Minerva

GROOT RIJBEWIJSKEURING

Health certificate: Large driving licence + Medibus

Are you a professional driver and want to renew your licence? If so, you must be able to prove at every driving licence renewal that you are healthy enough to drive. CBR assesses this with the Health Declaration.

What should you do?

• Start your application in good time. Assessing whether you are healthy enough to drive can sometimes take four months. Therefore, fill in your Health Declaration well in advance and digitally to be able to obtain or renew your driving licence on time.

• Complete the Health Statement on my CBR. You log in with DigiD and the extra check via SMS. Don't have a DigiD with SMS verification? Then apply for one first at www.digid.nl.

• Fill out the Health Statement yourself. Because it involves your personal data and these see confidential. Answer the questions on the Health Declaration and pay via Ideal.

• After submitting your Health Declaration, you will be notified via MyCBR. This can take up to 5 working days. You will then receive an examination report for the doctor and any other forms you need to have completed.

Make an appointment for a Major Driving Licence Examination at Medimark (0800 6334627) or www.medimark.nl. Bring your notice with all attachments and your proof of identity to the driving licence examination.

• The doctor will examine your general physical and mental health and complete the examination report and any other forms.

• Are you under treatment by a specialist for a health problem? And do you already know that CBR needs a report from the specialist? Then you can often visit your own treating specialist for a report and also send this directly along with the examination report.

• There is a unique code on the examination report you received. Medimark will use this code to send all the requested information digitally to CBR.

• CBR assesses all the information. Via MijnCBR you will receive notification of the results.

For Medibus examination, you should complete the questionnaire by using the client code from the e-mail appointment details, which you received from Medimark in your mailbox. Once you have done the above, we can examine you for Medibus and Grand Driving Licence in one appointment.

If you have a question, please give us a call, we will be happy to help!

Validity inspection: 5 years
Inspection duration: 20 minutes

Duration of examination: 30 minutes

• Client completes Crane operator questionnaire.

• Doctor discusses questionnaire with client

• Height

• Weight

• Blood pressure

• Wrist

• Vision test (5 metres)

• Field of vision

• Urine (small stick)

• Audiogram (hearing test)

• Resting ECG (heart pulse in when relaxed >40 years)

At your request, Medimark can also perform a targeted additional examination during the crane operator examination to assess your fitness to drive goods. This is not a driving licence examination.

Validity of examination: 5 years
Duration examination: 20 minutes

Preventive Medical Examination Woman-II

• Client completes online PMO questionnaire

• Comprehensive physical examination

• Biometrics

• WHR (size measurement , waist and hip ratio)

• Fat percentage measurement

• Blood pressure

• Pulse (heart rate)

• Eyesight test

• Audiogram (hearing test)

• Lung function

• Urine test

• Ergometry:
ECG Rest (cardiac video when relaxed)
ECG Stress (exercise heart monitor: cycling test)

• Blood tests:
Alanine aminotransferase, Aspartaat aminotranferase, Cholesterol, HDL-Cholesterol, LDL-Cholesterol,Bezinking, Gamma-GT / GGT, Glucose, Hemoglobine, Kreatinine, Ureum, Triglyceriden.

Blood count: Leucocytes, MCV, Thrombocytes.

Test duration: 60 minutes

Preventive Medical Examination Woman-I

• Client completes online PMO questionnaire

• Comprehensive physical examination

• Biometrics

• WHR (size measurement, waist and hip ratio)

• Fat percentage measurement

• Blood pressure

• Pulse (heart rate)

• Eyesight test

• Urine test

• Ergometry:
ECG Rest (cardiac video when relaxed)

• Blood tests:
Cholesterol
Settlement
Hemoglobin

Test duration: 40 minutes

Preventive Medical Examination Man-I

• Client completes online PMO questionnaire

• Comprehensive physical examination

• Biometrics

• Percentage measurement

• WHR (size measurement, waist and hip ratio)

• Blood pressure

• Pulse (heart rate)

• Eyesight test

• Urine test

• Ergometry:
ECG Rest (cardiac video when relaxed)

• Blood tests:
Cholesterol
Settlement
Hemoglobin

Test duration: 40 minutes

Preventive Medical Examination Man-II

• Client completes online PMO questionnaire

• Comprehensive physical examination

• Biometrics

• WHR (size measurement , waist and hip ratio)

• Fat percentage measurement

• Blood pressure

• Pulse (heart rate)

• Eyesight test

• Audiogram (hearing test)

• Lung function

• Urine test

• Ergometry:
Resting ECG (heartbeat when relaxed)

• Blood tests:
Cholesterol, HDL-Cholesterol, LDL-Cholesterol,Sedimentation, Gamma-GT / GGT
Glucose, Hemoglobine, Kreatinine, Triglyceriden.

Blood count: Leucocytes, MCV, Thrombocytes.

Test duration: 60 minutes

KNAF medical examination International license holders under 45 years of age

KNAF medical examination International license holders under 45 years of age jonger dan 45 jaar

• Review questionnaire
• Urine test for glucose (sugar)
• Height weight and blood pressure measurement
• Physical examination
• ECG/resting heart monitor
• Medical certificate

Test duration: 30 minutes

KNAF medical examination International licence holders over

KNAF medical examination International license holders under 45 years of age ouder dan 45 jaar

• Review questionnaire
• Urine test for glucose (sugar)
• Height weight and blood pressure measurement
• Physical examination
• ECG/heart monitor with exercise test (bring sportswear)
• Medical certificate

Duration of examination: 45 minutes

KNAF motorsport medical examination National EU

KNAF motorsport medical examination National EU

• Review questionnaire
• Urine test for glucose (sugar)
• Height weight and blood pressure measurement
• Physical examination
• Medical certificate

Duration of examination: 20 minutes

KEURING HEALTH CHECK UITGEBREID inclusief inspanningstest

• Cliënt vult Health Check Uitgebreid vragenformulier in
• Physical examination
• Biometrics
• Fat percentage measurement
• Blood pressure
• Pulse (heart rate)
• Saturatiemeting (zuurstof bloed)
• Eyesight test
• Urine test
• Ergometry:
ECG at rest. (relaxed).
ECG stress. (hartfilmpje bij inspanning: fietsproef)
• Blood tests:
Cholesterol Totaal, Gamma-GT, Kreatinine

Duur:                             60 minuten
Inspection location: Only in Amstelveen, Breda, Eindhoven and Rotterdam

NAUTICAL EXAMINATION

• Client completes the examination form Medical Examination of Shipping Personnel from the Ministry of Infrastructure and Water Management.

• Examination according to the examination sheet of the form

• Biometrics

• Blood pressure

• Pulse (heart rate)

• Eyesight test

• Ishihara test (colour discrimination)

• Audiogram (hearing test)

• Urine test

• After the medical examination, one receives a completed Medical Certificate with it. Medimark notifies the Ministry of Infrastructure and Water Management.

Please bring completed form Medical Examination Shipboard Personnel before the appointment.

Validity of examination: 2 years
Duration of examination: 30 minutes

COMPRESSED AIR MEDICAL EXAMINATION
(FIRE WATCH MEDICAL EXAMINATION)
(Including exercise ECG)

• Client completes questionnaire Compressed air examination

• Physical examination

• Biometrics

• Blood pressure

• Pulse (heart rate)

• Eyesight test

• Audiogram (hearing test)

• Lung function

• Urine test

• Ergometry:
ECG at rest (relaxation)
Exercise ECG (exercise, cycling)

De werkgever ontvangt een certificaat als de werknemer is goedgekeurd.
Cliënt ontvangt men een pasje met goedkeuring.
Wanneer men een veiligheidspaspoort bij zich heeft kan dan daarin een stempel worden gezet, de handtekening van de arts, de soort keuring en de geldigheidsduur.

Validity inspection:
Age up to 39 years, 3 years
Age 40-49 years, 2 years
Age from 50 years, 1 year

Duration of examination: 30 minutes
Inspection location: Only in Amstelveen, Breda, Eindhoven and Rotterdam

Offshore NOGEPA Basic

• Client completes NOGEPA form

• Physical examination

• Biometrics

• Blood pressure

• Pulse (heart rate)

• Audiogram (hearing test)

• Lung function

• Urine test

• Shoulder width measurement

• X-ray only on indication

A NOGEPA stamp will be placed in the green booklet. (Pass is available if required) Certificate sent to employer.
Certificate sent to employer.

Duration of examination: 2 years
Duration of examination: 30 minutes

SOIL REMEDIATION MEDICAL EXAMINATION C
(outside-independent breathing air)

• Client completes Soil Sanitation C form
• Physical examination
• Chronic skin disorders
• Allergies airways asthma / COPD
• Applicability of respiratory protection
• No low-salt diet
• Biometrics
• Blood pressure
• Pulse (heart rate)
• Smell test
• Ishihara test (colour discrimination)
• Eyesight test
• Audiogram (hearing test)
• Urine test (large stick)
• Lung function test
• Ergometry:
ECG at rest. (relaxed).
Exercise ECG. (exercise, cycling test).
• Blood tests:
ASAT, ALAT, Gamma-GT, Kreatinine, Urea.
Blood count: Leucocytes, Hb. MCV, Thrombocytes.

The employer receives a certificate if the employee is approved. Client receives a pass with approval.

If one carries a safety passport, one can then put a stamp in it, the doctor's signature, the type of examination and the validity period.

Validity of examination: 1 year
Duration of examination: 60 minutes

ONSHORE, working at height G41

• Client completes Onshore questionnaire

• Comprehensive physical examination

• Musculoskeletal, balance organ, vertigo, cardiac, depth perception.

• Biometrics

• Blood pressure

• Pulse (heart rate)

• Vision

• Urine test

• Lung function

• Ergometry:
ECG at rest (relaxation)

A stamp is placed in the green booklet. One is examined according to the G41 guidelines. (Pass is available if required)
Certificate sent to employer.

Validity of examination: 2 years
Duration of examination: 30 minutes

COMPRESSED AIR MEDICAL EXAMINATION (Excluding Ergometry)

• Client completes online Compressed air examination questionnaire

• Physical examination

• Biometrics

• Blood pressure

• Pulse (heart rate)

• Eyesight test

• Audiogram (hearing test)

• Lung function

• Urine test

De werkgever ontvangt een certificaat als de werknemer is goedgekeurd.
Cliënt ontvangt men een pasje met goedkeuring.
Wanneer men een veiligheidspaspoort bij zich heeft kan dan daarin een stempel worden gezet, de handtekening van de arts, de soort keuring en de geldigheidsduur.

Validity inspection:
Age up to 39 years, 3 years
Age 40-49 years, 2 years
Age from 50 years, 1 year

Duration of examination: 30 minutes

Health certificate: Large driving licence + Medibus

Are you a professional driver and want to renew your licence? If so, you must be able to prove at every driving licence renewal that you are healthy enough to drive. CBR assesses this with the Health Declaration.

What should you do?
• Start your application in good time. Assessing whether you are healthy enough to drive can sometimes take four months. Therefore, fill in your Health Declaration well in advance and digitally to be able to obtain or renew your driving licence on time.

• Complete the Health Statement on my CBR. You log in with DigiD and the extra check via SMS. Don't have a DigiD with SMS verification? Then apply for one first at www.digid.nl.

• Fill out the Health Statement yourself. Because it involves your personal data and these see confidential. Answer the questions on the Health Declaration and pay via Ideal.

• After submitting your Health Declaration, you will be notified via MyCBR. This can take up to 5 working days. You will then receive an examination report for the doctor and any other forms you need to have completed.

• Make an appointment for a Major Driving Licence Examination at Medimark (0800 6334627) or www.medimark.nl. Bring your notice with all attachments and your proof of identity to the driving licence examination.

• The doctor will examine your general physical and mental health and complete the examination report and any other forms.

• Are you under treatment by a specialist for a health problem? And do you already know that CBR needs a report from the specialist? Then you can often visit your own treating specialist for a report and also send this directly along with the examination report.

• There is a unique code on the examination report you received. Medimark will use this code to send all the requested information digitally to CBR.

• CBR assesses all the information. Via MijnCBR you will receive notification of the results.

For Medibus examination, you should complete the questionnaire by using the client code from the e-mail appointment details, which you received from Medimark in your mailbox. Once you have done the above, we can examine you for Medibus and Grand Driving Licence in one appointment.

If you have a question, please give us a call, we will be happy to help!

Validity of test: 5 years
Duration of examination: 20 minutes

ONSHORE, working at height G41 with blood test

• Client completes Onshore questionnaire

• Comprehensive physical examination

• Musculoskeletal, balance organ, vertigo, cardiac, depth perception.

• Biometrics

• Blood pressure

• Pulse (heart rate)

• Vision

• Urine test

• Lung function

• Ergometry:
ECG at rest (relaxation)

• Blood tests:
Gamma-GT, Kreatinine, Cholesterol, Triglycerides, CRP, Glicose

Blood count: Leucocytes, Hb, MCV, Thrombocytes.

A stamp is placed in the green booklet. One is examined according to the G41 guidelines. (Pass is available if required)
Certificate sent to employer.

Validity of examination: 2 years
Duration of examination: 30 minutes

Erytrocyten

What are erythrocytes?

Erythrocytes are red blood cells that transport oxygen through the body via the Hb (see Hb or Haemoglobin). They also transport carbon dioxide back to the lungs to be discharged. The erythrocytes (Ery's) have a red colour due to the Hb but they are special mainly because they do not have a nucleus like other cells. They are made in the bone marrow thereby, for example, prompted by the kidneys making a substance called erythropoietin (EPO also known as doping). The cells live for about 120 days so the bone marrow is busy continuing to make new cells each time. There are about 5.3 million per cubic mm of blood.

Normal values?

In women, the normal value is approximately between 3.8 and 5.5 and in men between 4.3 and 6.0.

Malaria.

In malaria, the plasmodium parasite enters the erythrocyte and grows in it. People who have a form abnormality of the red blood cell, for example sickle cell, do not get malaria.

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

FSH

What is FSH?

Follicle-stimulating hormone is formed in the pituitary gland in the brain. It causes the maturation of eggs in women and the maturation of sperm in men. FSH, together with LH (luteinising hormone) (see LH), ensures a proper menstrual cycle. Two weeks before ovulation, FSH ensures oocyte maturation through oestrogen production (see oestrogen); after ovulation (ovulation), together with LH it ensures the formation of the hormone progesterone (see progesterone). It can be measured at what stage ovulation is but also whether menopause has begun.

Normal values?

Women 1.0-8 before and after ovulation

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

ASAT

What is ASAT?

ASAT is aspartic aminotransferease is a substance used to detect liver damage and it is often determined together with ALAT (see ALAT). The ratio of these two substances is an indication for the doctor to determine the status of the liver. If ASAT is higher than ALAT then there is often liver cell death but if the ratio is the opposite with no liver cell death, it is usually viral hepatitis (virus infection of the liver). ASAT is found in many cells of our body and this means that if ASAT is elevated, it could possibly be due to a problem other than with the liver but, for example, a ruptured muscle. This makes ASAT less liver-specific than ALAT.

Normal values?

Men less than 45 and in women less than 35.

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

ALAT

What is ALAT?

ALAT is alanine aminotransferase is a substance used to detect liver damage and it is often determined together with the ASAT (see ASAT). The ratio of these two substances is an indication for the doctor to determine the status of the liver. If ASAT is higher than ALAT then there is often liver cell death but if the ratio is the opposite with no liver cell death, then it is usually viral hepatitis (viral infection of the liver).

Normal values?

Men less than 50 and in women less than 40.

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

BSE

What is the BSE?

This is where we measure the rate at which erythrocytes (red blood cells) sink into a laboratory tube (sedimentation rate). It gives an impression of whether or not there is an infection and sometimes its severity.

Normal values?

Women under 50 less than 20 and over 50 less than 30. For men, under 50 less than 15 and over 50 less than 20.

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Albumin

What is Albumin?

Albumin is a protein in the blood that carries other proteins, hormones, nutrients, drugs and vitamins. The liver makes Albumin. If we do not drink enough fluids, we see that the Albumin in our blood rises. If the kidneys are damaged, you can also find Albumin in the urine and at the same time the Albumin level in the blood will drop. Similarly, if the liver is damaged. Similarly, if blood pressure is too high, the kidneys excrete Albumin.

Normal values?

Men/Women 35-55

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

CK

What is CK?

CK or too creatine kinase is an enzyme found in almost every muscle but also in our brain. When there is damage, the enzyme enters the blood and we can measure this increase. We determine CK to recognise and prosecute muscle diseases. Total CK is a sum of CK-MM (skeletal muscle), CK-MB (cardiac muscle) (see CK-MB) and CK-BB (brain). With damage to heart muscle, CK-MB is elevated.

Normal values?

Men < 200
Women < 170

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

CK-MB

What is CK-MB?

CK-MB is a creatine kinase, an enzyme released after damage to the heart. CK-MB is part of total CK (see CK).
CK-MB levels will rise between 4 and 6 hours after a heart attack and reach their highest levels within 24 hours. After about 3 days, the level will have returned to normal. Now Troponin (see Troponin) is used as a marker for heart attack.

Normal values?

Men < 25
Women < 30

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Alkaline phosphatase

What is Alkaline phosphatase?

This is an enzyme that can split phosphate molecules from other substances. The enzyme is found in several tissues such as liver, intestine and kidney. It is usually determined along with Gamma-GT, ALAT, ASAT because it is usually an elevation due to a liver problem. A bone problem can also be an indication to determine Alkaline phosphatase.

Normal values?

Men/Women less than 125

Amylase

What is amylase?

Amylase is made in the pancreas (pancreas) and salivary glands. It can break down sugars. In inflammation of the pancreas (pancreatitis), amylase may be elevated. Pancreatitis occurs with gallstones but also with excessive alcohol consumption. Amylase is excreted through the kidneys. If the kidneys are not working properly, Amylase levels will also be elevated.

Normal values?

Women/Men less than 107

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

APTT

What is APTT?

APTT is a test used to check for proper blood clotting. In addition, PTT and PT is used.

Blood type

What are blood groups?

It is a classification of different types of blood that may or may not match, think blood transfusions. There are many types of blood groups. In general, we use the ABO system and the Rhesus + or - system. About 85% have Rhesus + blood.
In het algemeen gebruiken wij het ABO systeem en het Rhesus + of – systeem. Ongeveer 85% heeft Rhesus + bloed.

BMI

What is a BMI

BMI stands for Body Mass Index. The BMI tells you whether your weight is healthy in relation to your height. With a healthy weight, you have less risk of cardiovascular disease, high blood pressure, high cholesterol and diabetes.

How do I calculate my BMI?

1. Divide your weight in kg by your height in metres e.g. divide 80 kg by e.g. 1.80 metres that becomes the answer 44.4444
2. Divide 44.4444 again by your height and the answer is 24.69
3. 24.69 is the BMI in this example

For a woman and man, a BMI of between 18.5 and 24.9 is considered good.

A percentage below 18.5 means underweight. A percentage of 25 to 29.9 overweight and above 30 that one is severely overweight (obese).

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

CA

What is CA?

Calcium is involved in building the skeleton, clotting our blood and contracting muscles. In osteoporosis, when bones become brittle, Calcium is determined.

Normal values?

Women/Men 2.10-2.55

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

CEA

What is CEA?

CEA is a glycoprotein, Carcino-Embryonic-Antigen. During foetal development, it is made but has disappeared before birth. In various cancers, it reappears in the blood and can therefore be used as a tumour marker, such as in colon, breast, lung, liver and pancreatic cancer. It is non-specific and therefore can only be used to monitor tumour growth. CEA may also be elevated in smokers.

Normal values?

Women/Men < 2.5

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

CA 15.3

What is CA 15.3?

CA 15.3 is a glycoprotein and is elevated when cancer cells develop. CA 15.3 is used to detect and monitor breast cancer (mammary carcinoma).

CA 19.9

What is CA 19.9?

CA 19.9 is a glycolipid and is produced in epithelial tissues. In this case, tissues that produce mucus. It is used to find and follow up pancreatic adenocarcinoma (pancreatic cancer) and hepatobiliary cancer (cancer of the liver and bile ducts).

CA 125

What is CA 125?

CA 125 is a glycoprotein found in small amounts in the blood. When cancer cells are formed, CA 125 will rise.
CA 125 is used to detect and monitor ovarian cancer (ovarian carcinoma)

CRP

What is CRP?

CRP is C-reactive protein and it is called an acute phase protein. CRP is produced in the liver and it is released into the bloodstream within a few hours of inflammation, such as infection and arthritis, as well as after a heart attack or surgery. CRP can be used to monitor the activity of the disease process.

Normal values?

Men/Women < 10

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Ferritine

What is ferritin?

Ferritin is a protein that can bind and store iron in cells. There is only a small amount in the blood. Determining Ferritin is used to investigate anaemia and whether too much iron is stored in the body (haemochromatosis).

Normal values?

Men 25-250

Women pre-menopausal 20-150
Post-menopausal 20-250

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Glucose

What is glucose?

Glucose is a sugar in the blood. Too high a level is called hyperglycaemia and too low a level is called hypoglycaemia. Blood sugar levels are controlled by insulin which in turn is produced in the islets of Langerhans in the pancreas (pancreas). Carbohydrates such as starch and sugar enter the blood after digestion mainly as glucose. Glucose in the blood is determined in two ways; after about 6 hours of not eating (the fasting glucose) and the glucose just throughout the day. Glucose is also sometimes checked at different times of the day this is to follow the progression after eating.

Normal values?

Men/Women

Glucose sober 3.5-6.0 mmol/l
Glucose not sober 3.5-7.8 mmol/l

Diabetes (diabetes).

There are two types of diabetes type 1 and type 2.
In 1, no or little insulin is produced because probably the immune system attacks its own islets of Langerhans. Diabetes 1 can start at a young age or after an illness such as the flu. These people need to inject insulin. Diabetes 2 is sometimes called a disease of affluence. The disease usually starts later in life, the body becomes less sensitive to insulin. Many are overweight and eat unhealthily. They usually have to take tablets to keep glucose levels at the right level in severe cases, insulin will also have to be injected. Some population groups such as Hindus have a much higher risk of diabetes.

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

PSA

What is PSA?

PSA (prostate specific antigen) is a protein made in the prostate gland. As men get older, the level of PSA in the blood increases slightly, just as the prostate also gets slightly larger, Prostate hypertrophy. In cancer of the prostate, the PSA goes up sharply. It is important to note that the PSA only gives an indication but cannot be properly used to diagnose (recognise) prostate cancer. However, if there is a strange rise, further investigation should take place.

Normal values?

Men < 4

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Progesterone

What is Progesterone?

Progesterone is made after ovulation by LH (see LH) and FSH (see FSH). It ensures that the endometrium is made ready for a fertilised egg to nestle. During the first three months of pregnancy, this hormone also ensures, that the pregnancy is maintained. Progesterone is also measured when ovulation has occurred.

Normal values?

Progesterone
< 1, 0 - 3, 0 before ovulation
12 - 60 after ovulation

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Reticulocytes

What are reticulocytes?

These are red blood cells in their "infant" stage. If the number of erythrocytes (red blood cells) is reduced, we look to see if there are enough reticulocytes and if they are produced enough by the bone marrow.

LH

What is LH?

LH is a luteīniscent hormone which is made in the pituitary gland. It works closely with FSH (see FSH) and triggers ovulation. After ovulation, progesterone (see progesterone) and oestrogen (see oestrogen) are then produced. It can be measured at what stage ovulation is, but also whether menopause has begun.

Normal values?

Women 1, 0-8, 0 before and after ovulation

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Hb (Hemoglobine)

What is Hb (haemoglobin content)?

Haemoglobin is a protein high in iron and is found in the erythrocytes. It gives the red colour to the blood. The Hb with the iron provides oxygen transport through the body. Oxygen-rich blood is lighter red than oxygen-poor blood. Often fatigue is the first sign of lowered Hb usually due to iron deficiency.

Why iron deficiency?

It can be caused by poor nutrition. But also due to blood loss, in women think of excessive bleeding during the menstrual period. There can also be blood loss through the intestines, this usually happens without being noticed and fatigue can then be the first sign.

Normal values?

In women about between 7.5 and 10. In men about 8.5 and 11. The Hb can vary over the course of a few weeks and a level of 9.5 at first and a few weeks later of, say, 7 has no significance. One is not better than the other.

Athletes.

In athletes, for example professional cyclists, doping (EPO) is sometimes used to raise erythrocytes and thus Hb levels. Whether this really helps to increase performance remains a matter of debate to this day. However, it does increase the risk of thrombosis (blood clotting) as the blood becomes more viscous

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Iron

What is Iron?

Iron is a component of haemoglobin (Hb) (see Hb). This iron is needed to bind and transport oxygen through the blood from the lungs to the tissues and vice versa. 70% of our iron is attached to Hb, the rest is linked to Ferritin (see Ferritin). Iron deficiency will result in a shortage of red blood cells (erythrocytes) (see erythrocytes). Iron levels go up and down throughout the day so iron levels are often measured together with Ferritin.

Normal values?

Men 14-28
Women 10-25

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Hematocriet

What is the haematocrit?

The haematocrit is the ratio of erythrocytes (red blood cells see erythrocytes) to the rest of the blood. Top athletes like the haematocrit to be high because then the theory is that one can perform better. People use doping like EPO for this purpose but they also go into oxygen tents or live at high altitude for a while.

Normal values?

The haematocrit is almost always determined when a full blood count is requested.

Normal values for a woman are about 0.36 to 0.47 and in a man these values are 0.41 to 0.50

Haematocrit too high?

This occurs in people who are dehydrated or when too many red blood cells are made. This causes viscosity of the blood with risk of cardiovascular disease and thrombosis (blood clotting).

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

HIV

What is HIV?

The HIV (human immunodeficiency virus) test is popularly known as the AIDS (acquired immune deficiency syndrome) test. It takes about 4-6 weeks after infection before HIV can be determined in the blood.

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Kalium

What is potassium?

Potassium is a salt and is also called an electrolyte. Another salt is Sodium (see Sodium). The balance of potassium is often disturbed by diarrhoea, kidney disease and/or medications such as urine pills. When potassium is too high, one gets loss of strength, heart rhythm disturbances up to cardiac arrest. When potassium is too low, heart rhythm disturbances and loss of strength can also occur.

Normal values?

Men/Women 3.55

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Kreatinine

What is Kreatinine?

Creatinine is used to calculate kidney function. If this determination is made in both blood and urine, we can calculate the clearance. This is particularly important to determine how waste products are processed but also medicines we take.

Normal values?

Women 45-80
Men 45-100

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Leucocyten

What are leucocytes?

Leucocytes are white blood cells, which provide our body's defence. When we have an infection, as well as during pregnancy, for example, the number of these "soldiers" goes up significantly. There are about five different types of white blood cells; Neutrophilic granulocytes, Lymphocytes, Eosinophilic granulocytes, Basophilic granulocytes and Monocytes. Each of these has its own task. Eosinophilic granulocytes play a role in parasite infections. Neutrophilic granulocytes provide direct defence in infections caused by bacteria. Lymphocytes make antibodies; we have the T cells and the B cells. Basophilic granulocytes play a role in allergic reaction. Monocytes are quickly on the spot to give an immune response. If we have too many of them it is called leucocytosis and if we have too few of them it is called leucopenia.
Als we er teveel van hebben heet dat leucocytose en als we er te weinig van hebben wordt dat leucopenie genoemd.

Normal values?

Men/Women

Leucocyte differentiation?

When leucocytes are looked at under the microscope, we determine which type is elevated to get an impression of which type of possible infection is involved. This is to set up proper treatment. We also check for leukaemia. Leukaemia is a greatly increased level of white blood cells.

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Sodium

What is Sodium?

Sodium, like potassium (see Potassium), is a salt and is also called an electrolyte. Sodium is determined to determine the fluid balance in the body and check if the body is dehydrated.

Normal values?

Men/Women 136-144

Sodium deficiency.

Severe Sodium deficiency can cause the following symptoms: cardiac arrest, breathlessness, confusion, insulence, nausea, vomiting, headache.

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

MCH

What is MCH?

Mean Corpuscular Hemoglobin (MCH), which is the amount of Hb (Haemoglobin) in red blood cells that carries oxygen.

Normal values?

Men/women 1.7-2.1

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

MCHC

What is MCHC?

MCHC (Mean Corpuscular Hemoglobin Concentration) is the level concentration of Hb (haemoglobin) in erythrocytes (red blood cells).

Normal values?

Women/Men 19.3-22.5

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

MCV

What is MCV?

Mean Corpuscular Volume (MCV) is the average size of erythrocytes (red blood cells). When it is too high, there is often anaemia due to Vitamin B12 deficiency. If the value is too low, there is often iron deficiency.

Normal values?

Men/Women 82-98

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Testosterone

What is Testosterone?

Testosterone is a male sex hormone but also occurs in women, especially during pregnancy. Just as the female sex hormone Oestrogen (see Oestrogen) also occurs in men. Testosterone determines our sex in utero. It is an anabolic hormone that determines muscularity and other male characteristics.

Normal values?

Men 12-35
Women 0.5-3.0

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Platelets

What are thrombocytes?

Platelets are responsible for clotting our blood and are also called the platelets. If there are too many platelets it is called thrombocytosis and if there are too few it is called thrombocytopenia. Platelets, like erythrocytes, are made in the bone marrow.
When something is damaged in our body and something is bleeding, the thrombocytes come into action a "net" is created where the thrombocytes are trapped and the blood coagulates and repair of the damage can begin.

Normal values?

In men and women, normal values are between 150 and 400.
If the amount of platelets is too low, bleeding can occur that clots poorly. Quick bruising that would otherwise not come at all. If too much, clots can form in all sorts of places in our bodies.

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Troponin

What is Troponin?

Troponin is a protein that acts to relax and tighten muscles. The protein consists of three parts: C(TnC), T(TnT) and I(TnI). Usually, only I and T are measured. An increase in Troponin can be measured within 2 hours of a heart attack. In heart problems, Troponin is often determined together with CK-MB (see CK-MB).

Normal values?

Women/Men
Troponin I < 0.10
Troponin T < 0.01

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

TSH

What is TSH?

TSH (Thyroid Stimulating Hormone) is a hormone produced by the pituitary gland, a gland in the brain. This hormone stimulates the thyroid gland (thyroid) to work. If there is too much TSH, the thyroid starts working too hard and one may feel agitated, get palpitations. Incidentally, even without this hormone, the thyroid can sometimes work too fast or too slow. TSH is usually determined together with free T3, T3, free T4, T4 (see T3 and T4). These hormones are produced by the thyroid gland itself and provide feedback to the pituitary gland. Sometimes the TSH is slightly elevated throughout life without any consequences, the elevated TSH then ensures that the thyroid continues to do its job properly.

Normal values?

Women/Men 0.4-4.0

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

T3, Free T3

What is T3 and Free T3?

T3 is a Triiodothyronine and is made by the thyroid gland. Most of the hormone is bound to thyroxine-binding globulin and only a small percentage is unbound. The unbound part is precisely the hormone that does the work. The bound part ensures that the level of the unbound part remains constant and all in conjunction with the TSH (see TSH).

Normal values?

Men/Women
Total T3 1.2-3.4
Free T3 3-8

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

T4, Free T4

What is T4 and Free T4?

T4 is called Thyroxine. In total T4, the bound and unbound portion is measured. The bound part is attached to thyroxine binding globulin but also to Transthyretin and Albumin. When thyroid function is elevated (one then feels agitated, sometimes palpitations and weight loss), T4 is usually elevated, when the thyroid gland works too slowly, weight gain and fatigue can occur. T4 free and unbound is usually determined together with the TSH and free T3 and T3 (see TSH, T3 and free T3).

Normal values?

Men/Women
Total T4 64-154
Free T4 9-24

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

Uric acid

What is uric acid?

Uric acid is made by the breakdown of body cells and the breakdown of food, such as beans, mackerel, beer. Uric acid is excreted by the kidneys and if it gets too high then the uric acid can precipitate as crystals in the joints; but also other tissues and this is called gout (well-known example is pain and redness on the big toe). Too high levels of uric acid can also lead to kidney stones.

Normal values?

Women 0.12-0.34
Men 0.20-0.42

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

WHR

What is the WHR?

That is the "waist to hip ratio " It is calculated by dividing the abdominal circumference (after exhaling) by the size around the hips. For example, an abdominal circumference of 76 cm and a hip circumference of 97 cm gives a WHR of 0.78.

What does it indicate?

It is used to serve as an indicator of whether serious health issues may arise e.g. cardiovascular disease, diabetes. But it is also used (there would be a relationship with) to predict fertility.

Normal values.

For men, a value of 0.9 would be optimal. They would have less risk of prostate cancer and testis cancer and their fertility would be optimal. For women, that value is at 0.7 they would then be less likely to have cardiovascular disease, as well as diabetes or ovarian cancer (ovarian cancer).

Note! These normal values are only an indication and depend, among other things, on the determining laboratory.

ASBESTOS MEDICAL EXAMINATION

• Client completes online Asbestos questionnaire

• Physical examination

•  Biometrics

• Blood pressure

• Pulse (heartbeat)

• Urinalysis (large stick)

• Lung function

De werkgever ontvangt een certificaat als de werknemer is goedgekeurd.
Cliënt ontvangt men een pasje met goedkeuring.
Wanneer men een veiligheidspaspoort bij zich heeft kan dan daarin een stempel worden gezet, de handtekening van de arts, de soort keuring en de geldigheidsduur.

Validity inspection:
3 years at age up to 49 years
1 year from 50 years of age and older

Duration of examination: 25 minutes

EXAMINATION SOIL DECONTAMINATION A
(1T to 3T)

• Client completes online Soil Remediation A questionnaire
• Physical examination
• Biometrics
• Blood pressure
• Pulse (heart rate)
• Smell test
• Ishihara test (colour discrimination)
• Eyesight test
• Audiogram (hearing test)
• Urine test
• Lung function test
• Blood tests;
ASAT, ALAT, Gamma-GT, Kreatinine, Urea.
Blood count: Leucocytes, Hb. MCV, Thrombocytes.

The employer receives a certificate if the employee is approved. Client receives a pass with approval.

If one carries a safety passport, one can then put a stamp in it, the doctor's signature, the type of examination and the validity period.

Validity of examination: 1 year
Duration of examination: 50 minutes

Diver medical examination

• Client completes Personal Declaration for sport diving examination and examination form

• Examination according to medical examination form

• Biometrics

• Blood pressure

• Eyesight test

• Lung function

• Urine test

Please bring your own completed self-declaration forms and medical examination form to the appointment.

Validity test: 3 years
from 50 years and older is 1 year

Medicala examination duration: 30 minutes

MEDIBUS MEDICAL EXAMINATION

• Client completes online Medibus questionnaire.

• Biometrics

• Blood pressure

• Pulse (heart rate)

• Eyesight test

• Field of vision

• Urine test

Validity of examination: 5 years
Duration of examination: 15 minutes

Parachuting medical examination

• Client completes online Medical Declaration skydiving certificate

• Physical examination according to form (see medical examination requirements 1 to 6)

• Biometrics

• Blood pressure

• Eyesight test

• Urine test

• Whisper test

• Teeth

Medical examination requirements Parachuting

1. Absence of any physical or mental illness, defect or abnormality, which may lead to sudden unfitness to perform a parachute jump properly.

2. Sufficient function of the four limbs, paying particular attention to knee and ankle joints, as well as shape and function of the spine and the trainedness of the band apparatus and musculature.

3. Normal function of heart, lungs, kidneys and nervous system.

4a. Een actieve, acute of chronische pathologische toestand van een of beide ogen of van de adnexae waardoor goed functioneren in zulke mate zou kunnen worden belemmerd, dat de veiligheid tijdens de sprong niet is gewaarborgd, leidt tot ongeschikt verklaring.

4b. The applicant shall have a distance visual acuity of at least 6/12 (20/40, 0.5) in each eye separately, with or without correction. If this visual acuity is obtained only with the aid of corrective lenses, the applicant may be declared fit provided that the lenses are worn during sports parachuting.

5. The candidate should understand conversational speech well, standing 2.5 metres away with the back to the examiner. The tubae eustachii should be well permeable. Disturbances in the vestibular apparatus lead to unqualified explanation.

6. The teeth must be in good condition. Loose teeth, dentures or otherwise, must have been removed during jumping. Certificate is valid for 24 months from date of approval.

Validity test: 2 years
Test duration: 20 minutes
Medical certificate : Medimark issues pass as medical certificate

DRIVING LICENSE MEDICAL EXAMINATION 75+

Health certificate: 75 years or older

Are you 75 years or older and want to renew your driving licence? If so, you must be able to prove for every licence renewal that you are healthy enough to drive. CBR assesses this with the Health Declaration. This rule does not apply to moped licences.

What should you do?
• Start your application in good time. Assessing whether you are healthy enough to drive can sometimes take four months. Therefore, complete your Health Declaration well in advance and digitally to be able to obtain or renew your driving licence on time.

• Complete the Health Statement on My CBR. You log in with DigiD and the extra check via SMS. Do you not yet have a DigiD with text message verification? Then apply for one first at www.digid.nl.
You can also complete the Health Declaration on paper. In some municipalities, you can also buy this Health Declaration.

• You complete the Health Declaration yourself. Because it involves your personal data and they are confidential. Answer the questions of the Health Declaration and pay via iDeal.

• After submitting your Health Declaration, you will receive a message from us via My CBR . This can take up to 5 working days. You will then receive the examination report for the doctor and any other forms you need to have completed.

• Make an appointment for a driving licence examination at Medimark (0800 6334627 or www.medimark.nl Take your message with all attachments and your identity document with you to the driving licence examination.

• The doctor will examine your general physical and mental health and complete the examination report and any other forms.

• Are you under treatment by a specialist for a health problem? And do you already know that CBR requires a report from a specialist? Then you can often visit your own treating specialist for a report and also send this directly along with the examination report.

• Send all requested information to: CBR, attn medical administration Health Declaration, PO Box 1062, 2280 CB RIJSWIJK.

• CBR will evaluate all the information. You will receive notification of the results via My CBR.

• At Medimark you can be examined at short notice, make an appointment via the website ( www.medimark.nl ) or call us at ( 0800 6334627 ).

• If you have a question, give us a call, we are happy to help!

MEDICAL EXAMINATION TAXIPASS

• Client fills in Kiwa form

• Biometrics

• Blood pressure

• Pulse (heart rate)

• Eyesight test

• Field of vision

• Urine test

Please bring the completed KIWA form with you before the appointment.

Validity: 5 years
Duration examination: 15 minutes

KEURING HEALTH CHECK BASIS

• Cliënt vult online Health Check Basis vragenformulier in
• Physical examination
• Biometrics
• Fat percentage measurement
• Blood pressure
• Pulse (heart rate)
• Saturatiemeting (zuurstof bloed)
• Eyesight test
• Urine test
• Ergometry:
ECG at rest. (relaxed).

Duration examination: 20 minutes

KEURING HEALTH CHECK BASIS inclusief inspanningstest

• Cliënt vult Health Check Basis vragenformulier in
• Physical examination
• Biometrics
• Fat percentage measurement
• Blood pressure
• Pulse (heart rate)
• Saturatiemeting (zuurstof bloed)
• Eyesight test
• Urine test
• Ergometry:
ECG Rust. (hartfilmpje bij ontspanning)
ECG Stress. (hartfilmpje bij inspanning: fietsproef)

Duur:                                50 minuten
Keuringslocatie:         Alleen in Amstelveen, Breda, Eindhoven en Rotterdam

KEURING HEALTH CHECK UITGEBREID

• Cliënt vult Health Check Uitgebreid vragenformulier in
• Physical examination
• Biometrics
• Fat percentage measurement
• Blood pressure
• Pulse (heart rate)
• Saturatiemeting (zuurstof bloed)
• Eyesight test
• Urine test
• Ergometry:
ECG at rest. (relaxed).
• Blood tests:
Cholesterol Totaal, Gamma-GT, Kreatinine

Duur:           40 minuten

Preventive Medical Examination Woman-II

• Client completes online PMO questionnaire

• Comprehensive physical examination

• Musculoskeletal examination

• Biometrics

• WHR (size measurement , waist and hip ratio)

• Fat percentage measurement

• Blood pressure

• Pulse (heart rate)

• Eyesight test

• Audiogram (hearing test)

• Lung function

• Urine test

• Ergometry:
ECG Rest (cardiac video when relaxed)
ECG Stress (exercise heart monitor: cycling test)

• Blood tests:
Alanine aminotransferase, Aspartaat aminotranferase, Cholesterol, HDL-Cholesterol, LDL-Cholesterol, Bezinking, Gamma-GT/GGT, Glucose, Hemoglobine, Kreatinine, Ureum, Triglyceriden.

Blood count: Leucocytes, MCV, Thrombocytes.

Duur keuring:             75 minuten
Kosten:                          €345,-
Keuringslocatie:         Alleen in Amstelveen, Breda, Eindhoven en Rotterdam.

Preventive Medical Examination Woman-III Plus X-Thorax

• Client completes online PMO questionnaire

• Comprehensive physical examination

• Musculoskeletal examination

• Biometrics

• WHR (size measurement , waist and hip ratio)

• Fat percentage measurement

• Pulse (heart rate)

• Blood pressure

• Eyesight test

• Audiogram (hearing test)

• Lung function

• Urine test

• Ergometry:
ECG Rest (cardiac video when relaxed)
ECG Stress (exercise heart monitor: cycling test)

• Blood test

INLAND SHIPPING MEDICAL EXAMINATION

• Client completes the examination form Medical Examination of Shipping Personnel from the Ministry of Infrastructure and the Environment.

• Examination according to the examination sheet of the form

• Biometrics

• Blood pressure

• Pulse (heart rate)

• Eyesight test

• Ishihara test (colour discrimination)

• Audiogram (hearing test)

• Urine test

• After the medical examination, one receives a completed Medical Certificate with it. Medimark notifies the Ministry of Infrastructure and Environment.

Please bring completed form Medical Examination Shipboard Personnel before the appointment.

Validity of examination: 2 years
Duration of examination: 30 minutes
Inspection location: Only in Rotterdam

Preventief Medisch Onderzoek Man-III Inclusief X Thorax

• Client completes online PMO questionnaire

• Comprehensive physical examination

• Musculoskeletal examination

• Biometrics

• WHR (size measurement , waist and hip ratio)

• Fat percentage measurement

• Blood pressure

• Pulse (heart rate)

• Eyesight test

• Audiogram (hearing test)

• Lung function

• Urine test

• Ergometry:
ECG Rest (cardiac video when relaxed)
ECG Stress (exercise heart monitor: cycling test)

• Blood tests:
Alanine aminotransferase, Aspartaat aminotranferase, Cholesterol, HDL-Cholesterol, LDL-Cholesterol, Bezinking, Gamma-GT/GGT, Glucose, Hemoglobine, Kreatinine, Ureum, Triglyceriden.

Blood count: Leucocytes, MCV, Thrombocytes.

• X-Thorax (röntgenfoto van borstkas)

Duur keuring:         75 minuten + 60 minuten X-Thorax
Kosten:                      €415,-
Keuringslocatie:    Alleen in Amstelveen, Breda, Eindhoven en Rotterdam.

Preventive Medical Examination Man-III

• Client completes online PMO questionnaire

• Comprehensive physical examination

• Musculoskeletal examination

• Biometrics

• WHR (size measurement , waist and hip ratio)

• Fat percentage measurement

• Blood pressure

• Pulse (heart rate)

• Eyesight test

• Audiogram (hearing test)

• Lung function

• Urine test

• Ergometry:
ECG Rest (cardiac video when relaxed)
ECG Stress (exercise heart monitor: cycling test)

• Blood test