Block 4 Week 4 - Occupational Health Flashcards

1
Q

Work is….

What review paper backs this up?

A

Work is generally:

  • Generally good for health
  • Needs to be good work
  • and is a Social Determinant of health: Marmot R/v: the lower social/ economic status -> the poorer the health and shorter life expectancy
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2
Q

What does worklessness lead to?

A
  • •Poorer physical health –> more likely to die sooner
  • •Poorer mental health
  • •More medical care
  • •Less social integration & loss self-confidence
  • •Less monetary resources
  • •Effect on next generation -> those born to unemployed parents have higher risk ill health
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3
Q

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?

A
  • Disability employment gap: Need to provide support for disabled people in and out of work
  • 1 in 3 of working age have L TC putting working participation at risk- give timely & appropriate health & employment support
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4
Q

What is the future of the workforce?

A
  • 2020 1/ 3 workforce >50 yrs old
  • Life Expectancy & Retirement age increasing but not disability free years are not!
  • still going to become disabled at roughly the same age
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5
Q

Occupational Health- define

A
  • Promotion & maintenance of the highest degree of: Physical, Mental & Social well-being of workers in all occupations
  • Prevent ill health caused by working conditions
  • place and maintain worker in occupational environment that is adapted to physiological and psychological capability -> adapt work to each person
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6
Q

What are the factors encouraging the sick role?

A

1/ Culture, Beliefs & Attitudes: (needs changing)

  • Misconceptions about health & work (have to be 100% fit to 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
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7
Q

Give some examples of the changing nature of work

A
  • Manufacturing –> Service industry
  • Physical –> Sedentary
  • Full time –> Flexitime/ Part Time
  • Male –> Diverse
  • Women at home –> Women at work
  • Retire –> Work beyond 65
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8
Q

Give examples of work related ill health

a) During industrial revolution
b) Currently

A

Industrial Revolution

•Accidents, Poisoning, MSK

Current:

  • MH- Depression/Anxiety
  • MSK- Skin, Resp, Infection
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9
Q

Define a hazard?

What are the types of hazard?

A

Something that has the potential to cause harm

  • Physical
  • Chemical
  • Mechanical
  • Biological
  • Organisational/ Psycho-social (Shift, Bullying, Workload, Commuting, Home-Work interface, Stress)
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10
Q

What is risk

A

The likelihood of harm actually occuring

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11
Q

What do risk assessments do?

A

Identify hazard

Ax risk to health

Manage/ Control risks

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12
Q

Mental health- what are the stats?

A

1 in 5 have MH condition

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13
Q

What are the causes of MH @ work?

A

1/ Demands

  • workload vs percieved capacity
  • Family/ personal life

2/ Control -> pace or organisation of work

3/ Support -> colleagues/ manager/ human resources etc

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14
Q

How can a Dr recognise work related ill health?

A
  • History
  • Examination
  • Investigation
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15
Q

What questions would you ask in an occupational history?

A
  • 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?
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16
Q

What is the the role of the GP in assessing fitness to start work?

A

Rarely invovled

Employers responsibility occupational health service

17
Q

How can promoting return to work be encouraged in a ‘clinical setting’?

A

Returning to work should be a key clinical outcome that the success of Tx is measured against

Should be integral part of management plan

18
Q

How long can you self certify illness for?

What do you need post 7 days?

A

7 days

Fit Note (AKA Medical Certificate)

19
Q

What does a fit note do?

A

•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
20
Q

When must the comments box of a fit note be filled in?

What should be included?

A

If ticked “may be fit to work”

  • What can they not do
  • Amended duties?
  • Altered hours
  • Phased return to work
  • Workplace adaptations
  • Redeployment
21
Q

Fit note- one other key point: what must you circle?

A

You must circle if you need to ax the patient again after a period of illness

22
Q

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)

A

Disability = 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 in workplace.
23
Q

What is the legal standing with OH serivces?

Are they part of the NHS?

A
  • Not part of NHS
  • No legal obligation for employers to provide OH service
24
Q

What is the role of the OH team?

A
  • 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
25
Q

What is the role of the Health & Safety Executive?

A

Health and safety executives:

  • Enforce the law
  • Shape & review regulations
  • Produce research & statistics
26
Q

Department of work and pensions: Access to Work Scheme

What type of help is provided?

A
  • Special aids/equipment
  • Adaptations toequipment
  • Travel to work
  • Travel in work
  • MH support service
27
Q

What are the back pain blue flags in workplace?

A
  • Fear re-injury
  • High physically demanding job
  • Low expectation return to work
  • Low job satisfaction
  • Low support
  • Lack adjustments
  • Poor communication
28
Q

What should you do when a patient presents with work-related neck and UL disorders?

(think more about the steps)

A
  • Establish anatomical Dx
  • Consider work-related risk factors
  • Exclude recreation risk factors
29
Q

Give common examples of Work-Related Neck & UL disorders:

And how they may occur?

A
  • Shoulder pain
  • Epicondylitis
  • Tenosynovitis
  • Non-specific diffuse forearm pain
  • Carpal Tunnel Syndrome:
  • Prolonged/extreme wrist flexion
  • Forceful/ Repetitive wrist movement
  • Direct pressure on carpal tunnel
  • Hand held vibrating tools
30
Q

How can work related neck and UL disorders be resolved?

A
  • Improved ergonomics- Work layout, posture to reduce force/ repetition
  • Job rotation-Reduced time at repetitive task
  • New employee to work @ slower rate initially
  • Rest breaks- Allow recovery
  • Redeployment- If measure aren’t effective
  • Rehab for affected workers:
    • •Reduced hours
    • •Reduced work-rate
    • •All above
31
Q

What are the risks and hazards to junior drs?

A

Hazards: Patients, investigations, therapeutics, environment, biological risk, chemical risks, psychosocial risk

E.g. Biological hazard from infection

Chemical hazard -> aldehydes/ anaesthetics/ antineoplastic drugs

Therapeutics/ physical hazard -> ionising radiation and manual handling

Psychosocial hazard -> working hours/ shift pattern, bullying, hierarchy, workload, stress