Aerb Is-4
Aerb Is-4
Aerb Is-4
AERB/SG/IS-4
GOVERNMENT OF INDIA
GUIDELINES FOR PRE-EMPLOYMENT MEDICAL EXAMINATION AND FITNESS FOR SPECIAL ASSIGNMENTS
GUIDELINES FOR PRE-EMPLOYMENT MEDICAL EXAMINATION AND FITNESS FOR SPECIAL ASSIGNMENTS
Price
The Administrative Officer Atomic Energy Regulatory Board Niyamak Bhavan Anushaktinagar Mumbai-400 094 India
FOREWORD
The Atomic Energy Regulatory Board (AERB) is responsible for enforcing safety in all atomic energy related activities within India, as well as for enforcing the provisions of the Factories Act, 1948 in the units of Department of Atomic Energy (DAE) that are under its purview. Towards this, AERB has been developing safety requirements in the form of codes, standards, guides, manuals and guidelines to facilitate the concerned organisations to implement the relevant safety regulations in their facilities. This document entitled Guidelines for Pre-employment Medical Examination and Fitness for Special Assignments lays down the requirements for the medical examination of personnel to be recruited for various units of DAE. These examinations help to determine the fitness of the individual for the work that he/she would be assigned and get baseline data on some physiological aspects, which would also assist in determining if any ailments developed later have any relation to the work environment. Earlier, a document on the subject was issued by DAE in 1962, and it was felt that a review of this document is now necessary, to take into account the growth and diversity of activities in DAE and changes that have taken place in the applicable rules and regulations over the years. Also in 2001, in a meeting of the Certifying Surgeons of all DAE units organised by AERB, it was recommended that preparation of such a document is desirable. Accordingly, a sub-committee was constituted by the Advisory Committee on Occupational Health for DAE for developing the guidelines. The document was not only examined by the Advisory Committee, but also vetted by Medical Professionals and Certifying Surgeons of DAE units.
DEFINITIONS
Competent Authority Any official or authority appointed, approved or recognised by the Government of India for the purpose of the Rules promulgated under the Atomic Energy Act, 1962. Dangerous Manufacturing Processes or Operations The manufacturing processes or operations as specified under Rule 88 of Atomic Energy (Factories) Rules, 1996. Dose A measure of the radiation received or absorbed by a target. The quantities termed absorbed dose, organ dose, equivalent dose, effective dose, committed equivalent dose, or committed effective dose are used, depending on the context. The modifying terms are used when they are not necessary for defining the quantity of interest. Hazardous Process Any process or activity in relation to an industry where unless special care is taken, raw materials used therein, or the intermediate or finished products, bye products, waste or effluent thereof would: i) ii) cause material impairment to the health of the persons engaged in or connected therewith, or result in the pollution of the general environment.
Occupier One who has been given the ultimate control over the affairs of the installations. Radiation Worker Any person who is occupationally exposed to radiation and who in the opinion of the regulatory body should be subjected to radiation surveillance.
ii
CONTENTS
FOREWORD ............................................................................................. DEFINITIONS ........................................................................................... 1. INTRODUCTION ....................................................................... 1.1 General ......................................................................... 1.2 Objective ...................................................................... 1.3 Scope ........................................................................... DETAILS OF MEDICAL EXAMINATION .............................. 2.1 General ......................................................................... 2.2 Types of Medical Examination ..................................... 2.3 Records to be maintained ............................................. 2.4 Guidelines for General Medical Examination ............... 2.5 Job Specific Guidelines for Certain Categories of Employees .................................................................... 2.6 Special Medical Examination for Special Assignments (Pre-placement) ...................................... TABULATION OF DISQUALIFICATIONS DUE TO ABNORMALITIES ..................................................................... LIST OF FORMS ....................................................................... Form-1: Candidates Statement and Declaration ....................... Form-2: Examining Physicians Report ...................................... Form-3: Medical Certificate of Fitness for Employment ............ MEDICAL EXAMINATION OF CANDIDATES HAVING NEURAL LEPROSY ..................................... MEDICAL EXAMINATION OF PHYSICALLY HANDICAPPED PERSONS ......................................... ARRANGEMENTS FOR THE MEDICAL EXAMINATION OF PERSONNEL RECRUITED IN THE DEPARTMENT OF ATOMIC ENERGY ................................................. NO SPECIFIC STANDARDS FOR EMPLOYMENT IN NON-GAZETTED (CIVIL) POSTS ........... i ii 1 1 2 2 3 3 3 3 5 7 11
2.
3.
12 13 14 16 20
4.
APPENDIX- A
21
APPENDIX - B
23
ANNEXURE- I
25
ANNEXURE-II
29
ANNEXURE-III CASES OF NO DISQUALIFICATION FOR SOME PHYSICAL DISABILITIES ............................. ANNEXURE-IV EMPLOYMENT OF WOMEN CANDIDATES IN A STATE OF PREGNANCY ................................. ANNEXURE- V NORMS FOR RECRUITMENT OF FIRE SERVICE PERSONNEL ................................................ ANNEXURE-VI EXEMPTION OF MEDICAL EXAMINATION ......... ANNEXURE-VII GUIDELINES FOR MEDICAL FITNESS TESTS FOR PERSONS WORKING AT HEIGHT ........................................................................ LIST OF PARTICIPANTS ........................................................................ ADVISORY COMMITTEE ON OCCUPATIONAL HEALTH ................. PROVISIONAL LIST OF REGULATERY DOCUMENTS ON INDUSTRIAL SAFETY ............................................................................
30
31
32 35
36 39 40
42
1. INTRODUCTION
1.1 1.1.1 General Medical examination prior to employment is essential to assess the initial physical and mental fitness of a worker for the intended job, irrespective of the workplace hazardous or otherwise. Pre-employment medical examination is as important for the concerned worker as for the organisations effective functioning. In view of the wide and diverse activities of the Department of Atomic Energy (DAE), including some involving hazardous processes and operations, such medical examinations assume greater significance. In this respect it has been observed that no uniformity exists among various units of DAE. In order to achieve this uniformity, it was deemed necessary to bring out a guidelines for ready reference of the medical Officers of DAE units. The guidelines would cover not only the range of activities/ operations presently undertaken by the units of DAE, but also update it in tune with the currently applicable statutory acts and rules. The status of recent medical knowledge has altered perceptions of fitness in many of the physiological conditions/ ailments earlier considered as disqualifications for specific jobs as they can be now controlled medically; this information has been taken into consideration. It is pertinent to quote the philosophy as outlined in the original guidelines issued by DAE vide Office Memorandum No. 7/14/56 dated November 16, 1962 and further amended vide Office Memorandum No. 40/64/62 dated October 5, 1963 called as Regulations as to the Medical Examination of Candidates for Admission into Scientific and Technical Civil Services Class I & II (Gazetted) under the Department of Atomic Energy (Annexure-I) : To be passed as fit for appointment, a candidate must be in good physical and mental health and free from physical defects likely to interfere with efficient performance of the duties of his appointment. Under Fundamental Rules 10, no person may be appointed to the post in Government Service without a medical certificate of health and as per Section 41-C of the Factories Act, 1948, it is the responsibility of Occupier where hazardous process is being carried out, to provide medical examination of every worker who is assigned a job involving the handling of or working with a hazardous substance and while continuing such jobs. 1.1.4 The basic principles of Medical Examination and Fitness for Special Assignments (Pre-placement Medical Examination) are: i) To assess the physical and mental fitness of the workers to perform specific job/tasks.
1.1.2
1.1.3
ii)
To determine the presence of medical condition or risk factors, that increase the likelihood of aggravating/ precipitating any injury or disease in future. To establish a baseline record of physical conditions (medical data) for future reference in determining any deviation/ new trend in the morbidity pattern.
iii)
1.2
Objective The objective of the document is to help and guide the medical officers of DAE units to follow a uniform pattern of medical examination/ test procedure and documentation, for newly persons for different jobs, taking into consideration the demands of the job and hazards involved.
1.3
Scope For the purpose of Pre-employment Medical Examination, employees for recruitment in DAE have been divided into two categories - General and Specific. The guidelines for General category are applicable to all DAE employees irrespective of placement. The medical tests mentioned in item number 2.5 and 2.6 are screening tests to be carried out in the specific category of employees to be engaged in the jobs mentioned in Table 1. This is in addition to the tests mentioned in the General category. Forms 1, 2 and 3 outline the specific tests to be carried out and records to be maintained. Relevant Office Memoranda have been added as Appendixes and references mentioned for clarification of some special category tests.
2.1.2
The requirements of medical examination for various categories of employees are given in Table 1. 2.3 Records to be Maintained The following Forms shall be filled up during the medical examination and all the relevant records of the examination/ laboratory investigation prescribed in it shall be available. Form 1 Form 2 Candidates Statement and Declaration Examining Physicians Report (along with reports of Routine Laboratory Investigation and Specific Investigation) Medical Certificate of Fitness for Employment
Form 3 -
_______________________________
1 The Department of Atomic Energy vide Office Memorandum dated 16 November, 1962, has declared the Medical Division of its respective regional units as the competent authority for conducting medical examinations and issuing certificates, and will be called as Medical Authority.
Table - 1
TYPES OF PRE-EMPLOYMENT MEDICAL EXAMINATION RECOMMENDED FOR DIFFERENT CATEGORIES OF EMPLOYEES S.No. A. B. C. D. E. F. G. H. Category of Employees Scientific and Technical Graduate and Stipendiary Trainees Security Fireman Crane Operators and Drivers Workers in Dangerous Operation {as per Atomic Energy (Factories) Rules, 1996} Ministerial Staff 2 and Non Technical Staff Temporary and Work charged workers Types of Medical Examination General General General and Specific General and Specific General and Specific General and Specific General General and Specific according to duties
___________________________
2 A person working in a subordinate service whose duties are entirely clerical in nature (e.g. persons working in Administration, Accounts, stores etc.).
2.4
Guidelines for General Medical Examination (i) (ii) These guidelines apply to all candidates for admission into DAE. No specific standard of physical fitness other than visual acuity is required for appointment of non-technical staff. It is left to the discretion of the examining Medical Officer to determine whether in his existing state of health the candidate is fit to discharge the duties continuously and efficiently. (Annexure- II) To be certified as fit for appointment, a candidate must be in good mental and bodily health and free of any physical defect likely to interfere with the efficient performance of the duties of his appointment. The fitness should be decided on the health status at the time of medical examination and not on anticipatory problems in future. Medical Officers opinion is an expert advice on fitness. However, the management has every right to accept an individual, whom Medical Officers may have rejected, if in its opinion, the candidate can be employed gainfully for the organisation. In such cases the management should inform the Medical Authority of its decision. Medical Officers duty will be to inform the management the abnormality detected, its limitations and liability. Only those candidates suffering from infectious diseases that they are likely to communicate to other persons with whom they may have to work, should be disqualified from appointment e.g. Lepromatous Leprosy (Appendix-A) and active T.B. with sputum positive for Tubercle Bacilli. Disabilities such as poor sight, which can be corrected by wearing glasses, deformity of the leg caused by poliomyelitis or such other disabilities (e.g. colour blindness), which in the opinion of the Medical Authority do not come in the way of efficient discharge of duties, should not operate as a bar to appointment under the Department. Such disabilities should however be communicated to the officer under whom the candidate is likely to be appointed, as general information. (Annexure III). There shall be no limit for minimum unaided eye vision but the unaided eye vision of the candidate shall, however, be recorded by the Medical Authority in every case, as it will provide the base line information in regard to conditions of the eye. In general, the level of Myopia shall not exceed -8.00D and total Hypermetropia shall not exceed +6.00D in the case of candidates above the age of 22 years and -6.00D and +6.00D in the case of those up to the age of 20 years.
(iii)
(iv)
(v)
(vi)
(vii)
(viii)
Whenever possible, fundus examination should be carried out and results recorded. The necessity for carrying out such an examination shall be left to the discretion of the Medical Authority. Any progressive pathologies should be considered while determining fitness. Testing of colour vision and field of vision shall be performed wherever found to be necessary in the opinion of the Medical Authority i.e. in specified categories of employees such as drivers and firemen. Security personnel require testing of the field of vision and only complete colour blindness may be considered a disqualification for them. A systolic blood pressure of over 140 mm of mercury and a diastolic over 90 mm of mercury should be regarded as suspicious. All such candidates should be thoroughly evaluated by Cardiologist/ Physician. If the evaluation reveals no damage to target organs, candidate can be considered fit. The urine should be tested for presence of sugar and a blood sugar level obtained for Diabetes Mellitus. If found positive, the candidate should be subjected to a detailed evaluation (including a glycoslated Hb level) by a medical specialist as Diabetes Mellitus is known to result in damage to the target organs. Only such cases of well controlled Diabetes Mellitus with no associated complications may be considered for appointment taking into due consideration the nature of duties the candidate will have to undertake and also keeping in mind associated risk factors. Wherever an organic disease is suspected on physical examination, the Medical Authority shall undertake to perform such investigations on the candidate, as may be necessary to establish the diagnosis. Intra-ocular lens implant is accepted provided visual acuity is as prescribed for the post. The decision as to the fitness or otherwise of a candidate will, however, rest with the Medical Authority only, who will take a decision after consulting the Appointing Authority3 concerned regarding job requirements. In the event of any difference of opinion, the final decision shall rest with the Appointing Authority.
(ix)
(x)
(xi)
(xii)
(xiii) (xiv)
____________________________
3 The authority, which appointed the employee to such service, grade or post.
(xv)
The opinion of the Medical Authority shall be final in all matters relating to the physical fitness of candidates. However, if the Appointing Authority is satisfied with the evidence of a possible error of judgement in the decision of the Medical Authority who carried out the medical examination, he may constitute a second Medical Authority to review the case. After obtaining two opinions, the final decision shall rest with the Appointing Authority.
2.4.1
Some Special Considerations during Pre-employment Examination i) Women Candidates Temporarily unfit due to pregnancy Unless the post involves strenuous or hazardous duties, a woman candidate shall not be declared temporarily unfit and her appointment should not be kept in abeyance until confinement is over. (Annexure-IV) For employment in DAE, pregnant women should be placed only in non-radiation jobs during the period of pregnancy. ii) Fitness of persons suspected of having Lepromatous Leprosy should be referred to a specialist/ dermatologist for a Disease Arrested Certificate (Appendix-A) Fitness of persons having active TB-Temporarily unfit if sputum is AFB Positive. Physical fitness of persons recruited under Physically Handicapped category (Appendix-B) Continuing Medical Fitness of the Ageing Employees: for following Classes of Employees: a. b. c. Security Fireman Crane operators and drivers
iii) iv) v)
Persons in these categories require periodic medical examination to assess their continuing fitness in the performance of their duties. However with advancing age, they may not be able to match the stringent standards for active duty, as physical endurance is age related. Even in cases of initial employment of the ageing employee, the candidate may not meet the physical criteria prescribed for appointment. A relaxation in norms for purpose of rehabilitation is recommended. 2.5 Job Specific Guidelines for Certain Categories of Employees In addition to general examination, following investigations/tests are recommended to detect presence of abnormalities and also to provide baseline data for persons to be placed in specified jobs as mentioned in Table-1. 7
2.5.1
Workers involved in Dangerous Operations as per Rule 88 (schedule numbers in parenthesis) of Atomic Energy (Factories) Rules, 1996: The different categories of employees are to be examined as follows: i) Electroplating (Schedule I): ii) X-ray Chest P.A. view, in case of chromium plating, examination for nasal septum perforation and test for chromium in urine, in case of nickel plating, test for nickel in urine, and in case of cadmium plating, test for cadmium in urine and alpha-2 microglobulin in urine.
Chemicals and Chemical Works (Schedule II): Workers employed in the processes for manufacture, manipulation or recovery of the chemicals given in Appendix A of the Schedule II of Atomic Energy (Factories) Rules, 1996, are required to undergo a general medical examination.
iii)
Manipulation of Stone or any other material containing free silica (Schedule III) and Grinding or glazing of metals and processes incidental thereto (Schedule IV): Pulmonary function tests (PFT) and full sized Chest X-ray (PA view) is to be carried out.
iv)
Foundry - Production of Iron or Steel or non-ferrous castings and processes incidental thereto (Schedule VI) and Finishing by Abrasives propelled by Compressed Air or Steam (Schedule X): Pulmonary function tests (PFT) and full sized Chest X-ray (PA view) is to be carried out.
v)
Beryllium Plants (Schedule VIII): Pulmonary Function Tests Upper Airway check X-ray-Chest P.A. view Liver Function Tests Check for Atopic Dermatitis
vi)
Operations involving High Noise Levels (Schedule XI): An auditory examination by a Certifying Surgeon
Including tests which the Certifying Surgeon may consider appropriate, and shall include determination of auditory thresholds for pure tones of 125, 250, 500, 1000, 2000, 4000, and 8000 Hz
vii)
Radioactive Substances (Schedule XIII) and Rule 25 of Atomic Energy (Radiation Protection) Rules, 2004 Every (radiation) worker initially on employment shall be subjected to the General Medical Examination as specified by order by the Competent Authority.
2.5.2
Workers in Other Categories: i) H2S based Heavy Water Plants Check intactness of tympanic membranes Perforation of tympanic membrane to be recorded. (Condition is not a disqualification)
ii)
Work in Protective Suits and at High Temperatures Cardio-vascular examination Pulmonary Function Tests Renal Function Tests
iii)
Security Requirement Body Mass Index (BMI) = Weight in kg/height in metres squared, Recommended BMI is 19-25 for young adults and 28 for middle ages Hearing should be normal
Disqualification iv) One eyed vision Myopia over-4.00D and Hypermetropia over + 4.00D Seizure Disorders Complete color blindness
Fireman (Annexure-V) In presence of Hypertension (HT) and abnormal Electrocardiogram (ECG) refer to Physician Varicose veins-refer to specialist Hernia /Hydrocele-fit after surgery 9
Requirement Normal Hearing Candidate should qualify in physical endurance test like running 100 metres with 64 kg weight in one minute, climbing rope and/or vertical pipe to a height of at-least three metres from the ground. (Physical Endurance Tests to be conducted by Industrial Safety Section) Physical Standard-Height and weight 165 cms, 50 kg respectively Recommended BMI - 19-25 for young adults and 28 for middle ages Chest 81 cms normal, + 5 cm expanded, No deformity Visual Acuity - 6/6 without glasses
Disqualification v) Uncontrolled Hypertension and/or IHD Seizure Disorders, EEG if indicated Night and color blindness One-eyed vision Bilateral Nystagmus and Positive Romberg Sign
Crane operators, riggers, forklift operators and drivers Requirement Binocular 3-D (Stereoscopic) vision Field of vision should be normal Normal hearing
Disqualification 2.5.3 Nystagmus One-eyed vision Seizure Disorders Colour blindness Night blindness
Medical fitness examination is not required-for appointment of less than 3 months duration (Annexure-VI)
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2.5.4
Contractors, Temporary and Work-charged workers: Depending on the area of working the requirement for medical examination will be relevant to the guidelines provided in item No. 2.5.1 and 2.5.2(i) to 2.5.2(v)
2.5.5
Initial Medical Examination and Fitness Certificate for contractors workers: AERB Safety Manual on Radiation Protection for Nuclear Facilities (Rev-3, 1996) requires initial medical examination and fitness certificate for contractors workers. For casual workers it specifies a general and physical examination to reveal abnormalities, skin diseases or contagious diseases, eyesight test and a fitness certificate including declaration of physical and mental fitness for any job in nuclear industry, issued by a Registered Medical Practitioner. No further endorsement by Departmental Medical Authority is required on such certificates. Medical fitness of such workers is contractors responsibility and all liabilities thereafter rest with him. Medical Division is only expected to provide first aid, on chargeable basis, in case of any emergency.
2.6 2.6.1
Special Medical Examination for Special Assignments (Pre-placement) Special assignment for working at height-Height Pass-(Annexure-VII) Requirement In presence of HT and abnormal ECG - refer to Physician Physical Ability Tests (Annexure-VII) - Walking freely over a horizontal 6" narrow bar at 1 ft height. Walking freely over a horizontal bar at 9/12 ft height wearing a safety belt. Climbing a 12 ft high rope. (Obesity hinders mobility and markedly obese are unfit for climbing ladders etc.). To be tested by industrial safety section Tests for labyrinthine functions and for sense of position
Disqualification 2.6.2 Postural Hypo-tension Cardio-vascular-Uncontrolled Hypertension and/or Ishaemic Heart Disease (IHD) Bilateral Nystagmus and Positive Romberg Sign Seizure Disorders, EEG if indicated
Special assignment for working at/ on Overhead Traveling Cranes and other Cranes, Heavy earth moving machinery and Heavy vehicles: Examination is to be done for his eyesight and colour vision and declared fit, by a qualified ophthalmologist, to work with or without the use of corrective glasses. [Rule 55 of Atomic Energy (Factories) Rules, 1996].
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Table-2
DISQUALIFICATION DUE TO ABNORMALITY
Condition Stammering Deafness Squint (with absence of binocular vision) -Even if visual acuity is normal One eye vision (provided visual acuity is normal) Implanted Pacemakers Colour Blindness
Disqualification For Telephone Operator Security, Firemen, Drivers, Crane Operators, Machinists, Telephone Operators etc. Security, Firemen, Drivers, Crane Operators, Machinists Security, Firemen, Drivers, Crane Operators, Machinists etc. Security, Bus Drivers, Firemen, Crane Operators Work in electro-magnetic areas Drivers, Forklift Operators, Crane Operators, Other Locomotive Operators and Control Panel Operators
12
4. LIST OF FORMS
Forms for Pre-employment Medical Examination prescribed under these guidelines should be maintained. The list of the forms are given below: Form 1 - Candidates Statement and Declaration Form 2 - Examining Physicians Report Form 3 - Medical Certificate of Fitness for Employment
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3. (a)Have you ever had chickenpox, small : pox, intermittent or any other fever, enlargement or suppuration of glands, spitting of blood, asthma, heart disease, lung disease, fainting attacks, rheumatism, and appendicitis? OR (b) Any other disease or accident requiring confinement to bed and medical or surgical treatment ? 4. 5. Details of Vaccination/ Immunization :
__________________________
__________________________ __________________________
Have you or any of your near relations : been afflicted with tuberculosis, asthma, fits, epilepsy, insanity or birth defects ? Have you suffered from any form of nervousness due to overwork or any other cause ? : Have you been examined and declared : unfit for Government Service by a Medical Officer/Medical Board, within the last three years ?
6.
7.
__________________________ __________________________
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8.
Mothers age at death No. of sisters living, No. of sisters dead, and cause of death their ages and state of their ages at death health and cause of death
9.
Past Occupation: Give details of Name of the Company and Job Hazards if any. _____________________________________________________________ _____________________________________________________________
10. Personal History: Diet: ______________________________ Smoking: ___________________________ Other Habits: _______________________ 11. Marital Status: Married /Unmarried: _________ No. of Children: ________
I declare all the above answers to be, to the best of my belief, true and correct. I also solemnly affirm that I have not received disability certificate/pension on account of any disease or other condition. Candidates signature: _______________ Signed in my presence: _____________ Signature of Medical Officer: __________________
______________________________
Note: The candidate shall be held responsible for the accuracy of the above statement. By willfully suppressing any information, he will incur the risk of losing the appointment or forfeiting all claims to superannuation allowance / gratuity, if appointed.
15
______________
_____________________________________________________ _____________________________________________________
General _____________________________________________________ Appearance: _____________________________________________________ Present posting: Type of job _______________ (occupational hazard, if any)____________ Marks of Identification: I. _____________________________________________ II. _____________________________________________
________________________________________________ ________________________________________________
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d)
Occupational: Previous________________ Duration with year_________ Type of work done_____________________________________ (Details of past exposure to any significant occupational hazards)
e)
Female Candidate: Menstrual History: i) Age at menarche: _________ ii) LMP: __________ iii) History of miscarriages/abortions/ still births/ congenital malformation etc. ______________________________________________________ _________________________________________________________
3.
a) Temperature: __________ C c) Height: __________ cm. e) Blood Pressure: _____________ f) Acuity of Vision: Without glasses
With glasses
g) h) i) j)
Night Blindness: ________________________________________ Colour Vision: __________________________________________ Depth of Vision:_________________________________________ Fundus Examination:______________________________________ Normal/Abnormal Comment if any__________________ Normal/Abnormal Comment if any __________________ Normal/Abnormal Comment if any___________________ Normal/Abnormal Comment if any___________________
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k)
Special Investigation i) ii) iii) iv) v) vi) vii) viii) ix) Varicose Veins: ________________________________________ Deformities: __________________________________________ Hernia: ____________________________________________ Hydrocele:___________________________________________ Haemorrhoids: ________________________ _______________ Lymph nodes:_________________________________________ Oedema: ____________________________________________ Fistula: ______________________________________________ Thyroid: _____________________________________________
l) 4. a) b) c) d) e) f) g) 5.
Others: ___________________________________________________ Systemic Examination: Respiratory system: Cardiovascular system: Locomotor system: Genito-Urinary system: Others: _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________
Laboratory Investigation: (Routine) a) WBC: TLC: _____ /cmm DLC: _____ b) Urine: Sp. Gravity: ___________; Reaction: ___________; Sugar: _________ ; Albumin: __________;
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6.
Job Specific Test (if any) (Audiometry, Spirometry, etc.) _______________________________________________________ _______________________________________________________ _______________________________________________________
7.
19
20
Reference is invited to G.I., M.H., O.M. No. 5 (II)-41/56-M. II, dated the 24th October, 1957 (not printed) on the subject mentioned above and after careful consideration of the development of knowledge and treatment in the field of leprosy, it has been decided that candidates having suffered from leprosy but now declared as disease-arrested or cured by a competent authority should not be regarded as physically unfit for public services, subject to the following conditions:(i) In addition to the normal medical examination by the appropriate medical authority, prescribed in the rules from time to time, for physical fitness for initial appointment to Government service, candidates should also be examined at the time of their initial appointment, by a Government Leprosy Medical Officer working in a Leprosy Control Unit or Hospital, or as District Leprosy Officer trained in leprosy from a recognised Leprosy Training Centre, and with not less than five years standing in the diagnosis and treatment of leprosy. It should be specifically certified by the Government Leprosy Medical Officer, who examines the candidates at the time of their first appointment, that the candidates concerned have taken the full course of treatment and have been declared as disease-arrested, verifying from the available records of treatment and certificate of the patient as well as clinical and bacteriological examination of the patient. Ministries, in consultation with the Department of Health, may exclude certain specific posts where high standard of physical fitness is necessary, but such exclusion should be reduced to the minimum as the main purpose of this order is to break the psychological barrier between harmless ex-leprosy patients and the public. The position should be reviewed after a period of five years. Apart from the initial medical examination at the time of recruitment, such persons should be medically examined annually (for a period of five years after initial appointment) to check that they take the maintenance dose of the drug, if any, advised by the Medical Officer who declared him as diseasearrested and that the disease-arrested condition has been maintained. In case the medical examination discloses, at any time, that the person concerned is having a recurrence of the disease with infectiousness, such cases should be dealt with under the normal rules for the purpose of their being given leave for treatment and the treatment period, if required to be continued for over
(ii)
(iii)
(iv)
21
three years to make the patient noninfectious, he/she may be considered for invalidation from service. (v) The confirmation of such a Government servant should be proceeded with only after two years of service, during which he continues to be non-infective and the disease has remained in the arrested or cured condition.
In all cases of doubt, or where a departure is required to be made from the above procedure, the case should be referred to the Department of Health. [G.I., M.H., O.M. No. A. 17011/6/79-MS (I), dated the 25th June, 1980.]
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Cases of physically handicapped persons seeking employment in public service that may be referred to the appointing and medical authority shall be viewed with the utmost sympathy. On nomination of the physically handicapped persons by the Employment Exchanges for appointment against posts under the Government, they should not be subjected to the usual medical examination on first appointment in Government service, but the question of their appointment should be decided on the basis of the reports of the Medical Board attached to the Special Employment Exchanges for the physically handicapped. These persons need not be examined by the Medical Board at the time of their registration with the Employment Exchange, but they should be sent for medical examination to the Medical Board attached to the Special Employment Exchanges after they have actually been selected for a particular post. [G.I.M.H.A, O.M. No. 20/29/57Estt.(D), dated the 17th December 1957, O.M. No. 5/1/60, dated the 28th June 1960, O.M. No. 5/1/62-Estt.(D), dated the 31st July 1967, O.M. No. 5/1/66-Estt.(D), dated the 12th October, 1966 and the 8th December, 1967.] Arrangements have now been made for the medical examination of those handicapped persons who are registered with ordinary Employment Exchanges, i.e. those dealing with able-bodied persons, by Medical Boards to be constituted on the lines of the Medical Boards attached to Special Employment Offices. Accordingly, on nomination of these persons by the Employment Exchanges for appointment against posts under Government, they should not be subjected to the usual medical examination on first appointment in Government service and the question of their appointment should be decided on the basis of the reports of the Medical Boards referred to above. [G.I., M.P.&T.O.M.No. 5/1/62-Estt.(D), dated the 31st July 1962] The Special Employment Exchanges for physically handicapped persons, Vocational Rehabilitation Centres have been given the co-sponsorship powers to nominate physically handicapped persons for employment into Government services. Both these institutions have Medical Boards attached to them who examine the physically handicapped persons before recommending them for employment. It has been brought to the notice of the Central Government that, while the reports of physical fitness of the candidates issued by the Boards attached to the special Employment Exchanges are accepted for the purpose of employment under the Central Government, the reports of fitness of the candidates issued by the Medical Boards attached to the Vocational Rehabilitation Centres are not being accepted, and the candidates recommended by the
23
Vocational Rehabilitation Centres are again subjected to fresh medical examination at the time of their appointment. The question has been considered in consultation with the Department of Health and the Ministry of Labour (DGE & T) and it has been decided that the certificates of fitness issued by the Medical Boards attached to Vocational Rehabilitation Centres for physically handicapped persons, should be treated at par with the reports of fitness issued by the Medical Boards attached to the Special Employment Exchanges. It will therefore, be no longer necessary to hold fresh medical examination of the candidates recommended by the Vocational Rehabilitation Centres at the time of their appointment, i.e. they should be appointed straightaway on the basis of the certificate of fitness issued by the Medical Boards attached to the Vocational Rehabilitation Centres. [G.I. Dept. of Per. & Trg., O.M. No. 14016/4,85-Estt (D), dated the 22nd November, 1985].
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ANNEXURE - I
ARRANGEMENTS FOR THE MEDICAL EXAMINATION OF PERSONNEL RECRUITED IN THE DEPARTMENT OF ATOMIC ENERGY No. 7/14/56-Adm.II Government of India Department of Atomic Energy Apollo Pier Road, Bombay - 1 November 16, 1962 OFFICE MEMORANDUM Sub: Arrangements for the medical examination of personnel recruited in the Department of Atomic Energy for purposes of determining physical fitness for entry into Govt. service, grant of sick leave, etc. Taking into consideration the hazards to health that are involved in work connected with atomic energy and the facilities established by the Department of Atomic Energy for medical examination / treatment of its staff, the President is pleased to decide that the Medical Health Division of the Atomic Energy Establishment, Trombay of this Department shall be competent to conduct medical examination of all the employees under its administrative control, stationed at Bombay and issue medical certificate for all purposes under the relevant Fundamental and Supplementary Rules, Pension Rules and all other service rules applicable to Central Government Servants. The certificates issued by the aforesaid Medical and Health Division shall be accepted as valid for all service matters. The President is further pleased to decide that the Department of Atomic Energy shall be competent to prescribe regulations for medical examination of candidates for appointment to various posts under its administrative control and also prescribe medical report form for the purpose, provided that in the case of administrative and non-technical personnel, the physical standards shall be the same as applicable to other corresponding civil departments of the Govt. of India. Orders in this regard will be issued separately. The aforesaid orders shall be deemed to take effect retrospectively and past cases of medical examination and issue of medical certificates by the Medical and Health Division of the Atomic Energy Establishment Trombay of this Department, in respect of the employees of this Department, shall be deemed to have been dealt with in accordance with these orders. Sd/(U.C. Mehta) U/S to Gov. of India To: The Director Head, Accounts Division Atomic Energy Establishment Trombay, Bombay Annexure - I .....Contd. 25
1.
2.
3.
No. 40/64/62-Tech.II(A) Government of India Department of Atomic Energy Apollo Pier Road Bombay - 1 October 5, 1963 OFFICE MEMORANDUM Sub: Arrangement for the medical examination of personnel in the Department of Atomic Energy for purposes of determining physical fitness for entry into Govt. service, grant of sick leave, etc.
The undersigned is directed to invite a reference to para 2 of this Department Office Memorandum No. 7/14/56-Adm.II Dt: November 16, 1962 on the subject mentioned above and to forward herewith a copy of the Regulations which have been prescribed for the medical examination of candidates for admission to the Scientific and Technical Civil Services Class I & II (Gazetted) under the administrative control of Department of Atomic Energy. Sd/(U.C. Mehta) U/S to Govt. of India To: The Director Atomic Energy Establishment Trombay (Head, Accounts Division) Bombay - 1
No. 40/64/62-Tech.II(A) October 5, 1963 Copy forwarded to the Auditor, Department of Atomic Energy (Shri S. Sankaran), Accountant General, Maharashtra, Bombay Sd/(U.C. Mehta) U/S to Govt. of India
Annexure - I .....Contd.
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REGULATIONS AS TO THE MEDICAL EXAMINATION OF CANDIDATES FOR ADMISSION INTO SCIENTIFIC AND TECHNICAL CIVIL SERAVICES CLASS I & II (GAZETTED) UNDER THE DEPARTMENT OF ATOMIC ENERGY. (ISSUED BY DAE VIDE OFFICE MEMORANDUM NO. 7/14/56 DATED NOVEMBER 16, 1962 AND FURTHER AMENDED VIDE OFFICE MEMORANDUM NO. 40/64/62 DATED OCTOBER 5, 1963) Not withstanding the regulations laid down, it must be clearly understood that the Atomic Energy Commission reserve to themselves an absolute discretion to reject as unfit any candidate whom they may consider, on the report of the Medical Authority, to be physically disqualified and that their discretion is in no respect limited by these regulations. 1. 2. These regulations apply to all candidates for admission into Scientific and Technical Civil Services Class I & II (Gazetted). To be passed as fit for appointment, a candidate must be in good mental and bodily health and free from physical defect likely to interfere with the efficient performance of the duties of his appointment. Only those candidates suffering from infectious diseases, which they are likely to be communicated to those with whom they may have to work, should be disqualified from appointment. Disabilities such as colour blindness, poor sight which can be corrected by wearing glasses, deformity of the leg caused by poliomyelitis, or such other disabilities as in the opinion of the Heads of Divisions approved by the Directors of Groups, do not come in the way of efficient discharge of duties, should not operate as a bar to appointment under the Department. Such disabilities set out in (4) above should however be communicated to the officer under whom the candidate is likely to be appointed, for general information. In the matter of correlation of the age, height and chest girth of candidates. it is left to the Medical Authority to use whatever correlations figures are considered most suitable as a guide in the examination of the candidate. Failure to satisfy the adopted standard of correlation figures, shall not render the candidate unfit if he is found to be otherwise healthy. The height of the candidates and the chest measurements shall be recorded in centimeters and the weight in kilograms. There shall be no limit for minimum naked eye vision but the naked eye vision of the candidate shall, however, be recorded by the Medical Authority in every case, as it will provide the basic information in regard to the conditions of the eye. Annexure - I .....Contd.
3.
4.
5.
6.
7. 8. 9.
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10.
In general, the total amount of Myopia shall not exceed -8.00D and total Hypermetropia shall not exceed +6.00D in the case of candidates above the age of 22 years and -6.00D and +6.00d in the case of those up to the age of 20 years. Whatever possible fundus examination should be carried out and results recorded. The necessity for carrying out such an examination is left to the discretion of the Medical Authority. Testing of colour vision and field of vision shall be performed where necessary, in the opinion of the Medical Authority. An approximate method of computing normal maximum systolic pressure is as follows: a) b) Subjects between 15-25 years, the average is about 100 plus the age. Subject over 25 years, the average is about 110 plus half the age.
11.
12. 13.
14.
A systolic blood pressure over 140 mm of mercury and a diastolic over 90 mm of mercury should be regarded as suspicious. The final decision as to the fitness or otherwise of a candidate will, however, rest with the Medical Authority only, who will take a decision after consulting the Head of the Division through the Director of the Group concerned. In the event of any difference of opinion between the Medical Authority and the Director of Group, the final decision shall rest with the Director, Atomic Energy Establishment, Trombay. The urine (passed in the presence of the examiner) should be examined and the result recorded. The finding of glycosuria per sec. may not be considered as disqualification unless the candidate presents symptoms and signs of organic and degenerative changes as a consequence of uncontrolled diabetes. Where an organic disease is suspected on physical examination, the Medical Authority shall undertake to perform such investigations on the candidate as may be necessary to establish the diagnosis. The opinion of the Medical Authority shall be final in all matters relating to the physical fitness of the candidates. However, if the Director, Atomic Energy Establishment, Trombay, is satisfied on the evidence produced before him of the possibility of an error of judgment in the decision of the Medical Authority, which carried out the medical examination, it will be open to him to refer the candidate to a new Medical Authority.
15.
16.
17.
28
No specific standard of physical fitness other then visual acuity have been prescribed for examining candidates for non-gazetted appointments. Designation and nature of duty should be indicated in the letter to the Medical Authority and it is left to the discretion of the examining Medical Officer to determine whether in his existing state of health the candidate is fit to discharge the duties required of him continuously and efficiently. [G.I., M.H.O.M. No.5(II)-12/57-M.II. dated the 17th December, 1957]
29
a)
Stammering: Stammering is not to be considered a physical defect requiring disqualification of a candidate for a clerical post. [G.I. M.H.A. O.M.No.5(1)-55-H.II, dated the 6th June 1955]. Deafness: In the case of Group C or Group D posts of the artisan class or those involving manual or skilled labour or a routine type of work, deaf muteness or deafness by itself need not be regarded as a disqualification against appointment, provided that the person concerned is otherwise fit and qualified to hold the post. [G.I. M.H.A. O.M.No.60/137/50-Estt. dated the 28th July 1950]. Loss of one eye: The loss of one eye is not a disqualification for non-gazetted services, provided the prognosis about the functioning eye is good and its vision is not likely to be endangered by the condition of the worse eye and the visual activity standards are fully satisfied. Squint: the presence of squint is not to be considered as a disqualification, if the actual visual acuity is of the prescribed standards. [G.I. M.H.O.M.No.F.5-(II)-12/57-M.II (Pt.II), dated the 17th December 1957]. Intra-ocular lens implant: In the case of a person who has undergone intraocular lens implant, if the visual activity with intra-ocular lens is according to the standards laid down for the post, the person concerned may be considered fit for Government service. [G.I.M.H. & F.W. O.M. No.A. 17020/1/86-MS, dated the 25th July 1986]. Candidates with implanted Pacemakers: - A candidate having a Pacemaker implanted, may be considered fit for Government service, except for the candidates selected for the following posts: 1) Pilots 2) Jobs in the Defence Forces, Police and Security 3) Railway or Bus Drivers 4) Posts attached to electro-magnetic areas 5) Any other posts requiring higher standards of physical fitness In case of doubts about any category of services or posts, a reference will be made to this Ministry for obtaining clarifications. [G.I.,M.H.&F.W. O.M. No.A. 17020/2/86-M.S, dated the 17th March 1988]. 30
b)
c)
d)
e)
f)
The present practice of declaring women candidates found to be pregnant of twelve weeks standing as temporarily unfit and their appointment being held in abeyance until the confinement is over, has been under examination of this department. It has now been decided in consultation with the Ministry of Health and Family Welfare, etc., that it shall no longer be necessary to declare a woman candidate as Temporarily unfit, if she is found to be pregnant during medical examination before appointment against posts which do not prescribe any elaborate training, i.e. they can be appointed straightway on the job. However, where pregnant women are to be appointed against posts carrying hazardous nature of duties, e.g. in Police Organisations, etc. and they have to complete a period of training as a condition of service, the existing instructions laid down in OM, dated the 19th July, 1976, below will continue to apply. [G.I. D.P. & A.R. O.M. No. 14034/4/84-Estt. (D), dated the 13th February 1985] It has been decided that a woman candidate who as a result of tests is found to be pregnant of twelve weeks standing or over shall be declared temporarily unfit and her appointment held in abeyance until the confinement is over. She should be re-examined for a fitness certificate after the date of confinement subject to the production of medical certificate of fitness from a registered medical practitioner. The vacancy against which the woman candidate was selected should be kept reserved for her. She should be re-examined for medical fitness six weeks after the date of confinement. If she is found fit she may be appointed to the post kept reserved for her and allowed the benefit of seniority in accordance with para 4 of Annexure to M.H.A. O.M. No. 9/11/55/RPS, dated 22nd December, 1959. (Not printed - See Chapter 38, Swamis Complete Manual on Establishment and Administration - Sixth Edition, 1997. ) [G.I. , Dept. of Per & A.R., O.M. No. 14034/5/75-Estt. (D), dated the 19th July, 1976].
_______________________________
Note: It has been clarified that these orders are applicable to all services and posts in the P&T Department. [D.G, P&T New Delhi, Letter no. 34/1/68-SPB-I, dated the 28 th July, 1969]
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Driver-cum-Operator: Physical Standards (Minimum): No deformity Height : 165 cm Weight : 50 kg Chest : 81 cm (normal) Chest : 86 cm (expansion) Vision : 6/6, without wearing glasses or any other aid. Night or colour blindness shall be a disqualification.
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Age : Not more than 32 years. Relaxation in upper age limit will be allowed in the case of candidates with longer experience and outstanding merit Foot Note : 1) 2) 3) 3. Experience in a fire service organisation/defence service will be preferred. Knowledge of English is desirable. Recruitment for this category is contemplated normally at Drivercum-operator (A) level only.
Leading Fireman : Physical Standards (Minimum): No deformity Height : 165 cm Weight : 50 kg Chest : 81 cm (normal) Chest : 86 cm (expansion) Vision : 6/6, without wearing glasses or any other aid. Night or colour blindness shall be a disqualification. Candidates should qualify in physical endurance test like running 100 metres with 64 kg weight in one minute, climbing of rope and/or vertical pipe to a height of at least three metres from the ground. Age : Not more than 32 years. Relaxation in upper age limit will be allowed in the case of candidates with longer experience and outstanding merit.
4.
Sub-Officer : Physical Standards (Minimum): No deformity Height : 165 cm Weight : 50 kg Chest : 81 cm (normal) Chest : 86 cm (expansion) Vision : 6/6, without wearing glasses or any other aid. Night or colour blindness shall be a disqualification. Age : Not more than 40 years. Relaxation in upper age limit will be allowed in the case of candidates with longer experience and outstanding merit.
33
Foot Note : 1) 2) 5. Experience as Fireman/Leading Fireman/Driver-cum-operator in a recognised Civil/Industrial Fire Service Station is essential. Recruitment for this category is contemplated normally at Sub-Officer A level only.
Station Officer: Physical Standards (Minimum): No deformity Height : 165 cm Weight : 50 kg Chest : 81 cm (normal) Chest : 86 cm (expansion) Vision : 6/6 without wearing glasses or any other aid. Night or colour blindness shall be a Disqualification.
6.
Dy.Chief Fire Officer/Chief Fire Officer : Physical Standards (Minimum): No deformity Height : 165 cm Weight : 50 kg Chest : 81 cm (normal) Chest : 86 cm (expansion) Vision : 6/6, without wearing glasses or any other aid. Night or colour blindness shall be a disqualification. Age : Not more than 40 years. Relaxation in upper age limit will be allowed in the case of candidates with longer experience and outstanding merit. Foot Note : 1) Should possess a valid Heavy Vehicle Driving Licence and must be fully conversant with the operation and maintenance of fire engines, fire pumps and other fire fighting equipment. Experience in a post not below the rank of Station Officer in a wellestablished whole time Fire Services organisation is essential No direct recruitment is contemplated if eligible Departmental candidates are available.
2) 3)
34
SR.4-A Except where a competent authority by general or special order directs otherwise, the following classes of Government servants are exempted from producing a medical certificate of health. 1) (i) (ii) Deleted A government servant recruited through a competitive examination who had to undergo medical examination in accordance with the regulations prescribed for appointment to service under government.
2)
A qualified student of the Thomason College, Roorkee, permanently appointed to the Public Works Department within 18 months from the date of health certificate granted to him on the completion of the College course. A Government servant appointed in a temporary vacancy for a period not exceeding three months. Not printed. A temporary Government servant, who has already been medically examined in one office, if transferred to another office without a break in his service. A retired Government servant re-employed immediately after retirement.
3) (3-A) 4) 5)
The production of a medical certificate is necessary when: A government servant is promoted from non-qualifying service paid from a local fund to a post in Government service; a person is re-employed after resignation or forfeiture of past service. When a person is re-employed in circumstances other than those referred to in Clause (a) (2) above, the appointing authority will decide whether a medical certificate should be produced.
Note 2: Deleted
35
ANNEXURE- VII GUIDELINES FOR MEDICAL FITNESS TESTS FOR PERSONS WORKING AT HEIGHT
Reference:Guidelines issued by Dr. R.K. Kapoor, Head, Industrial Safety Group, NPCIL vide Ref. No. ANPC/DHS/ISG/96/B/897 dated October 10, 1996
1.
2.
Special Examination a) Cardiovascular Uncontrolled hypertension or ischemic heart disease will be a contraindication. In the presence of hypertension and abnormal ECG findings, the employee should be referred to a physician for fitness. b) Tests for Lybrinthine functions and for sense of position Eye Examination for Bilateral Nystagmus Romberg sign. The presence of bilateral nystagmus and a positive romberg sign will be an absolute contra-indication. c) Neurological examination - for seizure disorders E.E.G if indicated d) Assessment of Diabetic Control Status: (in case of employees suffering from Diabetes Mellitus) e) Any other examination if indicated
Annexure- VII.....Contd.
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Name of Contractor with whom engaged at present: Ref. W/Order No. Description of present job: Previous experience of working at heights: Name of Employer Duration of employment work experience
13.
Do you suffer from any of these ailments: (Write YES/NO against each) a) c) e) Blood Pressure Frequent headache or reeling sensation Mental depression b) d) f) Epilepsy Flat foot Limping gait
Declaration: I hereby declare that the above information furnished by me is true and correct. I shall always wear the safety belt and the lifeline whenever working at heights or in depths of about 10 ft. I shall not misuse the height pass issued to me or transfer it to any other person. I shall never come to duty or work at height/depth under influence of alcohol.
Date:
37
The above applicants performance in the above tests has been satisfactory/ unsatisfactory. He has been issued at Height pass bearing S.No. ..................................... If found unsatisfactory, mention reasons ......................................
Date:
Seal:
38
LIST OF PARTICIPANTS
SUB-COMMITTEE FOR DRAFTING THE GUIDELINES
: : :
39
Dates of meeting:
Dr. B.J. Shankar Dr. T.V. Ranga Rao Dr. G. Kulkarni Dr. P.R. Bongirwar Dr. B.M. Vachharajani Dr. G. Mohan Dr. P.P. Srivastava Shri. P.K. Ghosh Smt. S.Bhattacharya Dr. Hemant Haldavnekar (Invitee) Shri. S.R. Bhave (Invitee) Shri. N.M. Chodankar (Invitee)
: : : : : : : : : : : :
BARC (Former) Central Labour Institute, Mumbai Siemens AG, Mumbai BARC NPCIL (Former) IREL HWP`1 AERB AERB BARC AERB AERB
40
Date of meeting:
March 2, 2005
Dr. P.T.V. Nair Dr. T.V. Ranga Rao Dr. P.R. Bongirwar Dr. B.M. Vachharajani Dr. T.N.U. Nambidi Dr. J.Vijaya Rao Shri. P.K. Ghosh Smt. S.Bhattacharya Dr. Hemant Haldavnekar (Invitee) Shri. S.R. Bhave (Invitee) Shri. N.M. Chodankar (Invitee)
: : : : : : : : : : :
BARC Central Labour Institute, Mumbai BARC NPCIL (Former) IREL NFC AERB AERB BARC AERB AERB
41
AERB/SG/IS-3 AERB/SG/IS-4
2004 2005
AERB/SM/IS-2 AERB/SM/IS-3
42
NOTES
43
NOTES
44
Published by
Atomic Energy Regulatory Board Niyamak Bhavan, Anushaktinagar Mumbai - 400 094. INDIA
BCS