The organization of labour protection that was inherited by the Russian Federation from previous times represented a hierarchical structure that had been built up under the former society and functioned under rigorous administrative control accompanied by planning and allocation of resources. Recent changes in the country’s economic and social systems caused by the transition to a market economy have necessitated both the revision of the existing labour legislation and the reorganization of the whole system of labour protection and particularly the provision of occupational health services to the working population.

Labour Legislation

Labour protection in Russia is recognized as a complex system for ensuring safe and healthy working conditions, which includes legal, socio-economic, organizational, preventive, safety, hygienic, technical and other measures.

Labour legislation in the Russian Federation comprises certain provisions of the Russian Constitution, the Labour Code, the Basic Law on Labour Protection, and enabling legislation, which consists of the relevant legal acts, regulations and directives, as well as guidelines, instructions, state standards and various standards approved by the appropriate authorities of the Russian Federation and those of the republics in the territory of Russia.

Article 37 of the Constitution of the Russian Federation stipulates that each citizen has the right to work in an environment that meets occupational safety and health requirements, to remuneration for work that is paid without any discrimination at a rate that is not less than the minimum established by the federal government, and to be protected from unemployment.

The Basic Law on Labour Protection, adopted in August 1993, contains provisions ensuring workers’ rights to protection of their health. It also regulates labour relations between employers and workers in all branches of the economy regardless of the forms of property. According to Article 4 of this Law, workers have the right to:

• safe and healthy working conditions

• workplaces that are protected against occupational hazards that may cause occupational accidents or diseases or decrease working capacity

• compensation for occupational injuries and occupational diseases

• information on existing occupational hazards and health risks and the measures undertaken by the employer to control them

• provision of personal protective equipment at the expense of the employer.

Article 9 of the Basic Law on Labour Protection makes management responsible for ensuring safe and healthy working conditions, while Article 16 specifies economic penalties for allowing unsafe and unhealthy working conditions, as well as for the impairment of workers’ health resulting from occupational exposures, injuries or diseases.

Chapter 10 of the Labour Code of the Russian Federation concerns occupational safety and health in industry. Article 139 stipulates the responsibility of management for the provision of safe and healthy working conditions through the introduction of up-to-date safety procedures and accident prevention measures that will ensure appropriate hazard control and the prevention of occupational accidents and diseases.

Article 143 of the Labour Code requires management to equip worksites with safe machinery and equipment and create safe working conditions in conformity with technical and hygienic standards as well as inter-industry and sectoral regulations on occupational safety and health that have been developed and adopted in accordance with the existing labour legislation.

The inter-industry occupational safety and health regulations cover all branches of industry. They consist of legal requirements applicable to all enterprises regardless of the types of their economic activity (e.g., hygienic norms SN 245-71 for the design of industrial enterprises). The inter-industry regulations are adopted by the Council of Ministries of the Russian Federation, or by other appropriate authorities if requested by the Council of Ministers.

The sectoral occupational safety and health regulations define requirements for diverse industrial processes, types of works and equipment specific for particular branches of industry (e.g., regulations on safety rules for welding operations in construction, or for the operation of loading cranes in dockworks). They take into account specific characteristics of particular branches of the economy and are adopted by respective ministries, state committees, state supervision bodies and other appropriate authorities.

Ministries also issue safety and health guidelines, instructions and technical standards for their respective fields of economic activities. Other instructions such as those that oblige employers to organize in-plant safety and health training for workers or those that oblige workers to comply with safety requirements are subject to consultations with employers’ and workers’ organizations.

Employers have the obligation to provide workers with proper clothing or uniforms and personal and collective protective equipment as specified by the regulations. They are also responsible for the organization of periodic health examinations for certain specific categories of workers, such as those doing heavy work or in hazardous occupations, transport workers and some others.

Along with the duties and responsibilities of the employers (when the state owns the property, the management of the enterprise represents the employer), labour legislation makes workers responsible for complying with the occupational safety and health requirements specified by relevant regulations and instructions. For example, they are required to participate in occupational safety and health training, properly maintain and use personal protective equipment, be trained in fire prevention, maintain the machinery and equipment they use and keep their workplaces clean.

At the enterprise level, everyday supervision of occupational safety and health standards and requirements is the responsibility of the occupational safety and health bureau, which is an integral unit of the enterprise, and enjoys an independent status. Its main functions include evaluation of occupational hazards, risk assessment, recommendation of safety and control measures, prevention of industrial accidents, analysis of the causes of occupational accidents, cooperation with other units of the enterprise in preventing work accidents and injuries, control of machinery and equipment and the implementation of safety programmes. The bureau has the authority to halt the operation of certain machinery or processes or the performance of jobs that may endanger workers’ life and health.

Small-scale enterprises are usually not in a position to organize an occupational safety and health bureau (see “Occupational health services in small-scale enterprises”). Article 8 of the Basic Law on Labour Protection gives them the right to consult external occupational safety and health specialists and to employ them on a contract basis.

In order to make the regulations covering the protection of workers in the Russian Federation more effective, there exists a system for establishing state standards on occupational safety and health (GOST). The state standards have the force of law and appropriate state authorities enforce their implementation.

In all, there are now more than 2,000 regulations, directives, instructions, hygienic norms and state standards on occupational safety and health, most of which had been developed by the various ministries, state committees and other authorities of the former USSR. These rules and regulations are still in effect, even though 700 had been established before 1981 and were intended to be applicable for a period of only five years. Most of them need reconsideration and modification in the light of the new economic situation.

As part of the reorganization of the system of labour protection in Russia, the Presidential Decree of 4 May 1994 created the Federal Labour Inspectorate (Rostrudinspekcija) under the Ministry of Labour and made it responsible for enforcing labour legislation in all territories of the Russian Federation. This established the system of state control and supervision in the field of labour protection. (Before this, the enforcement of labour legislation was the responsibility of trade union inspectors.) Regional Inspectorates with a networking structure are to be set up in all constituent regions of the Russian Federation to complete the organizational structure of the Federal Labour Inspectorate.

Health Legislation

Health legislation of the Russian Federation represents an instrument for the realization of the state policy on public health and epidemiological welfare. The Federal Hygienic and Epidemiological Service of the Russian Federation performs its activities in accordance with health legislation and plays an important role in activities aimed at the promotion of safety and health at work and public health in general.

Health legislation consists of the Hygienic and Epidemiological Welfare of the Population Act, adopted on 13 April 1992 by the Supreme Council of the Russian Federation, and of relevant directives and regulations adopted by respective competent authorities by virtue of this Act.

Article 1 of the Act defines the term hygienic and epidemiological welfare as “such a state of public health and the environment under which there is no hazardous influence of environmental factors on the health of the populations and there exist favourable conditions for creative activities.”

Health legislation establishes hygienic standards for enterprises, new types of machinery and equipment, and new technological processes and materials. It also stipulates the enforcement of existing norms and standards.

State hygienic supervision has two forms:

• Preventive hygienic supervision includes the enforcement of hygienic standards in the design, construction and reconstruction of enterprises, introduction of new technologies, manufacturing of machinery and equipment, and monitoring the environment.

• Routine hygienic supervision involves regular surveillance of the working environment of the enterprises using hygienic methods of exposure monitoring, sampling and analysis. It also includes control of the application of hygienic standards in the operation of machinery and equipment and the maintenance of the enterprise in general.

Article 9 of the Act requires enterprises to comply with health legislation by complying with established hygienic standards and by exercising control over their industrial environment. They are required to prevent environmental pollution and to develop and implement safety and health programmes that are aimed at the improvement of the working environment and the prevention of work accidents and injuries.

Chapter 4 of the Act determines the various degrees of liability for infringement of the Russian health legislation. Persons responsible for breaking the law may be prosecuted either under civil or criminal law (Article 27) of the Russian Federation.

Chapter 5 of the Act stipulates functions of the state hygienic and epidemiological supervision. It includes:

• assessment and prognosis of environmental health for the public

• identification of occurrences of communicable diseases, wide-spread non-communicable diseases and poisonings, and their causes

• development of mandatory measures to ensure hygienic and epidemiological welfare of the population

• supervision of the compliance of enterprises with health legislation and hygienic standards

• prosecution of organizations and persons for non-compliance with health legislation and hygienic standards

• compiling statistics on communicable diseases, occupational diseases, widespread non-communicable diseases and poisonings resulting from adverse environmental factors.

As a result of the structural changes taking place in employment patterns, the Act, for the first time, places obligation for the observance of health legislation, hygienic standards, hygienic quality of products and the prevention of environmental pollution not only on management and workers but also on self-employed persons who are involved in full-time employment (Article 34).

According to Article 32 of the Act, the Federal Hygienic and Epidemiological Service of the Russian Federation is assigned responsibility for enforcement of the health legislation. In addition, the Council of Ministers of the Russian Federation approved Directive No. 375, which reorganized the former hygienic and epidemiological stations into Centres for State Hygienic and Epidemiological Supervision (CSHES), operating in all territories of the Russian Federation.

The new health legislation is a crucial development in the legal regulation of the hygienic and epidemiological welfare of the population, as is the radical restructuring of the Federal Hygienic and Epidemiological Service of the Russian Federation to implement it. The Service has recently received the status of a Federal Service and is now included in the federal bodies of state control. As a result, the Federal Committee of the Russian Federation for Hygienic and Epidemiological Supervision has been established to provide overall supervision of this Service.

The Federal Hygienic and Epidemiological Service of the Russian Federation is made up of the following bodies:

• The Federal Committee of the Russian Federation for Hygienic and Epidemiological Supervision

• Centres for State Hygienic and Epidemiological Supervision (CSHES) at the republic, regional, municipal, district and local levels

• linear CSHES in water and air transport

• Information and Analytical Centre of the Russian Federation

• medical institutes and specialized training centres for the education and training of specialists to staff the CSHES

• research institutes specializing in occupational hygiene and epidemiology

• specialized medical establishments producing vaccines

• disinfection centres.

As defined in Directive No. 375, the main functions of the Federal Hygienic and Epidemiological Service include:

• enforcement of health legislation

• development of hygienic norms and standards

• elaboration of federal, republic, regional and local programmes for health protection and health promotion

• provision of technical information to appropriate authorities, enterprises, employers’ and workers’ organizations and other institutions involved in occupational safety and health activities, including information about hygienic and epidemiological conditions in the country, statistics on population morbidity and interpretation of legal documents relating to health legislation

• coordination of the activities of enterprises, employers’ and workers’ organizations, scientific associations and other institutions and organizations with respect to both the development and implementation of hygienic standards.

CSHES specialists have the right to visit and inspect enterprises in order to enforce health legislation. They investigate causes of occupational diseases and identify potential environmental and occupational hazards that may give rise to work-related diseases, injuries and poisonings. Ideally, where necessary, they cooperate with the occupational physicians and nurses staffing the occupational health services.

CSHES funds are provided directly from the federal budget of the Russian Federation. In addition, the CSHES may provide specialized services and advice under contract to enterprises and any others who may need their expertise. The list of specialized services provided by CSHES is approved by the Federal Committee for Hygienic and Epidemiological Supervision.

Health legislation is enforced through the application of relevant directives, regulations, instructions, norms and standards and legal requirements. These include:

• hygienic regulations, hygienic standards and requirements intended to create safe and healthy working conditions, protect the environment and promote public health in general

• hygienic standards establishing occupational exposure limits and maximum permissible levels for potential hazards encountered in workplaces and the environment

• hygienic norms establishing criteria for specific factors that may affect the health of future generations

• uniform hygienic regulations that combine different norms and standards.

Protection of workers’ health

Article 41 of the Constitution of the Russian Federation states that each citizen has the right to health protection and medical care. New legal acts provide for the development of municipal and private health care systems to supplement the state health care system. Health care in the state and municipal medical settings is provided without charge to patients, the costs being met by federal and local budgetary funds, health insurance funds and other sources.

The Hygienic and Epidemiological Welfare of the Population Act includes the following provisions aimed at the protection of workers’ health:

• Workers at enterprises shall undergo pre-placement and periodic health examinations.

• Pre-placement and periodic health examinations shall be required for all workers exposed to specific occupational hazards and hazardous types of work included in a list approved by the Federal Committee for Hygienic and Epidemiological Supervision and the Ministry of Health of the Russian Federation in consultation with representative organizations of employers and workers.

• Enterprises shall undertake all necessary measures to provide health examinations for workers.

A feature of the country’s health care system is the introduction, in 1991, of compulsory health insurance, which was amended in 1993. The Health Insurance of the Citizens of the Russian Federation Law encompasses a new insurance model under which employers contribute premiums amounting to 3.6% of their total payrolls to local administrations to meet health insurance needs. In 1996, about 40 million workers were covered by the Federal Compulsory Health Insurance Fund of the Russian Federation.

The main aim of the introduction of the compulsory health insurance was to ensure the financing of health care in the post-Soviet economic system based on insurance principles, using funds contributed through compulsory and voluntary dues. Compulsory health insurance introduced two types of public relationships into the health care system of the Russian Federation that had not existed before: the involvement of insurers, represented by local authorities that are responsible for the health insurance covering public employees and the unemployed; and the involvement of industrial insurers represented by the employers and enterprises that are responsible for the coverage of workers. According to Article 23, Health and Epidemiological Welfare of the Population Act health examinations of workers are included in the list of services covered by the compulsory health insurance.

In accordance with the Basic Law on the Health Protection of the Citizens of the Russian Federation, adopted by the Supreme Council of the Russian Federation on 22 July 1993, the basic principles of health protection are:

• observance of human rights in the field of health protection that are guaranteed by the government

• priority of prevention in health protection

• universal access to social and medical care

• social protection of workers in case of disability

• responsibility of the state, appropriate authorities, enterprises regardless of their forms of property, and the management of institutions and organizations for the protection and promotion of workers’ health.

The Basic Law specifies the relationships with respect to health protection and health promotion between the working population and the appropriate authorities, state enterprises, private sector establishments, and the state, municipal and private medical settings providing health care services.

In practice, occupational health services are provided to workers by public health care settings (hospitals and polyclinics) that are located near their residences, and by the specialized occupational health services located for the most part in large enterprises. The objective of this arrangement is to bring qualified health care services as close as possible to the workers and their workplaces.

Occupational health services are normally organized at large enterprises employing over 4,000 workers and in chemical, petrochemical, mining and quarrying industries with over 2,000 employees. An in-plant unit staffed by an occupational physician and an occupational nurse is required for all enterprises with more than 800 workers; those with 300 to 800 workers are required to have only an occupational nurse; the minimal number for enterprises with chemical, petrochemical, mining and quarrying operations is 200 employees. These in-plant units are part of the public health care system.

Small-scale enterprises rely for occupational health services on the hospitals and polyclinics of the public health care system, which are expected to provide an occupational physician to perform the health examinations of workers.

The occupational health service at very large enterprises usually includes a hospital providing inpatient services, a polyclinic providing outpatient services, occupational nursing services and a dispensary. Its services may be “closed” (i.e., limited to individuals working in the enterprise), or “open” (i.e., also providing services to workers’ families and, sometimes, to individuals living in the neighbourhood of the plant).

Conclusions

Significant transformations in Russia’s economic and social systems reflect the transition to a market economy, the appearance of various forms of property, the granting of economic independence to enterprises and the abolition of state administrative control, all of which have resulted in a great many changes in the society.

The system of labour protection in the Russian Federation described above, while preserving its general features, is still undergoing major reorganization to conform with changing realities and to be able to respond effectively to emerging issues. Although well under way, this process is also just beginning.

The provision of occupational health services to the working populations needs special attention because of the partial disintegration of the old network of occupational health services resulting from well-known economic problems, and also because of such innovations as the appearance of a private sector, the introduction of compulsory health insurance, and the integration of private medical settings into the country’s health care system.

Although some progress has been made in reducing the numbers of work accidents and the incidence of occupational injuries and diseases, the rates remain unacceptably high, which may have serious consequences in terms of the deterioration of workers’ health and its resultant impact on the economy. The improvement of working conditions and the working environment and the protection and promotion of workers’ health consequently command a high priority in revising the social policy of the state. Active participation of knowledgeable occupational safety and health professionals in this process is critical.

Some prerequisites for the improvement of the system of labour protection in Russia include:

• creation of economic stimuli for the improvement of working conditions and the working environment

• formulation of a coherent national policy on occupational health, occupational safety and the working environment

• revision of existing labour legislation and the establishment of a solid legislative basis for occupational safety and health practice

• effective enforcement of labour legislation

• wider cooperation of employers and workers on matters related to occupational safety and health

• authorizing state control bodies to close down enterprises with unsafe and unhealthy working conditions, as well as those polluting the environment

• emphasizing the improvement of working environment together with the protection of the general environment

• detailed analysis and prognosis of possible effects of the design and construction of new enterprises on workers’ health and the environment

• providing more options for workers in the procurement of occupational health services and increasing professional independence of occupational health professionals

• providing access to a “standard” package of health care services for all workers

• establishing comprehensive, multidisciplinary occupational health services at large-scale enterprises that are capable of providing a full range of services, including treatment and rehabilitation, to workers and their families

• upgrading the technical facilities of occupational health services and CSHES and enhancing the levels of the expertise of their staff

• organizing and deploying health centres to provide occupational health services for small-scale enterprises

• providing recommended types of health examinations to all workers, including workers in agriculture and the informal sector, through the most efficient use of various medical settings

• upgrading the education and training of occupational health professionals

• emphasizing workers’ education and training in occupational safety and health.

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