occupational diseases (take samples of harmful elements for analysis);

c) Examine documents about occupational hygiene, workers’ health and occupational diseases at the workplace;

d) Interview workers, the employers and other persons at the workplace related to the management of occupational hygiene, workers’ health and occupational diseases;

dd) Carry out examinations and necessary tests if workers are suspected of having occupational diseases (if necessary);

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3. Disclosing the investigation record:

The investigation team shall hold a meeting right after the investigation is done to disclose the investigation record. The meeting shall be attended by:

a) The chief who will chair the meeting;

b) Investigation team members;

c) The employer or a person authorized by the employer in writing;

d)The representative of the internal trade union or provisional trade union or a person selected by the workers if a trade union is not established;

dd) The requester, witnesses, and persons having relevant responsibility and interests;

e) Representative of the supervisory body of the employer (if any);

g) The minutes of the meeting shall bear signatures of the participants. The person who does not concur with the investigation record may have his/her dissenting opinion written on the record but it still has to bear his/her signature and seal (if any). Other recommendations of the investigation team shall be followed;

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Article 19. Occupational disease investigation documents

1. Workplace examination record.

2. Relevant evidence and documents.

3. Documents about occupational hygiene, workers’ health and occupational diseases at the workplace.

4. Records of interviews with workers, the employers and other persons at the workplace related to the management of occupational hygiene, workers’ health and occupational diseases.

5. Examination and test result (if any).

6. The investigation record.

7. The minutes of the meeting for disclosing the investigation record.

8. Other documents relevant to the investigation.

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Article 20. Funding

1. The State shall cover the costs of operation of occupational disease investigation teams established by regulatory bodies.

2. The person or organization that requests the investigation shall pay for the costs of the investigation team established at their request.

Chapter V

RESPONSIBILITY FOR IMPLEMENTATION

Article 21. Responsibility of workers

1. Provide truthful information about their medical history and occupational exposure during the health checkup.

2. Attend pre-employment health checkup, screening and periodic examinations (if acquired) held by the employer.

3. Follow instructions, prescriptions of physicians.

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Article 22. Responsibility of the employer

1. Compile, manage and retain medical records and occupational disease dossiers of workers while they are still working at the workplace; return them to workers when they move to another workplace, resign or retire.

2. Cooperate with health facilities capable of occupational disease diagnosis to provide pre-employment health checkup, screening and periodic examinations for workers.

3. Enable workers to receive treatment and recovery as prescribed by law.

4. Complete documents and have workers diagnosed with occupational diseases to undergo assessment within 20 working days after treatment or recovery (for curable occupational diseases) or after screening (for incurable diseases).

5. Improve the working conditions and prevent occupational diseases; provide personal protective equipment and perquisites for workers as prescribed.

6. Give tasks suitable for workers’ health.

7. Provide information, documents and cooperate with occupational disease investigation teams.

8. Submit periodic and ad hoc reports to local health authorities as prescribed by regulations of law on occupational hygiene and safety.

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a) Report the disease in accordance with this Circular;

b) Inform other workers of the occupational disease in order to prevent it;

c) Hold a meeting to disclose the investigation record.

Article 23. Responsibilities of the examining facility

1. Cooperate with the employer in planning and carrying out pre-employment health checkup, screening and periodic examinations for workers.

2. Organize occupational disease consultations (if necessary) and take legal responsibility for results thereof.

3. Participate in medical assessment councils on request.

4. Submit biannual and annual reports on occupational disease examination to the Provincial Department of Health or the Ministry of Health before July 05 and January 10 as instructed in Appendix 9 and Appendix 12 enclosed herewith.

Article 24. Responsibility of Provincial Departments of Health

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2. Publish the list of licensed examining facilities on the website of the Provincial Department of Health and send it to Health Environment Management Agency within 03 working days from the day on which a facility is licensed.

3. Carry out periodic and surprise inspections at licensed examining facilities.

4. Submit biannual and annual reports on occupational disease examination to Ministry of Health (Health Environment Management Agency) before July 15 and January 15 as instructed in Appendix 9 and Appendix 12 enclosed herewith.

Article 25. Responsibility of Health Environment Management Agency – The Ministry of Health

1. Give instructions and carry out pre-employment health checkup, screening, periodic examinations for workers and occupational disease investigations nationwide.

2. Develop an occupational disease database which contains information about:

a) Infrastructure, equipment and human resources serving occupational disease examination;

b) Harmful elements at workplaces;

c) Number of workplaces where workers have occupational diseases;

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dd) Developments of occupational diseases;

e) Provision of benefits for workers having occupational diseases.

3. Publish the list of licensed examining facilities on the website of the Ministry of Health.

4. Instruct defensive medicine institutes, medicine and pharmacy universities to develop and provide training courses in occupational diseases.

5. Cooperate with relevant units in providing guidelines for implementation of this Circular and carrying out inspections examining facilities.

Chapter VI

EFFECT

Article 26. Reference clause

Where a document cited in this Circular is replaced or amended, the newest one shall apply.

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1. This Circular comes into force from August 15, 2016.

2. Circular No. 08/1998/TTLT-BYT-BLĐTBXH dated April 20, 1998 and Circular No. 12/2006/TT-BYT dated November 10, 2006 are abolished from the effective date of this Circular.

Difficulties that arise during the implementation of this Circular should be reported to the Ministry of Health (Health Environment Management Agency) for consideration./.

PP MINISTER
DEPUTY MINISTER




Nguyen Thanh Long

APPENDIX 3

SPECIMEN OF THE OCCUPATIONAL DISEASE SCREENING RECORD
(Enclosed with Circular No. 28/2016/TT-BYT dated June 30, 2016 of the Minister of Health)

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Color picture
(4 x 6cm)

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom – Happiness
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No.

OCCUPATIONAL DISEASE SCREENING RECORD

1. Full name (UPPER CASE): ……………………………………………………………………

2. Male □ Female □  Date of birth: ……………….……………………………………

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4. Permanent residence: …………………………………………………………………………

5. Current residence: ……………………………………………………………………………

6. Current job: ………………………………………………………………

7. Workplace: …………………………………………………………………….

8. Workplace address: …………………………………………………………………….

9. Date of beginning of work: ……………………….

10. Previous jobs (over the last 10 years in reverse chronological order):

(1) ……………………………………………………………………………………………………

……………………………………………………………………………………………………….

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Work duration: From …………………. To ………………………….

Exposed to:  ……………………………. Exposure duration …………………………………

(2) ……………………………………………………………………………………………………

………………………………………………………………………………………………………

………………………………………………………………………………………………………

………………………………………………………………………………………………………

11. Family medical history: ……………………………………………………………………

12. Personal medical history: …………………………………………………………………

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(Date)
Book maker
(Signature and full name)

I. OCCUPATIONAL DISEASE SCREENING

1. Overall examination*

No.

Content

Result

Rank

1

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Date:

Examiner's signature and full name

Height ………..cm, Weight ……….. kg

BMI ……………………………………

Blood pressure ………… ; pulse …………..

2

Internal medicine diagnosis

Date …………………….

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Circulatory system

Respiratory system

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Digestive system

Kidney – Urinary system

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Musculoskeletal system

Nervous system

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Mental health

Other examinations

3

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Date …………………….

Physician’s signature and full name

4

Eyes

Date …………………….

Physician’s signature and full name

Visual acuity test:

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                     Left eye ……………………

With glasses: Right eye: …………………

                      Left eye ……………………

Eye diseases (if any): ………………

5

Ear – Nose - Throat

Date …………………….

Physician’s signature and full name

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Left ear: Normal voice: ………….m;

             Quiet voice: …………….m;

Right ear: Normal voice: ………….m;

               Quiet voice: …………….m;

- ENT diseases (if any) …….

……………………………………………….

……………………………………………….

6

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Date……………………

Physician’s signature and full name

Maxilla: ……………..

           Mandible: …………….

Dentomaxillofacial diseases (if any)

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Dermatology

Date …………………….

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Gynecology

Date …………………….

Physician’s signature and full name

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Date……………………

10

Subclinical examinations

Date……………………

*Not required if the worker has undergone periodic checkup in accordance with Circular No. 14/2013/TT-BYT.

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- Clinical:

………………………………………………………………………………………………………

- Subclinical:

………………………………………………………………………………………………………

II. CONCLUSION

1. Health ranking: ...…………………………………………………………………………

2. Diseases and disabilities (if any): ……………………………………………………………

3. Occupational diseases

3.1. Preliminary diagnosis

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3.2. Conclusion after consultation (enclosed with consultation record, if any)

………………………………………………………………………………………………………

3.3. Official diagnosis

………………………………………………………………………………………………………

4. Solution: consultation, treatment, sick leave, rehabilitation, assessment, career change (if possible): ………………………………………………………………………………

(Date)
HEALTH FACILITY
(Signature, seal and full name)

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CONTENTS OF SCREENING FOR OCCUPATIONAL DISEASES COVERED BY INSURANCE

No.

Disease

Harmful elements

Content

Clinical

Subclinical

1.

Silicosis

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Respiratory system, circulatory system

- Chest radiography; respiratory function test.

- Tomography, testing for AFB in sputum (if necessary).

2.

Asbestosis

Asbestos dust

Respiratory system, circulatory system

- Chest radiography, respiratory function test.

- Tomography, testing for AFB in sputum (if necessary)

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Byssinosis

Cotton, jute, flax dust

Respiratory system, circulatory system, ENT.

- Respiratory function test.

- Skin sampling

- Blood: blood formula

- Chest radiography, pharmacokinetics test, IgE, IgG testing (if necessary).

- Bronchus recovery test (if necessary).

4.

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Bronchitis-causing elements

Respiratory system, circulatory system.

- Respiratory function test.

- Chest radiography (if necessary)

5.

Occupational bronchial asthma

Allergens

Respiratory system, circulatory system

- Respiratory function test before and after a shift

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6.

Talc pneumoconiosis

Talcum dust

Respiratory system, circulatory system

- Chest radiography; respiratory function test.

- Tomography, testing for AFB in sputum (if necessary)

7.

Coal worker's pneumoconiosis

Coal dust

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- Chest radiography; respiratory function test.

- Tomography, testing for AFB in sputum (if necessary)

8.

Occupational lead poisoning

Organic, inorganic lead and lead compounds

Digestive system, circulatory system, nervous system, ENT, eyes, bones and joints, skin, mucous membrane and blood production system.

- Blood test: quantifying lead in blood (in case of exposure to inorganic lead), blood formula, RBC, hemoglobin, etc.

- Urine test: quantifying lead in urine (in case of exposure to organic lead), delta ALA in urine (in case of exposure to inorganic lead), urinary casts, RBC.

9.

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Benzene, toluene or xylene

Respiratory system, digestive system, circulatory system, urinary system, mucous membrane and blood production system.

- Blood test: blood formula, hemoglobin, platelet, clotting and bleeding time

- Urine test: albumin, urinary casts, RBC in urine, t,t-muconic acid in urine or phenol in urine (exposure to benzene), O-crezon or hyppuric acid in urine (exposure to toluene), methyl hyppuric acid in urine (exposure to xylene)

10.

Occupational mercury poisoning

Organic or inorganic mercury and mercury compounds

Nervous system, digestive system, urinary system, eyes, skin, mucous membrane and teeth.

- Blood test: blood formula, mercury in blood (in case of suspected acute poisoning)

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- Bone marrow aspiration (if necessary)

11.

Occupational manganese poisoning

Manganese and manganese compounds

Respiratory system, nervous system, musculoskeletal system, digestive system.

- Blood test: blood formula

- Urine test: manganese in urine, albumin, urinary casts, RBC in urine

- Bone marrow aspiration (if necessary)

12.

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Trinitrotoluene (TNT)

Nervous system, skin and mucous membrane, digestive system, urinary system, eyes, etc.

- Blood test: methemoglobin, blood formula, hemoglobin, alanine aminotransferase.

- Urine test: quantifying TNT in urine, albumin, RBC in urine, urinary cast

- Bone marrow aspiration (if necessary)

13.

Occupational arsenic poisoning

Arsenic and arsenic compounds

Nervous system, urinary system, digestive system, respiratory system, circulatory system, skin.

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- Urine test: arsenic in urine, albumin, RBC in urine, urinary cast

- Quantifying arsenic in hair

14.

Occupational nicotine poisoning

Nicotine

Nervous system, respiratory system, circulatory system.

- Blood test: blood formula

- Urine test: quantifying cotinine or nicotine in urine.

15.

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Pesticides of phosphorus or carbamate group

Nervous system, digestive system, circulatory system, skin

- Blood test: blood formula, quantifying RBC or plasma choline

- Urine test: albumin, RBC in urine, urinary cast

- Quantifying pesticide in blood or metabolite in urine (if necessary).

16.

Occupational carbon monoxide poisoning

Carbon monoxide (CO)

Nervous system, circulatory system

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- ECG

- Echocardiography (if necessary)

17.

Occupational cadmium poisoning

Cadmium and cadmium compounds

Nervous system, urinary system, digestive system, respiratory system, circulatory system, skeletal system.

- Urine test: cadmium in urine, albumin, beta2-micro-globulin in urine, RBC in urine, urinary casts, urine calcium.

- Bone mass measurement, bone x-ray

- Liver, kidney function test, cardiopulmonary x-ray (if necessary)

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Occupation radiation sickness

Ionizing radiation

Digestive system, respiratory system, circulatory system, lymphatic system

- Blood test: Blood aspiration

- Bone marrow aspiration and/or chromosome analysis (if necessary)

19.

Noise induced hearing loss caused by noise

Noise

ENT

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- Mastoid x-ray, tympanometry, stapedius reflex test, auditory brain-stem response (if necessary).

20.

Occupational diseases caused by local vibration

High-frequency vibration by hand tools

Skeletal system, nervous system and peripheral vascular system

- Wrist joint, elbow, shoulder x-ray

- Cold test.

- Capillary imaging, measuring vibration and pain perception threshold (if necessary).

21.

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Rapid drop of external pressure

Nervous system, skeletal system, respiratory system, circulatory system, urinary system, ENT.

- Bone and joint x-ray.

- Monophonic audiometry.

- ECG

- Urine test: finding albumin in urinary casts, RBC

- Blood test: blood formula, calcium quantification (if necessary).

22.

Whole-body vibration sickness

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Musculoskeletal system, nervous system, digestive system, urinary system

- Lumbosacral spine X-Ray

- Lumbosacral spine CT scanner or MRI, stomach endoscopy (if necessary)

23.

Occupational skin darkening

Skin-darkening elements

Skin, mucous membrane

- Biodose measurement

- Urine test: porphyrin, melanogen in urine (if necessary)

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Dermatitis and nasal septum ulcers caused by chromium

Chromium VI

Skin, ENT

- Patch test

25.

Leptospira

Leptospria spirochaete bacteria

Digestive system, respiratory system, circulatory system, skin

- Martin and Petit test

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26.

Black acne disease

Dirty fats and oils

Skin, mucous membrane

- Prick test.

- Skin pH measurement

- Burchardt’s alkali neutralization test (if necessary)

27.

Occupational skin disease due to prolonged exposure to humid and cold environment

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Skin, mucous membrane, nails

- Skin pH measurement

- Test for skin and nail fungi, germs in injured skin (if necessary)

- Burchardt’s alkali neutralization test (if necessary)

28.

Occupational skin disease due to exposure to rubber and rubber additives

Natural rubber and rubber additives

Skin, respiratory system

- Prick test

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- Determination of IgE, IgG content in blood (if necessary)

29.

Occupational tuberculosis

Mycobacteria

Digestive system, respiratory system, circulatory system, skin, urinary system, skeletal system, etc.

- Chest radiography.

- Test for AFB in sputum, biofluid, Mantoux test, RBC sedimentation rate

- Lymph node biopsy, PCR (if necessary)

30.

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Hepatitis B virus

Digestive system, respiratory system, circulatory system, skin, mucous membrane

- Blood test: HBsAg, AST, ALT, blood formula

- Urine test: albumin, bilirubin, bile salts, etc.

- Liver, bile ultrasonography.

31.

Occupational HIV infection

HIV

Skin, digestive system, respiratory system, circulatory system, urinary system

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32.

Occupational hepatitis C

Hepatitis C virus

Digestive system, respiratory system, circulatory system, skin, mucous membrane

- Blood test: Anti HCV, AST, ALT, blood formula

- Urine test: albumin, bilirubin, bile salts, etc.

- Liver, bile ultrasonography.

- HCV-RNA (if necessary)

33.

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Asbestos dust

Respiratory system, circulatory system, digestive system

- Chest radiography; CT scanner, respiratory function test.

- Histopathology, immunohistochemistry

- Echocardiography and Abdominal ultrasound (if necessary)

34.

Occupational cataract

ionizing radiation, artificial ultraviolet radiation, thermal radiation, microwaves

Eyes, nervous system

...

...

...

APPENDIX 5

SPECIMEN OF THE CONFIRMATION OF EXPOSURE TO ACUTE OCCUPATIONAL DISEASE-CAUSING FACTORS
(Enclosed with Circular No. 28/2016/TT-BYT dated June 30, 2016 of the Minister of Health)

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom – Happiness
---------------

CONFIRMATION OF EXPOSURE TO ACUTE OCCUPATIONAL DISEASE-CAUSING FACTORS

Full name: ……….…………………………………. Age : ………..Gender: …………………..

Occupation: ……………………………………………………………………………………….

Workplace: ……………………………………………………………………………………….

...

...

...

………………………………………………………………………………………………………

………………………………………………………………………………………………………

Disease status:

………………………………………………………………………………………………………

………………………………………………………………………………………………………

Sources, contributing factors, exposure circumstance:

………………………………………………………………………………………………………

………………………………………………………………………………………………………

Responses:

...

...

...

………………………………………………………………………………………………………

………………………………………………………………………………………………………

Patient’s health status:

………………………………………………………………………………………………………

………………………………………………………………………………………………………

Patient

Witness

(Location and date)
Head of unit
(Signature, seal and full name)

...

...

...

APPENDIX 6

TIME AND CONTENT OF PERIODIC EXAMINATIONS FOR WORKERS HAVING OCCUPATIONAL DISEASES

No.

Disease

Period (months)

Content

Specialist consultation

Subclinical

1.

...

...

...

12

Respiratory system, circulatory system

- Chest radiography; respiratory function test.

- Tomography, testing for AFB in sputum (if necessary).

2.

Asbestosis

12

Respiratory system, circulatory system

- Chest radiography, respiratory function test.

...

...

...

3.

Byssinosis

12

Respiratory system, circulatory system, ENT.

- Respiratory function test.

- Prick test

- Blood test: blood formula

- Chest radiography, pharmacokinetics, IgE, IgG testing (if necessary).

4.

...

...

...

6

Respiratory system, circulatory system.

- Respiratory function test.

- Chest radiography (if necessary)

5.

Occupational bronchial asthma

12

Respiratory system, circulatory system

- Respiratory function test before and after a shift

...

...

...

6.

Talc pneumoconiosis

12

Respiratory system, circulatory system

- Chest radiography; respiratory function test.

- Tomography, testing for AFB in sputum (if necessary)

7.

Coal worker's pneumoconiosis

12

...

...

...

- Chest radiography; respiratory function test.

- Tomography, testing for AFB in sputum (if necessary)

8.

Occupational lead poisoning

6

Digestive system, circulatory system, nervous system, ENT, eyes, bones and joints, skin, mucous membrane and blood production system.

- Blood: quantifying lead in blood (in case of exposure to inorganic lead), blood formula, RBC, hemoglobin, etc.

- Urine: quantifying lead in urine (in case of exposure to organic lead), delta ALA in urine (in case of exposure to inorganic lead), urinary casts, RBC.

9.

...

...

...

6

Respiratory system, digestive system, circulatory system, urinary system, mucous membrane and blood production system.

- Blood test: blood formula, hemoglobin, platelet, clotting and bleeding time

- Urine test: albumin, urinary casts, RBC in urine, t,t-muconic acid in urine or phenol in urine (exposure to benzene), O-crezon or hyppuric acid in urine (exposure to toluene), methyl hyppuric acid in urine (exposure to xylene)

10.

Occupational mercury poisoning

6

Nervous system, digestive system, urinary system, eyes, skin, mucous membrane and teeth.

- Blood test: blood formula, mercury in blood (in case of suspected acute poisoning)

...

...

...

- Bone marrow aspiration (if necessary)

11.

Occupational manganese poisoning

6

Respiratory system, nervous system, musculoskeletal system, digestive system.

- Blood test: blood formula

- Urine test: manganese in urine, albumin, urinary casts, RBC in urine

- Bone marrow aspiration (if necessary)

12.

...

...

...

6

Nervous system, skin and mucous membrane, digestive system, urinary system, eyes, etc.

- Blood test: methemoglobin, blood formula, hemoglobin, alanine aminotransferase.

- Urine test: quantifying TNT in urine, albumin, RBC in urine, urinary cast

- Bone marrow aspiration (if necessary)

13.

Occupational arsenic poisoning

6

Nervous system, urinary system, digestive system, respiratory system, circulatory system, skin.

...

...

...

- Urine test: arsenic in urine, albumin, RBC in urine, urinary cast

- Quantifying arsenic in hair

14.

Occupational nicotine poisoning

6

Nervous system, respiratory system, circulatory system.

- Blood test: blood formula

- Urine test: quantifying cotinine or nicotine in urine.

15.

...

...

...

6

Nervous system, digestive system, circulatory system, skin

- Blood test: blood formula, quantifying RBC or plasma choline

- Urine test: albumin, RBC in urine, urinary cast

- Quantifying pesticide in blood or metabolite in urine (if necessary).

16.

Occupational carbon monoxide poisoning

6

Nervous system, circulatory system

...

...

...

- ECG

- Echocardiography (if necessary)

17.

Occupational cadmium poisoning

6

Nervous system, urinary system, digestive system, respiratory system, circulatory system, skeletal system.

- Urine test: cadmium in urine, albumin, beta2-micro-globulin in urine, RBC in urine, urinary casts, urine calcium.

- Bone mass measurement, bone x-ray

- Liver, kidney function test, cardiopulmonary x-ray (if necessary)

...

...

...

Occupation radiation sickness

6

Digestive system, respiratory system, circulatory system, lymphatic system

- Blood test: Blood aspiration

- Bone marrow aspiration and/or chromosome analysis (if necessary)

19.

Noise induced hearing loss caused by noise

12

ENT

...

...

...

- Mastoid x-ray, tympanometry, stapedius reflex test, auditory brain-stem response (if necessary).

20.

Occupational diseases caused by local vibration

12

Skeletal system, nervous system and peripheral vascular system

- Wrist joint, elbow, shoulder x-ray

- Cold test.

- Capillary imaging, measuring vibration and pain perception threshold (if necessary).

21.

...

...

...

12

Nervous system, skeletal system, respiratory system, circulatory system, urinary system, ENT.

- Bone and joint x-ray.

- Monophonic audiometry.

- ECG

- Urine test: finding albumin in urinary casts, RBC

- Blood test: blood formula, calcium quantification (if necessary).

22.

Whole-body vibration sickness

...

...

...

Musculoskeletal system, nervous system, digestive system, urinary system

- Lumbosacral spine X-Ray

- Lumbosacral spine CT scanner or MRI, stomach endoscopy (if necessary)

23.

Occupational skin darkening

12

Skin, mucous membrane

- Biodose measurement

- Urine test: porphyrin, melanogen in urine (if necessary)

...

...

...

Dermatitis and nasal septum ulcers caused by chromium

12

Skin, ENT

- Patch test

25.

Leptospira

6

Digestive system, respiratory system, circulatory system, skin

- Martin and Petit test

...

...

...

26.

Black acne disease

12

Skin, mucous membrane

- Prick test.

- Skin pH measurement

- Burchardt’s alkali neutralization test (if necessary)

27.

Occupational skin disease due to prolonged exposure to humid and cold environment

...

...

...

Skin, mucous membrane, nails

- Skin pH measurement

- Test for skin and nail fungi, germs in injured skin (if necessary)

- Burchardt’s alkali neutralization test (if necessary)

28.

Occupational skin disease due to exposure to rubber and rubber additives

12

Skin, respiratory system

- Prick test

...

...

...

- Determination of IgE, IgG content in blood (if necessary)

29.

Occupational tuberculosis

6

Digestive system, respiratory system, circulatory system, skin, urinary system, skeletal system, etc.

- Lung x-ray.

- Test for AFB in sputum, biofluid, Mantoux test, erythrocyte sedimentation rate

- Lymph node biopsy, PCR (if necessary)

30.

...

...

...

6

Digestive system, respiratory system, circulatory system, skin, mucous membrane

- Blood test: HBsAg, AST, ALT, blood formula

- Urine test: albumin, bilirubin, bile salts, etc.

- Liver, bile ultrasonography.

31.

Occupational HIV infection

6

Skin, digestive system, respiratory system, circulatory system, urinary system

...

...

...

32.

Occupational hepatitis C

6

Digestive system, respiratory system, circulatory system, skin, mucous membrane

- Blood test: Anti HCV, AST, ALT, blood formula

- Urine test: albumin, bilirubin, bile salts, etc.

- Liver, bile ultrasonography.

- HCV-RNA (if necessary)

33.

...

...

...

12

Respiratory system, circulatory system, digestive system

- Chest radiography; CT scanner, respiratory function test.

- Histopathology, immunohistochemistry

- Echocardiography and Abdominal ultrasound (if necessary)

34.

Occupational cataract

12

Eyes, nervous system

...

...

...

* Addition of clinical examination and subclinical examination shall depend on the development of the disease and prescriptions of the physician.

APPENDIX 7

SPECIMEN OF THE OCCUPATIONAL DISEASE DOSSIER
(Enclosed with Circular No. 28/2016/TT-BYT dated June 30, 2016 of the Minister of Health)

GOVERNING BODY
NAME OF ORGANIZATION
-------

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom – Happiness
---------------

OCCUPATIONAL DISEASE DOSSIER

No. _____________

...

...

...

Patient’s full name: _____________________________________________________

Gender: _______________________________________________________

Date of birth: ____________________________________________________

ID number: ________ Issuer:_______ Date of issue:_______

Occupation: _____________________________________________________

Seniority (years): ________________________________________________________

Current residence: _______________________________________________________

Occupational disease screening record number: _____________________________

Name of workplace: _____________________________________________________

...

...

...

Workplace address: _______________________________________________

Phone: ______________________________ Fax: _______________________

Year ____

PART I. OCCUPATIONAL DISEASE SCREENING

...

...

...

I. INFORMATION ABOUT OCCUPATIONAL DISEASE-EXAMINING FACILITY

Name of examining facility: __________________________________________

Address: ________________________________________________________________

Date of dossier compilation: _______________________________________________

Phone: ______________________________ Fax: _______________________

E-mail: ___________________________Website: _____________________________

II. OCCUPATIONAL HISTORY AND CURRENT OCCUPATION

1. Previous occupations and durations thereof:_________

_______________________________________________________________________

...

...

...

_______________________________________________________________________

2. Current works and working conditions (harmful elements, available personal protective equipment):

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

(*) This must be enclosed with a valid copy of working environment survey result or confirmation of exposure to acute occupational disease-causing factors.

III. OCCUPATIONAL DISEASE EXAMINTION RESULT

1. Medical history

- Acquired diseases (time, treating facility, treatment result): ______________________

...

...

...

_______________________________________________________________________

_______________________________________________________________________

+ After starting to work: __________________________________________________

_______________________________________________________________________

_______________________________________________________________________

2. Disease developments:

- Current health status (primary, developments of occupational diseases):__________

______________________________________________________________________

3. Current result

...

...

...

______________________________________________________________________

______________________________________________________________________

3.2. Diagnoses relevant to occupational diseases

a) Functional symptoms

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

b) Physical examination

...

...

...

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

c) Subclinical examinations (tests, medical imaging, function probing)

______________________________________________________________________

______________________________________________________________________

3.3. Summary of other examination results

______________________________________________________________________

______________________________________________________________________

...

...

...

______________________________________________________________________

______________________________________________________________________

IV. CONCLUSION

1. Preliminary diagnosis

______________________________________________________________________

______________________________________________________________________

2. Conclusion after consultation (enclosed with consultation record, if any)

______________________________________________________________________

______________________________________________________________________

...

...

...

3. Official diagnosis

______________________________________________________________________

4. Solution: consultation, treatment, sick leave, rehabilitation, assessment, career change (if necessary):

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

(Date)
Chief physician
(Signature, seal and full name)

...

...

...

PART II. PERIODIC OCCUPATIONAL DISEASE EXAMINATION

(Done by occupational disease- examining facility and added to occupational disease dossier)

I. INFORMATION ABOUT OCCUPATIONAL DISEASE-EXAMINING FACILITY

Name of examining facility: __________________________________________

Address: ________________________________________________________________

Date of dossier compilation: ______________________________________________

Phone: ______________________________ Fax: _______________________

E-mail: ___________________________Website: _____________________________

II. ASSESSMENT OF WORK CAPACITY REDUCTION

...

...

...

Diagnosing facility: __________________________________________

Date of diagnosis: ____________________________________________________

Date of periodic examination ______________________ Time: _______________

Occupational disease assessment (if any):

- Medical Assessment Council:

- Medical assessment record No. ____ dated _________________________________

- Work capacity reduction rate: __________________________________________

Benefit book dated _________________________

III. OCCUPATIONAL HISTORY AND CURRENT OCCUPATION

...

...

...

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

2. Current works and working conditions (harmful elements, available personal protective equipment):

_______________________________________________________________________

_______________________________________________________________________

(*) A valid copy of the latest working environment survey result must be enclosed herewith.

IV. PERIODIC OCCUPATIONAL DISEASE EXAMINATION RESULT

- Clinical:

...

...

...

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

- Subclinical:

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

...

...

...

1. Preliminary diagnosis

_______________________________________________________________________

_______________________________________________________________________

2. Conclusion after consultation (enclosed with consultation record, if any)

_______________________________________________________________________

_______________________________________________________________________

3. Official diagnosis (specify seriousness and developments of the disease compared to result of the previous examination)

_______________________________________________________________________

_______________________________________________________________________

...

...

...

_______________________________________________________________________

_______________________________________________________________________