OCCUPATIONAL HEALTH SERVICES ACT 

of 27^th June 1997

Art. 1. With the aim of protecting the health of those exposed to hazardous conditions connected with working environment and the way the work is being performed, and with the aim of covering all the workers preventive health care, occupational health services are established.

Art. 2 1. Occupational health services consist of physicians, nurses, psychologists and other persons having professional qualifications useful for the accomplishment of multidisciplinary tasks of this services.

2. Those mentioned in sec. 1 perform occupational health services tasks within their employment in health care facilities as listed in sec. 3 entry 1 let. a) and b) and entry. 2, or they may accomplish them outside those institutions within their individual practice.

3. Organizational units of occupational health services are:

1) primary units:
    a)public health care facilities, founded and maintained with the aim of providing the preventive health care for         workers,
    b)health care facilities founded and maintained by employers and other subjects, if the preventive health care         for workers is their statutory task,
    c)physicians who carry on individual practice, further on referred to as the "primary units of occupational health          services",
2) voivodeship or intervoivodeship centers of occupational health.

  Art. 3. Those who perform occupational health services tasks while accomplishing professional activities, are independent of employers, workers and their representatives and other subjects who ordered them to accomplish the tasks of the services.

  Art. 4. Whenever the Act refers to:

1) preventive health care - all those activities are meant which are aimed at the prevention of the occurrence and spreading of adverse health effects, associated, whether directly or indirectly, with the conditions or type of work, 2) workers - people mentioned in art. 5 sec. 1 and 3 are meant,
3) employer - organizational unit is meant (also those without the status of legal person), and also natural person - if those have employees - or the service /on duty/ subject which acts as the employer,
4) occupational risk - means a possibility of the occurrence of adverse health effects resulting from occupational hazards in working environment or from the way the work is being performed,
5) Act on Health Care Facilities - means the Act of 30 August 1991 related to health care facilities (Law Gaz. No 91, sec. 408, of 1992 - No 63, sec. 315, of 1994 - No 121, sec. 591, of 1995 - No 138, sec. 682, and of 1996 - No 24, sec. 110).

Art. 5. 1. Occupational health services perform the tasks specified in the Act with reference to:

1) employees,
2) people in service (on duty),
3) those working according to agreements on cottage work,
4) applicants for secondary or university schools, pupils and students of those schools who within their practical      vocational training are exposed to agents which are hazardous, strenuous or dangerous for health,
5) participants of doctor' degree studies who within their studies are exposed to agents which are hazardous, strenuous or dangerous for health,
6) those who perform their work while being detained at penitentiaries, in custody, or while being imprisoned.

2. Responsibility for rendering the preventive health care rests with:

1) employers - with reference to those listed in sec. 1 entries 1-3,
2) schools, including university schools - with reference to those listed in sec. 1 entry 4,
3) institutions entitled to carry on doctor' degree studies - with reference to those listed in sec. 1 entry 5,
4) employing subjects - with reference to those mentioned in sec. 1 entry 6.

  3. Preventive health care with occupational health services covers on their request the following:

1) those who carry on economic activities on their own account (self-employed) and those who cooperate with them,
2) those who work on other grounds than the employment contract, except for those listed in sec. 1 entry 3,
3) individual farmers and their families as well as members of agricultural production cooperatives,
4) former employees and those who worked on other grounds, not by virtue of the employment contract, as well as those who remained in the service relation.

Art. 6. 1. Occupational health services are competent for accomplishing the following tasks:

1) limiting the harmful effects of work on health, particularly through:

a) identification and assessment of working environment factors and the ways of work performance which may have adverse effect on health,
b) identification and assessment of occupational risk in working environment and informing the employers and workers about the possible occurrence of resultant adverse health effects,
c) rendering to employers and workers the advice on work organization, ergonomics, occupational physiology and psychology,

2) preventive health care for workers, especially through:

a) pre-employment, periodical, and follow-up examinations stipulated in the Labor Code,
b) medical certification for purposes provided by the Labor Code and by regulations issued thereof,
c) evaluation of the possibility of work performance or education, considering the health condition and hazards occurring at the place of work or education,
d) consultative, diagnostic and therapeutic activities within occupational pathology,
e) active care for patients suffering from occupational diseases or other diseases connected with the work they perform,
f) immunization indispensable for the work being performed,
g) health monitoring of special risk group workers, especially those working under the conditions exceeding the hygienic standards, as well as adolescents, the disabled, and women in reproductive age and pregnant,
h) examinations enabling early diagnosis of occupational diseases and other diseases connected with work,

3) outpatient rehabilitation, justified by recognized occupational pathology,
4) arranging and rendering the medical first aid in emergencies occurring at the place of work, service or education,
5) launching and accomplishing the health promotion, especially health-promoting preventive programs, resulting from evaluation of workers health status,
6) initiating employers' actions aimed at employees' health protection, and assistance at their accomplishment, particularly in:

7) analyses of employees' health status, especially occupational diseases and their causes, as well as the causes of accidents at work,
8) collecting, storing and processing of data on occupational exposure, risk, and health status of those covered by the preventive health care.

2. For those who work not by virtue of employment contracts but on other grounds, the occupational health services perform the tasks specified in sec. 1 entries 2-4 and 6-8.
3. For those mentioned in art. 5 sec. 1 entries 4 and 5, the occupational health services perform tasks specified in sec. 1 entry 2 letter c) and - entries 3-8, respectively.
4. The Minister of Justice, in consultation with the Minister of Health and Social Welfare, will specify, by an order, the scope in which the occupational health services perform the tasks towards those listed in art. 5 sec. 1 entry 6.
5. The Minister of Health and Social Welfare, in consultation with the Minister of Education, will specify by an order, the scope and course of medical examinations for those listed in art.5 sec. 1 entries 4 and 5 and the way of documenting these examinations.
6. The Minister of Health and Social Welfare will specify, by an order, the scope and course of accomplishing - by occupational health services - the preventive health care for those mentioned in art. 5 sec. 3, covered by this care at their request.

Art. 7. 1. The occupational health services perform their tasks in cooperation with:

1) employers and their organizations,
2) employees and their representatives, especially the trade unions,
3) physicians who provide the primary health care services,
4) Social Insurance Company, Agricultural Social Insurance Company and Office of Plenipotentiary for the Disabled,
5) State Labour Inspection, State Sanitary Inspection, and other authorities which supervise and control the working conditions,
6) reserach institutions, universities and other organizations and institutions whose activities are directed towards occupational health protection.

2. Cooperation with employers and their organisations and with employees and their representatives consists especially in:

1) current exchange of information on health hazards occurring at workposts; presentation of suggestions on how to confine or remove the hazards,
2) participation in health promoting initiatives for workers, especially those connected with accomplishment of health promotion programmes,
3) realization and selection of health care models and implementation programmes adjusted to the type of workplace and hazards inherent in it.

3. Cooperation with physicians mentioned in sec. 1 entry 3 consists particularly in an exchange of information on the health status of workers covered by their case, especially in the care of diseases which may result from occupational hazards or the way the work is performed.
4. Cooperation with Social Insurance Company, Agricultural Social Insurance Company, and the Office of Plenipotentiary for the Disabled, consists particularly in the performance, by occupational health services, as they order, of specialistic examinations and medical consultations for the authorities which certify work disability, conditioning the right for social insurance benefits and agricultural social insurance benefits, and carrying out certification described in the regulations on employment and vocational rehabilitation of the disabled.
5. Within the cooperation with the State Labour Inspection, State Sanitary Inspection, and other authorities which supervise and control the working conditions:

1) occupational health services units inform appropriate inspections or other authorities about health hazards occurring at workplaces and about cases of failure - on the employer's part - to fulfil his duties related to employees' health care, as determined by the Labour Code, this Act, and regulations issued thereof,
2) relevant inspections and other authorities inform appropriate occupational health services units about the results of inspecting the employers, in the matters which affect the employees' health.

6. Cooperation with research institutions, universities and other organizations and institutions whose activities are aimed at workers health care comprises especially - following the principles specified in other, separate, regulations - participation in research, scientific congresses and symposia, imparting of scientific information, participation in postgraduate training courses and in consultations dealing with settlement of teaching and vocational training programes.

Art. 8. The Ministers of: National Defence, Interiority and Administration, Justice, Transport and Maritime Economy, in agreement with the Minister of Health and Social Welfare, each within his own responsibility area, will determine - by orders - occupational health services tasks not stated in art. 6 sec. 1 and resulting from specific on occupational risk for employees and those remaining in service-relation in subordinated or supervised workplaces or other organizational units.

Art. 9. 1. Entitled to perform the occupational health services tasks within pre-employment, periodical, and follow-up examinations and to provide the preventive health care for employees, indispensable due to working conditions, are the physicians who meet additional qualification requirements, as specified in art. 229 § 8 entry 4 of the Labour Code.
2. Additional qualification requirements, mentioned in sec. 1, are also mandatory for the physicians who accomplish occupational health services tasks specified in art. 6 sec. 1 entry 2 letter c).
3. The Minister of Health and Social Welfare will determine - by an order - medical specialties indispensable for certification of occupational diseases.
4. The Minister of Health and Social Welfare may determine - by an order - occupational health services tasks whose accoplishment by those who are not physicians requires additional qualifications; he will also determine the type and course of acquiring of such qualifications as well as the confirming documents.

Art. 10. 1. Commencement or closure the activities - by a physician or a nurse - within the preventive health care for workers should be notified in appropriate occupational health centre - voivodeship or intervoivodehip - whichever is locally competent.
2. The notification rests with the primary unit of occupational health services or with a nurse in those cases when occupational health services tasks are being accomplished within individual practice.
3. The Minister of Health and Social Welfare will specify, by an order, the information to be included into the notification of commencement or closure the activities by a physician or a nurse providing the preventive health care for workers, and the course of conveying such notifications.

Art. 11. 1. The occupational health services unit carries on the medical documentation for those covered by its activities.
2. The duty of carrying on the medical documentation comprises also a nurse who performs occupational health services tasks within individual practice.
3. The data included in medical documentation should be subjected to professional and official secrecy. The data may be rendered accessible exclusively to the subjects specified in art. 19 and the subjects described in separate regulations.
4. The Minister of Health and Social Welfare will specify by an order, having consulted respectively either the Principal Physicians' Council or the Principal Council of Nurses and Midwives, the type of medical documentation described in sec. 1 and 2 as well as the way the documents are to be collected and stored.

Art. 12. 1. Pre-employment, periodic and follow-up examinations of employees, as well as other medical services, are carried out by virtue of an agreement concluded by the subject which is responsible for their provision, pursuant to art. 5 sec. 2, further on referred to as "ordering party", with the primary unit of occupational health services, further on referred to as "contractor".
2. The agreement should specify particularly:

1) its parties and persons covered by services according to the agreement,
2) scope of the health care which in relation to employees should involve at least those types of services which the ordering party has to provide pursuant to the Labour Code, this Act, and regulations issued thereof.
3) conditions and the way of providing the health services, especially: the way of registering those covered by the agreement, arrangement of services provision, course of conveying the medical certificates on ability to work or education, and the way of transmitting the information to whom it may concern,
4) the way of execution by the ordering party how the provisions of the agreement are met,
5) duties of ordering party towards the contractor, regarding:

a) transmitting the information on the occurrence of hazardous or strenuous conditions, along with current results of tests and measurements of those hazards,
b) arranging for the participation in the committee of safety and hygiene of work acting at the workplace,
c) ensuring the possibility of an inspection of workposts in order to assess the work conditions,
d) rendering available the documentation of the results of inspecting the work conditions as related to health care,

6) amount of charge, calculation method, way and course of payment,
7) possibility of entrusting the third persons - by the contractor - with some duties resulting from the agreement, pursuant to art. 14,
8) the period for which the agreement was concluded, which cannot be shorter than one year,
9) the way of termination of the agreement with notice and cases which give grounds for its immediate effective termination,
10) course of dissolution of controversies connected with accomplishment of agreement and its settlement of accounts especially in cases of stated defects as specified in art.18 sec. 2 entry 2.

3. Accomplishment of occupational health services tasks, specified in art. 9 sec. 4, by the nurse who carries on individual practice is set in with the agreement concluded with the ordering party. The regulation of sec. 2 is applied respectively.

Art. 13. The ordering party, in consultation with employees' representatives, has the right to choose the primary unit of occupational health services.

Art. 14. 1. The primary unit of occupational health services may order by virtue of an agreement, the performance of certain services, especially diagnostic tests and specialist medical consultations, by health care facilities or subjects which render such services within individual practice.
2. The costs of such orders mentioned in sec.1, are charged against the primary unit of occupational health services.

Art. 15. 1. The Voivode, with art. 16 reservation, establishes and maintains the voivodeship centre of occupational health.
2. The head of the voivodeship centre of occupational health is a physician specialized in occupational health or industrial medicine.

Art. 16. 1. Voivodes may enter an agreement on establishing an intervoivodeship centre of occupational health to carry out the tasks mentioned in art. 17 in the voivodeships covered by the agreement.
2. The agreement should particularly specify:

1) location of the intervoivodeship centre of occupational health,
2) inputs contributed by each of the partners,
3) scope of financing the intervoivodeship centre of occupational health and form of settlement of accounts between the partners,
4) the partners rights as regards the contents of the statute, appointing and dismissing the manager of the centre, and liquidation of the centre.

3. The intervoivodeship centre of occupational health is established through the transformation of the voivodeship occupational health centre by the Voivode in whose area the intervoivodeship centre of occupational health will be located.
4. The Voivode mentioned in sec. 3, is entitled to have the rights of the authority which established and maintains the health care facility, as specified in the Act on Health Care Facilities, including the provisions of the agreement.
5. The supervisory board of the intervoivodeship centre of occupational health consists of:

1) as president - representative of the Voivode in whose area of activities the intervoivodeship centre of occupational health is located,
2) as members:

a) representatives of Voivodes who entered the agreement,
b) representatives selected by self-governmental councils in the voivodeships covered by the agreement, two for each voivodeship.

6. Regulation of art. 15 sec. 2 applies respectively.

Art. 17. 1. The tasks of the voivodeship or intervoivodeship centre of occupational health comprise primarily:

1) rendering the consultations to the primary units of occupational health services,
2) carrying on the inspection of the primary units of occupational health services and people who accomplish the tasks within this services outside the health care facilities, to the extent and in the way specified in the Act,
3) carrying on the postgraduate education in occupational health, except those forms which pursuant to, separate regulations are reserved for the competence of other institutions,
4) diagnostics and certification in occupational diseases,
5) examining the appeals from medical certificates issued for the purposes provided by the Labour Code,
6) programming of activities aimed at health promotion and rendering assistance in their accomplishment,
7) rendering consultations to Voivodes and issuing opinions on matters connected with arrangements and functioning of health care for workers and other affairs related to workers' health care,
8) registration of notifications mentioned in art. 10,
9) rendering medical services supplementing the services connected with the activities of the primary units of occupational health services, including those consistent with the rules specified in art. 12 and 14.

2. The voivodeship or intervoivodeship centre of occupational health may, having first received a positive opinion of appropriate research institutes of occupational health, render health services within occupational diseases in those cases which have to be hospitalized.

Art. 18. 1.The inspection, described in art. 17 sec. 1 entry 2, comprises the course, scope, and quality of medical services and health care, as specified in the Act.
2. Basing on the inspection, the manager of the voivodeship or intervoivodeship centre of occupational health:

1) directs to the primary unit of occupational health services a post-inspection report indicating the sources and causes of faults and present suggestions on how to remove them, and specifies the date of notifying about realization of the recommendations contained in those suggestions or reasons for failure to realize them,
2) if significant faults are found as regards the course, scope and quality of health services, he refers to the ordering party a motion for subjecting the contractor to the rigours stipulated in the agreement; at the same time he sends to a locally competent plenipotentiary of professional responsibility in the district chamber of physicians or district chamber of nurses and midwives - a motion of launching legal proceedings due to professional responsibility.

Art. 19. The employees of the voivodeship or intervoivodeship centre of occupational health, entitled to carry on the inspection, have the right to demand:

1) indispensable information and availability of documents, provided that the medical documents may be rendered accessible only to those who perform appropriate medical professions,
2) access to workposts in order to verify assessment made by the primary unit or the subject under inspection.

Art. 20. 1. The Minister of Health and Social Welfare entrusts the research institutes in occupational health with the control of the quality of health services in voivodeship and intervoivodeship centres of occupational health and the control of realization the tasks described in art. 17 sec. 1.
2. Regulations of art. 18 and 19 do not violate regulations on the inspection of health care facilities and regulations on the performance of the profession of physician or regulations on the profession of nurse and midwife.

Art. 21. The State budget covers the costs of:

1) tasks of occupational health services, mentioned in art. 6 sec. 1 entry 2 let. d-f and entries 3 and 4,
2) tasks of occupational health services accomplished pursuant to art. 6 sec. 3,
3) preventive health care for those who work while being detained at penitentiaries, in custody, or while being imprisoned, if it is not the employer who is responsible for the provision of preventive health care.
4) activitites of voivodeship or intervoivodeship centres of occupational health,
5) preventive activities resulting from health-oriented programmes related to the prevention and treatment of particular diseases and health promotion programmes established by the Minister of Health and Social Welfare or Voivodes,
6) periodic medical examinations carried out under the terms of art. 229 § 5 of the Labour Code when the subject who employed the employee was liquidated.

Art. 22. Employers:

1) incur the costs of pre-employment, periodic, and follow-up examinations as well as the costs of preventive health care indispensable due to the working conditions, on principles specified in the Labour Code and regulations issued thereof,
2) finance the medical services selected by them from the package of preventive health services, pertaining to the tasks of occupational health services as specified in art. 6 sec. 1.

Art. 23. The following finance the preventive health care carried out by occupational health services from their own financial means:

1) people carrying on economic activities on their own account /self-employed/ and those who cooperate with them,
2) individual farmers with their families and members of agricultural production cooperatives, except for certification related to agricultural occupational diseases, financed according to the principles specified in regulations on farmers' social insurance,
3) former employees or people who were performing work not by virtue of employment contracts but on other grounds, or those who remained in service relation, unless separate regulations provide for another way of financing.

Art. 24. Within the scope not regulated by the Act in relation to those organizational occupational health services units which are not health care facilities, regulations of the Act on Health Care Facilities apply.

Art. 25. 1. Supervisory boards of voivodeship occupational health centres carrying on their activities on the day when the Act becomes effective, within 3 months after this day will adjust the centres'statutes to their functioning conditions, specified in the Act, and will submit them to respective Voivodes for approval.
2. If no voivodeship centre of occupational health was established in the voivodeship, the Voivode will establish such a centre or enter an agreement on the establishing an intervoivodeship centre of occupational health, pursuant to art. 16, within 6 months after the day on which the Act becomes effective.
3. The managers of voivodeship centres of occupational health carrying on their activities on the day when the Act becomes effective, who do not meet the condition specified in art. 15, sec. 2, may fulfill this function by the end of the period for which they were appointed, but no longer than for 2 years from the day on which the Act becomes effective.

Art. 26. 1.The subjects mentioned in art. 10, carrying on preventive health care on the day when the Act becomes effective, will notify it within 2 months from this date at the locally competent voivodeship centre of occupational health.
2. If there is no voivodeship centre of occupational health, the notification described in sec. 1 should be done within 2 months after the voivodeship or intervoivodeship centre is established.

  Art. 27. 1. Ministers of: National Defense, the Interiority and Administration, Justice, as well as the State enterprise "Polskie Koleje Pa_stwowe" /Polish State Railways/ establish and maintain in their subordinate enterprises the services which perform tasks that are respective to the tasks of occupational health services.
2. The ministers mentioned in sec. 1, and the Minister of Transport and Maritime Economy in relation to the units which were established and maintained by the State enterprise "Polish State Railways", in agreement with the Minister of Health and Social Welfare, each within his area of activities, will specify by an order:

1) detailed principles of the establishing and organisation of the services performing the tasks respective to occupational health services tasks,
2) professional qualifications of employees who accomplish those tasks,
3) detailed principles of controlling these services.

Art. 28. The Act does not violate any regulations of medical certification, especially the regulations on certification of disability for work, conditioning the right for social insurance benefits and agricultural social insurance benefits, and on certification described in regulations of employment and vocational rehabilitation of the disabled.

Art. 29. Invalid becomes the Act of 15 December 1951 on the inclusion of employees health care organization into the State administration of health services (Law Gaz. No 67, sec. 466).

Art. 30. The Act becomes effective on 1 January 1998