Unofficial translation
Footnote. Abolished by the Order of the Minister of Health of the Republic of Kazakhstan dated November 30, 2020 No. KR DSM-217/2020 (effective after ten calendar days after the date of its first official publication).In accordance with subparagraph 89-1) of paragraph 1 of Article 7 of the Code of the Republic of Kazakhstan dated September 18, 2009 "On Public Health and Health Care System", I ORDER:
1. To approve the attached:
1) list of diseases connected with exposure to ionizing radiation;
2) Rules for establishing causal relationship of diseases.
2. The Department of organization of medical assistance of the Ministry of Healthcare of the Republic of Kazakhstan in the manner established by the legislation of the Republic of Kazakhstan shall ensure:
1) state registration of this order in the Ministry of Justice of the Republic of Kazakhstan;
2) within ten calendar days from the date of state registration of this order, sending its in paper and electronic form in the Kazakh and Russian languages to the Republican state enterprise on the right of economic management "Republican Center for Legal Information" for official publication and inclusion to the Standard control bank of regulatory legal acts of the Republic of Kazakhstan;
3) placement of this order on the Internet resource of the Ministry of Healthcare of the Republic of Kazakhstan after its official publication;
4) submission of information on implementation of measures provided for in subparagraphs 1), 2) and 3) of this paragraph on to the Department of legal service of the Ministry of Healthcare of the Republic of Kazakhstan within ten working days after the state registration of this order.
3. Control over execution of this order shall be assigned to the Vice-Minister of Healthcare of the Republic of Kazakhstan L. M. Aktayeva.
4. This order shall be enforced upon expiry of ten calendar days after its first official publication.
| Minister of Healthcare | |
| of the Republic of Kazakhstan | E. Birtanov |
"AGREED"
Ministry of Labor and
Social Protection of the
Republic of Kazakhstan
"AGREED"
Ministry of Energy of the
Republic of Kazakhstan
| Approved by the order of the Minister of Healthcare of the Republic of Kazakhstan dated April 10, 2019 № KR MHC-24 |
List of diseases connected with exposure to ionizing radiation
1. Diseases in occurrence or progression of which, a causal relationship can be established in persons who have been directly exposed to ionizing radiation:
1) For the persons whose diseases are directly connected with exposure to ionizing radiation:
acute and chronic radiation sickness;
radiation cataract;
radiation dermatitis and burns;
radiation hypothyroidism;
radiation autoimmune thyroiditis.
2) for the persons whose individual radiation dose or parents’ radiation dose is:
acute leukemia - 5 rem (Sv);
chronic leukemia (excluding chronic lymphocytic leukemia), myelodysplastic syndrome-10 rem (Sv);
malignant lymphoma-15 rem (Sv);
solid malignant neoplasms – 20 rem (Sv);
3) for the persons whose individual radiation dose or parents' radiation dose is 35 rem (Sv):
diseases of the cardiovascular system: ischemic heart disease, complicated arterial hypertension;
diseases of the blood and blood-forming organs: agranulocytosis, hypoplastic and aplastic anemia;
thyroid diseases (autoimmune thyroiditis, diffuse nodular goiter);
degenerative-dystrophic lesions of the musculoskeletal system (except for infectious and traumatic genesis);
mental retardation not caused by encephalopathy of traumatic, vascular, or infectious genesis;
congenital diseases and malformations:
microcephaly;
malformations of the facial skull and musculoskeletal system.
2. Diseases in occurrence or progression of which, a causal relationship with exposure to ionizing radiation can be established in persons who born from irradiated parents:
1) for the persons whose individual dose or parents’ radiation dose is 10 rem (Sv) or more:
acute myeloid leukemia;
acute lymphoid leukemia;
chronic myeloid leukemia;
2) for the persons whose individual dose or parents’ radiation dose is 25 rem (Sv) or more:
lung cancer;
breast cancer;
arterial hypertension complicated;
ischemic heart disease complicated;
microcephaly;
malformations of the facial skull;
mental retardation, not caused by encephalopathy of traumatic, vascular and infectious genesis.
3. List of diseases in descendants whose grandparents' radiation dose is 25 rem (Sv) or more:
acute myeloid leukemia;
acute lymphoid leukemia;
chronic myeloid leukemia;
malformations of the facial skull;
mental retardation, not caused by encephalopathy of traumatic, vascular and infectious genesis.
| Approved by the order of the Minister of Healthcare of the |
|
| Republic of Kazakhstan dated April 10, 2019 № KR MHC-24 |
Rules for establishing causal relationship of diseases
Chapter 1. General provisions
1. These Rules are developed in accordance with subparagraph 89-1) of paragraph 1 of Article 7 of the Code of the Republic of Kazakhstan "On Public Health and Health Care System".
2. Examination of the causal relationship of diseases with exposure to ionizing radiation in the population of the Republic of Kazakhstan shall be carried out by Regional and Central interdepartmental expert councils on establishing the causal relationship of diseases with exposure to ionizing radiation (hereinafter- RIEC and CIEC).
3. CIEC is created by the authorized body in the field of healthcare.
4. The authorized body in the field of healthcare shall determine the feasibility of creating a RIEC, approve its composition and powers.
5. The conclusion of RIEC and CIEC shall be the basis for the relevant bodies in determining the cause of disability or death connected with radiation exposure.
6. The following concepts and definitions are used in these Rules:
1) ionizing radiation-radiation consisting of charged, uncharged particles and photons that, when interacting with the environment, form ions of different signs;
2) the authorized body in the field of healthcare (hereinafter- the authorized body) – central executive body, carrying out management and inter-sectoral coordination in the field of public health protection, medical and pharmaceutical science, medical and pharmaceutical education, sanitary and epidemiological welfare of the population, circulation of medicines and medical products, control for quality of medical services;
3) the authorized state body (hereinafter- the authorized body) - central executive body, carrying out management in the field of social protection of the population;
4) effective radiation dose – a measure of the risk of long-term consequences of exposure to the human body and its individual organs, taking into account their radiosensitivity.
Chapter 2. Organization and work of the Regional interdepartmental expert council on
determination of causal relationship of diseases with exposure to ionizing radiation
7. RIEC - a permanent body, carrying out an expert-consultative activity in order to establish a cause-effect relationship between diseases, death and exposure to ionizing radiation in people who have been exposed to radiation.
8. The composition of RIEC is made up of specialized specialists from healthcare organizations and a representative of the authorized state body.
9. RIEC considers the relationship of diseases with exposure to ionizing radiation on the basis of clinical and laboratory data, the effective dose and nature of exposure.
10. RIEC calculates the radiation dose of citizens on the basis of documents confirming the fact of their stay on the territories of radiation pollution.
11. Examination of the causal relationship of diseases, death of descendants shall be carried out taking into account the effective dose of parents, grandparents.
12. Examination of the causal relationship of diseases with exposure to ionizing radiation shall be carried out in availability of a full package of documents; in case of sending by mail, the copies of documents must be notarized.
13. Applicants' documents shall be under consideration by the RIEC within 30 calendar days after receipt and registration.
14. Examination of the causal relationship of death with exposure to ionizing radiation shall be carried out according to the diagnosis specified in the certificate of death.
15. RIEC issues an expert conclusion signed by the Chairman of the RIEC, under the personal signature of the applicant or under the signature of his/her authorized representative.
16. The conclusion of the RIEC shall be sent to the citizens of other cities by mail within five working days after the date of taking decision.
17. The citizens shall have the right to submit documents to the RIEC for re-examination in case of changing the diagnosis or effective dose.
18. The RIEC submits a statistical report on its activity for the first half of the year to the CIEC.
19. The conclusion of the RIEC shall be appealed to the CIEC within 30 calendar days from the date of issuance of the decision.
20. The package of documents submitted to the RIEC includes:
1) application;
2) identity card;
3) an extract from the medical record of an outpatient indicating the diagnoses of existing diseases in chronological order, frequency of exacerbations, persistent disability;
4) an extract from the medical record of an inpatient with description of the anamnesis and dynamics of the underlying disease, with the results of clinical and diagnostic (laboratory, instrumental and functional) studies, consultations of specialized specialists according to clinical protocols for diagnosis and treatment;
5) conclusion of the MAC;
6) in case of death – a certificate of death indicating the diagnosis;
7) a certificate confirming the right to benefits for the victim (s) as a result of nuclear tests at the Semipalatinsk test site, approved by the resolution of Government of the Republic of Kazakhstan № 110 dated February 20, 2006;
8) copies of documents confirming residence (study, work, service in the Armed Forces and military formations) in the contaminated territories: birth certificate, general education certificate, diploma, work record, archival certificate, military ID, business trip certificate, business trip orders, certificate of the participant in liquidation of consequences of the Chernobyl accident;
9) marriage certificate (when examining the connection of death cases);
10) for calculating the effective radiation dose of descendants – documents of parents, grandparents, confirming the fact and period of their residence on the contaminated territories;
11) address certificate;
12) a folder;
13) certificate of effective dose ( issued by the RIEC).
Chapter 3. Organization and work of the Central interdepartmental expert council on
determination of causal relationship of diseases with exposure to ionizing radiation
21. The composition of the CIEC shall be formed from specialized specialists of healthcare organizations, representatives of the authorized state body and the authorized body in the field of healthcare.
22. The CIEC shall consider applications of citizens if they disagree with the conclusion of the RIEC.
23. For conducting re-examination, the CIEC requests the originals of medical documentation of the applicant from the RIEC.
24. The meetings of the CIEC are held at least once a quarter.
25. The conclusion of the CIEC shall be signed by the Chairman of the CIEC. The applicant's appeal against the conclusion of the CIEC shall be conducted in the court.
26. Documents on diseases that are not included in the list of diseases connected with exposure to ionizing radiation shall not be considered in the RIEC and CIEC.
