B11-MANAGE OCCUPATIONAL HEALTH

Question 1

(a) Outline the meaning of vocational rehabilitation. (2)

Answer 1

VR = the provision of help / support (via counselling, reasonable adjustments to work procedures, systems, activities, layout etc) to someone remaining in work / accessing work / preparing to return / returning to work following either injury or illness.

Question 2

(b) Outline the benefits of vocational rehabilitation. (5)

Answer 2

benefits include reduced sickness absence costs, improved productivity, retention of skilled employees, improved staff morale, compliance with the Equality Act 2010.

Question 3

(c) Identify three types of health practitioner who may be involved in vocational rehabilitation. (3)

Answer 3

health care practitioners involved in VR: occupational physicians and occupational nurses, counsellors, occupational therapists.

Question 4

(a) Identify the possible range of specialists involved in Occupational Health provision in a large manufacturing company. (5)

Answer 4

occupational health nurse;

occupational physician / doctor;

occupational hygienist;

ergonomist;

psychologist / counsellor;

physiotherapist.

Question 5

(b) 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. (5)

Answer 5

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
• monitoring / recording MH-related sickness absence - OH nurse
• providing MH training - ergonomist and / or physiotherapist
• advising management on MH issues - OH nurse / physician / ergonomist
• investigating MH incidents / accidents / ill-health - OH nurse / ergonomist

Question 6

(a) Outline the four stages in occupational health and hygiene practice. (4)

Answer 6

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

Question 7

(b) 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. (6)

Answer 7

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 8

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; (5)

Answer 8

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 9

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. (5)

Answer 9

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 10

(a) Identify the possible range of specialists involved in Occupational Health provision in a large manufacturing company. (5)

Answer 10

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

an occupational health physician and nurse;

an occupational health nurse;

a physiotherapist;

an occupational hygienist;

a counsellor or psychologist;

and

an ergonomist.

Question 11

(b) 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. (5)

Answer 11

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 12

(a) Outline the four stages in occupational health and hygiene practice. (4)

Answer 12

The first stage in occupational health and hygiene practice is recognising and identifying hazards that can cause harm in the workplace.

This would be followed by taking measurements to determine who might be affected and to what extent.

Once the measurements have been completed, an evaluation of the level of risk posed by the identified hazards will have to be carried out and this will point to the need to
introduce control measures to eliminate or minimise the risk.

Question 13

(b) 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. (6)

Answer 13

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 14

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; (5)

Answer 14

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 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:

(b) when an employee returns to work after ill-health. (5)

Answer 15

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 16

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.

(a) Outline the benefits, composition, role and possible functions of an Occupational Health Service within this organisation. (12)

Answer 16

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 17

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

Answer 17

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 18

Outline the possible functions of an occupational health service within a large
manufacturing company. (10)

Answer 18

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 19

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

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

(i) when recruiting new employees; (4)

Answer 19

During the recruitment of new employees, the occupational health department would have an important part to play in carrying out screening of the applicants and reviewing their health history so that they might be in a position to advise management on their suitability for employment.

In particular they would need to check the fitness and ability of potential warehouse staff to undertake manual handling tasks, check the eyesight of applicants for positions as drivers whether of road or internal vehicles and also screen them for evidence of the possible mis-use 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 20

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

Answer 20

(ii) when an employee returns to work after ill-health. (5)

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 where necessary arranging for or even providing rehabilitation treatment in house.

Question 21

(b) Outline other ways in which the occupational health department can
assist the management team to improve health and safety within this organisation. (You do not need to consider those functions you have already addressed in part a). (11)

Answer 21

maintaining health records of employees and carrying out monitoring of sickness absence;

providing first aid treatment and training for employees appointed as first aiders;

providing information and advice to employees on weight management, exercise and smoking cessation;

undertaking health surveillance;

providing training in manual handling and the management of stress;

providing an input to the development of policies and procedures and participating in management team meetings and meetings of the health and safety committee;

making a specialist input to risk assessments and liaising with the enforcement authority on health issues.

Question 22

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

(a) Identify the possible functions of this company’s occupational health department:
(i) when recruiting new employees; (4)

Answer 22

During the recruitment of new employees, the occupational health department would have an important part to play in carrying out screening of the applicants and reviewing their health history so that they might be in a position to advise management on their suitability for employment.

In particular they would need to check the fitness and ability of potential warehouse staff to undertake manual handling tasks, check the eyesight of applicants for positions as drivers whether of road or internal vehicles and also screen them for evidence of the possible mis-use 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 23

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

(ii) when an employee returns to work after ill-health. (5)

Answer 23

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 where necessary arranging for or even providing rehabilitation treatment in house.

Question 24

Give the meaning of the term occupational health. (4)

Answer 24

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 25

(a) Outline the purpose of medical surveillance AND identify who should carry it out. (3)

Answer 25

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 26

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

Answer 26

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 27

(c) Identify functions (other than medical surveillance) that may be carried out by an occupational health service in a large manufacturing organisation. (4)

Answer 27

maintaining health records of employees and carrying out monitoring of sickness absence;

providing first aid treatment and training for employees appointed as first aiders;

providing information and advice to employees on weight management, exercise and smoking cessation;

undertaking health surveillance;

providing training in manual handling and the management of stress;

providing an input to the development of policies and procedures and participating in management team meetings and meetings of the health and safety committee;

making a specialist input to risk assessments and liaising with the enforcement authority on health issues

Question 28

Outline the possible functions of an occupational health service within a large manufacturing company. (10)

Answer 28

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 29

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 pressures of work and also high levels of
sickness absence.

(a) Outline the benefits, composition, role and possible functions of an Occupational Health Service within this organisation. (12)

Answer 29

Benefits = legal / moral / financial; legal compliance - less likelihood of enforcement / “protection” from civil claims / reduced insurance / improved staff morale / reinforces

H&S culture / reduced
sickness absence etc

Composition - occ health nurse / doctor / hygienist / ergonomist / counsellor / epidemiologist / physiotherapist;

Role = 1. Identification / recognition of health hazards;

2. Evaluation of risk;
3. Monitoring / measuring levels of exposure;
4. Implementing control measures; Functions -

Question 30

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

Answer 30

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 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.