Block 4 Week 4 - Occupational Health Flashcards
Work is….
What review paper backs this up?
- Generally good for health
- Needs to be good work
- Social Determinant of health: Marmot R/v: Lower social/ economic status -> poorer health
What does worklessness lead to?
- •Poorer physical health –> die sooner
- •Poorer MH
- •More medical care
- •Less social integration & loss self-confidence
- •Less monetary resources
- •Effect on next generation
What does: Improving Lives. The Future of Work: Health & Disability White Paper 2017 state?
What does it say we should do in response to this?
- Disability employment gap: Need to support these people in & out of work
- 1 in 3 of working age have L TC putting working participation at risk- timely & appropriate health & employment support
What is the future of the workforce?
- 2020 1/ 3 workforce >50
- Life Expectancy & Retirement age increasing but not disability free years are not!
Occupational Health- define
Promotion & maintenance of the highest degree of: Physical, Mental & Social well-being of workers in all occupations
•Prevent ill health from work
What are the factors encouraging the sick role?
1/ Culture, Beliefs & Attitudes: (needs changing)
- Misconceptions about health & work
- Poor retention in work of those with disabilities/ chronic disease
2/ Inadequate Systems:
•No rapid intervention pathways keeping you in work or returning you to work
3/ Lack of Primary Care Involvement:
- Rehabilitation to work is not health care performance measure- it should be
- Lack OH advice
Give some examples of the changing nature of work
- Manufacturing –> Serviceindusty
- Physical –> Sedentary
- Full time –> Flexitime/ Part Time
- Male –> Diverse
- Women at home –> Women at work
- Retire –> Workbeyond65
Give examples of work related ill health
a) During industrial revolution
b) Currently
Industrial Revolution
•Accidents, Poisoning, MSK
Current:
- MH- Depression/Anxiety
- MSK- Skin, Resp, Infection
Define a hazard?
What are the types of hazard?
Something that has the potential to cause harm
- Physical
- Chemical
- Mechanical
- Biological
- Organisational/ Psycho-social (Shift, Bullying, Workload, Commuting, Home-Work interface, Stress)
What is risk
The likelihood of harm actually occuring
What do risk assessments do?
Identify hazard
Ax risk to health
Manage/ Control risks
Mental health- what are the stats?
1 in 5 have MH condition
What are the causes of MH @ work?
1/ Demands
- Capacity vs capability
- Family/ personal life
2/ Control
3/ Support
How can a Dr recognise work related ill health?
- History
- Examination
- Investigation
What questions would you ask in an occupational history?
- What is your job?
- What do you do in your job? Tasks? Work with?- chemicals, vapours, fumes etc.
- How long?
- Had any other jobs? What were you exposed to?
- Told that something you use may make you ill?
- Anyone at work had same symptoms?
- Domestic exposure to work agents
- Any hobbies? – Exposure to causes
- Do the symptoms get better away from work?
What is the the role of the GP in assesing fitness to start work?
Rarely invovled
Employers responsibility
How can promoting return to work be encouraged in a ‘clinical setting’?
Should be a key clincal outcome that is a success of Tx is measured against
SHould be integral part of management plan
How long can you self certify illness for?
What do you need post 7 days?
7 days
Fit Note (AKA Medical Certificate)
What does a fit note do?
- Provide certification for statutory sick pay
- Advise pts about period of sickness absence
- Advise employer about suitable adjustments
- Facilitate return to work through communication w/ Dr’s, Pt’s & Employers
When must the comments box of a fit note be filled in?
What should be included?
If ticked “may be fit to work”
- What canthey not do
- Amended duties?
- Altered hours
- Phased return to work
- Workplace adaptations
- Redeployment
Fit note- one other key point: what must you circle?
You must circle if you need to ax the patient again after a period of illness
The Equality Act 2010: Disability Discrimination: What does it say?
Give an example, how should the Ax be done? What should be done in response to this (keep it general)
Physical or mental impairment that has substantial & long term adverse effects on ability to carry out normal day-to day activities
- Eg: Getting dressed, preparing meal, walking etc..
- Ax: without meds, prosthesis, aids
- Make: Reasonable adjustments so not at disadvantage compared to non-disabled people
What is the legal standing with OH serivces?
ARe they part of the NHS?
- Not part of NHS
- No legal obligation for employers to provide OH service
What is the role of the OH team?
- Independent & Impartial advice to Employer & Employee
- Investigate &Dx those sick/injured@work
- Assist return to work of sick/ injured @ earliest opportunity
- Match people with jobs appropriate to their: health, fitness & susceptibility status
