The on-the-job physical examination is a kind of special physical examination, which aims to ensure that employees' physical condition is suitable for their professional work, and will not cause the epidemic of infectious diseases in collective life and will not affect others because of personal physical reasons. There are relatively fixed physical examination items and standards, and choosing a professional physical examination center can ensure the quality of physical examination. However, due to the simple content of physical examination, it cannot completely replace health examination.
Chinese name: On-the-job physical examination
Mbth: entrance examination
General items: blood drawing, blood routine 18, etc.
Special requirements: no hepatitis B survey.
Objective: To prevent infectious diseases.
Precautions: Eat regularly before physical examination.
background
With the development of science and technology, the continuous progress of society and the improvement of living standards, general units require physical examination. It is necessary to make good preparations before the physical examination if it is to be carried out smoothly without interference from other factors. Physical examination is a basic measure for enterprises to protect the health interests of most people for their own production and collective activities, mainly to prevent infectious diseases. Physical examination can't reflect one's health level.
People generally need to know clearly the matters needing attention before physical examination to avoid unqualified physical examination. In addition, it is necessary to understand the medical examination process and the medical examination eligibility criteria.
Matters needing attention
Dietary principle
1, please keep a normal diet for three days before physical examination.
2. Pay attention to rest the day before the physical examination, and don't drink alcohol and eat high-fat and high-protein foods.
3. Stop eating after dinner the day before the physical examination, and take blood on an empty stomach 10- 12 hours.
4. Fasting and drinking water on the morning of the physical examination, and eating after completing fasting items (blood drawing, abdominal color Doppler ultrasound, human body composition).
Female concern
1. Women should avoid routine gynecological examination, urine and urine examination and transvaginal color ultrasound examination during menstruation. Please inform the medical staff in advance and arrange other unchecked items.
2. Avoid X-rays and gynecological examinations during pregnancy. Please inform the medical staff in advance.
3. Please hold your urine before gynecological color ultrasound examination.
4. Gynecology and transvaginal color ultrasound should be performed 5-7 days after menstruation is clean. Vaginal medication is prohibited the day before the examination to avoid sexual life.
Special population
1. For patients with chronic diseases such as diabetes and coronary heart disease, please take routine (first aid) drugs with you.
2. For those with blood sugar 2 hours after meals, eat two steamed buns (from the first bite) and draw blood for 2 hours after completing the fasting project.
3. Please inform the doctor of your discomfort and illness during the physical examination, so as to pay attention to the key examination, comprehensive analysis and evaluation.
Physical examination process
Consultation and selection (front desk individual, information department collective, can make an appointment by phone)
On-the-job physical examination (2)
pay
The reception desk receives the medical examination notice or form.
Check blood drawing, abdominal color ultrasound and human color ultrasound before meals.
have a meal
Examination of various subjects
Color Doppler ultrasound (uterus, adnexa, prostate)
Check physical examination items
Return the medical examination notice or form to the reception desk.
Physical examination results are generally available after three days [1]?
Selection of physical examination institutions
1. The physical examination center with the most accurate data should be selected. The accuracy of data depends on the equipment, instruments, reagents used in physical examination and the experience of doctors.
2. The selection of projects can best reflect the requirements of WHO. The five principles of WHO are:
(1) The incidence of community diseases is high;
(2) The screened diseases are meaningful;
(3) Disability and mortality can be reduced after screening and treatment;
(4) The screened diseases have effective treatment methods;
(5) The screening method has high sensitivity, accuracy and low cost.
You should choose the most professional physical examination center.
(1) Physical examination must be separated to avoid cross infection. Therefore, it is recommended that you have a physical examination and try not to go to the hospital and use the same equipment as the patient for examination.
(2) Check the doctor's operation level and work experience.
4. You should choose the physical examination center with the best service in the later period.
Physical examination is not the purpose, but the later health promotion and health management are the most important, which is difficult to do in general hospital physical examination. Except for the three major health check-up institutions in the world, the general health check-up centers are not very professional.
You must go to the hospital for a blood test on an empty stomach. It is stipulated that hospitals above Grade II are effective, or hospitals designated by the company. Now it is between 98- 108 yuan.
Prepare for physical examination
At present, many employees need to undergo routine health examination before taking up their posts. However, many problems are often exposed in the pre-job physical examination. For example, a normal graduate who is about to become a primary school teacher recently found suspected tuberculosis in physical examination and was further diagnosed as obsolete tuberculosis. If it is active tuberculosis, it is difficult to cure for a while, and the graduate student's job is likely to be ruined; A prospective civil servant admitted to the traffic police post was brushed off because his naked eye vision was not up to standard. If he can find symptomatic treatment earlier, he has successfully embarked on his job now; A business graduate found abnormal urine protein in the physical examination, and was diagnosed as chronic pyelonephritis by further examination, and his renal function has declined. At present, she lives on hemodialysis, and her work is naturally hopeless ... [2]?
Wait, these events fully demonstrate the importance of preparing for physical examination before employment. Therefore, Jiang Yongbao, director of the physical examination center, suggested that job seekers might as well do a preparatory physical examination before applying for a job and have a general understanding of their physical condition. Once a serious illness is found, job seekers also have relatively ample time for treatment.
physical examination
General project
1. Bleeding
Laboratory test (all disposable vacuum negative pressure blood collection tubes are used)
Medical report
2. Blood Routine 18 Project
Check for anemia, inflammation, blood diseases, etc. Red blood cell number (RBC), white blood cell number (WBC), platelet number (PLT), hemoglobin (HGB), intermediate cell number (Mid#), lymphocyte number (lymph #), granulocyte number (Gran#), average red blood cell volume (MCV), average red blood cell hemoglobin (MCH), average red blood cell hemoglobin concentration (MCH) Red blood cell distribution width (RDW), hematocrit (HCT), platelet distribution width (PDW), hematocrit (PCT), lymphocyte percentage (lymph%), granulocyte percentage (Gran%) and intermediate cell percentage (Mid%)*** 18 test results. Anemia, inflammation, abnormal hemostasis, hematological diseases, liver and spleen diseases and temporary infections can be found.
3. Liver function
Alanine transaminase (ALT) is the most direct index of liver function.
4. Blood type
Blood group test
5, chest fluoroscopy, also known as X-ray examination, is mainly to check the health of the lungs. Here, we should remind those who are planning to get pregnant or are already pregnant not to do chest X-ray examination, which will have side effects on children's health.
6. Medical examination mainly includes the doctor's pressing and auscultation examination of the heart, liver, lung, spleen, kidney and gallbladder for systematic examination.
7. Surgeons check whether there are any injuries on the skin and spine by observing and touching. [3]?
8, hematuria routine hematuria routine examination.
Departmental project
1. electrocardiogram
The most common way to check the heart. The examination of ECG reactive diseases is the most accurate diagnostic method, especially for arrhythmia, myocardial ischemia and other non-circulatory diseases, such as hypokalemia and hyperthyroidism.
2. chest x-ray
Examination of heart, lung and diaphragm diseases
3. Choose one of the following options
A. Internal medicine
Examination of heart, lung, liver, spleen, gallbladder and nervous system.
B. Ophthalmology
Visual acuity, eyelid, conjunctiva, eyeball, color vision, fundus, slit lamp examination, etc. Among them, through slit lamp examination, fundus changes caused by lesions in other parts of the body can be found. Such as: diabetes, hypertension and so on.
survey fee
Five items of hepatitis B (hepatitis B surface antigen exchange)
Determine whether you are infected with hepatitis B virus, whether you are immune to hepatitis B, and prompt whether the virus replicates.
On the morning of February 29, 2009, the Ministry of Health held a media briefing on the problems related to the detection of hepatitis B virus in physical examination. Mao Qunan, a spokesperson for the Ministry of Health, said that the Ministry of Health plans to formulate a policy in the near future to cancel the "five items of hepatitis B" (that is, two and a half items of hepatitis B) in the physical examination for enrollment and employment. It is explicitly forbidden to carry hepatitis B virus as a condition to restrict enrollment and employment. At present, the problem of hepatitis B virus carriers being restricted and treated unfairly in enrollment and employment is still outstanding. In order to properly solve this problem, the relevant departments have carefully demonstrated and made careful decisions on whether hepatitis B virus carriers affect the health of others, and intend to formulate this policy in the near future.
At present, the state has completely banned employers and medical institutions from requiring two and a half items (that is, five items of hepatitis B) in physical examination, only requiring normal liver function.
But there are still some small companies that have this requirement. If they encounter problems in this respect, they can seek legal aid. In the world, hepatitis B carriers can engage in any industry, which is the gap between China's current cognition of hepatitis B and international cognition.
reference standard
Article 1 Organic heart diseases such as rheumatic heart disease, cardiomyopathy, coronary heart disease, congenital heart disease and Keshan disease are unqualified. People with congenital heart disease who don't need surgery or surgical cure are qualified. In case of any of the following circumstances, the reasonable change of heart disease is ruled out and qualified:
(a) the heart auscultation physiological murmur;
(2) Contraction is less than 6 times per minute (strictly controlled for those with a history of myocarditis);
(3) The heart rate is 50-60 beats per minute or 100- 1 100;
(4) Other conditions of abnormal electrocardiogram.
Article 2 The blood pressure is qualified when it is within the following range: systolic blood pressure is 90 mmHg-140 mmHg (12. 00- 18。 66 kpa)； Diastolic pressure 60mmHg-90mmHg(8. 00- 12。 00 kpa).
Article 3 Blood disease, unqualified. Simple iron deficiency anemia, male hemoglobin is higher than 90g/L and female hemoglobin is higher than 80g/L, which is qualified.
Article 4 Tuberculosis is unqualified. But the following conditions are qualified:
(1) Primary pulmonary tuberculosis, secondary pulmonary tuberculosis and tuberculous pleurisy, and the stable period after clinical cure is 65438 0 years;
(2) Extrapulmonary tuberculosis: renal tuberculosis, bone tuberculosis, abdominal tuberculosis, lymph node tuberculosis, etc. There was no recurrence in 2 years after clinical cure, and there was no change after examination in a specialized hospital.
Article 5 Chronic bronchitis with obstructive emphysema, bronchiectasis and bronchial asthma is unqualified.
Sixth serious chronic gastrointestinal diseases, unqualified. Gastric ulcer or duodenal ulcer has healed, and there is no bleeding history within 1 year, and those who are asymptomatic above 1 year are qualified; Those without serious complications after subtotal gastrectomy are qualified.
Class VII acute and chronic hepatitis, unqualified. After examination, hepatitis was excluded, and the carrier of hepatitis B pathogen was qualified.
Article 8 All kinds of malignant tumors and liver cirrhosis are unqualified.
Article 9 Acute and chronic nephritis, chronic pyelonephritis, polycystic kidney disease and renal insufficiency are unqualified.
Tenth diabetes, diabetes insipidus, acromegaly and other endocrine system diseases, unqualified. Those who have no symptoms and signs 1 year after hyperthyroidism is cured are qualified.
Article 11 Those who have a history of epilepsy, psychosis, hysteria, sleepwalking at night and severe neurosis (frequent headache, dizziness, insomnia, obvious memory loss, etc.). ), but the abuse and dependence of psychoactive substances are unqualified.
Twelfth lupus erythematosus, dermatomyositis, polymyositis, scleroderma, polyarteritis nodosa, rheumatoid arthritis and other diffuse connective tissue diseases, unqualified.
Thirteenth advanced schistosomiasis, advanced filariasis with rubber swelling or chyluria, unqualified.
Fourteenth skull defect, intracranial foreign body retention, brain malformation, post-traumatic syndrome, unqualified.
Fifteenth severe chronic osteomyelitis, unqualified.
Sixteen degree simple goiter, unqualified.
Seventeenth gallstones or urinary stones with obstruction are unqualified.
Article 18 Takayasu's arteritis, angiitis obliterans and Raynaud's disease are unqualified.
Nineteenth gonorrhea, syphilis, chancre, sexually transmitted lymphogranuloma, condyloma acuminatum, genital herpes and AIDS are unqualified.
Twentieth binocular corrected vision is less than 0.8 (standard logarithmic vision is 4.9) or people with eye diseases with obvious visual impairment are unqualified.
Twenty-first both ears have hearing impairment, and those who can't hear in a whisper within 3 meters when wearing a hearing aid are not qualified.
Twenty-second other serious diseases that are not included in the medical examination standards and affect the normal performance of duties are unqualified. [4]?
halt
There is discrimination
Xiao Sanyang, some diseases unrelated to employment, and the disabled are all worried about being discriminated against during physical examination. Problems such as disability discrimination and health discrimination are common in real employment. Monday's super homicide in 2003 was a vicious case caused by this discrimination. On Monday, poor and excellent college graduates topped the civil service examinations, written examinations and interviews, but were turned away because of the "Little Three Sheep" found in the physical examination. In anger, he raised his knife at the staff in charge of recruitment.
From June 5438 to/kloc-0 to October 20, 2005, the "General Standard for Civil Servants' Employment Physical Examination (Trial)" issued by the Ministry of Personnel and the Ministry of Health was officially implemented, and hepatitis B virus carriers finally jumped out of the forbidden list.
According to statistics, the number of hepatitis B virus carriers in China is nearly 654.38+0 billion, but such a huge population is facing various crises in employment and job hunting because of social prejudice. The Investigation Report on the Survival and Treatment of Hepatitis B Patients in China released by Chinese Medical Association on June 5438+ 10, 2005 shows that more than 50% of hepatitis B patients have lost their ideal job and study opportunities, and 47% of them are worried that they will lose their jobs if they are diagnosed with hepatitis B. ..
Mr. Lu Jun, the general coordinator of Beijing Yirenping Center and the head of hepatitis B public welfare website, said that because many people don't know about hepatitis B, discrimination spreads. Although the anti-hepatitis B discrimination movement and voice have never stopped in recent years, there is still too much discrimination due to deep-rooted prejudice.
Falsification phenomenon
In Beijing, Shanghai, Shenzhen and other places, there was such an ethnic group many years ago. For example, their job is to help them get a "qualified health examination form" when they enter school and work. They went in and out of major hospitals, waiting for an opportunity to replace the customers in the blood drawing laboratory and let their blood be taken away by the laboratory. People call this nation "Dai Jian". In recent years, the most famous is "assured physical examination instead of inspection"! Most comrades-in-arms have been looking for them to act as agents for cheating in on-the-job medical examinations.
Did not investigate hepatitis B.
National laws prohibit five tests for hepatitis B, not to mention DNA. 20 10/0,65438+21,the Ministry of Health and other three ministries and commissions issued "Opinions on Further Safeguarding the Employment Rights and Interests of HBsAg Carriers (Draft for Comment)", which clearly stipulated that five items of hepatitis B should be cancelled in the physical examination of enrollment and employment, and medical and health institutions at all levels should not provide five items of hepatitis B in the physical examination of enrollment and employment. Speaking of the topic of hepatitis B discrimination, can this provision be alleviated?