Investigation of COVID-19 diseases of medical workers in the context of implementing the state policy on occupational safety

Problem setting. Ensuring the rights of workers to a safe working environment, the priority of their lives and health during their professional activity is the main goal of the state policy of Ukraine on occupational safety.However, in a pandemic, due to the significant spread of acute respiratory COVID-19 disease caused by the coronavirus SARS-CoV-2, the risk of infection of health care workers, especially those in direct contact with patients, is very high.According to the Center for Public Health of the Ministry of Health of Ukraine, for the period from the beginning of the pandemic to January 26, 2021, 1197,107 cases of coronavirus COVID-19 were recorded in Ukraine. As of January 26, 2021, 2,779 new laboratory-confirmed cases of coronavirus COVID-19 disease were recorded, of which 175 cases are those of medical workers. During the first 9 months of 2020, cases of infection with COVID-19 by medical and other workers whose work is related to the performance of professional duties in conditions of increased risk of infection, led to an increase in the number of reports of accidents/acute occupational diseases by 3.7 times, compared to the same period in 2019. In particular, for 9 months of 2020, 11,591 reports of accidents/acute occupational diseases of medical workers were registered, which is 71.2% of the total number of such reports.Recent research and publications analysis. The study of the main causes of occupational injuries, analysis of its state and consequences is reflected in the works of such researchers as A. Dengin, Y. Kundiev, O. Bodnarchuk and others. Researchers V. Averyanov, G. Astapova, G. Atamanchuk, V. Bakumenko devoted their work to the theory and practice of forming and implementing public policy. The solution of topical issues of the development of methods of monitoring the state of labor protection in Ukraine, to one degree or another, is covered in the works of the following domestic researchers: V. Afanasyev, G. Gogitashvili, A. Amoshi, and others. At the same time, it should be noted that the issue of investigating cases of COVID-19 didease of the healthcare professionals has not been investigated yet due to its novelty.Highlighting previously unsettled parts of the general problem. The paper objective is to analyze the theoretical and methodological approaches to investigating cases of COVID-19 disease among medical workers in the context of implementing the state policy on occupational safety. Paper main body. Following the recommendations of the Ministry of Health of Ukraine and the State Labor Service, laboratory-confirmed cases of COVID-19 infection of medical and other workers associated with the performance of professional duties in conditions of increased risk of COVID-19 infection are investigated as cases of acute occupational disease under the requirements of the Procedure for investigating and accounting of accidents, occupational diseases and accidents at work, approved by the Resolution of the Cabinet of Ministers of Ukraine of April 17, 2019, ¹ 337 (hereinafter the Procedure of Investigation), which determines the procedure for holding the investigation and accounting of accidents, occupational diseases and accidents at work. The Procedure of Investigation provides three types of investigation of acute occupational diseases: special investigation, investigation (general), investigation of acute occupationalCOVID-19 disease caused by coronavirus SARS-CoV-2, which led to a fatal outcome. Conducting any of the above types of investigation is preceded by:– emergency notification of the victim’s appeal about an acute occupational disease (according to Annex 1 to the Procedure of Investigation);– notification of the employer about an acute occupational disease (according to Annex 2 to the Procedure of Investigation).The investigation commission’s composition is determined by items 13, 15, 142 of the Procedure of Investigation and depends on the type of investigation. If the commission establishes the employee’s infection during the performance of professional duties, an acute occupational disease is recognized as related to production. In the context of the above-mentioned, it is important that a medical staff member is or is not included in the “List of positions of medical and other staff directly involved in the epidemic and measures to prevent the spread of acute respiratory COVID-19 disease caused by coronavirus SARS-CoV-2, and treatment of patients with cases of acute respiratoryCOVID-19 disease caused by coronavirus SARS-CoV-2”, approved by the Order of the Ministry of Health of Ukraine of July 15, 2020, ¹1604. By the investigation results, the commission is obliged to draw up an act on the form H-1 (according to Annex 11 to the Procedure of Investigation), which is subject to approval by the employer. The tasks of the investigation of acute occupational disease are, in particular, to determine the compliance of working conditions and safety with the requirements of labour protection legislation, clarifying the circumstances and the causal link between the acute occupational disease and the performance of professional duties of the victim. The Investigation Procedure does not regulate the procedure for classifying the disease as acute occupational but regulates the procedure for linking chronic disease (poisoning) with the working conditions of the employee by his requirements and the List of Occupational Diseases approved by the Cabinet of Ministers of November 8, 2000, ¹ 1662.The list of occupational diseases, in accordance with the Instructions for its use is the main document that should be followed when diagnosing an occupational disease, its connection with the work or profession. The diagnosis of an acute occupational disease that occurs at work is established by a doctor of any treatment and prevention facility after mandatory consultation with an occupational pathologist and an occupational health doctor; and in diseases of infectious origin – the diagnosis is established by an infectious disease doctor and occupational pathologist, taking into account the epidemiological investigation.There is no legal act in Ukraine that determines the procedure for conducting an epidemiological investigation. Instead, for registration of results of the epidemiological inspection, the form of the accounting statistical documentation 350/î “Map of epidemiological inspection of the centre of an infectious disease” approved by the Order of the Ministry of Health of Ukraine of July 11, 2000, ¹ 160 is applied. Conclusions of the research and prospects for further studies. According to the results of the investigation of acute occupational disease, which is duly reflected in the act of investigation of acute occupational disease in the form of H-1, victims of acute respiratory COVID-19 disease caused by coronavirus SARS-CoV-2 may be recognized as medical workers, who within the limits of their official duties, in compliance with the rules of labour protection and safety, following the order of the head of the health care institution, have directly provided medical care to patients with COVID-19, have worked with the pathogen COVID-19 or participated in disinfection measures in the conditions of compliance with the rules of infection control and the use of personal protective equipment. Since the act of investigation of acute occupational disease is made solely based on the epidemiological investigation of the case of infection of a health worker and the conclusion of an infectious disease specialist and occupational pathologist to establish a connection of acute respiratory COVID-19 disease caused by coronavirus SARS-CoV-2 with the professional activity, there is a need in legal regulating of: 1. Procedure for conducting an epidemiological investigation of epidemics and outbreaks of infectious diseases;2. Detailing the procedure for the investigation of acute occupational disease, in particular in the following part:– sending an emergency message and notifying the employer of acute occupational disease, namely – only after the appropriate diagnosis of acute occupational disease;– delimitation of powers and specification of conditions (criteria) for the formation of a commission of special investigation (whose competence includes the investigation of fatalities that caused serious consequences and group acute occupational diseases) and the commission of investigation of acute occupational COVID-19 disease caused by coronavirus 2 SARS-CoV, which led to a fatal outcome.Thus, implementing the state policy on occupational safety requires a conceptual approach to the rule-making process and stipulates the necessity for further scientific research.