Decree No. 11 / 2023 Coll.
Ordinance on inland navigation medical fitness
Valid
Effective from 01.03.2023
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11
DECLARATION
of 3 January 2023
on medical fitness in inland navigation
The Ministry of Health provides, pursuant to § 52 (2) for the implementation of § 24k (9), § 24w (9) and § 26h (9) of Act No. 114 / 1995 Coll., on Inland Navigation, as amended by Act No. 372 / 2022 Coll., hereinafter referred to as "the Act":
Subject matter
(1) This decree implements the relevant European Union1 provisions and regulates the medical fitness conditions of the applicant for the full authorisation to perform the duties of a member of the vessel's crew under Section 24b of the Act ("the applicant for an EU certificate") and the holder of the European Union certificate of qualification as a member of the vessel's crew under Section 24g (1) of the Act ("EU certificate holder").
(2) In addition, this decree regulates the medical conditions of the applicant for a restricted authorisation to perform the duties of a vessel crew member under § 24c of the Act, the applicant for a licence to operate a floating machine under § 24u of the Act, the applicant for a licence to conduct a small craft under § 26a of the Law, the applicant for authorisation to conduct a recreational craft under § 26b of the Law (hereinafter referred to as "applicant for a licence ') and the licence holder for a crew member under § 24g of the Act, the holder of a train operator's licence under § 24a and the holder of an international licence for a recreational vessel leader under § 24a).
Type of medical examinations
Natural persons (hereinafter referred to as "person ') shall be subject to medical examination.
(a) in order to obtain a medical opinion on medical fitness for applicants for an EU certificate or for applicants for a certificate;
(b) in the regular assessment of the medical fitness of the EU certificate holder and the licence holder before the age of 60 years and after reaching that age limit, no later than the day preceding the date on which it is reached
1. the age of 60, but not earlier than 90 days before that date, and no later than five years after the date of the last inspection, if the crew member of the vessel or of the engineer,
2. Age 65, but not earlier than 90 days before that date, if it is the leader of a small vessel or recreational craft,
3rd age 70 years, but not earlier than 90 days before that date, and no later than 2 years after the date of the last inspection, if the crew member, the leader of the small or recreational vessel or the engineer, is involved,
(c) in exceptional medical assessment
1. a member of the crew of a vessel or a engineer in the event of a reasonable suspicion of a navigational authority, of the operator of the vessel or of the master of the vessel for the change of health which could lead to the loss or condition of his medical fitness;
2. where there is a reasonable suspicion of a navigational office, the leader of a small or recreational vessel for the change of health which could lead to the loss or condition of its medical fitness;
in such cases, the assessor shall perform and indicate all necessary expert examinations corresponding to the current state of health of the person under assessment.
Content of medical examinations
(1) The medical examination provided for in Article 2 (a) to (c) is aimed at identifying the health status and assessment of the medical fitness of those persons for the purpose of enabling the performance of inland navigation activities, namely diseases, defects and conditions which exclude or make medical fitness conditional.
(2) The medical examination provided for in Article 2 (a) to (c) is further aimed, in particular, at identifying the effects of symptoms of diseases, defects and medical conditions which make it impossible for the persons under consideration to:
(a) carry out the tasks necessary for the operation of the vessel;
(b) fulfil the obligations granted; or
(c) to properly perceive the environmental conditions.
The medical examination referred to in § 2 (a) to (c) shall include a medical examination, including, in particular, an indicative examination of vision and hearing, including visual acuity and hearing, an examination of motor functions, an examination of the neuropsychological condition, an examination of the cardiovascular condition to be carried out at all times, and an examination of other functions and conditions, if the assessor indicates them as necessary for carrying out work related to the operation of the inland waterway vessel, and an assessment of the medical fitness to allow the performance of activities of the crew member of the vessel, the leader of a small or recreational vessel or the engineer with a targeted focus on diseases, defects and conditions which:
(a) allow medical fitness associated with the ability of a crew member, a leader of a small or recreational vessel or a engineer to carry out assigned duties and carry out activities resulting from the operation of the vessel;
(b) permanently exclude medical fitness in the light of their manifestations and effects on the health of a crew member of a vessel, a leader of a small or recreational vessel or a engineer, which do not permanently permit the performance of assigned duties and the pursuit of activities resulting from the operation of an inland waterway vessel;
(c) subject to medical fitness assessment
1. temporary medical incapacity as determined by the medical assessor on the basis of a prognosis of disease, defect or condition;
2. restricted medical fitness, where the crew member, the leader of a small or recreational vessel or a engineer is given the scope of the duties or tasks which he is able to carry out or the scope of duties or tasks for which he is not fit for health,
3. the possibility of applying mitigation measures and restrictions that allow for medical fitness.
The medical examination referred to in points (a) to (c) of Article 2 may be further extended by additional technical examinations requested by the medical assessor, where the crew member, the leader of a small or recreational vessel or a engineer is required to rule out suspected illness, defect or condition, or to identify their stage or degree which may justify the exclusion or condition of medical fitness.
The medical examination referred to in Article 2 (c) shall be aimed at assessing the current diseases, defects and conditions which may exclude or make subject to the medical fitness of a crew member of a vessel, a engineer, a leader of a small vessel or a recreational vessel.
The criteria for assessing the medical fitness of the holder of an EU certificate and the applicant for an EU certificate and the diseases, defects and conditions under which the medical fitness is assessed and which exclude or make its award conditional are set out in Annex IV to Commission Delegated Directive (EU) 2020 / 12.
The criteria for assessing the medical fitness of the licence holder or the applicant for a licence and disease, the defects and the conditions under which the medical fitness is assessed and which exclude or make its award conditional, are set out in the Annex to this Order.
Medical assessment on medical fitness
(1) The medical opinion on medical fitness (hereinafter referred to as the medical opinion) shall be issued by the medical assessor under the Law on specific health services following an assessment of the health status of the natural person who has been diagnosed with medical examination, on the basis of an evaluation of the previous records in the medical file kept on the person under assessment, information on the health status communicated by the registrant health services provider in the field of general medical practice or practical medicine for children and adolescents, and on the results of the further professional examinations requested.
(2) The medical opinion must be clear and must not contain a diagnosis of the disease. The assessment must be carried out in accordance with the Health Services Act and the Health Documentation Decree.
(3) The conclusion of the medical opinion shall make it clear whether the natural person is for the purpose for which he is assessed,
(a) medically fit;
(b) incapacitated; or
(c) medically fit on condition; This condition shall be clearly and clearly stated in the assessment conclusion and shall be included in the EU certificate or licence at the same time.
(4) The medical opinion shall specify the period of validity of the medical examination if, on the basis of the medical condition established by the person under assessment, the assessment doctor determines the date of the medical examination before the date provided for in Article 2 (b), in the case of the anticipated development of the disease, defects and conditions which may be expected in the course of a further development of a health change affecting the safety of the inland navigation operation or the pursuit of activities resulting from the operation of the inland navigation vessel, where the medical examination must be carried out before the expiry of the period of the medical assessment.
Efficacy
This Decree shall take effect on 1 March 2023.
Minister for Health:
Prof. MUDr. Válek, CSc., MBA, EBIR, v. r.
Annex to Decree No 11 / 2023 Coll.
Diseases, defects or conditions excluding or subordinating to the medical fitness of a crew member of a vessel, a leader of a vessel, a leader of a small or recreational vessel and a engineer
1. Diseases, defects or conditions which exclude medical fitness
1.1. Fungal cancer
(a) any disease caused by malignant cell growth (except basecellular skin cancer) up to 5 years after the cure, or up to 5 years after the last recurrence,
b) basecellular skin cancer until healing.
1.2. Endocrine and metabolic diseases
diabetes mellitus, which causes medical complications, especially
1. the second and other hypoglycaemia that occurs within 12 months of the first hypoglycaemia and that need to be managed by another person, or
2. second and other hypoglycaemia, which occurs within 12 months of the first hypoglycaemia, with no warning symptoms,
3. diabetes mellitus accompanied by organ complications.
1.3. Mental illness
(a) organic mental disorders manifested by dementia (dementia in Alzheimer's disease, vascular dementia, dementia in diseases classified elsewhere, unspecified dementia),
(b) organic amnesty syndrome,
(c) organically contingent personality and behavioural disorders,
(d) non-specific organic or symptomatic mental disorders;
(e) acute, chronic or untreated forms, in particular schizophrenia, schizophrenia, acute and transient psychotic disorders, schizophrenia, permanent mental disorder with delusions, induced delusion disorder, other non-organic psychotic disorders,
(f) mental retardation;
(g) pervasive developmental disorders;
(h) serious mental disorders congenital, caused by illness, injury or neurosurgery;
(i) clinically serious forms of specific personality disorders resulting in serious impairment of judgement, behaviour or adaptability;
(j) active dependence on alcohol or other addictive substances;
(k) regular use of medicines or combinations thereof, the effect of which may reduce attention.
1.4. Diseases of Blood and Blood Organs
(a) congenital or hereditary haemolytic anaemia,
(b) acquired haemolytic anaemia with repeated haemolysis.
1.5. Nervous system disorders
(a) degenerative and inflammatory diseases of the nervous system or post-traumatic conditions of the nervous system which cause a disturbance in the coordination of movements or balances or speech with impaired communication or impaired consciousness or sleep, possibly accompanied by long-term pain;
(b) epilepsy for 5 years without seizure after discontinuation of antiepileptic therapy;
(c) a condition after an isolated or first unprovoked epileptic seizure, if anti-epileptic therapy has not been initiated, for 12 months without seizure period,
(d) seizures with impaired consciousness or momentum, such as uncompensated narcolepsy or cataplexy,
(e) the occurrence of transient stroke of ischaemic or embolic origin, even without a permanent functional restriction;
(f) post-stroke conditions with severe physical or mental impairment.
1.6. Circular system diseases
a) severe cardiac arrhythmias (heart rhythm disorders),
(b) severe heart and vascular disease in functional class III and IV. NYHA classification and severe heart rhythm disorders,
(c) difficult to correct hypertension, hypertensive illness with advanced organ changes causing severe impairment of their function and malignant hypertension,
(d) a history of two or more attacks of thromboembolic disease,
(e) heavier forms of obligating peripheral arterial atherosclerosis with trophic defects or haemodynamically severe carotid stenosis or larger aortic aneurysms;
(f) varicose complex which has already been manifested by the formation of a leg ulcer at least twice, according to the history,
(g) post-defibrillator implantation conditions.
1.7. Respiratory disease
(a) all diseases resulting in a reduction in the vital capacity of the lungs below 60% of the appropriate value or a reduction in the ratio of the one-second lung capacity and the formulated vital capacity of the lungs below 0,6, including situations where the ratio is reduced below that only during seizures;
(b) two or more history of spontaneous pneumothorax which are not resolved by surgical intervention;
(c) respiratory insufficiency of type I or type II regardless of cause,
(d) chronic obstructive pulmonary disease, with significant lung function limitations, see point (a);
(e) interstitial lung processes with significant lung function limitations, see point (a) above, in particular progressive fibrotic interstitial lung processes;
(f) chronic or recurrent pleural disease causing significant pulmonary function limitation, see point (a);
(g) asthma of bronchiale with insufficient control of treatment and significant lung function limits, see point (a).
1.8 Nasal, ear and throat disorders
a) Ménier's disease and other imbalances requiring treatment,
(b) aphonia and more severe dysphonia with communication disruption,
(c) severe diseases of the middle ear or nipple eruption,
(d) the continuing deteriorating hearing disorders which make it impossible to communicate by speech or in the course of an audiometric examination, the total loss of hearing is greater than 30%.
1.9 Diseases of the digestive system
(a) ulceration of the stomach or duodenum according to the following criteria:
1. peptic ulcer within 1 year of proven healing,
2. perforation or penetration of ulcer or massive bleeding from the ulcer within 1 year after surgical healing of the underlying disease,
(b) colostomy;
(c) a history of two or more attacks of acute pancreatitis, chronic recurrent pancreatitis with functional insufficiency of the external secretory part of the pancreas,
(d) hernia within 3 months after surgical recovery,
(e) the condition after hepatitis A, B, C, D or E virus activity within 6 months after stabilising ALT and AST enzyme activity in the blood,
(f) chronic liver disease associated with hepatic impairment or greater biochemical activity or hyperbilirubinaemia (with a total bilirubin greater than 50 mmol / l),
(g) evidence of Crohn's disease, ulcerative colitis and other diseases, including recurrent diarrhoea.
1.10. Diseases of the exclusion system
(a) any kidney disease resulting in a decrease in glomerular filtration relative to the standard body surface area below 1,0 millilitre per second or causing an increase in blood urea or creatinine concentration above the physiological limit;
(b) large or recurrent hydrocele;
(c) partial or complete obstruction of at least part of the exclusion system.
1.11. Musculoskeletal Diseases
(a) amputation of the upper limb in the forearm and above;
(b) amputation of the lower leg in the lower leg and above;
(c) ankylose or a very significant limitation of the momentum of the shoulder, elbow, hip, knee or ocular joint;
(d) post-traumatic change, inflammatory or degenerative disease of the spine or large joint requiring continuous or repeated treatment or significantly limiting stable walking or posture, in particular rheumatoid arthritis, Bechreva's disease, disease of the spine associated with repeated attacks of spondylogous algic syndromes, severe hip or knee arthrosa.
1.12. Eye disorders
(a) binocular visual acuity, including using corrective lenses, of less than 0,5;
(b) visual acuity of less than 0,5 at complete functional loss of vision on one eye or in the case of use of only one eye, for example in the case of diplopia, including using corrective lenses;
(c) total functional loss of vision on one eye or use of only one eye if this condition lasts less than 6 months;
(d) the horizontal field of vision of both eyes is less than 120 degrees, the vertical field of vision is less than 20 degrees upwards and downwards;
(e) intolerance to corrective lenses if necessary to achieve visual acuity;
(f) diplopia;
(g) severe contrast sensitivity disorder.
1.13. Skin disease
Severe and extensive forms of skin disease.
1.14. Other diseases
Severe fatigue syndrome regardless of cause.
2. Diseases, defects or conditions requiring professional assessment and for which the positive assessment conclusion is subject to assessment by the physician of the relevant specialised competence
2.1. Fungal cancer
(a) a history of cancer,
(b) a history of basecellular skin cancer.
2.2. Endocrine and metabolic diseases
(a) all forms of endocrine and metabolic diseases which are fully compensated by regular oral intake or do not require drug compensation;
(b) diabetes mellitus when treatment has been initiated with medicines that are at risk of causing hypoglycaemia and no hypoglycaemia has occurred during the previous 12 months and there are no medical complications associated with diabetes mellitus.
Regular medical examination of the medical condition by the physician of the relevant specialised competence is always a condition of medical fitness, to be performed at least once every 2 years.
2.3. Mental illness
(a) postencephalic syndrome,
(b) severe neurotic disorders, behavioural syndromes associated with physiological disorders and somatic factors;
(c) severe sleep disorders,
(d) occasional use of medicines or combinations thereof, the effect of which may reduce attention;
(e) alcohol dependence (alcoholism), a history of addictive substances after a safe withdrawal period; a safe withdrawal period shall be considered as an undisputed consistent and sustained abstinence of at least 2 years, the demonstration of which results from the conclusions made by the competent expert.
Regular medical examination is a condition of medical fitness always.
2.4. Diseases of Blood and Blood Organs
Haematological diateses (vasculopathy, thrombocytopathy, coagulopathy) and all conditions at increased risk of bleeding.
2.5. Nervous system disorders
(a) a history of stroke;
(b) brain vascular disease with subsequent disorders,
(c) abnormal electroencephalographic findings regardless of cause,
(d) conditions associated with diseases, accidents or surgical interventions affecting the central or peripheral nervous system and causing psychological, sensory or motor disorders;
(e) a condition following an isolated, unprovoked epileptic seizure, unless antiepileptic treatment has been initiated and no related brain pathology is found in the neurological examination, and no epileptiform activity on the electroencephalogram (EEG) is recorded, 1 year after the seizure,
(f) epilepsy or post-epileptic seizure condition, if antiepileptic therapy has been initiated and no associated brain pathology is found in neurological examination, and no epileptiform activity is observed on the electroencephalogram (EEG), 5 years after discontinuation of treatment,
(g) diseases associated with an increased risk of epileptic seizures, such as arteriovenous malformations or intracranial bleeding, although seizures have not yet occurred.
2.6. Circular system diseases
(a) heart valve defects and other defects without haemodynamics,
(b) heart and vascular diseases such as severe forms of heart disease congenital and acquired with functional restriction or more severe heart rhythm disorders;
(c) a pathological finding in an electrocardiographic examination regardless of the cause;
d) arterial systemic hypertension,
(e) cardiac arrhythmias,
(f) heart and vascular disease in functional class III. NYHA classification and heart rhythm disorders,
g) stenocardia during calm or psychological stress (excitement),
(h) permanent cardiac stimulation, except for uncomplicated or non-serious conditions where expert examination is performed by the assessor; regular medical examination of health status is a condition of medical fitness at all times.
2.7. Respiratory disease
(a) asthma bronchiale;
b) Chronic obstructive pulmonary disease
(c) interstitial pulmonary processes
(d) chronic or recurrent pleural disease
2.8 Nasal, ear and throat disorders
(a) chronic festering inflammation of the nasal or central sinuses;
(b) other ear diseases,
(c) for audiometric examination, the total loss of hearing is greater than 30%.
2.9. Diseases of the digestive tract
(a) conditions after abdominal surgery, if they persist in moderate or severe digestive problems;
(b) a history of perforation or penetration of an ulcer or massive bleeding from an ulcer;
(c) pseudoulcerose syndrome and other digestive tract disorders that have a history of requiring treatment;
(d) chronic appendicitis;
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Regulation Information
| Citation | Decree No. 11 / 2023 Coll., on medical fitness in inland navigation |
|---|---|
| Regulation Type | - |
| Author | - |
| Collection | Code of Laws |
| Date of Promulgation | 11.01.2023 |
|---|---|
| Effective from | 01.03.2023 |
| Effective until | - |
| Status | Valid |
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