B11-Manage Occupational Health

Question 1

MEANING OF HEALTH

Answer 1

WHO defines health as:

“a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity.”

Question 2

MEANING OF OCCUPATIONAL HEALTH

Answer 2

Occupational health is defined as:

“…the promotion and maintenance of the highest
degree of physical, mental and social well-being of
workers in all occupations by preventing departures from health, controlling risks and adapting work to people and people to their jobs”

Question 3

MEANING OF WELL-BEING

Answer 3

The Economic & Social Research Council defines well-being as:

“a state of being with others, where human needs are met, where one can act meaningfully to pursue one’s goals and where one enjoys a satisfactory quality of life.”

Question 4

DEFINITION OF DISABLED

Answer 4

According to the Act, a person is disabled if they have:

“a physical or mental impairment which has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities.”

Question 5

THE EFFECT CATRGORYS OF DISABLED

Answer 5

That ‘effect’ must be:

• Substantial (i.e. more than minor or trivial).
• Long-term (i.e. it has lasted or is likely to last for at least a year or for the rest of the life of the person affected).
• Adverse.
• ‘Normal day-to-day activities’ are those carried out by most men and women on a fairly regular and frequent basis.

Interpretation of the term ‘disabled’ can be a complex issue.

• People with some progressive conditions would fall within the meaning e.g. MS
• Certain conditions mean the person qualifies on diagnosis e.g. cancer

•Certain conditions do not qualify
Such as smoking, hay fever etc

Question 6

MANAGING SHORT-TERM FREQUENT ABSENCE

Answer 6

Employee is repeatedly absent for short periods of time, e.g. one or two days.

Can affect performance and be disruptive to others and the organisation as a whole.

Systematic approach to managing short-term absence:
•Proactive application of organisational policy.

• Return-to-work interviews to establish real reasons for absence.
• Procedures to deal with unacceptable absence levels and/or breach of the policy.
• Use of trigger mechanisms to review attendance.
• Early involvement of occupational health professionals.

Question 7

MANAGING LONG-TERM ABSENCE

Answer 7

Extended periods of absence:

Easier to plan for, less disruptive and easier to manage.

When discussing an employee’s return to work from long-term absence, may consider:

• Phased return.
• Lighter duties.
• Amended shift patterns.
• Re-training.
• A buddying system with a colleague.
• Task assessment to identify adjustments.

Key actions employers can take:

• Identification of someone to undertake initial enquiries.
• Keeping in contact with the individual.
• Flexibility and restricting sick pay.
• Detailed assessment by relevant specialists.
• Health, occupational or rehabilitation interventions.
• Changes to work patterns or the environment.

Question 8

VOCATIONAL REHABILITATION

Answer 8

“Vocational rehabilitation is whatever helps someone with a health problem to stay at, return to and remain in work.”

Has historically been associated with the rehabilitation of people with disabilities.

Now frequently used much more broadly to refer to anything that facilitates attendance.

Question 9

VOCATIONAL REHABILITATION BENEFITS

Answer 9

Employer:
•Reduced absence.
•Higher performing staff.
•Reduced staff turnover (retention of experience).
•Increased productivity and competitive edge.
•Enhanced reputation (caring organisation).

Employee:
•Better physical health.
•Better mental health.
•Increased financial security.

Question 10

Outline the meaning and benefits of occupational health.

Answer 10

“The promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations.”

Aim:
To anticipate and prevent health problems which can be caused by the types of work people do

Benefits:

Statutory compliance.

Reduction in absence rates.

Improved management of rehabilitation and return to work.

Early recognition of work-related health hazards.

Improved management of work-related ill health.

Reduction in ill health compensation claims.

Better matching of the job to the individual.
Improved worker morale.

Question 11

Identify the possible range of specialists involved in Occupational Health provision in a large manufacturing company.

Answer 11

occupational health nurse;

occupational physician / doctor;

occupational hygienist;

ergonomist;

psychologist / counsellor;

physiotherapist.

Question 12

Outline the specific activities that occupational health specialists could undertake as part of a programme to reduce accidents and absences relating to manual handling.

For each activity identify the most appropriate occupational specialist to undertake the activity.

Answer 12

Roles in relation to manual handling include:

• manual handling assessments - ergonomist and / or physiotherapist
• fitness to work / medical questionnaire assessment or return-to-work fitness assessment - OH nurse / physician
• treatment or referral for treatment of MH injuries - OH nurse / physician
• delivery of rehabilitation programme - OH nurse / physician / physio

Question 13

Outline the four stages in occupational health and hygiene practice.

Answer 13

1. Identification / recognition of health hazards;
2. Evaluation of risk;
3. Monitoring / measuring levels of exposure;
4. Implementing control measures

Question 14

An organisation is concerned about the level of absence arising from work related injuries and ill-
health. Suggest practical ways in which the organisation’s occupational health department could assist
in the management of this problem.

Answer 14

Review sickness absence stats / data;

Carry out investigations of incidents;

Implement and deliver sickness absence policy - interviews / home visits / return to work interviews;

liaise with GP;

provide confidential source of guidance;

counselling / support;

rehabilitation - carrying out risk assessments / making reasonable adjustments;

health monitoring / health surveillance service - lung function / audiometry / biological monitoring; running campaigns / raising awareness of health issues - reduce
incidence.

Question 15

A catalogue distribution company employs 300 employees as drivers, warehouse operatives and office staff, processing telephone and internet orders.

Identify the possible functions of this company’s occupational health department:

(a) when new employees commence employment;

Answer 15

When new employees commence employment the occupational health department would have an important part to play in carrying out the screening of the employees and reviewing their health history so that they might be in a position to advise management on their suitability for the work for which they have been chosen.

In particular they would need to check the fitness and ability of potential warehouse staff to undertake manual handling tasks, check the eyesight of drivers whether of road or internal vehicles and also screen them for evidence of the possible misuse of alcohol or other substances.

Additionally it would be important to carry out eyesight tests on those who would be employed in the office to use display screen equipment.

Question 16

A catalogue distribution company employs 300 employees as drivers, warehouse operatives and office staff, processing telephone and internet orders.

Identify the possible functions of this company’s occupational health department:

(b) when an employee returns to work after ill-health

Answer 16

As for those employees preparing to return to work after a period of ill-health, an
assessment of their current health condition would enable recommendations to be
made to management on whether the return should be phased or whether the
employee should be redeployed on other or lighter duties.

This would necessitate liaison with the employee’s GP, and responding to the requirements of a fit note.

There would also be occasions when counselling would be necessary and making
arrangements for or even providing rehabilitation treatment in house.

Question 17

Outline the specific activities that occupational health specialists
could undertake as part of a programme to reduce accidents and
absences relating to manual handling. For EACH activity identify
the most appropriate occupational specialist to undertake the
activity.

Answer 17

The contribution the specialists could make as part of a programme to reduce accidents and ill health in relation to manual handling include the assessment of manual handling tasks - the ergonomist or physiotherapist;

the assessment of the physical capabilities of the employees to carry out a task either pre-employment or after a return to work – the physician or nurse;

the treatment of or referral for
treatment of manual handling injuries – the physician or nurse;

drawing up a rehabilitation programme for return to work – the physiotherapist or nurse;

monitoring and recording sickness absence – the occupational health nurse;

the provision of manual handling training – the physiotherapist or ergonomist;

giving advice to management on controls for manual handling tasks – the physician or nurse;

and

the investigation of manual handling injuries – the physician, nurse or ergonomist.

Question 18

An organisation is concerned about the level of absence arising from work related injuries and ill-health.

Suggest practical ways in which the organisation’s occupational health department could assist in the management of this problem.

Answer 18

using pre-employment screening to identify potential employees who would be at a greater risk of suffering ill-health resulting in absence;

carrying out regular health surveillance of
existing employees engaged in activities with known health hazards;

collecting data on sickness absence and analysing it to identify trends in or reasons for absence;

liaising with general practitioners and providing rapid access to treatments such as
physiotherapy and counselling which will aid return to work;

assisting managers to arrange phased return to work in certain circumstances and providing practical advice on adaptations to work practice to minimise risk of repeat injury;

taking an active part in carrying out risk assessments at the workplace and encouraging and advising employees on healthy life styles such as smoking cessation and the importance of nutrition and exercise.

Question 19

A soft drinks manufacturer employs 400 people undertaking a range of different
jobs including production, warehousing, delivery and administration.

It has been noted that there are significant risks to staff from noise, manual handling /
ergonomic issues and pressure of work and also high levels of sickness
absence.

Outline the benefits, composition, role and possible functions of an Occupational Health Service within this organisation.

Answer 19

Benefits of an Occupational Health Service include:

legal compliance where health surveillance is required;

sick absence management leading to a reduction and therefore saving money;

contributing to risk assessment process;

providing advice on occupational
health controls and competent advice in specialised areas;

and

it is often seen as independent from the employer.

The composition will depend on the actual activity of the organisation but might include:

an occupation health physician and nurse;

a screening nurse;

physiotherapist;

occupational hygienist;

counsellor or psychologist;

manual handling trainer;

and an ergonomist.

The role and function includes:

training on occupational health
controls;

pre-employment screening; health surveillance and record keeping;

fitness to work assessments;

sick absence reviews;

counselling; rehabilitation; testing and monitoring (eg audiometry);

immunisation; liaison with GP, or enforcing agency; and health promotion.

Question 20

What contribution could an Occupational Health specialist make in
addressing the risks to staff from stress, manual handling / ergonomic
issues and noise? (8)

Answer 20

The contribution the specialist could make in relation to:

ƒ stress include: rehabilitation; counselling; and in carrying out risk assessment and
ensuring control measures are reasonable

ƒ manual handling / ergonomic issues include: assessment and control; physical
competency of workers; eye sight screening and rehabilitation

ƒ noise includes: noise assessment, control and audiometry. In all cases the specialist could contribute to training, monitoring and managing sickness
absence.

Question 21

Outline the possible functions of an occupational health service within a large
manufacturing company.

Answer 21

The possible functions of an occupational health service that could have been outlined
include pre-employment health screening or other medical examinations (for example, of
employees returning to work following accidents or of those such as transport drivers whose work demands particular physical competencies), biological monitoring and health surveillance.

The service would also very likely have a role in contributing to health and safety policies, providing specialist input to risk assessments and health education and training programmes, carrying out sickness and absence monitoring and keeping health
records, managing first-aid provision, implementing rehabilitation programmes and liaising with other professionals such as local GPs and HSE/EMAS.

Other possible functions, depending on the organisation and its activities, might include immunisation, drug and alcohol screening and involvement with environmental monitoring programmes.

Question 22

Outline the purpose of medical surveillance AND identify who should carry it out.

Answer 22

Provides a means for the early detection of (potential) w-r health issue - alerts employee, employer / raises awareness;

highlights possible deficiencies in control;

allows for intervention - medical
treatment / change of work activity / advice on whether further exposure is permissible - eg CLAW / IRR, CAR / COSHH r11 Sched 6 - must take place under the supervision of an appointed doctor /
EMAS - specialist in occ medicine - FOM.

Question 23

b) Identify circumstances when it is appropriate to carry out medical surveillance. (3)

Answer 23

Appropriate when a statutory requirement - as above - CLAW / IRR, CAR / COSHH r11 Sched 6

Firstly, when an employee is exposed to a specified substance while engaged in a specified process as set out in Schedule 6 to the Regulations (unless that exposure is not significant) eg those working with vinyl chloride monomer in certain processes requires health surveillance to be conducted.

Secondly

• when there is an identifiable disease or adverse health effect associated with exposure to a hazardous substance; and
• when there is a reasonable likelihood that the effect will occur; and
• when there are valid techniques available for detecting indications of the disease or ill health effect

Question 24

Outline the possible functions of an occupational health service within a large manufacturing company.

Answer 24

The functions of an occupational health service include carrying out:

Pre-employment health screening / fitness to work assessments when recruiting new staff
(eyesight tests etc); other medical examinations:

• on return to work following accident / sickness
• specific medical examinations (eg physical for professional train drivers / pilots etc)
• biological monitoring eg blood sample for lead levels
• health surveillance eg skin inspection (dermatitis); lung function testing (occupational asthma); audiometry (NIHL) etc In general:
• managing sickness absence - reviewing absenteeism records + liaison with absent staff
• rehabilitation / return to work management / interviews / counselling / support
• reviewing the organisation’s ill-health statistics
• making RIDDOR reports for cases of occupational ill-health
• providing treatment on behalf of medical practitioners

• provision of health education / training (eg manual handling; stress management PPE
selection and use etc)

• provision of a counselling service (occ. stress / violence and /or personal issues)
• provision of a first-aid service (assessment, training, treatment, record keeping)

• advising management on legislation / occ health issues; contribution to policy
development and procedures (smoking / drugs / alcohol etc)

• advising staff (contractors) on well-being / fitness - diet, smoking, substance abuse,
retirement etc

• carrying out immunizations (tetanus, TB, rubella, Hepatitis B/C)

• carrying out workplace monitoring (fixed and personal) – dusts, vapours, fibres / noise /
vibration

• providing specialist input to risk assessments - ergonomic, DDA, pregnancy etc
• carrying out drug / alcohol screening / testing

• liaison - with enforcement agencies (HSE / CMU / EMAS, LAs / EHOs) and medical
professionals (GPs CMU / EMAS)

• maintaining health records / health surveillance data .

Question 25

What is the purpose of carrying out a workplace needs assessment?

Answer 25

Used by organisations to identify the health priorities that exist within a population of workers to:

Provide an appropriate occupational health service

and

Develop and implement appropriate occupational health strategies within the workplace.

Question 26

What are the typical functions of an occupational health service.

Answer 26

Pre-employment Screening.

Health Surveillance.

Return-to-Work Rehabilitation.

Sickness Absence Management.

Counseling.

General Risk Assessments.

Individual Risk Assessments.

Health Education and Promotion.

Advice to Managers and Employees.

Treatment Services and First Aid.

Management of Infectious Diseases.

Immunity Assessment and Vaccination.

Question 27

Outline the meaning and benefits of occupational health.

Answer 27

“The promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations.”

Aim:
To anticipate and prevent health problems which can be caused by the types of work people do

Benefits:

Statutory compliance.

Reduction in absence rates.

Improved management of rehabilitation and return to work.

Early recognition of work-related health hazards.

Improved management of work-related ill health.

Reduction in ill health compensation claims.

Better matching of the job to the individual.
Improved worker morale.

Question 28

Give three examples of occupations where there are defined fitness-to-work standards.

Answer 28

Vehicle driving, e.g. forklift trucks (FLT), Heavy

Goods Vehicles (HGV).

Working with dangerous machinery.

Working at heights.

Working in confined spaces.

Emergency-service workers.

Night-shift workers.

Divers.

Question 29

Outline some of the main sources of data used by the HSE to compile occupational ill-health statistics.

Answer 29

Sources used by HSE for statistics:

RIDDOR – specific reportable diseases only.

Labour Force Survey (LFS) - national survey of private households managed by ONS.

The Health and Occupation Reporting (THOR) network - specialist doctors voluntarily report new cases of work-related ill health.

The Industrial Injuries Scheme - DWP compensation for workers disabled by a prescribed occupational disease.

Death certificates – for asbestos-related and other occupational lung diseases.

Question 30

State the five categories of health hazard. Give an example of each.

Answer 30

Chemical
Corrosives, toxics, CMR, etc. (in the form of liquids, dusts, fibres, gases, vapours, etc.).

Physical
Noise, vibration, radiation, heat, etc.

Biological
Bacteria, fungus, virus, protozoa, etc.

Psycho-Social
Stress, drugs and alcohol, violence at work, etc.

Ergonomic
Posture, workplace layout, etc.

Question 31

You are a health and safety advisor to a large warehousing company who employ a significant number of fork-lift truck drivers.

Outline the key points that should be included in the company policy and procedures on drug misuse. (20)

Answer 31

The policy should initially contain a general statement setting out: the organisation’s
aims,(such as to ensure that drug misuse does not have a detrimental effect on the
work of the employees);

that sufficient resources would be allocated to ensure the aims were achieved;

the responsibilities for carrying the policy into effect such as those of management, employees and occupational health staff;

those who would be covered by the policy such as the organisation’s own employees and those of contractors;

and the definition of drug misuse including the use of prohibited and the misuse of prescription drugs with the provison that those employees who were obliged to take prescription drugs would have to make this known to the organisation.

More detailed procedures would then have to be drawn up for matters such as the
circumstances in which drug testing would be carried out such as in pre-employment
examinations, following any forklift truck accident or incident, and randomly as a
safety measure for all drivers;

the practical arrangements for testing and for analysing samples taken;

the procedures to be followed after a positive test or a refusal to provide a sample and the procedures for appeal.

The policy should also contain a clear statement on the sanctions that would be taken following a positive test whether
dismissal, suspension or re-deployment.

Finally it would be beneficial to explain what
help and advice would be available for employees who are found to have a drug
problem recognising that treatment might result in absence from work which would be
treated as normal sick leave and setting out the arrangements for return to work and
re-instatement following treatment.

Question 32

When is health surveillance a legal requirement under MHSWR 1999?

Answer 32

Regulation 6

Every employer shall ensure that his employees are provided with such health surveillance as is appropriate having regard to the risks to their health and safety which are identified by the assessment.

Determination of a worker’s state of health with regard to a specific hazard (e.g. noise) and the tracking of their health forward in time.

Required where the following criteria are met:
There is an identifiable disease or health condition related to the work;

and valid techniques exist to detect indications of disease;

and there is a reasonable likelihood that the work may cause the disease;

and

surveillance is likely to further the protection of the employee
(MHSWR Reg 6)

Question 33

WHAT ARE HEALTH NEEDS ASSESSMENTS AND WHAT ARE THE KEY STAGES IN CARRYING OUT A HEALTH NEEDS ASSESSMENT

Answer 33

Used by organisations to identify the health priorities that exist within a population of workers to:

• Provide an appropriate occupational health service and
• Develop and implement appropriate occupational health strategies within the workplace.

Key stages in carrying out a health needs assessment

STAGE 1: Obtain senior management commitment and support, which will include securing resources such as:

• Time
• Access to workers
• Access to other data (e.g risk assessments, accident reports/investigation, manufacturers data sheets, results of biological monitoring/health surveillance, statutory requirements etc.

STAGE 2: Decide on the method on collection: survey, interviews, focus groups, etc.

STAGE 3: Consider the factors associated with:

• The Job and processes
• Physical and physiological demands of the job
• Individuals health affect on the job
• Adverse health effect of the job on the individual
• Specific fitness standards
• Special cases

STAGE 4: Gather data.

STAGE 5: Analyse data.

STAGE 6: Develop and implement workplace health and well being strategy with regards to the identified needs of the workforce (in consultation with the workforce)

STAGE 7: Review, evaluate and monitor progress

Question 34

Define what is a “relevant doctor” in terms for conducting medical surveillance?

Answer 34

A “relevant doctor” is:
a medical inspector of the HSE’s Employment Medical Advisory Service, or
a doctor appointed by the HSE.