10 years ago, in May 2014, Decree 127/014 was approved, which regulated the ILO International Labor Convention No. 161 on Health Services at Work, ratified in Uruguay by Law No. 15,965. This meant for our country the duty to gradually establish the mandatory nature of these services for all workers and in all companies, through partial regulations according to availability and convenience. However, the implementation of these regulations has generated confusion due to regulatory variations and the complexity of the requirements, ultimately making compliance difficult. We therefore believe it is convenient to clarify the current obligations and explain in a clear and concise manner the current state of the regulations, with the aim of helping companies understand their duties and avoid non-compliance that could lead to severe sanctions.

A little context:

According to the original 2014 standard, the National Council for Safety and Health at Work (CONASSAT), chaired by the General Inspection of Labor and Social Security of the Ministry of Labor and Social Security, and integrated by the Ministry of Public Health, the The State Insurance Bank, the Social Security Bank, the representation of workers (PIT CNT) and employers, carried out an exhaustive analysis of the minimum conditions for Prevention and Health Services at Work (SPST). This included its integration, objectives and functions, as well as the general conditions and a mechanism for its gradual incorporation into all branches of activity.

The implementation was carried out through successive decrees proposed by CONASSAT to the Executive Branch over the years. As a result, the regulations have created confusion among companies. In addition, the health emergency due to the COVID-19 pandemic and its impact on the economy made it difficult to meet the originally established deadlines.

What are Occupational Health and Prevention Services (SPST)?

The SPST are a multidisciplinary advisory team on the prevention of occupational risks and diseases, which in short must be made up of a safety advisor and a doctor specializing in occupational health (or occupational medicine company), who work together. and coordinated.

In other words, we are talking about the birth of the obligation to work on prevention, not only in terms of work accidents, but also health, incorporating the advice of a doctor in addition to that of a preventionist.

They can be articulated as external services common to several companies, without the need for exclusivity or for professionals to be part of the company's payroll.

It is also established that companies must have a risk prevention and health monitoring plan, prepared by these services, with the cooperation of the health delegate workers (so that the advisors can, for example, identify any relationship between the causes of illness or certifications and the health risks that may occur in the workplace). Workers must be informed of the health risks that their work entails and how to prevent them.

Companies in all activities must have these SPSTs, whether commercial, services, industrial, rural (for-profit or non-profit), and both in the public and private spheres. The Decree in 2014 provided that the Executive President could anticipate its application for some sectors of activity (as initially happened with the chemical, dairy, and meat processing industries, among others).

Which companies are currently obligated?

As of May 2024, the standard is already applicable to all companies that employ more than 5 workers, with different degrees of requirement, as we will see below:

1. Companies with more than 300 workers (a number that can be reached by adding different works or personnel from several premises of the same company): they must have a permanent service integrated into the management, made up of an advisor on workplace safety. (e.g. Preventionist Technologist Engineer or Preventionist Technician) and a Doctor specializing in occupational health (or occupational medicine company). The SPST can be external.

2. Companies with between 50 and 300 workers must have a service made up of the same professionals, which must intervene on a quarterly basis, at least, and may also be external.

3. Companies with between 5 and 50 workers must put SPST into operation only in those cases in which risks are identified that require special protection for workers and in which the IGTSS may require it. In return, they must necessarily have a Risk Prevention Plan carried out by an authorized technician (e.g. Prevention Technician). This plan must be updated at least every 6 months, or when there are changes in working conditions, production process, etc. It must have a clear identification of hazards, risk assessment, proposed corrective measures, compliance schedule, etc. The exhibition of the plan is required during inspections by the agency or when companies are ordered to present it. It is expected that the MTSS will now begin to supervise compliance with this requirement.

What are the functions of these SPSTs?

Regarding the tasks or tasks, the standard lists point by point a list of functions that we abbreviate below:

• Identification and evaluation of occupational risks.
• Monitoring and advice on factors that affect health at work.
• Participation in programs to improve working conditions.
• Assistance in the adoption of vocational rehabilitation measures.
• Collaboration in the dissemination of information and training in health and hygiene.
• Organization of first aid and emergency care.
• Analysis of occupational accidents and occupational diseases and statistical registration.
• Preparation of emergency and contingency plans.

How is compliance monitored?

Companies must keep in mind that the General Labor Inspection (IGTSS – MTSS) is in charge of supervising and controlling the operation of these services, with advice from the MSP on health matters.

The IGTSS may sanction companies in accordance with current regulations, taking into consideration that these fines (based on occupational health and safety reasons) are among the most burdensome.

Finally, it is worth mentioning that - in some cases - failure to comply with this obligation could affect the application of the “Corporate Criminal Responsibility Law” (Law No. 19,196). This rule created a crime that is established when it is found that the employer has endangered the safety and/or health of workers if it has not adopted the preventive measures provided for in the laws that govern occupational safety and health. . It could eventually be the case with these SPSTs.

The latest news: Creation of a registry for the SPST survey.

The Ministry of Public Health (MSP) recently ordered the creation of an electronic registry for the survey of Prevention and Health Services at Work (Ordinance No. 324/024).

Registration with the MSP will be mandatory and will be carried out in electronic format, with free access through the Ministry's web portal. This portal will be managed by the Environmental and Occupational Health Division. Companies must register those responsible for the Service and update the information annually or in the event of a change in the person responsible for the Service. All information provided will be considered an affidavit.

In short, it is currently essential (and not just “advisable” as until now), to obtain advice on what, according to this regulation, is expected of each company and especially on the good practices that can be used, being essential the documentation and written record of what was acted.