SP 1230
SP 1230
SP 1230
Document ID SP-1230
Security Unrestricted
Version 6.0
Keywords: This document is the property of Petroleum Development Oman, LLC. Neither the
whole nor any part of this document may be disclosed to others or reproduced, stored in a
retrieval system, or transmitted in any form by any means (electronic, mechanical,
reprographic recording or otherwise) without prior written consent of the owner.
Final
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i Document Authorisation
Authorised For Issue
Document Authorization
Document Authority Document Custodian Document Controller
(CFDH)
Dr Rawahi, Sulaiman Dr Yaqoubi, Nasser Dr Rawahi, Malik
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ii Revision History
The following is a brief summary of the 4 most recent revisions to this document. Details of all
revisions prior to these are held on file by the issuing department.
Scope/Remarks
Version No.
Author
Date
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3.0 Apr 2009 Dr. Salim Sawai Shell Group FTW new version integrated into PDO SP-
MCOH 1230. Requirements for medical examinations are similar to
the old one but now tabulated and the procedures are
clearer.
Changes in the required number of First Aiders,
requirement reduced from 10% to 5%.
Amendments to specific conditions which may affect fitness
to work. i.e. from using the general term of unfit to work in
interior to unfit to work in the field.
Changes regarding frequency of health surveillance
Medical Examinations. Moving towards risk based medical
examination; hence the frequency has been reduced from
the 2 yearly medical examinations for everybody to every 5
years for those under 40 years of age, every 2 years for
those between 40 and 60 and annually for those above 60.
Except the following categories have to undergo FTW
medical evaluation every 2 years regardless of their age:
1. Persons who are required to wear tight sealed full face
masks or half sealed face masks breathing apparatus
when undertaking a work task (Breathing apparatus
work).
2. Fire fighting and rescue team workers.
3. Business travellers
4. Catering and food preparation workers.
Clinic requirements- Number of beds from one bed to 2
beds or more depending on the size of workforce.
Pages 26-60 are new additions to this specification to make
medical examinations requirements and procedures
simpler, clearer, user friendly and in line with group
standards.
2.0 Nov 2003 Khalifa Maskery Changes made:
CSM/31 2.1.1 HSE Classified jobs: Routine medical check-up for
all the positions is same (2 yearly)
Appendix H: Defibrillator is added to the minimum
requirements for the Camp/Site Clinics
1.0 Jun 2002 Wayne Austin
CSM/32
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TABLE OF CONTENTS
i Document Authorisation ...................................................................................................... 3
ii Revision History .................................................................................................................. 4
Added specification for the converted emergency evacuation vehicles. ...................... 5
iii Related Business Processes .............................................................................................. 6
iv Related Corporate Management Frame Work (CMF) Documents ..................................... 6
1 Introduction........................................................................................................................ 11
1.1 Purpose ....................................................................................................................... 11
1.2 Changes to the Specification ...................................................................................... 11
2 Scope ................................................................................................................................ 12
2.1 Process Definition ....................................................................................................... 12
2.2 Process Deliverables ................................................................................................... 12
2.2.1 Records ..................................................................................................... 12
2.2.2 Reporting Format ....................................................................................... 12
2.3 Responsibilities ........................................................................................................... 13
2.4 Performance Levels / Indicators.................................................................................. 13
2.5 Performance Monitoring .............................................................................................. 13
2.6 Effective period ............................................................................................................ 13
2.7 Review and Improvement ........................................................................................... 13
2.8 Compliance.................................................................................................................. 14
3 Medical Treatment ............................................................................................................ 15
3.1 PDO ............................................................................................................................. 15
3.2 Contractors .................................................................................................................. 15
4 First Aid Treatment ............................................................................................................ 16
4.1 General ........................................................................................................................ 16
4.2 First Aid Team ............................................................................................................. 16
4.3 First Aiders and certification ........................................................................................ 16
4.4 First Aid Kits ................................................................................................................ 17
5 Clinics ................................................................................................................................ 19
5.1 PDO ............................................................................................................................. 19
5.2 PDO, Contractors, and Subcontractors ...................................................................... 19
5.3 Medical confidentiality, for all employees .................................................................... 21
6 Ambulance Services ......................................................................................................... 22
6.1 Ambulance Vehicles .................................................................................................... 22
6.2 Converted Emergency Evacuation vehicles. .............................................................. 22
6.3 Ambulance Drivers ...................................................................................................... 23
6.4 PDO Paramedics ......................................................................................................... 24
7 Medical professionals (PDO and Contractors) ................................................................. 25
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1 Introduction
1.1 Purpose
This Specification describes PDO's requirements for managing medical examinations,
medical treatment, and medical emergency and medical facilities in line with MoH, OPAL,
and Shell group requirements. In this specification we have adopted the Shell group FtW
standards. All definitions of terms that appears in this specification can be found in
Appendix 30.
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2 Scope
This Specification applies to all PDO, employees, all contractors and sub-contractors
authorised to work on behalf of PDO.
Medical treatment
First aid and Medical Emergency Response (the details of MER are found in
documents PR- 1243)
Clinics and other related medical facilities
Ambulance services
Nursing services
Medical examinations including FTW protocols.
OPAL Camp Standard requirement (Section 6. Health Care Facilities)
2.2.1 Records
A monthly report of key health performance indicators (HPIs) from contracting health
services shall be submitted to PDO Medical Officers in the respective locations copied
OH Advisor/Chief Medical Officer who will reviewed these on quarterly basis.
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2.3 Responsibilities
Managers
Managers are responsible for ensuring that the activities they control are managed in
accordance with the requirements of this Specification.
Corporate Functional Discipline Heads are responsible for ensuring that the
requirements of this Specification are reflected in the documents for which they are
responsible.
Contract Holders
Contractors
Contractors are responsible for ensuring that activities undertaken within the scope of
their contracts are managed in accordance with the requirements of this Specification.
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2.8 Compliance
Any non-compliance with this Specification by PDO, contractors or subcontractors shall
be notified, investigated and reported as per the ‘Non Compliance Report Form’ (refer to
CP 122 HSE management system manual, Part 2 Chapter 6) and the HSE defaults
consequence management shall be applied and followed.
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3 Medical Treatment
3.1 PDO
All PDO staff is entitled to free medical care at PDO clinics at a General Practitioner level
and within the limits available at PDO facilities i.e. a primary health care.
Notwithstanding any primary medical treatment provided by PDO, any staff requiring
further treatment shall be referred to a Ministry of Health hospital or at approved private
health institutions as per the new improved PDO self- insurance benefits.
3.2 Contractors
Contractor shall provide medical treatment facilities and medical emergency response
for its employees at its own cost.
Contractors that are authorised by PDO to obtain primary medical treatment at PDO
clinic facilities shall provide the clinic with a list of all personnel who may require medical
treatment at any time during the term of the Contract. The list shall provide information
to include:
employee name,
employee number,
Contractor shall notify PDO Clinic administrator (MCA) quarterly of any amendments to
the list.
On each occasion that medical services are provided to the Contractor by PDO, the
contractor shall complete and submit the "Contractor Medical Attendance and Cost
Record" Form. The contractor shall be charged for any medical services provided or
arranged by PDO.
PDO shall provide out-patient medical treatment to seconded staff at PDO Interior clinics
whilst these persons are performing work or services in the Interior. The contractor shall
be charged for any medical services provided or arranged by PDO.
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4.1 General
All PDO employees, and both contractors and visitors spending more than one month
in any 12-month period on the site shall be trained in First Response (TIER 0) in order
to ensure that everyone knows what to do in the event of an incident.
The first response is the immediate assistance delivered by any person(s) nearest to the
casualty (bystanders) at the time of the incident. That is, Make Safe, Call Out to
Designated First Aider (DFA) and site control centre, and follow standard ‘Do’s and
Don’ts.
Designated First Aider (DFA): an individual trained and certified in First Aid and receiving
regular skills maintenance from the Site Medical Professional.
First Aid treatment that include having competent ‘First Aiders’(TIER 1) and fully-stocked
First Aid kits shall be available at all PDO and contractor facilities within the PDO
concession area, at all times people are at work. All employees (PDO and Contractors)
to be informed about the names of first aiders in each location or department.
When more than 20 people are working at a particular location, a minimum of 10% of
staff per shift shall be competent First Aiders with access to suitable First Aid kits. One
additional competent First Aider with access to First Aid kits shall be provided for every
10 additional employees.
When less than 20 people are working at a particular location, at least Two persons per
shift is to be competent First Aider with access to suitable First Aid kits.
The Nurse (PDO or Contractor) shall maintain a list of names, telephone numbers and
locations of each member of the First Aid Team in their area. This list shall be up to date
and available at the clinic and the local emergency control room.
The first aid certification expiry date is mentioned on the certificate and is usually valid
for 2 or 3 years. Thereafter regular re-certification by an accredited center is mandatory.
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The First Aider is also responsible for keeping their First Aid certification up to date and
initiating plans for ensuring regular updating of his/her knowledge and skills. The First
Aiders shall undertake refresher drills and familiarisation training every 4 months. This
shall include familiarisation with the Medical Emergency Plan, the layout of the clinic, the
location and use of equipment and first aid management of different medical cases. This
drill and training shall be arranged and organised by his /her department.
Assess the scene and the casualties and identify the principal problem(s)
Assess the condition of casualty[ies] and provide immediate first aid treatment.
Omani law does not restrict trained First Aiders from using the AED to save lives.
Keep the AED maintained properly including installation of a new battery and
replacement of electrod pad as needed.
Make sure AED works properly, If the AED machine starts beeping or you see the
light flashing, this means the battery is low and you must contact the MCN team
for replacement.
portable.
All first aid kits shall contain, as a minimum, the contents listed in Appendix 24 – Contents
of First Aid Kits. A list of the contents shall be stored with each kit.
A designated First Aider for a particular location shall be assigned responsibility to check
each First Aid Kit weekly, to maintain the kit fully-stocked, and to record and retain the
checks. The location of First Aid kits, and names, telephone numbers and locations of
First Aiders shall be centrally posted at each work location.
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First Aid kits for PDO staff shall be obtained through logistics department. The PDO
Medical department shall provide the contents of the first aid kits upon receiving a request
from the assigned PDO First Aiders. Contractor First aider will secure their own First aid
items.
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5 Clinics
5.1 PDO
Access to the PDO Coastal Clinic shall be provided to the following people:
Primarily the current PAC clinics in respective locations are to serve as central clinics,
until a single unified medical center agreed and established. All companies with camp
and worksite bases within 30 kilometers of the PAC (Central Clinic) are to use the PAC
facility. PAC clinics are required to maintain adequate staff and resources to cope with
additional workforce i.e. at least 1 extra nurse in the clinic for additional 500 people.
PDO shall no longer authorise contractors’ own clinics especially those that are manned
by a single nurse except clinics at the rig site. However, under specific conditions, a step
out will be provided by the PDO Chief medical Officer for contractor clinic facilities to
operate for the purpose of providing own staff medical care. The conditions will include:
the contractor's work is classed as posing a high risk on the basis of Health
Risk assessment
the contractor's camp or base is remote. This will not only be based on the 30
kilometres distance but also the time it takes to travel to the nearest PAC Clinic.
30 minutes is regarded as an acceptable travel time.
Any contractor with 1,000 employees operating outside the specified 30 kilometers
boundary of the PAC (later Central Clinic) and have the above mentioned stepout shall
provide a doctor and a clinic onsite.
Similarly, smaller establishment of about 100 or more employees operating outside the
specified 30 kilometers boundary of the PAC (later Central Clinic) and have the above
mentioned stepout shall provide a clinic with a nurse.
A clinic shall be provided by the contractor for an average of less than 100 people if:
the contractor's work is classed as posing a high risk on the basis of Health
Risk assessment
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Two or more contractors in adjacent camps shall be permitted to share a clinic provided
the clinic has adequate staff and resources to cope with the additional workforce and
subject to prior approval from their Contract Holders and the location PDO Medical
officer.
Contractors shall provide transport for any personnel that require a visit to the clinic.
The site clinic shall be inspected, licensed and approved by the Ministry of Health and
the PDO Medical Department before commencement of business. Also the Clinic shall
be accessible 24 hours with easy access to ambulance services and shall be manned
by a PDO approved and ACLS certified medical Professional (a nurse or and a doctor)
and shall have:
communication facilities such as fixed land line or GSM and network service to
communicate with site manager and Remote Medical support direct from clinic
Adequate work area and lockable Storage cabinets for medications, medical
records and equipment
Material Safety Data Sheet (MSDS) archive and other medical reference.
The minimum requirements for Camp/Worksite clinics are detailed in Appendix 27 and
28.
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retain health surveillance records for a minimum of 30 years from the date of
employment
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6 Ambulance Services
Approved by ROP and MoH and meet OPAL Road Safety Standard Annnex B-
5
Sufficient capacity for carrying one or more patients lying down on stretcher(s)
well secured to the vehicle, and a nursing attendant. A sideways facing seat for
carrying each stretcher shall be acceptable if it is a permanent seat and at least
a retractable-type 2-point seatbelt is fitted.
Be suitable for stretcher recovery work - the doors should fully open to allow free
and unrestricted access
Any equipment, and cupboards shall be properly secured inside the vehicle
The nursing attendant shall be able to communicate directly with the driver
The vehicle shall be fitted with a radio, siren, and flashing warning light.
If a contractor provides a clinic, and the contractor camp is more than 30 kilometres by
road from the nearest PDO or PAC clinic, the contractor shall provide an ambulance.
One vehicle must be onsite at all times that can accommodate and secure a stretcher
inside the vehicle and shall comply with the following specifications:
Long wheel based, air conditioned, very well maintained 4 wheel drive vehicle
in a very good condition.
Able to carry one patient lying down on a well secured stretcher to the vehicle.
Availability of one Oxygen cylinder and a stand fixed to the inside of the vehicle
Be suitable for stretcher recovery work - the doors should fully open to allow
free and unrestricted access.
Have held a valid light vehicle driving license for no less than 5 years.
Have attended and passed the PDO emergency vehicle driver course.
Have attended and passed the Heart Saver Course (American Heart
Association accredited) which includes BLS and defibrillation skills. Hence
they are competent First Aiders.
Ability to read a road map and be familiar with the geographical area of
activities to enable a maximum response time of 10 minutes.
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Refer to PDO’s Medical Emergencies Contingency Plan and code of practice for
ambulance services for a detailed description of responsibilities relating to emergency
preparedness and response.
Their main roles are to operate emergency vehicle and help nurse performing victim(s)
health assessment at the site and provide initial stabilization prior to transfer to the clinic
or hospital for definitive care.
Competency:
Certified MET
Emergency Medical Service and Ambulance Ride & Defensive Driving Support
Basic Life Support (Approved by AHA)
Skill in the use defibrillator (AED)
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7.1 Doctors
Any set up or company with 1000 employees or more on the same site/area, a doctor
shall be recruited and shall be available on site at all times.
7.2 Nurses
The minimum number of nurses provided, shall be dictated by the number of people
served by the clinic as detailed in the table below. The required number of nurses shall
be maintained at all times, including cover for periods of nurse sickness absence and
annual leave.
0 - 500 1
Medical responsibilities of the nurse shall include, as a minimum, those listed in Appendix
29 and PDO Medical department procedure guide and shall take precedence over non-
medical duties.
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The contractor’s nurse shall refer treatment of all illnesses or injuries that are
beyond their abilities to the nearest PDO clinic. The nurse shall contact the PDO
doctor or nurse before transfer to discuss the case and any special requirements.
The contractor’s nurse or an HSE personnel shall provide monthly KPI (Key
Health Indicators) to the location PDO Medical Officer copying PDO
Occupational Health advisor (MCOH) and the PDO Chief medical Officer (MCC).
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8 Medical Examinations
8.1 General
The contractor shall arrange and pay for pre-employment and routine medical
examinations of all contractor staff to be engaged under a contract to perform work or
services for PDO and staff seconded to PDO under a contract.
All medical examinations shall be conducted either by a PDO Medical Officer or a PDO-
approved Medical Practitioner (refer to Appendix 23 for PDO approved clinics) in
accordance with PDO Medical Fitness Standards and within with the requirements of
Omani Labour Law.
complete and sign an Initial Medical Examination Report, EX1 (refer to Medical
Examination forms Appendix 32)
communicate the outcome of the medical examination. That is fit or unfit and
including any medical restrictions (temporary or permanent), to the concerned
contractor. Any person found to be medically unfit for the work shall not be
employed under the contract.
Any person found to have medical restrictions shall not be employed under the contract
until approved by PDO Medical Officer, and/or PDO Occupational Health Advisor.
If approval is withheld or rejected the contractor shall communicate the out come to the
person concerned at no cost to PDO.
The contractor shall maintain, update and store medical records of all staff working for
PDO under a contract for a period of at least 30 years.
to protect the individual and co-workers health and safety and to anticipate and,
where possible, prevent the avoidable occurrence of ill-health or worsening of pre-
existing medical conditions at work, which could place the individual, their
colleagues and the emergency rescue services at risk.
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A medical history questionnaire (Form EX1 or EX2) must be completed and signed. All
positive answers in the questionnaire must be discussed with the individual, and the
results recorded. A full clinical examination including dentition must be performed.
The full Medical assessment mandatory requirements and investigations include the
following:
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Medical findings
Location of the work site and the availability of medical services and in
some cases the availability of special medical support
b. Employee returning from long leave, or having been away from work for
more than a month (30 days or more) for other reasons including rest days,
annual leave, or sabbatical; he or she might have had some illness or an
upheaval that could affect his/her work performance, safety or hinder
him/her from coping well with work.
For both the above situations (a, and b), a short questionnaire/checklist (SQ6 -
Appendix 21) shall be completed by the returning employee and submitted to the
respective supervisor or directly to the respective medic/doctor in the field/at work site
(in case of significant health issues).
The purpose of this questionnaire/checklist is to extract information on their physical
and mental status, that would otherwise not outwardly declared by employees but one
that could impact on their personal health or affect their safety and work performance.
Direct supervisor/line shall submit any check list to the site doctor/medic nearby if the
answers to any of the questions (3, 4, 5, 6, 8, and 9) are “YES”. The medical
professional shall review and act upon the checklist accordingly.
The form should be kept with line supervisor for a period of at least 1 year (soft or hard
copy). For further clarification on this contact any of the PDO doctors.
Medical examinations to ensure the fitness of an individual for a particular job shall be
classified as one of six categories below which are described in more details under
section 8.8 through 8.14
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1. Pre-employment examination
2. Pre-placement examination
3. Pre-transfer or overseas
4. Fitness To Work Examinations (FTW)
5. Routine Medical Examinations (Wellness program/Health Surveillance)
6. Medical examination for ill-health retirement evaluation
C (unfit)
A firm offer of employment shall not be made until an opinion on whether the person is
fit for the job, including any restrictions, has been communicated to the line and human
resource by the doctor using fitness certificate (hard copy of electronic version).
Line is concerned that a person may not be fit for a planned job change; or
An employee is planned for a job change involving work tasks that they are not
required to perform in their existing position.
The person shall not be placed in a new position until an opinion on whether the person
is fit for the job, including any restrictions, has been communicated to line management
by the examining approved PDO Medical Officer using a fitness certificate.
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The person shall not be transferred to a new location until an opinion on whether the
person is fit for the job, including any restrictions, has been communicated to the
receiving medical team by the examining approved PDO Medical Officer.
Please note for a certain classified jobs/tasks employees are required to undergo FTW
medical evaluation every 2 years regardless of their age. Please refer to section
9.1(HSE classified jobs)
The examining doctor shall complete and sign the Medical Examination Report, EX2
(refer to Appendix 33).
All PDO employees and expatriates shall undergo a final pre-departure, pre-transfer at
the end of their posting with PDO and a pre-overseas medical examination.
For a case to be referred to the Medical Board, a PDO Medical Officer has to
recommend that a Medical Board is the most appropriate course of action and PDO's
Chief Medical Officer has to approve the recommendation.
In situations where a Medical Board decides that a person shall be assigned a category
C medical classification (unfit), medical severance award shall be considered. The
details of the award shall depend on prevailing PDO policy at the time.
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8.14.2 Introduction
Guidelines and protocols based on Shell group protocols and guidance notes are used
to specify PDO and Shell group requirements for the Medical Evaluation of Fitness to
Work. Specifically, they describe:
Work tasks place physical and psychological demands on the employee. Every
reasonable effort should be made to assist those with functional limitations such that
they are accommodated in the workplace whilst not compromising the health and safety
of that employee or a co-worker. The section also describes the medical evaluation
processes, which in specific circumstances support the safe execution of a task in the
workplace.
8.14.3 Purpose
The purpose of this FTW guide is to ensure that a lack of Fitness to Work (FTW) does
not result in significant injury or illness, risks to the business or risks to the community
or company reputation. This section provides simple but risk based protocols and
guidance for fitness to work medical evaluation. As such they complement, but do not
replace the clinical competences of the assessing health care professional. The
overarching principles of these protocols are that they:
Focus on the capacity of the employee and the essential tasks of a position
and not in isolation, the presence or absence of an illness or disease.
The decision regarding whether an employee is fit for work or not (and any
accommodation that may be required) should result from the outcome of the medical
evaluation and other relevant evaluations e.g. a trade test.
8.14.4 Objectives
Minimise the risk of liability arising from medical evaluation of fitness to work.
Medical evaluations of fitness to work are not voluntary and must be distinguished
from health promotion, health surveillance related to workplace exposures and / or
health and wellness evaluations. An employee, who refuses to participate in a required
medical evaluation as part of the fitness to work process, shall be temporarily declared
unfit for that position and referred to human resources and / or line management.
Medical evaluations for fitness to work may be rationally combined with other visits to
a medical facility for either health surveillance and or health promotion but the
mandatory elements of the fitness to work programme must not be confused with other
voluntary elements.
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Periodic review
based on the Initial screening
Protocol evaluation
Accommodation
Unfit
process
for task
This document describes the medical evaluation process that shall be applied in a
fitness to work program for PDO, contractors and subcontractors working for PDO.
Local legislation shall always be met, but if this guidance requires more frequent or
extensive evaluation, then the requirements of this document shall apply.
If any practice is required by law, it shall be followed. This may include the
content of an examination and / or the means of recording it.
If this document makes additional requirements over and above the Omani
specific requirements, they shall be followed and applied.
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8.14.7 Responsibilities
Ensuring that these protocols are applied to all employees before being engaged
in a task for which medical evaluation of fitness to work is required.
Reviewing the HSE case and health risk assessments to determine if activities
within their business include specific tasks or working conditions for which
medical evaluation of fitness to work has been identified as a control.
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A) Persons required to wear tight sealed full face masks or half sealed face masks
breathing apparatus when undertaking a work task (Breathing apparatus work).
G) Health professionals
The following high risk groups shall also undertake medical surveillance every
2 years regardless of their age. The medical surveillance shall include a urine or
serum biological monitoring of mercury, benzene or lead depending on the
nature of the job and the type of exposure.
A. Mercury workers who are exposed to Mercury at or above the 8 hours TWA
Occupational exposure limits(OEL) for more than 30 days/year or if there was
unexpected emergency exposure to the hazardous agent.
H) Benzene workers and vessel entry tasks including tank cleaning who are
exposed to Benzene at or above the 8 hours TWA Occupational exposure
limits(OEL) for more than 30 days/year or if there was unexpected emergency
exposure to the hazardous agent.
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(Examples of these jobs include operational and maintenance (e.g. drilling and
well service) personnel involved in GGP facility and potentially others like SR-
CPP, SNGP and KGP), crude oil sampling operators and lab analysts )
B. Lead workers (e.g. painters and batteries maintenance) who are exposed to
Lead at or above the 8 hours TWA Occupational exposure limits(OEL) for
more than 30 days/year or if there was unexpected emergency exposure to
the hazardous agent.
D. Asbestos workers.
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Where there is a past history of peptic ulceration or acute gastric erosion a person may
be acceptable provided that the examining physician is satisfied that the risk of
complications is reduced to an absolute minimum by successful surgery or the use of
appropriate medication. Cases of acute gastric erosion or peptic ulcer disease can be
reconsidered following absence of symptoms and healing that is assessed by
endoscopy.
An individual who has undergone successful cardiac surgery for valve or congenital heart
disease may be fit for employment if free from symptoms and the prescribed therapy
does not cause negative impacts on job performance. If otherwise, then cardiac review
is needed. Individuals in this grade may require more frequent assessment.
Ischaemic Heart Disease: Myocardial insufficiency and past or recent history of heart
attack is unacceptable but each case should be considered individually depending on:
health risk assessment- That you will be able to evacuate the patient to the
nearest Tier 3 hospital within 4 hours.
Coronary Bypass Surgery (CABG) and Angioplasty: Individuals who have undergone
these procedures must have their cardiac fitness assessed before returning to work. A
cardiological opinion is essential and will be appropriate not earlier than six months after
the event. This assessment must include sub-maximal exercise testing.
Cardiac Enlargement: Fitness will depend on the underlying cause and nature of the
job. You need to seek Cardiologist opinion.
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History of Transient ischemic attack (TIA) alone does not make the individual un-
acceptable, the underlining cause and job description have to be taken into
consideration.
Symptomatic anaemias, and any other disease of blood, or blood forming organs
which may adversely affect performance or safety, until investigated and
successfully treated.
Sickle cell disease (anaemia) is not acceptable for out doors field based jobs
which involve exposure to heat or any health and safety critical jobs.
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Psychosis
10.14 Skin
The skin must be healthy, without evidence of clinical disease:
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Insulin dependence employee is NOT accepted to work at rig site, in the field or doing
any hazardous jobs such as working at heights, heavy duty drivers or working near
sharp or rotating machineries.
Insulin dependent patients are acceptable to work in interior after careful consideration
of their job type and reasonable control of their disease with no history of frequent hypo
or hyperglycaemic attacks and diabetic ketoacidosis.
All cases of gross or mobid obesity require individual assessment. Those in whom
exercise tolerance, mobility, general health, or personal hygiene are adversely affected
are unacceptable. As a general rule and depending on the job type those in whom the
Body Mass Index exceeds 35 will probably be unacceptable for HSE critical jobs such
as fire fighters, rescue workers and professional drivers.However, we must take
individual masculinity and body physique into consideration.
Chronic renal failure or any renal disease which could lead to acute renal failure (i.e.
nephritis, nephrosis) is unacceptable for working in the desert locations.
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Obstructive airways disease, such as chronic bronchitis, emphysema, and any other
pulmonary disease causing significant disability or recurring illness, such as
bronchiectasis, is unacceptable for working in desert locations.
Disorders of the tympanic membrane (e.g. dry perforations and grommets) and the
middle ear require further assessment. Chronic middle ear disease may be
unacceptable for working in the desert. Intractable inner ear disorders with severe
motion sickness, vertigo, etc. (e.g. Meniere's disease) are unacceptable for certain
jobs.
Increasing noise induced hearing loss may be a reason for medical unfitness. All
personnel who may be exposed to work related noise must have audiometry
performed, both at initial assessment, and as directed thereafter by the examining
physician in line with PDO's Hearing Conservation Programme. Where the
measured loss is greater than 25 dBA, then special assessment of the individual by an
ENT specialist is advised. Refer to PDO noise protocol appendix 22.
Eye diseases
Any eye disease or visual defect rendering, or likely to render, the individual incapable
of carrying out job duties efficiently and safely, is unacceptable.
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Visual acuity, corrected, must be at least 6/12 in the better eye, demonstrated by
recognised test type procedures. A monocular individual is acceptable provided the job
functions can be performed efficiently and safely. Recent onset of monocular vision is
unacceptable (i.e. within six months of onset)
Colour perception should be adequate for the particular type of task to be undertaken.
Colour blindness per se does not disqualify the person from being commercial driver
as long as he/she meets the minimum requirement i.e he/she can recognise the colours
of traffic signals (red, green and amber)
10.20 Medicines
Individuals being treated with certain medicines require careful consideration:
Any previous adverse drug reaction must be brought to the attention of the examining
physician.
In certain circumstance the medical officer may decide to remove an individual from
working in the location despite being assigned office based task if the work environment
is unsafe for that particular staff. This shall be carefully reviewed as part of total care
of individual employee.
10.21 Age
With all the other findings in the Medical assessment, age must be considered and
taken into account during fitness to work assessment in desert locations. The minimum
age is 18 years and the maximum acceptable age with a medical waiver is 64 years.
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11 Appendices
Key fitness for work Adequate colour vision is an absolute requirement for this task.
issues
Critical activity and The 3 commonly used aviation fuels have different colours
potential hazards Avgas 100LL is blue
Avgas 100 is green
Jet A1 is white/straw
Accordingly the colour vision requirement is:
1. Ability to recognize and identify above three different fuel
types
2. Ability to detect change from yellow to blue green using
Shell water detection capsule
3. Ability to recognize and distinguish lettering and labelling
on Avgas (red) and Jet A1 (black)
An error when fuelling an aircraft could have result in a catastrophy
There are many engineering controls but this final colour dependent
identification of fuel is a required safe working practice.
Performance % of those who have been positively assured colour safe for task.
indicators
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Key fitness for work Previous successful use of BA is the best predictor of ongoing successful use.
issues The use of half face or full face respirator decreases the visual field and may
render it difficult to use corrective spectacles (Visual acuity and fields should
be adequate for task.
Depending on the frequency and physical demands during use, BA users may
need further cardiovascular risk assessment, especially those required to use
SCBA.
Scope and Persons who are required to wear breathing apparatus when undertaking
a work task. For the purposes of this FTW group, “Breathing apparatus”
Application
includes all personal respiratory protective equipment where a tight seal
is required to confer protection on the user. This is always the case for
self-contained breathing apparatus (SCBA) and a supplied air respirator
with full-face mask (SAR). It is also required for sealed half facemasks
but not necessary for simple non-sealed devices e.g. dust mask.
Critical activity and Breathing apparatus can increase work load due to increased cardio
respiratory effort related to breathing through a filter, thermoregulatory
potential hazards
demand and the additional weight of the equipment. In addition the work
task itself often increases cardio respiratory and thermal load.
Investigations Spirometry is desirable for a baseline on the pre placement evaluation but not
required unless clinically indicated at any point of evaluation. SCBA users
should have a CVS assessment including Framingham calculation and ECG
once every two years regardless of age.
Performance % employees using BA who complete periodic questionnaire and Fit test.
indicators
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Scope and Application Frequent business travellers have been defined as those who travel:
Within the region on travel of more than 4 hour flights three or more
times per month
On long distance (intercontinental) trips three or more times annually.
Less frequently but to high risk destinations (significant local health
risks/basic local health facilities/difficult access)
Critical activity and Travel to and operate in a country other than base location. Hazards may
include:
potential hazards
Those of destination e.g. infectious disease, altitude sickness, remote
location.
Those associated with travel e.g. jet lag, deep vein thrombosis (DVT).
Exacerbation of a pre-existing medical condition
Physical evaluation Only if considered necessary based on screening questionnaire follow up.
Attendance for vaccination and malaria prophylaxis required if appropriate
for country of destination.
Performance indicators % of business travellers completing assessment within the previous two
years
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Key fitness for work Recurrent skin disease may reduce frequency of hand washing. Self-
issues confirmation of symptom resolution is required following any illness
absence (self) or gastrointestinal disease (self or family).
Catering staff shall be excluded from work during, and for 48 hours
after any gastrointestinal illness.
Scope and Application A food handler is defined as a person who presents a risk of
transmitting pathogenic organisms in the course of their work which
involves touching unwrapped foods to be consumed raw or without
further cooking or other forms of treatment. (See Health Guidelines
for Catering refer to A to Z: Guides, Manuals, Standards
Critical activity and Good food handling techniques and storage are critical to minimize
potential hazards risk of food related disease transmission. Frequent hand washing is
required and staff should be trained in food preparation and handling.
The main control in the prevention of food contamination is
competence of the employed staff and appropriate working practice.
Questionnaire Pre- employment - EX1 Form- (Appendix 32) and SQ4 – (Appendix 18)
When returning to work after illness (food handlers) (Appendix 19)
Physical evaluation Thorough clinical examination particular review of skin and nails.
Reference Resources Health Guidelines for Catering refer to PDO SP1232 and the link below
A to Z: Guides, Manuals, Standards
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Key fitness Visual acuity with corrective lenses if necessary must be carefully assessed.
for work Cardiovascular risk must be assessed in all candidates and cardiology review
completed if indicated (pre-existing disease and/ or over age 40 with >20% 10 year
issues risk of myocardial infarction)
Assess endocrine disorders and impact of any medication. Potential for loss of
consciousness related to Insulin dependent diabetes, epilepsy or related condition must
be assessed.
Body Mass Index (BMI) - If BMI >30 and screen all for sleep apnoea.
Assess capacity to complete associated tasks (e.g. climb on trailer & crane gantry)
Scope and Drivers of overhead cranes, long vehicles, large buses and dozers, water tankers,
Application fuel and petrochemical tankers etc shall be assessed against this protocol. It may
be applied to smaller workshop cranes on the basis of a local risk assessment.
Critical Operate a heavy vehicle within above definition in a safe and reliable manner such
activity and that safety of self, colleagues or third party is not compromised.
potential Hazards of heavy vehicles driving may be exacerbated by pre-existing medical
hazards condition or treatment thereof. Particular attention should be made in the risk
assessment to the requirement to lift and place the load and to clear obstacles
during transfer.
Questionnaire EX1 Form – (Appendix 32) and Form SQ5 – (Appendix 20)
Investigations Audiometry.
Cardiovascular (CVS) assessment using Framingham risk calculator. Risk of 20%
or more requires further cardiac evaluation with Stress test (TME).
Drug and alcohol screening during pre-employment.
Frequency Every two years. 60 years is maximum acceptable age for drivers, no waiver beyond
60 year of age.
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Key fitness for work Visual acuity with corrective lenses if necessary must be carefully
assessed.
issues
Cardiovascular risk must be assessed in all candidates and cardiology
review completed if indicated (pre-existing disease and/ or over age 40
with >20% 10 year risk of myocardial infarction)
Assess endocrine disorders and impact of any medication. Potential for
loss of consciousness related to Insulin dependent diabetes, epilepsy
or related condition must be assessed.
Body Mass Index (BMI) - If BMI >30 and screen all for sleep apnoea.
Scope and Application Professional light or heavy vehicles drivers, whether PDO employed or
contracted, are those drivers where driving on PDO business is an integral
and significant part of their job, e.g. distribution tanker drivers, chauffeurs,
personnel transport drivers and van drivers.
Critical activity and Operate a vehicle within above definition in a safe and reliable manner such
potential hazards that safety of self, colleagues or third party is not compromised. Hazards
of driving may be exacerbated by pre-existing medical condition or
treatment thereof.
Questionnaire EX1 Form – (Appendix 32) and Form SQ5 – (Appendix 20)
Investigations Audiometry.
Cardiovascular (CVS) assessment using Framingham risk calculator. Risk of
20% or more requires further cardiac evaluation with Stress test (TME).
Drug and alcohol screening during pre-employment.
Frequency Every two years. 60 years is maximum acceptable age for drivers, no waiver
beyond 60 year of age
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Scope and Members of an emergency response team located on or offshore, hazardous material
Application handling team members or equivalent. It does not include office based emergency support
teams. (Team members not engaged in hazardous rescue activity do not require to meet
this standard – e.g. communication and coordination roles, drivers etc).
Investigations Audiometry.
Cardiovascular (CVS) assessment using Framingham risk calculator. Risk of 20% or more
requires further cardiac evaluation with Stress test (TME).
Drug and alcohol screening during pre-employment.
Frequency Every two years. With confirmation of Medical fitness 55 years is the maximum acceptable
age for actually performing strenuous fire fighting tasks.
Reference ------
Resources
Performance % of fire fighters/rescue staff completing assessment within the past 2 years.
indicators
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Key fitness for work Cardiovascular (CVS) risk must be assessed in all candidates and cardiology
review completed if indicated (See under Investigations)
issues
Assess chronic diseases and the need of monitoring and medication.
BMI - consider physical trade testing for fitness for duty if >35.
Check if there is any evidence of active alcohol or drug abuse or any other
psychiatric disorder.
Capacity to complete associated tasks - e.g. climb on different types of
transport, helicopters, boats etc.
Scope and Application Remote locations are those at which in foreseeable circumstances (e.g.
inclement weather) an injured or ill employee or family member cannot be
evacuated to a tier three (i.e. hospital) medical facility within four hours.
Critical activity and The particular hazard addressed by this standard is the potential for the
potential hazards remoteness of a place of work or domicile to add to the risk (probability and
outcome) of an adverse health event. i.e. that a delay in reaching a medical
facility (that is reasonably likely and foreseeable for the location in question),
might compromise the health and well being of an employee. The hazards of
any particular occupation at that location are additional to these requirements
(e.g. the need to wear breathing apparatus).
Investigations Cardiovascular (CVS) assessment using Framingham risk calculator for all
employees 40 years and above. Risk of 20% or more requires further cardiac
evaluation with Stress test (TME).
Drug and alcohol screening during pre-employment.
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Key fitness for work Group A pose few if any problems for a transferring employee and family.
issues However consideration should be given to:
any tasks of the position for which an FTW standard applies
Children with special educational needs.
Those with ongoing special medical treatment needs.
Scope and Application PDO and Shell employed (and dependents), transferred to work in a position
in any of the following countries:
Abu Dhabi, Dubai (United Arab Emirates), Australia, Austria, Bahrain, Belgium,
Canada, Denmark, Dubai, Finland, France, Germany, Gibraltar, Greece, Hong
Kong, Iceland, Ireland, Israel, Italy, Japan, Kuwait, Luxemburg, The
Netherlands, New Zealand, Norway, Portugal, Qatar, Singapore, Spain,
Sweden, Switzerland, United Kingdom, USA.
Procedure Pre-transfer screening questionnaire - Form EX4 (Appendix 35) and for a
child EX3 (Appendix 34) is designed to identify any medical needs in
country of destination.
In addition to considering the suitability for a candidate to live in country of
destination, an additional assessment should be made of any task that will be
required of the individual in the location and the appropriate additional standard
applied – e.g. requirement to participate in a rescue team or use SCBA.
Physical evaluation is not required unless requested by employee.
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Fitness to Work Group PDO and Shell employee (including partner and children), transferred to
work in a position in a group B country as a new hire or a transfer from a
new position.
Critical activity and Restricted medical services and/or remote sites with difficult access
potential hazards Psychological Hazards
Restricted schooling
Infectious diseases (malaria, yellow fever etc).
Reference Resources Refer to Shell Health Services - travel health for specific destination
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Employees age 40 or above require a CVS profile during their Medical examination.
A cardiovascular screening tool is provided online at
http://cvrisk.mvm.ed.ac.uk/calculator/framingham.htm
Physical examination including blood pressure and BMI
Lipid profile if not completed in previous 2 years or if change in treatment, diet or lifestyle.
Stress testing (TME) is not required unless employee falls into high-risk category (see
below) or there is a clinical indication or new recruits above 50 or above 60 years of age.
The purpose of this risk stratification exercise is to target a more detailed investigation to
those at greatest risk (Framingham >20% 10 year) who would require further cardiological
review and annual follow up thereafter.
Following % based on 10-year risk of myocardial infarction or Cardiovascular death.
< 10% low risk no action.
10-20% medium risk counsel on lifestyle and refer to Primary Health Care Provider if
appropriate. Normally fit for safety sensitive work without further investigation.
>20% high risk refer to Primary Health Care Provider and specialist cardiologist. A detailed
assessment and clearance from the specialist is required before confirming fit for any of
these HSSE critical tasks/jobs. This assessment may include stress testing, ECHO, work
capacity or other relevant testing as directed by a cardiologist.
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Appendix 12: FTW Evaluation Content Summary
CVS assessment
Task RAM Questionnaire and examination content
Blood pressure
Questionnaire
Colour vision
Examination
Hearing test
Spirometry
HIV test
Vision
BMI
Aircraft refuelling 4B Pre-placement questionnaire & examination
Catering Staff
of
Group A work
Group B work
location work
HG V driving
Professional
Emergency
equipment
team work
Breathing
refuelling
Business
response
traveller
Remote
Aircraft
Fitness to work group
drivers
LIGHT
Use
Blood pressure N/A <140/90 <140/ 90 N/A <140/90 <140/90 <140/90 <140/90 N/A <140/90
Body Mass index N/A <30 <35 N/A <35 <35 <30 <35 N/A NA
Spirometry N/A FEV1 / FVC >70% N/A N/A N/A N/A FEV1 / FVC >70% N/A N/A N/A
Values indicated in this table are minimum values for which candidate may be considered fit for the indicated task. These are not pass / fail
standards and if a candidate could not meet the standard then further assessment on a case-by-case basis should be conducted to address their
suitability for the task and any accommodation that may be necessary to permit the safe completion of the task. In the event accommodation
cannot be made, alternative employment should be sought.
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Appendix 14: Questionnaires and Evaluation Forms
Form Uses
E2 Certificate of of fitness for work completed with the statement by physician (An IT
based record of fitness to work is an acceptable alternative)
Name Department/Company
A5 Crane or forklift driving & all heavy vehicles A10 Transfers – group B country
Health Advisor Statement : The above named person has been examined according to the statements laid
down in “Protocols and Guidance Notes on the Medical Evaluation of Fitness to Work”. At this time his/her
fitness to work status for the above tasks is as follows.
The employee is fit for above work but should Temporary Permanent
avoid the following task(s) restriction restriction
Working at height
Use of a respirator
Flying
Other (Specifiy)
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Name: Department/Company:
This form is required to be completed either at the time of your fit testing for respirator use or
medical evaluation. If you have never completed an initial questionnaire form, you should
not be fit tested nor use a respirator until the initial questionnaire has been reviewed and
approved by a health care professional. All information provided on this form and during
consultations remains strictly confidential. When further clinical evaluation is required
following completion of a screening questionnaire, the details should be recorded on Q1 and
E1 forms.
2 Has here been any change in workplace conditions (e.g., physical work
effort, protective clothing, and temperature) that has or may result in a
substantial increase in the physiological burden placed on you when
performing your work that requires respirator use?
4 Do you have any medical problems (for example: issues related to the
heart, breathing problems, seizures, back problems, neck problems,
medications, etc.) that may affect your ability to safely wear a respirator?
5 Do you have any medical problems that prevent you or may prevent you
from working in a confined space?
6 Would you like to talk with a health professional regarding your health and
respirator use?
This form will be forwarded to the healthcare provider who will perform your evaluation for respirator use
fitness. If you answered “yes” or “not sure” to any of the questions, then you are prohibited from using
a respirator until this evaluation is completed and approval is granted.
Declaration: I, _________ (Print Name) certify that to the best of my knowledge the above
information supplied by me is true and correct.
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Name: Department/Company:
This questionnaire will help identify if you have any health condition which may need a more
detailed medical assessment as part of your fitness to work determination. If you have a
heath condition or concern which you think may be adversely affected by business travel,
please contact your doctor or local Health Services. They will assist you in making your trip
as safe and healthy as possible. All information provided on this form and during
consultations remains strictly confidential. When further clinical evaluation is required
following completion of a screening questionnaire, the details should be recorded on Q1 and
E1 forms.
Yes No
This form will be forwarded to the healthcare provider. If you answered “yes” to any question
you should seek a medical opinion from your doctor or local Health provider on your fitness
for business travel.
Declaration: I, _________ (Print Name) certify that to the best of my knowledge the above
information supplied by me is true and correct.
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Name: Department/Company:
This questionnaire will help identify if you have any health condition which may need a more
detailed medical assessment as part of your fitness to work determination. If you have any
queries please contact your doctor or local Health Services staff. All information provided
on this form and during consultations remains strictly confidential. When further clinical
evaluation is required following completion of a screening questionnaire, the details should
be recorded on Q1 and E1 forms.
Yes No
1 Do you have any medical condition that you believe may affect your ability
to handle food safely? (Answer “yes” if you do not know)
2 Have you been in contact with anyone with any infectious disease in the
past 12 months e.g. tuberculosis, typhoid, paratyphoid, or enteric fever?
3 Do you have any skin problems (on arms, hands or face) that require
treatment or affect your ability to wear gloves?
5 Have you suffered from a runny ear or chronic ear infection in the past year?
6 Have you ever previously been advised that you should not prepare or
handle food?
This form will be forwarded to the healthcare provider. If you answered “yes” to any question
you should seek a medical opinion from medical personnel on site before continuing to
prepare food at work.
Declaration: I, _________ (Print Name) certify that to the best of my knowledge the above
information supplied by me is true and correct.
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Appendix 19: (Form SQ4a), Catering & Food Prep. Follow up Screening.
Screening questionnaire following illness (Food handlers)
Name: Department/Company:
This form will be forwarded to the healthcare provider. If your answer is in any of the shaded boxes,
you must seek a medical opinion from local Health Services before continuing to prepare food at
work.
Have you suffered from vomiting, diarrhoea or a bowel disorder during the last 7
days
Are you currently free from an infection of the skin, ears, nose, throat and eyes?
Have you been in contact with anyone suffering from Enteric Fever, Typhoid or
Paratyphoid
Health declaration
I am currently free of any skin rash affecting my hands forearms and face
Declaration: I, _________ (Print Name) certify that to the best of my knowledge the
above information supplied by me is true and correct.
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Appendix 20: (Form SQ5): Epworth Screening Quest. for Sleep Apnoea
Name: Department/Company:
This questionnaire will help identify if you have any health condition which may need a more
detailed medical assessment as part of your fitness to work determination. If you have any
queries please contact your local Health Services staff. All information provided on this form
and during consultations remains strictly confidential. When further clinical evaluation is
required following completion of a screening questionnaire, the details should be recorded
on Q1 and E1 forms.
How likely are you to fall asleep in the following situations? (use 0 to 3 score as shown below)
watching TV
Total
If you score a total of 15 or more you should seek advice from medical personnel on site before
continuing to drive or operate machinery in the workplace.
Declaration: I, _________ (Print Name) certify that to the best of my knowledge the
above information supplied by me is true and correct.
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Name: Department/Company:
This checklist should be completed by any employee who return to work after significant
injury, major illness, long sick leave ( >/=10 days) or long annual leave (>/= 30 days). Submit
the completed checklist to your direct supervisor.
This questionnaire will help identify if you had any significant health condition while away
from work that could affect your work performance, safety or hinder you from coping well or
feeling overwhelmed.
Yes No
Have you had peaceful time off work?
1
Have you travelled outside Oman?
2
During your leave, at home or abroad, have If yes, please notify your doctor or
3
you visited a doctor for any illness or medic on site.
significant injuries?
If yes, please notify your doctor on
4
Have you been prescribed medication to use site to ensure you receive your
for long term use (10 days or longer)?
regular prescription
During your leave, at home or abroad, have
5
you had fever or were you admitted in a
hospital (even if for a day)?
Has your treating doctor ask you to inform
6
your employer or your doctor in Oman about
your health?
Medical reports can help your doctor to plan
7
and ensure you receive appropriate medical
support. Have you share your report with site
doctor/medic?
Now that you are back to work, do you have
8
any health or safety concern relating to your
work that you want to discuss with your
supervisor or privately with your site doctor?
Do you think you need to have a fitness to
9
work medical, before resuming work?
Has any of your close relative been treated
10
for significant chest problem while you were
on leave? (significant coughing)
If you answered “YES” to any of the questions (3, 4, 5, 6, 8, and 9), your direct supervisor shall
submit this questionnaire to the respective site doctor/medic nearby to decided on the
appropriate advice before you continuing to work. If you have any queries please contact your
doctor/medics.
Declaration: I, _________ (Print Name) certify that to the best of my knowledge the above
information supplied by me is true and correct.
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Exposure to noise NOTE: If exposure to loud noise <16 hours prior to audiometry or if
> 85 dB(A) TWA: suffering from a cold, URTI, ear infection, sinusitis or the like:
or NO audiometry but new appointment to be given for when employee has
not been exposed to noise > 24 hours and/or has fully recovered
As defined by local legislation respectively.
Repeat audiogram
New Employee: No noise
in 1-3 months;
exposur Abnormal
Baseline Evaluation: if still abnormal,
e
Audio-questionnaire + audiogram + refer to ENT for
Clinical assessment opinion
Exposed
Existing Employee Outcome
ABNORMAL ABNORMAL
Repeat every 2 years
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Abeer hospital
Al Bashayer [email protected]
Al Salama PolyClinic
AL-Maha PolyClinic
Burjeel hospital
Crystal Polyclinic
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Ibn Zuhr
KIMS Hospital
MB clinic
PDO Clinics
https://www.pdo.co.om/hseforcontractors/hs/P
ages/newappointment.aspx
SAGAR PolyClinic
Shifaa Al Jazeera
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Description Quantity
Scissors 1 pair
- Laboratory (minor)
- Physiotherapy
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Cardiac monitor
Glucometer
BP apparatus
Syringes
IV fluids
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4 Oxygen Masks with Tubing Asstd 2 Box Gloves (sterile and unsterile)
24%, 100% (size 7 and 8)
2 Oxygen Flow Meters 1 Doz Razor and Razor Blades
1 Box Suction Gatherers 1 Doz Suturing kits with(Assorted
Sutures and Steristrips,
needles and needl holders)
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Gastrointestinal tract
Mouth wash/gargles
Hyoscine butyl bromide (Buscopan) tablets and
injections
Metoclopramide 10 mg(tablets and injections)
Procto-Glyvenol cream/Suppositories
Ranitidine tablets 150 mg
Antacid suspension
Oral Rehydration Salts(ORS)
Lactulose suspension such as Duphalac
Urinary Tract
Ural alkalizer sachets
Musculoskeletal topical
applications
Deep Heat cream
Diclofnac Sodium gel
Ear
Cerumol ear drops
Eye
Artificial tears
Naphazoline Hydrochloride
Optrex
Fusidic acid eye drops
Skin
Calamine lotion
Eurax cream
Magnesium sulphate paste
Silver Sulphadizine 1% cream 50 g(Flamazine)
Fucidin cream/ointment
Hydrocortisone cream
Miscellaneous
Betadine solution
Hydrogen Peroxide
Water for injection
Tetanus toxid injection
Xylocaine 2% and 1 %
Anti-epileptic medications eg ( injectable 5mg
Diazepam)
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Clinic Manage the clinic by ensuring it is clean, orderly and fit for
purpose.
Ensure equipment selection and numbers are adequate
Emergency Deal initially with all emergencies
Response Be fully conversant in PDO emergency response procedures and
nurse duties with respect to emergency response
Ensure that all emergency contact numbers are prominently
displayed
Emergency Ensure that all emergency medical equipment is regularly
Equipment checked and functioning
Ensure emergency medical equipments are kept in a manner that
allows easy accessibility for utilisation to an incident
Medical Records Maintain securely individual patient files, containing all medical
records
Maintain a list of clinic attendances
Calculate non-confidential monthly attendance statistics
First Aid Maintain an updated list of First Aiders
Supervise the First Aid Team
Deliver regular, short refreshers in First Aid topics every 4 months
Liase with area coordinator to ensure adequate numbers of First
Aiders
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Health Advisors: A clinical physician, occupational physician, nurse practitioner or nurse who
has been assigned responsibilities in a fitness to work programme who is deemed competent
to complete the assigned tasks.
Safety Sensitive Position: These are positions in which the incorrect action of the incumbent
or a failure to act can be a significant factor in events causing or leading to unsafe acts,
environmental damage or material losses.
Functional capability (Non medical evaluation): Evaluations which are not medical in nature
but which are integral parts of the fitness to work decision making process. Examples include
strength and agility tests, substance abuse tests and trade tests (functional capability
testing).Trade Test: The process of evaluation, in controlled circumstances, of an employee’s
proficiency to complete a required task e.g. helicopter evacuation training, fire-ground training
and colour vision task testing.
Unfit: This describes a decision made as a result of medical and non-medical evaluation, that
an employee has a functional limitation such that they are not able to complete the designated
task safely. In these circumstances the process of accommodation is applied to facilitate the
retention of the employee in the workplace.
With cause evaluation: A with cause evaluation is one where an “off-schedule” review of
fitness to work is carried out. An essential element of any FTW program is the capacity to
review and repeat an assessment of an employee’s fitness to work between regularly
scheduled evaluations. Examples of circumstances when a “with cause” evaluation may be
appropriate include, but are not confined to:
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Pre-Overseas Area:
Name and address of family doctor List your last 3 jobs
(1)
(2)
Are you a Registered Disabled Person? (UK only) Do you belong to any Medical Insurance Scheme?
DO YOU HAVE OR HAVE YOU HAD:- (Tick “Yes” or “No” column or put a (?) if uncertain exclude minor ailments.)
Y N Y N Y N
1. Sinus trouble 21. Cancer HAVE YOU EVER BEEN:-
2. Neck swelling/glands 22. Heart Disease 40. Rejected for employment or
3. Difficulty in vision 23. Rheumatic fever insurance for medical reasons
4. Any ear discharge 24. Abnormal heartbeat 41. Awarded benefits for industrial
5. Asthma/bronchitis 25. High blood pressure injury/illness
6. Hayfever /other significant allergy 26. Stroke 42. Treated for a mental condition,
7. Any skin trouble 27. Serious chest pain e.g. depression
8. Tuberculosis 28. Any blood disease 43. Treated for problem drinking or
9. Shortness of breath 29. Kidney disease drug abuse
10. Coughed/vomited blood 30. Blood in urine 44. Exposed to toxic
11. Severe abdominal pain 31. Diabetes substance or noise
12. Stomach ulcer 32. Headaches/migraine FOR WOMEN ONLY
13. Recurrent indigestion 33. Dizziness/fainting Have you ever had:-
14. Jaundice or hepatitis 34. Epilepsy 45. An abnormal smear
15. Gall Bladder disease 35. Joints/spinal trouble
46. Any gynaecological treatment
16. Marked change in bowel habits 36. Surgical operation
17. Blood in stools (motions) 37. Serious accident/fracture 47. Are you pregnant?
18. Marked change in weight 38. Tropical disease 48. HAVE YOU HAD AN ILLNESS
19. Varicose veins 39. Fear of heights NOT MENTIONED ABOVE
20. Lump in breast/armpit
How much tobacco each day? Average daily alcohol consumption
Have you ever taken elicited drugs? ( ) PDO test all new/potential employees for elicited/recreational drugs
FAMILY HISTORY: Diabetes ( ) Tuberculosis ( ) Epilepsy ( ) Asthma ( ) Eczema ( )
Heart disease ( ) High blood pressure ( ) Stroke ( ) Blood Disease ( ) Cancer ( )
PLEASE READ THE FOLLOWING STATEMENT AND IF YOU AGREE KINDLY SIGN IT:-
I declared these statements to be true to the best of my knowledge and belief and I agree that the result of this medical examination in
general terms may be revealed to the Company if required, and the details sent to my own doctor if this is considered necessary by the
examining medical officer. I am also aware that PDO reserve the right to dismiss me if it was found that I have purposely withheld
important medical information.
Date: Signature of Applicant:
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OTHER FINDINGS (Physique, scars, disabilities, mental stability including behaviour, etc.)
ASSESSMENT:
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Personal Details
Are you a registered person with special needs? Do you belong to any Medical Insurance Scheme?
Previous Medical History: All important medical events should be listed and dated at every medical examination. To be completed together
with the interviewing Nurses or Doctor who will be able to help by referring to your notes.
Please answer the following questions and tick ‘N’ (no) or ‘Y’ (yes) in the column. If ‘Y’ please describe
N Y Description
Have you, since your last medical been treated by your family doctor or
specialist for significant (major) ailments?
1 Ear, nose, eye or throat problems
2 Chest problems like asthma, bronchitis, other bad cough
3 Heart abnormality, chest pains
4 Abdominal pains, abnormal bowel motions
5 Urogenital problems (kidney disease, menstrual disorder)
6 Skin trouble or allergies
7 Epileptic fits, dizzy spells or migraine
8 History of mental illness, depression anxiety
9 Diabetes, thyroid disease
10 Blood disorder e.g. anaemia, blood cancer e.g. leukaemia
11 Any history of accidents or fractures
12 Have you had any serious allergies
13 Do any dependants have a significant ongoing illness?
14 Any family history of cancers
Do you take any regular medicines, or have your taken in the past?
Do you smoke? If yes, what and how much each day?
Do you drink alcohol? If yes, what is your average weekly intake?
Have you ever taken elicited/recreational drugs?
Are you doing regular sports or physical activities?
STATEMENT: I have read the above questions and the above answers are correct and no information concerning my present or
past state of health has been withheld. . I understand and agree that this form will be held as a confidential record by PDO
Medical Department, and may be copied (by paper or secure electronic transmission) ) to the Occupational Health Services for
the purpose of Health Surveillance and other Occupational Health review .
OTHER FINDINGS (Physique, scars, disabilities, mental stability including behaviour, etc.)
REVIEW/CONSULTATION
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Dependant <12
Family Name First Names Date of Birth (dd/mm/yy) Nationality
Please answer the following questions and tick ‘N’ (no) or ‘Y’ (yes) in the column. If ‘Y’ please describe
Y N Description Y N Description
Tetanus Typhoid
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Yes No Details
21. Was the pregnancy with this child normal?
22. Was the delivery normal?
23. What was the birth weight?.......... grams
For children under 3 months
24. Is breast/bottle feeding well established?
25. If bottle fed, what Brand of milk used:
For children under 5 years
26. Has there been any unusual delay (in reaching the usual
milestones? (e.g. sitting-up, crawling, walking, talking)
27. Is the child on regular medication?
28. Is he/she attending a normal school?
EDUCATION ASSESSMENT: Please give details if you have replied YES to any of the following questions
29. Have there been any problems associated with the
education development of the child:
30. Has the child been referred to an education
psychologist?
31. Are there any medical conditions of which normal
school would need to be aware?
STATEMENT: I have read the above questions and the above answers are correct and no information concerning
my child’s present or past state of health has been withheld. I understand and agree that this form will be held as a
confidential record by PDO/Shell Health, and may be copied (by paper or secure electronic transmission) to the Senior
Medical Office of my future PDO/Shell employing company. The Employing company in question may be based in a
country outside the European Economic Area (EEA) and the country may therefore have a different level of protection
for an individual’s rights than those countries within the EEA.
Fit Restricted
(Regional)
Health Manager ___________________________ Date ___________ Signature___________________
INTERVIEW/CONSULTATION
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Registered Disabled Person? [ ] Yes [ ] No Medical Insurance? [ ] Yes GEMS [ ] Yes other [ ] No
Please answer the following questions and tick ‘N’ (no) or ‘Y’ (yes) in the column. If ‘Y please describe (overleaf)
N Y Description
Have you, since your last medical examination or during the last four years,
1
been treated by your family doctor or a specialist? If so, please specify.
Have you, in the recent past, taken medicines regularly, or are you still doing
2
so? If so, please specify
3 Do you have any allergies (food, medicines)? If so, please specify.
4 Do you have any medical problem related to travel? If so, please specify
Did you ever or do you suffer from mental health issues like stress, anxiety or
5
depression? If so, please specify.
Do you require any work-related medical examinations? e.g. remote location
6
(offshore), breathing apparatus use.
If you are going on an unaccompanied posting, do any dependents have a
7
significant ongoing illness/condition. If yes, please specify overleaf.
STATEMENT: I have read the above questions and the above answers are correct and no information concerning my present or past
state of health has been withheld. I understand and agree that this form will be held as a confidential record by Shell Health, and may
be copied (by paper or secure electronic transmission) to the Senior Medical Office of my future Shell employing company. The Shell
employing company in question may be based in a country outside the European Economic Area (EEA) and the country may therefore
have a different level of protection for an individual’s rights than those countries within the EEA
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Fit Restricted
Date __________
Temporarily Unfit (See correspondence)
(Regional)
Health Manager ___________________________ Date ___________ Signature___________________
INTERVIEW/CONSULTATION
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