FIRST 250MMSCFD

TRAIN OF KM500
GAS TREATMENT
PLANT

Fitness to Work Procedure

HAV-EXT-HS-PRO-0180

EXTERRAN - REVIEW STAMP

Proj. No.: 4996 P.O. No.: 89005190

DOCUMENT REVIEW CODES:

1 2

Approved & Accepted as Final. Approved & Accepted as

WORK may proceed. Marked. Revise & Re-Submit.
WORK may proceed.

3 4

Rejected & Returned. Revise and Review NOT required. For

Re-Submit. WORK shall NOT information only. WORK may
proceed. proceed.

Acceptance of this document by Exterran does not relieve the CONTRACTOR or

Supplier/Vendor of any responsibility for compliance with the terms and conditions
of the Contract/PO.

Name:
Akano Temitope Signature:
Date:
6 September 2021

B 06.09.2021 REISSUED FOR APPROVAL UE BO BO

A 25.06.2021 ISSUED FOR APPROVAL HY OY BO
REV. DATE REVISION STATUS PREPARED BY CHECKED BY APPROVED BY
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CONTENTS

1 PURPOSE ....................................................................................................................................................................... 3
2. SCOPE ............................................................................................................................................................................. 3
3. OBJECTIVES ................................................................................................................................................................... 3
4. DEFINITIONS AND ACRONYMS ................................................................................................................................... 3
5. REFERENCES ................................................................................................................................................................. 4
6. ROLES & RESPONSIBILITIES........................................................................................................................................ 4
6.1. Project Director ............................................................................................................................................................... 4
6.2. HSSE Manager ................................................................................................................................................................. 4
6.3. Health Lead / medic ......................................................................................................................................................... 5
6.5. Line Management ............................................................................................................................................................. 5
7. REQUIREMENTS ............................................................................................................................................................ 5
7.1. Medical Evaluation .......................................................................................................................................................... 5
7.2. Documentation for employee’s health .............................................................................................................................. 6
7.3. Fitness to Work Process ................................................................................................................................................... 6
7.4. Return to Work Authorization........................................................................................................................................... 8
7.5. Legal Requirements Constraints ...................................................................................................................................... 8
7.6. Records............................................................................................................................................................................. 8
8. ATTACHMENTS .............................................................................................................................................................. 9
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1 PURPOSE
The purpose of this document is to provide a procedure to ensure an effective fitness to work process is implemented on the
Project.
The content and frequency of the fitness to work assessment is based on the health risks associated with the work and living
environment, and risk factors in the population and individuals.
Havatek Project Coordinator will ensure that an effective fitness to work process is implemented for its personnel &
subcontractor’s personnel to assure they are fit to work.
This procedure also includes all respective local, regional and international requirements necessary for an adequate fitness
to work coverage.
2. SCOPE
The requirements in this process document apply to all Havatek (hereafter shall be referred as CONTRACTOR) personnel,
CONTRACTOR’s subcontractors and activities performed during execution of the Project. Activities covered do not only
include construction operations, but also temporary facilities and other support services, which will be monitored for
compliance throughout the Project.
Locations covered by the scope of this plan include all sites and accommodation utilized by CONTRACTOR and
CONTRACTOR’s subcontractors.
3. OBJECTIVES
The medical Evaluations of Fitness to Work process is designed to:
 Minimize the risk of an adverse consequence to the health and / or safety of an employee or third party,
resulting from a foreseeable health condition.
 Match, wherever reasonably practicable, the requirements of a position and its associated task to the functional
capacity (physical and psychological) of the employee.
 Defining a medical surveillance program for CONTRACTOR employees and subcontractors working on
project / facilities.
 Minimize the risk of liability, arising from medical evaluation of fitness to work.
 Complement other non-medical evaluations as part of the overall fitness to work process.
 Avoid non-risk based pre-employment medical examinations.
 Ensure that all steps are taken to identify the requirements and specific needs for establishing project specific
medical facilities, staffing and medical emergency response

4. DEFINITIONS AND ACRONYMS

COMPANY EXTERRAN

CONTRACTOR HAVATEK Makina Inc.

A Cardiovascular system risk calculator (e.g. Framingham or equivalent may

Cardiovascular(CVS) Profile
Fitness to Work (FTW).
Health Advisors
be used to give an indication of an employee’s potential for a cardiovascular
event directing the need for further investigation. They do not provide an
absolute and personal measure of individual risk).
An employee is currently in a physical and psychological condition in which
he / she can carry out specific work, without significant risk to him / herself,
the business and / or third parties. FTW is a category of the possible
occupational health controls (e.g. elimination substitution, engineering,
procedures and personal protective equipment) which may be required for the
safe execution of a task.
A clinical physician, occupational physician, nurse practitioner or nurse who
has been assigned responsibilities in a fitness to work program that is deemed
competent to complete the assigned tasks
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The process by which medical information is solicited through questionnaire

Medical evaluation and or examination as part of the decision making process in respect fitness to
work.
Evaluations which are not medical in nature but which is an integral part of
Non medical evaluation the fitness to work decision making process. Examples include strength and
agility tests, substance abuse tests and trade tests.
These are positions in which the incorrect action of the incumbent or a failure
Safety Sensitive Position to act can be a significant factor in events causing or leading to unsafe acts,
environmental damage or material losses.
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
Unfit 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.
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:
With cause evaluation  Return to work after illness or commencing new medication.
 Referral by a supervisor following observed behaviour in the
workplace e.g. failing to complete a task appropriately.
 Self-referral by an employee with concerns over fitness to work.
 Following an incident or accident in the workplace where it is
considered fitness to work may have been a factor.
5. REFERENCES
Project HSSE Plan
6. ROLES & RESPONSIBILITIES

6.1. Project Director

The Project Director's duties shall include mainly:
 Ensuring or allocate sufficient resources for the management of this procedure.
 Contributing as necessary to the program.
 Development, reviewing and endorsing fitness to work process and associated documentation ensuring that
these are updated and/or modified to suit any changes.

6.2. HSSE Manager

The HSSE Manager’s duties shall include mainly but not limited:
 Being familiar with all local, national, and international laws that is applicable to Health Management
 Establish an effective fitness to work plan
 Establish an effective medical emergency plan
 Identify required sufficient resources to the health management
 Supporting and consulting to medical team
 Audit implementation of this plan and report to CONTRACTOR’s Top Management
 Act as a lead to health risk assessment
 Determine the appropriate level of medical facility to be established at the location.
 Determine project/facility medical staffing needs.
 Ensure COSHH (Control of Substances Hazardous to Health) assessment must be provided to Engineer
 Develop the HSE awareness of all personnel employed on the project and ensures their participation in all
aspects of the health and HSE program.
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 Provide information to employees regarding their emergency response responsibilities

 Report health monitoring KPIs in monthly HSE plan to CONTRACTOR Management
6.3. Health Lead / medic
The Project Medic’s duties shall include mainly but not limited:
 Being familiar with all local, national, and international laws that is applicable to Health Management
 Implement and monitor this plan
 Establish an effective medical emergency plan with HSSE Manager
 Schedule health assessments for all appropriate site personnel
 Report to HSSE Manager on daily
 Report all incident and accident to HSSE Manager
 Report and keep all clinic visits and other statistical information
 Evaluate the standards of care and capabilities of local clinics and hospitals. Select a primary and, if
possible, a secondary provider
 Assess the needs and availability of medical supplies and equipment.

6.4. Administration Manager

Administration Manager’s duties shall include mainly but not limited:
 Being familiar with all local, national, and international laws that is applicable to Health Management
 Ensure all employees of CONTRACTOR and subcontractors have medical checks legally acceptable to
Kurdish authorities.
 Maintain his/her roles in medical emergency procedures

6.5. Line Management

 Monitor health condition of employees who is under his / her responsibilities

 Monitor return to work authorization of employees who is under his / her responsibilities
 Maintain his/her roles in medical emergency procedures
7. REQUIREMENTS
7.1. Medical Evaluation
All CONTRACTOR employees including CONTRACTOR’s subcontractors shall have pre-medical checks legally
acceptable to Kurdish authorities. Site Manager with the support of HSSE Manager shall ensure that, prior to
engagement for the performance of the work all personnel including subcontractors have been examined by a
medical professional and issued with a valid ‘Medical Certificate of Fitness to Work, with at least 1 year validity.
Preliminary Pre-employment Medical Screening Form is provided as Attachment 1.
Such records shall be reviewed by the Project Medic, who will prepare “fitness to work” report as part of
recruitment process. Any employee who is unfit shall not be hired by the Project.
The medical evaluations for fitness to work will 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 program must
not be confused with other elements.
HSSE Manager shall ensure that all the project personnel including subcontractors, Fitness to work certificates are
provided, verified and records kept with the Medical Department prior to commencement of work.
The Project’s Medic or designee/responsible person shall:
 Review all medical data and will prepare a report of an employee’s medical qualifications and, where
applicable, the employee’s ability to use respiratory protection.
 Note any restrictions or conditions that may increase the employee’s risk of adverse health effects and
limitations on work.
 Determine if the Project’s employees may work at a particular site or task.
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7.2. Documentation for employee’s health

The medical record for each individual will include, at a minimum:
 The employee’s name and social security number;
 The physician’s/Dr’s written opinions, recommended limitations, reports, and results of examinations
and tests;
 Medical Fitness Report / Questionnaire (Please see Attachment No.1)
 The Physician’s/Dr’s Statement Form (Please see Attachment No.2), signed and dated by the examining
or consulting physician/Dr. , certifying the employee as medically fit to work at the high risk work,
hazardous waste site or hazardous material site and to wear respiratory and other personal protective
equipment;
 Any employee medical complaints related to hazardous substance and unsafe act exposure;
 Information furnished to the physician by the HSSE Manager or the individual’s employer;
 Copies of Return to Work Authorizations signed by a physician/Dr. ; (Please see Attachment No.3)
 Copies of employee industrial hygiene exposure monitoring results;
 Copies of employee occupational noise exposure monitoring results;
 Copies of employee heat stress monitoring data

7.3. Fitness to Work Process

In addition to the Pre employment Medical Screening, Employees engaged in certain tasks shall undergo Fitness
to Work evaluation.

Initially, the following groups/ categories identified which required FTW protocols.
 International workers in Kurdistan
 All professional drivers
 Crane Drivers
 Food handlers
Project Director & Site Manager will ensure that the required fitness to work evaluations is completed for the identified
groups prior to the mobilization as per the Table 1 ‘Summary of Medical Examination and Document Requirements
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All CONTRACTOR local employees including CONTRACTOR’s subcontractors shall have pre-medical checks
legally acceptable to Kurdish authorities. The identified groups shall have fitness to work examination as defined in
the below table.
Table 1. Summary of Medical Examination and Document Requirements
All expat Professional
Crane Operator Food Handlers
workers drivers
Pre-employment Medical Screen by authorized
facilities
Pre-employment Medical Screen Questionnaire
Medical Checks
Blood Pressure
Body Mass Index
Visual skin check
ECG Test ( upper 50 years)
Chest X ray
Ears and hearing test
Internal Medicine
Surgery Check
Upper respiratory test
Eyes (included color vision)
Psychological test
Laboratory examination of at least one,
preferably three, fecal specimens, for the
presence of the enteric pathogenic organisms or
parasites (stool culture/microscopy).
Laboratory examination of throat and nose
swabs for isolation of streptococci.
Symptomatic or suspected gastrointestinal
disease;
Upon return from a visit to an area with known
high endemic incidence of gastrointestinal
disease.
Blood test (under 50 years)
HBsAG
AHBs
AHCV
AHIH
VDRL
Additional Blood test (upper 50 years)
Cholesterol
HDL
LDL
Urea
Keratin
Glucose
SGOT
SGPT
ALP
Proteins
Hemogram
Sedimentation
Urine Test
Vaccination validity - Hepatitis A & B,
Typhoid fever
“*” In 6 months period
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7.4. Return to Work Authorization

Where employees who because of an occupational injury or illness are to see a medical professional offsite must,
in all cases, obtain authorization to return to work as follows:
 Return to Work Authorization Form is to be completed by the physician who renders medical treatment.
In the absence of this form, the physician may provide other documentation to substantiate the
employee’s ability to return to work with a definition or explanation of any work restrictions.
 The employee will return the appropriate medical documentation substantiating his/her ability to return
to work to the project Medic or the HSSE Manager prior to the start of work.
7.5. Legal Requirements Constraints
Local Kurdistan legislation shall always be met, but if this guidance requires more frequent or extensive
evaluation, then this document shall apply.
Specifically this means the following:
 The frequency of evaluations in this document shall be applied if it is more frequent than that required
by local Kurdistan legislation.
 The content of the examinations specified in this document will apply. If country legislation requires
use of a specific form (e.g. for driving) it shall be used but at the frequency required by these
protocols.
 If any specified practice in this document, or a supporting reference, is not legal in a country of
operation, it is not to be carried out and an alternative means of assuring fitness to work identified.
 If this document makes additional requirements over and above the country specific requirements,
they shall be added to the assessment process.
7.6. Records
Project Medic shall maintain medical records for personnel and ensures all subcontractors maintains medical
records for each Project related personnel, which includes details of the pre-employment health assessment,
FTW Certificates, details of any subsequent first aid treatments, injury treatments or clinic visits, and details of
any health surveillance that may have been undertaken.
Medical records will be maintained in an accurate medical database containing the above information in an
electronic form and generate monthly reports on the health monitoring and surveillance activities, inclusive of
occupational illnesses and occupational injuries monitoring.
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8. ATTACHMENTS

Attachment No.1: Medical Fitness Report (Exhibit A)

MEDICAL FITNESS TO WORK REPORT FORM

Document Code:HAV-EXT-HS-REP-0182 Issue Date:- Rev. No:- Rev. Date :- Page No: 1/3

COMPANY AND PROJECT INFORMATION

Company Name

Company
Address

Project name
Picture
Project No

Project Address

EMPLOYEE INFORMATION

Full name

Sex

Education

Marital Status No of Children

Home Address

Phone

Profession

Job Performed

Department

HEALTH BACKGROUND

Blood Group

Congenital / chronic illness

Immunization

- Tetanus
- Hepatitis
- Other
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FAMILY INFORMATION

Mother Father Brother & Sister Children

MEDICAL HISTORY

1. Have you had any of the following complaints in the past year? No Yes Date

- Cough with mucous

- Shortness of breath
- Chest pain
- Palpitation
- Backache
- Diarrhea or constipation
- Pain in the joints
- Other (Specify)
2. Have you had any of the following diseases in the last year? No Yes Date

- Heart disease
- Diabetes
- Kidney disease
- Jaundice
- Stomach or duodenal ulcer
- Hearing loss
- Defect of vision
- Nervous system disease
- Skin disease
- Food poisoning
- Other (Specify)
3. Have you been hospitalized in the past year? No If Yes,
diagnosis
4. Did you have a major surgery within the last No If Yes, What is
year? it?
5. Did you have an accident at work within the last No If Yes, What is
year? it?
6. Did you go to Occupational Diseases Hospital No If Yes,
in the past year diagnosis
7. Have you received disability in the last year? No If Yes, What is
it and ratio?
8. Do you receive any treatment at the moment? No If Yes, What is
it?
9. Are you smoking? No

..........month/year Smoked
Forwent Smoked ...........each/per day
ago for.............month/year
Yes ..........years ..............each/per day

10. Are you having alcohol No

Forwent ..............year ago Drank for..............year Drank…………times/ per day

Yes Drink Drink ……………..times / per day

for..........year
PHYSICAL EXAMINATION RESULTS
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a) Sense organs

- Eyes

- Ears-Nose-Throat

- Skin

b) Examination of the cardiovascular

system

c) Examination of the respiratory

system

d) Examination of the digestive system

e) Examination of the urogenital system

f) Examination of the musculoskeletal

system

g) Neurological examination

h) Psychiatric examination

i) Other

-TA / mm-Hg

-Pulse / dk.

-Height: Weight:

LABORATORY FINDINGS

a) Biological analysis

- Blood (for hepatitis A-B and HIV)

- Urine

b) Radiologic analysis

c) Physiological analysis

- Audiometer

d) Psychological tests

e) Other

LABORATORY TESTS and RESULTS FOR FOOD HANDLERS

Throat and nose culture

Stool culture(for salmonella and

shigella)
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Microscopic examination of stool (For

Entamoeba, histolytica cysts, giardia
lamblia cysts and helminth eggs

Chest X-Ray (For tuberculosis)

OPINION and CONCLUSION:

1- He / She is physically suitable for the study at.………………………………………………………………..

2- He / She is suitable, condition to be treated the defects pointed out in the report.

NAME &SURNAME

SIGNATURE DATE: ........ / ......... / ..................

PERIODIC EXAMINATIONS:

(In this section, the results of periodic examination shall be written by taking into account of the
occupational diseases. The results of the tests of periodic examination shall be attached to the report)
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Attachment No.2

PHYSICIAN’S/Dr’s STATEMENT FORM

EMPLOYEE NAME: EXAM DATE:

COMPANY: LOCATION:

POSITION:

The Examining Physician or Medical Consultant has reviewed the medical information regarding the above employee, and the
following status has been established:

 There is no medical abnormality that will interfere with the duties of the individual or place the employee at
increased risk of health effects from designated tasks (fit to work)

 The employee may work at designated task with the following restrictions.

 Deferred pending further evaluation.

 Clearance for respirator use, if applicable.

On the basis of the information obtained from the medical examination, the above named individual has been
found medically:

 Qualified to use a respirator

 Not qualified to use a respirator
 Follow-up with personal physician recommended. See report of medical examination.

 Unfit to designated task

Physician’s/Dr.’s Signature:
Printed Name of Physician/Dr.:
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Attachment No.3

RETURN TO WORK AUTHORIZATION

COMPANY NAME: DATE:

EMPLOYEE: ID NO :

DATE OF INJURY: TIME OF INJURY:

AM/PM

NATURE OF INJURY:

HOW INJURY OCCURRED:

_______

ISSUED BY:
SIGNATURE: DATE: ________

TREATED FOR:

DAYS AWAY FROM WORK:

TO RETURN TO WORK _______

UNABLE TO RETURN TO WORK:

RETURN FOR TREATMENT ON:

MEDIC’S SIGNATURE DATE