The Division of Occupational Medicine and Health Risk Assessment continuously works to implement mandatory preventive health examinations, depending on the risk at the workplace, and in accordance with the Decree on the type, method and scope of health examinations of employees (Official Gazette of the Republic of Macedonia No. 60/2013).

Health examinations of employees, which are carried out by authorized health institutions in the field of occupational medicine, using the data from the employer's safety statement, are carried out as follows:

1. previous reviews,
2. periodic reviews,
3. targeted reviews, and
4. systematic reviews.

The preliminary examinations are carried out in order to determine the state of health and work ability to perform work at workplaces where, due to hazards and/or harm to safety and health at work, there is an increased risk of injuries and diseases, according to the standard minimum and the risk assessment of the workplace and the characteristics of the defined occupational hazards and dangers. The preliminary examinations are carried out:

1. before employment in a specific workplace with increased risk;
2. during a break in the performance of work at a certain workplace with increased risk, longer than 12 months;
3. before moving to another workplace with increased risk; and
4. with each determination of a new risk at the workplace with increased risk where the employee works.

Periodic examinations are carried out for the purpose of monitoring and evaluating the state of health and the working ability of employees to perform work at workplaces where, due to hazards and/or harm to safety and health at work, there is an increased risk of injuries and illnesses, in accordance with the standard minimum and the assessment of the risk at the workplace and the characteristics of the defined occupational hazards and dangers.

Targeted examinations are carried out for the purpose of monitoring and evaluating the state of health and the working ability of employees to perform work at workplaces where, due to hazards and/or harm to safety and health at work, there is an increased risk of injuries and diseases, according to the standard minimum and the assessment of workplace risk and the characteristics of defined occupational hazards and hazards.

Targeted examinations are carried out with targeted investigations and tests, depending on the reason for the referral, namely:

1. after the end of sick leave,
2. on the basis of a serious injury at work or sick leave lasting at least three months;
3. after illnesses or injuries not related to work
4. if there is a suspicion of reduced work ability
5. if there is a suspicion that there has been a violation of the employee's health due to work at the specific workplace;
6. if it is an employee who, within a period of one year, was injured at work, three or more times; - if it is an employee who, in a period of one year, due to illnesses or injuries related to the workplace, has been hospitalized five or more times.

Systematic examinations are performed according to the standard minimum, for the purpose of protecting and promoting health and preserving work ability, of every employee who works in a workplace that, according to the risk assessment of the workplace, does not represent a workplace with increased risk.

Standard minimum as a mandatory part of all preventive health examinations in accordance with Article 22 of the Law on Safety and health at work (Official Gazette of RSM no. 25/2013), consists of:

1. anamnestic data (work anamnesis, main difficulties, current illness, family anamnesis, personal anamnesis and socio-epidemiological data),
2. status by systems and anthropometry (body mass, body height and body mass index),
3. basic laboratory analyses, namely sedimentation, blood count (erythrocytes, hemoglobin, hematocrit, leukocytes, glycaemia, cholesterol, triglycerides), urine, sugar, proteins, bilirubin, urobilinogen, sediment,
4. examination of vision function (near and distance vision acuity),
5. audiometry,
6. spirometry,
7. ECG (12) leads and
8. radiograph of the chest - according to the doctor's decision.

At the same time, the Division will regularly work on the performance of mandatory examinations for workers professionally exposed to ionizing radiation, in accordance with the Regulations on health conditions for work with sources of ionizing radiation, as well as on the measures, content and method of performing health examinations of persons who work with sources of ionizing radiation (Official Gazette of the Republic of Macedonia No. 28 of 26.02.2010).

The purpose of health examinations of persons who work with sources of ionizing radiation and persons exposed to work is:

1. to determine that a work-exposed person is healthy and capable of working with sources of ionizing radiation and that the health condition of the same and his working ability are not an obstacle for performing that work;
2. to monitor the health condition of the occupationally exposed person during the performance of the work, especially in relation to the perception of some changes in the health condition that may represent an obstacle for continuing to perform that work
3. to determine the impact of exposure to ionizing radiation on the health of the occupationally exposed person when the dose limit is exceeded or is assumed to be exceeded according to the regulations for protection against ionizing radiation and radiation safety.

   - Where are these examinations performed?

   * In Institute for Public Health of the Republic of North Macedonia;

   -Method of payment

   * In cash or invoice

   The Division regularly collects and processes quarterly reports on the type, method and volume of services provided by the 40 authorized occupational medicine institutions in the Republic. Based on the received reports, the Annual Report on the work performed in the authorized institutions for occupational medicine for that year is published.

   The Division also collects and processes data on injuries at work and publishes the Annual Report on injuries at work for that year.

   The Division will regularly work on the development of methodologies and guides for good practice for workers, employers and professionals in the field of OSH in the context of the COVID-19 pandemic.

   Employees will continue to be involved in conducting epidemiological surveys and identifying contacts of persons who have been found to be positive for the SARS-CoV-2 virus.

   Vaccination against seasonal flu is carried out in the Division for healthcare workers.