IB1

Question 1

The meaning of health with reference to the definition used by the World Health Organisation

Answer 1

‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.’

Question 2

The meaning of Occupational Health reference

Answer 2

In most developed countries, occupational health care evolved as a consequence of the industrial revolution. In 1950 the World Health Organization (WHO) and the International Labour Organization (ILO) formulated a definition of occupational health care, and described the essential content of occupational health services (OHS)1 .

Definition, adopted by the Joint ILO/WHO Committee on Occupational Health in 1950 and revised in 1995:

Question 3

The meaning of Occupational Health

Answer 3

“Occupational health should aim at: the promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations; the prevention amongst workers of departures from health caused by their working conditions; the protection of workers in their employment from risk resulting from factors adverse to health; the placing and maintenance of workers in an environment adapted to their physiological and psychological capabilities; and, to summarize, the adaptation of work to workers and of each worker to his or her job.”

Question 4

The meaning of wellbeing reference

Answer 4

Economic and Social Research Council (ESRC) Research Group spent 5 years studying Wellbeing in Developing Countries. Involves exploring the extent to which people can achieve this state of being, and the social conditions that either enable or block this possibility.

Question 5

The meaning of wellbeing

Answer 5

‘Wellbeing is 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 6

The categories of occupational health hazards

Answer 6

• chemical
  
  • dust, fibre, gases, vapours, etc.
• physical
  
  • noise, vibration, radiation, heat, etc.
• biological
  
  • bacteria, fungi, viruses, human endoparasites, etc.
• psychosocial
  
  • stress and violence at work, as well as substance misuse.
• ergonomic
  
  • Posture, workplace layout, etc.

Question 7

The links between occupational health and general/public health Including arrangements to deal with epidemics.

Answer 7

Occupational health tends to focus on diseases and ill health conditions caused or made worse by work activities and / or situations. Public health tends to focus on the health of society as a whole. There may be some overlap such that public health issues such as pandemic illnesses may affect the levels of health and therefore productivity in the workplace. Individual organisations may wish to consider having contingency plans to deal with large scale sickness absence in the event of an outbreak of illness.

Question 8

Pandemic and epidemic diseases (PED)

Answer 8

• Airborne diseases
• Vector-borne diseases
• Water-borne diseases
• Rodent-borne diseases
• Haemorrhagic fevers
• Smallpox, monkeypox
• Other zoonotic diseases
• Any other emerging disease

Question 9

Airborne diseases

Answer 9

influenza (seasonal, pandemic, avian), severe acute
respiratory syndrome (SARS), Middle East respiratory syndrome coronavirus
(MERS-CoV)

Question 10

Vector-borne diseases

Answer 10

yellow fever, chikungunya, Zika fever, West Nile fever

Question 11

Water-borne diseases

Answer 11

cholera, shigellosis, typhoid fever

Question 12

Rodent-borne diseases

Answer 12

plague, leptospirosis, hantavirus, Lassa fever,

rickettsia (murine typhus)

Question 13

Haemorrhagic fevers

Answer 13

Ebola virus disease, Marburg virus disease,

Crimean-Congo haemorrhagic fever, Rift Valley fever

Question 14

Other zoonotic diseases

Answer 14

Nipah virus infection, Hendra virus infection

Question 15

The Department of Pandemic and Epidemic Diseases (PED)

Answer 15

develops strategies, initiatives, and mechanisms to address priority emerging and re-emerging epidemic diseases, thereby reducing their impact on affected populations and limiting their international spread.

Question 16

Bio-psychosocial model is widely accepted as …

Answer 16

Bio-psychosocial model is widely accepted as the framework for disability and rehabilitation. International Classification of Functioning, Disability and Health (ICF).

Question 17

The basic principles of the bio-psychosocial model and how it relates to the health of individuals.

Answer 17

The bio-psychosocial model has 3 core principles which also form its name. They are Biological - The physical and/or mental contrition of the individual; Psychological - the personal psychological factors which also influence functioning, the individual must take some measure of personal responsibility for their behaviour; and the last principle, social - the social context, pressures and constraints on behaviour and functioning must be considered.

Question 18

The principles of fitness to work and fitness to work standards.

Answer 18

The identification of which tasks a worker is capable of performing in order to expedite their rehabilitation and return to work.

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Question 19

Return to work controls

Answer 19

• a phased return to work
• workplace adaptation
• altered hours
• amended duties

Question 20

The roles and benefits of pre-placement assessment

Answer 20

Role

• To ensure as far as possible that the person is fit both mentally and physically to do the duties required of them in the job they have been successfully interviewed for.

Benefits

• Presents an opportunity to all parties, the worker and the organisation to actively engage in health discussions on joining the organisation
• This assists both the worker and the organisation to maintain good health and reduce the likelihood of injury
• For the individual, it should reinforce that the organisation they are joining places a value upon their overall safety
• Reduction in the absence rates and number of days lost through ill-health and the resulting costs associated with absence
• Pre-Employment medicals can also raise health issues, previously unknown or undetected that potentially, if left undiagnosed, can adversely impact upon the individuals health and have far reaching impacts other than simply their ability to work.
• From an employer’s perspective a pre-employment medical can also help address some of the cultural barriers around the mistrust of organisations using medical information, such as promotions

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Question 21

PH19-NICE

Answer 21

National Institute for Health and Care Excellence

Public health guideline [PH19] Published date: March 2009

Workplace health: long-term sickness absence and incapacity to work

Question 22

Managing long-term and short-term frequent sickness absence/incapacity for work with reference to PH19-NICE

Answer 22

• Identify someone who is suitably trained and impartial to undertake initial enquiries with an employee who is experiencing long-term sickness absence or recurring short- or long-term sickness absence.
• If necessary, arrange for a more detailed assessment by relevant specialist/s. This could be coordinated by a suitably trained case worker/s.
• Coordinate and support any health, occupational or rehabilitation interventions or services and any return-to-work plan agreed with the employee.

Question 23

The meaning of vocational rehabilitation

Answer 23

‘Whatever helps someone with a health problem to stay at, return to and remain in work.’

Vocational rehabilitation is the process of returning a worker back to meaningful work as a way of aiding their recovery and return to health following a period of physical or mental ill health. It can also be a way of improving the health of an individual through getting them into work and keeping them in work.

Question 24

The benefits of vocational rehabilitation within the context of the employee

Answer 24

• Better physical health
  Improvements in the physical health of employees who have been rehabilitated back into the workplace are derived from the physical and mental demands of the job they are performing. This is in contrast to some historic preconceptions that the best place for an ill worker to recover is at home.
• Better mental health
  Improvements to the mental health of employees are linked to the fact that many people define themselves by the work that they do and society at large defines individuals in the same way. Work is therefore often a vital component of an individual’s self-esteem. There is also a strong social component at work for many people. There are mental health benefits that come from that the interactions social contact that work provides.
• Increased financial security
  Benefits are both direct and indirect, such as wage or salary, pension contributions and the opportunity for advancement and pay increases that result from work.

Question 25

The benefits of vocational rehabilitation within the context of the employer

Answer 25

• Simple measures to prevent and manage ill-health can lead to a decrease in worker absence, which in turn can improve productivity and competitive edge
• Healthy working environments can contribute to reduced worker absence through sickness and stress.
• Workers who feel cared for are often more satisfied and perform better, which can have the effect of reducing staff turnover and increasing productivity.
• Getting workers back into work after illness reduces the loss of experienced staff and the cost of recruiting new staff.
• Being known as an employer that cares about workers can enhance a business’s reputation and help attract staff and customers

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Question 26

Overcoming barriers to ensure that rehabilitation of the individual is effective

Answer 26

Biological barriers

• the physical disease
• ill-health condition
• disability or mental health condition

Psychological barriers

• anxious about their future prospects if their rehabilitation back into work not go as smoothly as was hoped
• fearful that returning to work may worsen their ill-health condition.
• worry that their co-workers will think less of them if they are unable to work to the full extent of their normal duties due to restriction on working hours or types of work.

Social barriers

• access to and from the workplace
• appropriate sanitary conveniences and workstation design and layout
• workplace arrangements

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Question 27

Need to undertake or review risk assessments prior to return to work

Answer 27

■ One of the key steps in planning adjustments prior to return to work is reviewing health and safety risk assessments in the light of the proposed
modifications,
■ if there has been a significant change in your employee through illness, injury or
disability that makes them vulnerable to additional risk; or
■ if you are introducing adjustments as outlined in paragraphs 54-61 that could
affect the work and health of others.
■You do not need to amend your risk assessment if existing control measures
still offer your employee adequate protection or if additional measures would not offer increased protection.

Question 28

Liaison with other disciplines in assessing and managing fitness for work with specific reference to; existing health problems, fitness to work standards, discrimination.

Answer 28

Requires communication or link between:

• the worker
• the doctor
• the employer

Question 29

The prevalence of work-related sickness and ill-health with reference to reportable and self-reported sources of information

Answer 29

• Death certificates are available as a source of information on deaths from asbestos-related and other lung diseases
• The WHO publishes an array of statistics on illness and disease, which can be viewed by country.
• Information may be available from various national organisations and sources. In the UK, for example:
• HSE
• LFS administered by ONS
• THOR
• IIS administered by DWP

Question 30

HSE

Answer 30

The HSE compiles detailed statistics relating to the reporting of specific occupational diseases by the employer. Similar data is available from other national regulators.

Question 31

LFS

Answer 31

The Labour Force Survey (LFS) is a national survey of private households in the UK each quarter. The survey is managed by the Office for National Statistics.

Question 32

THOR

Answer 32

The Health and Occupation Reporting network (THOR) is a voluntary surveillance scheme for work-related ill health under which specialist doctors systematically report all new cases that they see in their clinics.

Question 33

IIS

Answer 33

The Industrial Injuries Scheme is administered by the Department for Work and Pensions (DWP) to compensate workers who have been disabled by a prescribed occupational disease.

Question 34

The role, function and benefits of occupational health services
PT1

Answer 34

• Compliance with national health and safety and equal opportunities legislation
• Reduction in the absence rates and number of days lost through ill-health and the resulting costs associated with absence.
• Improved management of rehabilitation and return to work processes
• Early recognition of work-related health hazards, allowing for improved identification, assessment and control

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Question 35

The role, function and benefits of occupational health services
PT2

Answer 35

• Improved management of work-related ill-health, allowing for earlier and better treatment and consequently better recovery and minimisation of ill-health.
• Reduction in ill-health compensation claims
• Better screening prior to employment to allow matching of personal characteristics and job requirements
• improved worker morale

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Question 36

The make up and roles of a typical occupational health services and the importance of determining competency:

Answer 36

Occupational health physician, occupational health nurse, occupational health adviser, occupational health technician.

Question 37

Occupational health physician

Answer 37

• concerned with the diagnosis and assessment of health hazards and stress at work
• specialist branch of the medical profession
• certain types of work can only be performed by an occupational health physician

Question 38

Occupational health nurse

Answer 38

• specialist branch of the nursing profession
• rarely involved in direct treatment of injury or ill-health
• concerned with proactive prevention of disease and ill-health and management of treatment and care programmes

Question 39

Occupational health adviser

Answer 39

advises

Question 40

Occupational health technician

Answer 40

• conducts aspects of health surveillance under supervision

- collect data on hazards to prevent harm to workers

Question 41

Typical services offered by an occupational health service

Answer 41

• health promotion
• health assessment
• advice to management
• treatment services
• medical and health surveillance

Question 42

health promotion

Answer 42

Running campaigns and providing support on various health issues and offer advice on work-related health, lifestyle (diet, exercise, smoking etc.)

Question 43

health assessment

Answer 43

Pre-employment screening - general health assessment of both general fitness and specific job fitness
Return-to-work rehabilitation programmes - management of the rehabilitation of specific workers back into work.

e.g. fitness for work, pre-placement employment, return to work, job related medical screening, pregnant workers.

Question 44

advice to management

Answer 44

Providing advice on specific health issues and queries.
Risk assessments - involvement in some general workplace assessments and conducting specific assessments, such as those for pregnant women.
Sickness absence management - recording and analysis of absence data and involvement in sickness absence procedures.

eg input to risk assessments, no-smoking policy, absence management etc

Question 45

treatment services

Answer 45

Management of main treatment facility and assessment and management of first aid provision.
Counselling - formal or informal listening service with in-house or external referral as required

e.g. first aid, counselling, physiotherapy, other rehabilitation services

Question 46

medical and health surveillance

Answer 46

Routine checks or tests focusing on specific aspects of health as a result of exposure to a specific hazard

Question 47

The benefits of health needs assessment in relation to the planning of occupational health services

Answer 47

• Describing the patterns of disease in the local population and the differences from district, regional, or national disease patterns;
• Learning more about the needs and priorities of their patients and the local population;
• Highlighting the areas of unmet need and providing a clear set of objectives to work towards to meet these needs;
• Deciding rationally how to use resources to improve their local population’s health in the most effective and efficient way;
• Influencing policy, interagency collaboration, or research and development priorities.
• Importantly, health needs assessment also provides a method of monitoring and promoting equity in the provision and use of health services and addressing inequalities in health

Question 48

SEQOHS

Answer 48

​SEQOHS stands for Safe, Effective, Quality Occupational Health Service and is a set of standards and a voluntary accreditation scheme for occupational health services in the UK and beyond

Question 49

The importance of auditing against standards in occupational health provision with specific reference to SEQOHS

Answer 49

SEQOHS 
Occupational Health
Service Standards
for Accreditation
Standard C2
An OH service must ensure appropriate clinical governance
C2.5 An OH service must undertake systematic audit of clinical practice and provide evidence of action
taken

By auditing against SEQOHS occupational health professionals will also be in compliance with existing law and regulations, standards set by their respective professional bodies in relation to their practice, as well as some other recognised accreditations,
for example ISO 9001 or 27001 or gained the Investors in People (IIP) Award.

Question 50

What is the minimum requirement for health surveillance and the keeping of a health record

Answer 50

The minimum requirement for health surveillance is that a health record is created for each employee exposed or potentially exposed to the hazard in question. That health record is simply a record of the fact that exposure has or is liable to have occurred.

The minimum details required to be kept in a health record are:
surname
forenames
sex
date of birth
permanent address
national identification number, eg social security number
date started present job
a historical record of job involving exposure to hazards for which health surveillance is required during the current spell of employment.

Question 51

What is a health record

Answer 51

A health record is a record of the conclusions of a clinician (such as an OH doctor) on health surveillance results. It does not contain clinical information and so is not medically confidential. It can therefore be viewed by the employer.

Question 52

What is a medical record

Answer 52

A medical record is created by a clinician, contains clinical information and is medically confidential. It cannot therefore be viewed by the employer without the authorisation of the individual concerned.

Question 53

Provision of vocational rehabilitation can require input from professionals from many different disciplines, including medical professionals, disability advisers and careers counsellors. According to the Vocational Rehabilitation Association (VRA), the techniques used can include

Answer 53

• assessment and appraisal;
• goal setting and intervention planning;
• provision of health advice and promotion, in support of returning to work;
• support for self management of health conditions;
• career (vocational) counselling;
• individual and group counselling focused on facilitating adjustments to the medical and
psychosocial impact of disability;
• case management, referral, and service coordination;
• programme evaluation and research;
• interventions to remove environmental, employment, and attitudinal obstacles;
• consultation services among multiple parties and regulatory systems;
• job analysis, job development, and placement services, including assistance with employment and
job accommodations; and
• the provision of consultation about and access to rehabilitation technology.

Question 54

IOSH’s good practice guide to rehabilitating people at work makes the following recommendations

Answer 54

Policy on rehabilitation
Line manager’s responsibility
Early intervention is important
Regular contact with employees
Rehabilitation should be considered as soon as it is clear that absence could be lengthy
Coordinated case management approach is best
Arrange for the employee to see an occupational health adviser
Ask about what the employee can and can’t do
Assess whether medical intervention, such as physiotherapy or counselling, will speed up the rehabilitation process
Plan a programme of rehabilitation
Make reasonable adjustments
Consider any health and safety issues
Agree the arrangements for rehabilitation, and record them
Progress should be monitored regularly
Agree any significant changes to the employee’s role with the occupational adviser or employee’s GP or specialist