Harmful factors 302. The list of harmful and dangerous production factors by profession - order on medical examinations

Order No. 302n on medical examinations establishes not only the categories of employees who must pass them, but also the procedure for conducting them. In March 2018, this regulation was amended. What - we'll tell you.

Read in our article:

Order of the Ministry of Health 302n with amendments and additions of 2018

The order approved the rules for passing medical examinations... The list of professions and jobs, upon admission to which an employee undergoes an examination, is determined based on the working conditions. It should be compiled by the employer.

If an employee performs work included in the list, he will be required to first go through this procedure. Appendix 2 is a table that is used not only by the employer, but also by the medical institution. Columns 3 to 5 provide:

• lists of specialists to be visited;
• list of studies as laboratory analyzesand functional measurements;
• additional contraindications for health.

It is worth noting that if several types of work are performed during production, it is necessary to take into account the need to carry out medical examinations for these types of work at the same time. Example: for the maintenance and repair of existing electrical installations.

Changes to Order 302n in 2018 were made in March. They touched upon Appendix 2. The list of workers who are sent for medical examinations was expanded. Instead of employees of social shelters and nursing homes, employees of organizations should be sent for medical examination social serviceproviding social services:

• in a stationary form of social service;
• semi-stationary form of social services;
• in the form of social services at home.

Harmful factors for a medical examination by profession in Appendix 1

In the process of work, various production factors constantly or periodically affect the employee.

They can be:

• optimal;
• acceptable;
• harmful;
• dangerous.

Such a gradation of factors of the production environment has been established.The presence of a production factor of a particular group is determined in the process special assessment working conditions.

The application concerns only groups 3 and 4 - harmful and dangerous factors.

Harmful working conditions are understood as those in which the impact of harmful and (or) hazardous factors exceeds hygienic standards and can lead to varying degrees of damage to health.

The 3rd group is subdivided into 3 subgroups depending on the expected.

Dangerous factors are considered that during the working day or shift can lead to a threat to the life of a citizen, and their prolonged exposure will inevitably lead to acute occupational diseases.

Order 302n on medical examinations does not contain a gradation according to the "harmfulness" of one or another impact. It gives a gradation depending on the acting factor (chemical, biological, physical, labor process). This classification allows you to quickly navigate the list.

The procedure for conducting medical examinations 302n

Medical examinations by profession can be carried out both during employment and in the process of work. Their main purpose is to identify health disorders that prevent an employee from performing work. The procedure is set in Appendix 3.

Preliminary medical examinations should be carried out even before the candidate starts working. In the personnel department of the organization, the future employee is given a referral to the medical examination, while it is possible to pass the medical department at the place of residence, and in any medical facility convenient for him.

The cost of the applicant's medical examination must be compensated by the employer.

The direction is drawn up on the letterhead of the organization. It must contain the name of the company, as well as its details. The text of the document itself contains the name of the candidate, his date of birth, position and division, production factors and types of work in accordance with Appendices 2 and 1. The direction is signed by an authorized person and the company stamp is affixed.

In the clinic, the employee must present a referral, passport, psychiatrist's conclusion and health passport, if available. Health workers make a list of necessary specialists and tests that need to be passed. After completing all the procedures, the employee is issued a medical examination. He must provide this conclusion to the employer.

Final act on medical examinations 302n (sample)

The final act is issued to the employer at the end of the medical examination as a whole, as established by paragraph 42. It is a summary table for the entire team of the enterprise or its part.

Download the final act form \u003e\u003e\u003e

The final act contains information about the employer, the number of personnel. Based on the results of the examinations, summary tables 1 and 2 are filled in by surname. The employer is given suggestions for health improvement measures and for. The act is filled in 4 copies.

The completed final act on medical examinations must be stored for 50 years in the medical organization that conducted the examinations.

Visual acuity corrected below 0.6 for the best eye, below 0.2 for the worst. Permissible correction for myopia and hyperopia 8.0DDDD.

Lack of vision in one eye with visual acuity below 0.8 (without correction) in the other.

The central scotoma is absolute or relative (with a scotoma and the presence of changes in visual function not lower than the values \u200b\u200bspecified in paragraph 1 of this column of the subparagraph - admission without restrictions).

Condition after refractive surgery on the cornea (keratotomy, keratomileusis, keratocoagulation, refractive keratoplasty). Allowed to drive a person 3 months after surgery with visual acuity with correction of at least 0.6 in the best eye, not lower than 0.2 - at the worst.

Permissible correction for myopia and hyperopia 8.0D, including contact lenses, astigmatism - 3.0D (the sum of the sphere and the cylinder must not exceed 8.0D). The difference in lens strength between the two eyes should not exceed 3.0D, in the absence of complications and initial (before surgery) refraction - from +8.0 to -8.0D... If it is impossible to establish preoperative refraction, questions professional suitability are resolved positively with an eye axis length from 21.5 to 27.0 mm.

Artificial lens in at least one eye. Trained drivers are allowed with visual acuity with correction of at least 0.6 for the best eye, not less than 0.2 for the worst. Permissible correction for myopia and hyperopia 8.0D, including contact lenses, astigmatism -
3,0 D(the sum of the sphere and the cylinder must not exceed 8.0D). The difference in lens strength between the two eyes should not exceed 3.0D, normal field of vision and no complications within six months after surgery.

Chronic diseases of the membranes of the eye, accompanied by a significant impairment of the function of vision, persistent changes in the eyelids, including their mucous membranes, paresis of the eyelid muscles that impede vision or limit the movement of the eyeball (after surgical treatment with a positive result, admission is carried out individually).

Chronic, not amenable to conservative treatment, inflammation of the lacrimal sac, as well as persistent, refractory lacrimation.

Paralytic strabismus and other disorders of friendly eye movement.

Persistent diplopia due to strabismus of any etiology.

Spontaneous nystagmus when the pupils deviate 70 ° from the middle position.

Limiting the field of view by more than 20 0 in any of the meridians.

Violation of color perception.

Diseases of the retina and optic nerve (retinitis pigmentosa, optic nerve atrophy, retinal detachment, etc.).

Glaucoma

The absence of one upper or lower limb, hand or foot, as well as deformation of the hand or foot, which significantly impedes their movement. As an exception, persons with one amputated lower leg may be allowed if the amputation stump is at least 1/3 of the lower leg and the mobility in the knee joint of the amputated limb is completely preserved.

The absence of fingers or phalanges, as well as immobility in the interphalangeal joints:

missing two phalanges thumb on the right or left hand;

absence or immobility of two or more fingers on the right hand, or complete reduction of at least one finger;

absence or immobility of three or more fingers on the left hand or complete reduction of at least one finger (while maintaining the grasping function and strength of the hand, the issue of admission to control is decided individually).

Shortening of the lower limb by more than 6 cm - those examined can be considered suitable if the limb does not have defects in the bones, soft tissues and joints, the range of motion is preserved, the length of the limb is more than 75 cm (from the calcaneus to the middle of the greater trochanter of the thigh).

The absence of an upper limb or hand, the absence of a lower limb at any level of the thigh or lower leg with impaired mobility in the knee joint.

Traumatic deformities and defects of the bones of the skull with the presence of pronounced neurological symptoms that impede control vehicles... In the presence of minor neurological symptoms, admission is carried out individually with a re-examination after one year.

Complete deafness in one ear when perceiving spoken language to the other at a distance of less than 3 m, whispering speech at a distance of 1 m, or perceiving spoken language to each ear less than 2 m (with complete deafness, deaf-muteness, admission is carried out individually with re-examination at least 2 years).

Chronic unilateral or bilateral purulent inflammation of the middle ear, complicated by cholesteatoma, granulation or polyp (epitympanitis). The presence of a fistular symptom (after surgical treatment with good result the issue is resolved individually).

Chronic purulent mastoiditis, complications due to mastoidectomy (cyst, fistula).

Diseases of any etiology causing dysfunctions of the vestibular analyzer, dizziness syndromes, nystagmus (Meniere's disease, labyrinthitis, vestibular crises of any etiology, etc.).

Diseases of the endocrine system of a progressive course with persistent pronounced dysfunctions of other organs and systems (admission to driving is decided individually, subject to annual re-examination after examination and treatment by an endocrinologist).

Ischemic heart disease: unstable angina pectoris, exertional angina, FCIII Art., high-grade heart rhythm disturbances or a combination of these conditions (admission to driving is decided individually, subject to annual re-examination after examination and treatment by a cardiologist).

Essential hypertension III stages, 3 degrees, risk 1V (admission to driving is decided individually, subject to annual re-examination based on the results of treatment and recommendations of a cardiologist)

Diseases of the bronchopulmonary system with symptoms of respiratory failure or pulmonary heart failure 2-3 tbsp. (admission to driving is decided individually after examination and treatment by a pulmonologist).

Prolapse of the uterus and vagina, retrovaginal and vesicovaginal fistulas, perineal ruptures with violation of the integrity of the rectal sphincters, dropsy of the testicle or spermatic cord, hernia and other diseases that cause restrictions and painful movements that impede driving.

The organization of medical examinations at some enterprises is mandatory. And the admission of employees to work without going through it entails serious legal implications for the employer. We decided to investigate in detail and tell you in which cases employees are required to undergo a medical examination, what threatens the employer for admission to work without examination, and how to issue a referral.

According to article 46 Federal Law dated November 21, 2011 No. 323-FZ, a medical examination is a complex of medical interventions aimed at identifying pathological conditions in workers. Thus, this is not only a useful measure for employees, allowing early detection of dangerous diseases, but also a good opportunity for employers to avoid industrial accidents with all the ensuing legal consequences.

Types of medical examinations

Article 46 of Federal Law No. 323-FZ of 21.11.2011 identifies the following types of medical examinations:

• preventive - aimed at early detection of dangerous diseases and conditions;
• preliminary - is carried out when hiring;
• periodic - carried out at enterprises in the periods established by regulatory enactments in order to identify and prevent occupational and other diseases;
• pre-shift or pre-trip - performed immediately before the employee leaves the shift;
• post-shift or post-travel - carried out at the end of the working day.

All of the listed types of medical examinations, according to articles and 213 Labor Codemust be paid by the employer. And for the duration of its passage, the employee must retain the average wage and position. This is stated in the articles, and 219 of the Labor Code of the Russian Federation... The cost of carrying out such medical examinations can be taken into account in the cost of profit, in accordance with sub. 7 p. 1 art. 264 Tax Code... The Ministry of Finance recalled this in a Letter dated 26.11.2018 No. 03-03-06 / 1/85069.

Order No. 302n on the passage of medical examinations

Order No. 302н dated 04/12/2011, adopted by the Ministry of Health and Social Development, establishes mandatory preliminary and periodic medical examinations for workers associated with hazardous types of production and in contact with factors harmful to health. Order No. 302n contains Appendix 1, which contains a list of harmful and hazardous production factors, in the presence of which compulsory medical examinations... Their approval has become one of the main innovations in the field of employee health monitoring. Information in this normative act presented in the form of a table, which, in addition to the name of harmful phenomena in the workplace, indicates the frequency of examinations, as well as a list of doctors that employees should visit. For example, workers who come into contact with nitrogen compounds should see an otorhinolaryngologist and dermatovenerologist once every two years.

As for the list of works in which it is mandatory to undergo medical examinations, Order No. 302n in Appendix 2 contains the relevant information. The table provides a direct list of activities, the frequency of visits to doctors, their list, as well as the types of tests required and contraindications for continuing labor activity... For example, drivers land transport must visit a neurologist, ophthalmologist, otorhinolaryngologist, surgeon and dermatovenerologist once every two years.

In 2018, by Order No. 49n dated 06.02.2018, changes were made to the Procedure - the list of employees was expanded and clarified social sphere, which must be annually examined by a dermatovenerologist, otorhinolaryngologist, dentist and infectious disease specialist, as well as a number of examinations: now the requirements apply to those workers who provide social services in stationary and semi-stationary forms of social services, as well as at home.

We would like to emphasize that employees under the age of 18 are subject to a mandatory medical examination, and employees under the age of 21 are required to undergo a medical examination annually.

The procedure for conducting a medical examination

The procedure for medical examination of employees is regulated by chapters 1 and 3 of Order 302 of the Ministry of Health. This document contains a detailed algorithm for organizing the event. The procedure for conducting preliminary and periodic inspections is somewhat different from each other. Let's consider both algorithms in more detail.

Preliminary medical examination

This type of examination is carried out when an employee is hired on the basis of a referral. This document is filled out based on the list of contingents for which a medical examination is mandatory. The existing legislation does not provide for a unified form of referral. However, in the 302nd Order on medical examinations there is a list of information that must be indicated. Thus, each company can independently develop the form of this document. However, in practice, employers try to use the forms used in hospitalsas this avoids controversial issues.

In the direction for a medical examination, the following data should be contained:

• employer name;
• form of ownership and type economic activity;
• the name of the medical institution, its address and OGRN code;
• type of inspection;
• FULL NAME. employee;
• date of Birth;
• name structural unit and positions;
• hazardous factors and types of work that the employee will face;
• FULL NAME. and the signature of the person responsible for issuing the referral;
• employee signature;
• FULL NAME. an employee responsible for recording the issued referrals.

A sample referral is shown below.

After receiving this document, the candidate for the vacancy is sent to a medical institution, where he provides a referral, passport, health passport (if any) and, if necessary, a psychiatric report. Then a medical card and a health passport are entered on the employee, where the conclusions of specialists are entered.

As a result of the medical examination, the employee is issued a conclusion, which indicates the result of the examination. Namely, are there any contraindications for the implementation of a specific type of activity? This document is drawn up in duplicate. One of them is attached to the outpatient card, and the second is issued to the employee.

Periodic physical examination

The considered type of inspections is carried out on the basis of the list of names. They include all employees engaged in hazardous or harmful work, with an indication of the position and harmful factor. The list must be prepared no later than two months before the start of the medical examination.

An important innovation is that immediately before undergoing a medical examination, the employer must give the employee a referral, which is drawn up in the same way as during the preliminary examination.

The medical organization with which the employer must have a contract prepares calendar plan inspections, which must be provided to the employer no later than 14 days before the start of the inspection. Further, the medical examination process takes place in the same order as the preliminary one, and ends with the issuance of conclusions to the employees. The medical organization then summarizes the findings and reflects them in the final act. This document states:

• the number of employees who have passed the inspection;
• the number of employees with contraindications;
• how many employees need treatment and additional examination, and so on.

The act is drawn up in four copies, which are certified by the head of the commission. One copy is sent to the enterprise, the second remains in the medical institution, the third - to the occupational pathology center, the fourth - to the territorial executive body responsible for the sanitary and epidemiological situation.

Responsibility of the employer and employee for admission to work without a medical examination

The existing legislation provides for liability for employers who admit employees to work without undergoing a mandatory medical examination. The punishment for such an offense is provided for in part 3 article 5.27.1 of the Administrative Code of the Russian Federation... According to this norm, officials face a fine of 15,000 to 25,000 rubles. For persons carrying out entrepreneurial activity without forming a legal entity - from 15,000 to 25,000 rubles. For legal entities promises a fine of 110,000 to 130,000 rubles. It should be borne in mind that the amount of the fine depends on the number of workers illegally admitted to work. If, due to evasion of medical examination, the employee's health is harmed or his death occurs, the employer's actions will be qualified in accordance with the norms of the Criminal Code.

As for employees who refuse to undergo a medical examination for any reason, they should be suspended from work until such time as they have a certificate confirming fitness for work. This responsibility is provided. We emphasize that during the period of suspension, the employee's wages are not saved, and he must be familiar with this fact.

Since the date of its original publication, the order 302n itself on the passage of medical examinations has never been changed or supplemented, but in 2013 and 2015 changes were made to its appendices.

Compared to the original edition, the following changes have been made to the annexes:

• the list of hazardous and harmful production factors has been expanded, for example:
  • chemical factors added welding aerosols with manganese and silicon-containing compounds;
  • in biologicals, the number of allergens, infected material has been significantly expanded and hepatitis B, C and AIDS viruses have been added, etc .;
  • a new section on ionizing radiation and increased gravitational overloads, etc., has been added to the physical;
• the number of specialist doctors performing medical examinations has increased (dentists, allergists, endocrinologists have been added to the sections where they were not originally there);
• the number of additional contraindications for work in certain conditions (for example, in electromagnetic fields) and certain types of work (for example, for work in remote geographic areas and for working with machine tools);
• a completely new section of substances and compounds, united by chemical structure, causing various kinds of diseases has been added (section 1.2 chemical factors), and the list of pesticides has been significantly expanded (section 1.3.2).

Contingent List by Order 302n

The contingent of workers who, in accordance with the order of the Ministry of Health and Social Development dated 04/12/2011 No. 302n, must be sent for a medical examination, is formed from the list of positions and professions for which employees are subject to a medical examination.

Everyone who is busy is sent for inspection:

• in harmful and dangerous working conditions ( chemical production, ionizing radiation, etc., a complete list of factors is indicated in Appendix No. 1);
• on a certain kind works (at height, under water, underground, etc., a complete list is given in Appendix No. 2).

The contingent list is mandatory document and should contain:

• the names of positions and professions, during employment for which mandatory and periodic medical examinations are carried out in accordance with current legislation (Appendix No. 2);
• harmful and dangerous working conditions (Appendix No. 1). Necessary clarification: all working conditions are determined based on the results of a special assessment of working conditions.

Due to the fact that the form of the document is not legally approved, it can be made in the form of a list, order 302n with the change in 2019 on the medical examination permits this.

Harmful production factors by profession

Each profession has its own harmful working conditions, but Order 302 of the Ministry of Health does not provide for a referral for a medical examination by profession as such. But it provides for the presence or absence of harmful and dangerous production factors, such as an increased level of electromagnetic radiation and decreased physical activity of the computer operator.

According to order 302n, harmful production factors by profession are:

• chemical;
• biological;
• physical;
• conditions of the labor process associated with the performance of work in certain conditions and with certain substances that can cause harm to health or lead to the death of a person.

The presence or absence of specific harmful conditions labor is determined based on the results of a special assessment of working conditions carried out in accordance with Federal law dated 28.12.2013 No. 426-FZ. Comprehensive checklists harmful factors are set out in Appendix No. 1 to order 302n on the passage of medical examinations.

List of employees by order 302n

A list of employees according to order 302 is compiled each time employees are sent for periodic medical examinations.

This document is drawn up on the basis of the "Contingent ..." (302n dated 04/12/11 of the Ministry of Health and Social Development, referral for a medical examination) and includes:

1. FULL NAME. employee, his profession or position.
2. The name of the harmful or hazardous production factor.
3. The name of the structural unit.

How to get a 302n referral for a medical examination

According to the norm, which was approved by Order 302n of 04/12/11 of the Ministry of Health and Social Development, a referral for a medical examination is issued during an interview for employment, while the candidate must sign for receiving the referral in a special journal. The referral is issued by an employee performing documenting hiring and firing employees.

In the direction by order 302n, the following must be indicated:

1. The name of the organization that issued the referral.
2. Ownership and eight-digit code of economic activity according to OKVED.
3. The name of the medical organization, the actual address of its location and the OGRN code.
4. Type of medical examination (preliminary or periodic).
5. FULL NAME. a person entering or working employee.
6. Date of birth of the person applying for the job (employee).
7. The name of the structural unit (if any) in which the candidate (or current employee) will be employed.
8. The name of the position (profession) or type of activity.
9. Harmful and hazardous production factors, as well as the type of work in accordance with the approved "Contingent of workers".

The referral is signed by the employee who issued the referral, indicating his position, surname, initials.

Final act of physical examination

In accordance with order 302n, a medical organization, upon completion of a periodic medical examination by employees, together with representatives of the employer and Rospotrebnadzor, draws up a final act by order 302n, which indicates:

• date of preparation;
• employer name;
• the name of the medical organization;
• the percentage of employees covered by periodic medical examinations;
• a list of newly established chronic somatic diseases with an indication of the class of diseases;
• the results of the implementation of the recommendations of the previous final act;
• recommendations for the implementation of a complex of recreational activities;
• lists of workers who have not completed, have not undergone a periodic medical examination, as well as those who have established a persistent degree of disability and other indicators ( full list there is in paragraph 43 of the procedure for conducting preliminary medical examinations by order 302n).

The final act on order 302 is approved by the chairman of the commission, who certifies it with the seal of the medical organization.

Order of the Ministry of Health and social development RF of April 12, 2011 N 302n "On the approval of lists of harmful and (or) hazardous production factors and works, in the performance of which mandatory preliminary and periodic medical examinations (examinations) are carried out, and the Procedure for conducting mandatory preliminary and periodic medical examinations (examinations) workers engaged in heavy work and work with harmful and (or) dangerous conditions labor "(with changes and additions)

Order of the Ministry of Health and Social Development of the Russian Federation of April 12, 2011 N 302n
"On approval of the lists of harmful and (or) hazardous production factors and work, in the performance of which mandatory preliminary and periodic medical examinations (examinations) are carried out, and the Procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions "

With changes and additions from:

a list of works in the performance of which mandatory preliminary and periodic medical examinations (examinations) of employees are carried out, in accordance with Appendix No. 2;

The procedure for conducting mandatory preliminary (upon admission to work) and periodic medical examinations (examinations) of workers engaged in heavy work and in work with harmful and (or) dangerous working conditions, according to Appendix No. 3.

2. Introduce lists of harmful and (or) hazardous production factors and work, during which preliminary and periodic medical examinations (examinations) are carried out, and the Procedure for conducting preliminary and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions, from January 1, 2012.

order of the Ministry of Health and Medical Industry Russian Federation dated March 14, 1996 N 90 "On the procedure for conducting preliminary and periodic medical examinations of workers and medical regulations for admission to the profession" (according to the conclusion of the Ministry of Justice of Russia, a document in state registration does not need, letter dated December 30, 1996 N 07-02-1376-96);

order of the Ministry of Health and Social Development of the Russian Federation of August 16, 2004 N 83 "On approval of the lists of harmful and (or) hazardous production factors and work, during which preliminary and periodic medical examinations (examinations) are carried out, and the procedure for conducting these examinations ( surveys) "(registered by the Ministry of Justice of the Russian Federation on September 10, 2004 N 6015);

order of the Ministry of Health and Social Development of the Russian Federation of May 16, 2005 N 338 "On Amendments to Appendix N 2 to the Order of the Ministry of Health and Social Development of Russia of August 16, 2004 N 83" On Approval of Lists of Harmful and (or) Dangerous Production Factors and Works , during which preliminary and periodic medical examinations (examinations) are carried out, and the procedure for conducting these examinations (examinations) "(registered by the Ministry of Justice of the Russian Federation on June 3, 2005 N 6677).

4. To establish that since January 1, 2012 on the territory of the Russian Federation, subparagraphs 11 (with the exception of subparagraphs 12.2, 12.11, 12.12), Appendix No. 2 to the order of the USSR Ministry of Health of September 29, 1989 No. 555 "On improving the system medical examinations of workers and drivers of individual vehicles ".

New lists of harmful and (or) hazardous production factors and works were approved, during which preliminary and periodic checkups (surveys). The procedure for conducting such inspections has been revised.

The lists establish the frequency of examinations, the composition of the medical specialists participating in them. The laboratory and functional studies carried out are listed, medical contraindications to work.

The examination can be carried out by any medical organization that has such a right, as well as carrying out an examination of professional suitability. The medical commission includes an occupational pathologist and medical specialists who have completed advanced training in the specialty "occupational pathology" or have a valid certificate for it.

The employer issues a referral for examination. Requirements for its completion are given. The employee presents a passport and a referral to the medical organization. A medical card and a health passport (if not available) are issued for him. The latter, after inspection, is handed over to the employee.

For periodic examinations, the employer sends to the medical organization list of names employees, on the basis of which the inspection schedule is drawn up. At the end of the examination, a medical certificate is drawn up in 2 copies (the first is issued to the employee, the second is attached to the medical record). The employee is assigned to one of the dispensary groups, they give recommendations for the prevention of diseases, if there are medical indications - for further observation, treatment and rehabilitation. If an occupational disease is suspected, a referral to an occupational pathology center is issued.

Participants of accidents, persons with persistent consequences of industrial accidents and a number of other workers pass through the periodic inspections in the centers of occupational pathology.

Based on the results of examinations, the medical organization draws up a final act and sends it to the employer, to the occupational pathology center, as well as to the territorial body of Rospotrebnadzor.

Order of the Ministry of Health and Social Development of the Russian Federation of April 12, 2011 N 302n "On the approval of lists of harmful and (or) hazardous production factors and works, during which mandatory preliminary and periodic medical examinations (examinations) are carried out, and the Procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions "