Occupational Health Flashcards
What is occupational health?
“Occupational health deals with all aspects of health and safety in the workplace and has a strong focus on primary prevention of hazards. The health of the workers has several determinants, including risk factors at the workplace leading to cancers, accidents, musculoskeletal diseases, respiratory diseases, hearing loss, circulatory diseases, stress related disorders and communicable diseases and others.”
Wha t is OSHA
Occupational Safety and Health Administration (OSHA)
main government agency that says what is considered an appropriate working condition
What requires employers to legally be required to protect workers from hazards
OSHA
must be reasonable
How does OSHA enforce its standards?
Visits - announced to unannounced
What can trigger an OSHA referal?
Complaint
Serious death that happened at work
What is the result of OSHA?
Worker deaths and injuries are down
even though it’s annoying to comply, it’s important!
What is occupational health?
Promote and maintain maximum physical, mental, and social well-being of workers in all occupations
“Adapt the work to the workers and each worker to his or her job”
PPE, special training, modification etc
Role of an occupational health provider
To assess whether the adaptation in work conditions will occur automatically, or if any accommodations are necessary.
Can set out regulations
What is the MC occupational injury in WV
Transportation
Contact with objects/equipment
What is a fitness to work examination?
Objective assessment of the PHYSICAL and MENTAL health of employees in relation to requirements and working conditions of specific jobs
Some jobs have different physical and mental requirements
aka fit to duty
When do you do a fit-to-work exam?
When an employee starts a new position requiring certain mental/physical standards of health to perform duties safely and successfully
As part of a regularly scheduled follow-up (e.g., yearly) to ensure an employee still meets the physical and mental standards of health to safely and successfully perform his or her job
To excuse an employee from his or her job, temporarily or permanently, as a result of a new-onset illness, injury or life event or newly diagnosed chronic disease
When an employee remains away from work and must be assessed for continuing short-term or long-term disability payment or worker’s compensation
When an employee is returning to work after being taken off work for a period of time due to an illness, injury, life event
At the patient’s request
What are some ethical dilemma of fit-to-work exams?
Employers can’t deny an applicant due to physical/emotional conditions
HOWEVER
Job offer can be contingent upon passing an exam that:
Ensures the employee will be able to perform the job
Ensures the employee will not be a hazard to self or others while working in that job
When can an a job application be excused?
The applicant can be refused if:
The health of the employee is not compatible with working conditions,AND
Working conditions/job requirements cannot be reasonably altered
What is health and safety risk used in fit-to-work exams?
Probability of occurrence of adverse event to worker, coworkers or public
Needs to be relatively high to exclude - no overprotection of worker
What is physical capacity used in fit-to-work exams?
Fitness for duty and physical fitness
Avoid considering non-essential job functions to avoid discrimination
Psych - often only done if known history of psychiatric disease, LOA for psychiatric reasons, or jobs with high psychiatric demands
Employment and earning capacity
Employer has the right to expect employees to attend work regularly
Does this justify discrimination against non-disabled candidates with diseases that increase the odds they will use more sick leave?
asthma, obesity, smoking, migraines
economics of fit-to-work exams
Fit-for-work exams predict company’s future financial losses because of potential health-related problems
sick leave, early retirement
permanent disability, worker’s compensation
overall worker productivity and efficacy
What are the steps of fit-to-work exams?
Determing the work conditions
Determining the Health standards
Determing employee health
then make a Final decision if they are fit to work
What are the 6 different results of fit-to work? Are these results permanent?
Fit to work
Temporarily fit
Fit, subject to work modifications (need these modifications)
Temporarily fit, subject to work modifications
Temporarily unfit (reassess later)
Permanently unfit
no permanently fit
If someone is unfit to work, what should you do?
Tell them and possible follow up later
What is not included in a fitness to work unless you sign off?
The actual diagonsis
if workers comp, you often sign off to allow to disclose
What is the MC fitness to work physical?
DOT
department of transportation
What are the 4 Major Categories of Workplace Hazards?
Physical Hazards
Ergonomic Hazards
Chemical Hazards
Biological Hazards
only so much we can do for certain jobs
What’s important to tell patients about their jobs?
The risks
Workplace education/training
Provision, fit-testing and training for PPE
Compliance with routine medical examination (if applicable)
acceptance is the patient’s choice, we just need to let them be aware
Around ____% of patients have exposure to the job
75% of hospitalized and ambulatory primary care patients report hazardous exposures
17% of these patients suspect their illness may be related to their occupation
Occupational disease diagnosed in 10%
Providers should raise their level of suspicion for workplace disease
What might clue you into an occupational disease?
The disease fails to respond to standard treatment
The disease does not fit typical demographics
The disease is of unknown origin
mesoamerican nephropathy
CKD in young, agricultural workers associated with with repeated episodes of heat stress, hypovolemia, and loss of minerals
abnormal fluid balance wears out kidneys
What are some occupational screening do you do?
What type of work do you do?
Do you think your health problems might be related to your work?
Are your symptoms different at work and at home?
Are you currently exposed to chemicals, dusts, metals, radiation, noise or repetitive work?
Have you been exposed to chemicals, dusts, metals, radiation, noise or repetitive work in the past?
Are any of your co-workers experiencing similar symptoms?
What is an occupational disease history ?
Job History
Employer name and service provided
Dates of employment
Job titles and major job duties
Exposures
Metals, chemicals, dusts, noise, radiation
Repetitive motion or major physical strain
Stress
Temporal relationship of symptoms to work
Symptoms among co-workers
Nonoccupational exposures
What is respiratory safety first and second goal?
First goal - Prevent general atmospheric contamination
Secondary goal - Use of PPE and respiratory
What is hearing protection first goal and secondary goal?
First goal - minimize exposure to and prevalence of harmful noise levels
Secondary goal - Use of PPE as appropriate
Ear plugs, noise-blocking headphones
-some placements are noisy, so it is important to do that
What is the MCC of hearing loss?
Loud noisy jobs
What are the noisiest jobs?
Manafacturing (#1)
construction
Anything over ____ dB can cause hearing loss
85 dB
What can occupational noise effect?
Hearing impairment
Hearing loss
Tinnitus
Negative effects on fetus
Increased emotional/mental stress
Impaired work communication
Increased risk for accidents
What is the MCC of occupational eye injuries?
Failure to wear eye protection
What are the MC activities that are associated with eye injury?
Welding (MC)
Drilling and cutting etc are also causes
chemical exposures
What are the occupational eye injuries?
Cataracts
Conjunctivitis
Corneal abrasion
Corneal ulceration
Mechanical injury
Vision impairment
Blindness
What is ergonomics?
“Applied science concerned with designing and arranging things people use so that the people and things interact most efficiently and safely”
repetitive tasks etc
OSHA has decreased this
What are some ergonomic related diseases
Carpal tunnel syndrome
Tendinitis and Tenosynovitis
Rotator cuff injuries
Epicondylitis
Trigger finger
Muscle strains and spasm
Low back injuries
What is biologic monitoring?
Substance in body tissue or excreted substances
Metals
Solvents
Pesticides
Air Pollutants
Others
Biological Effect Monitoring - physiologic effects of a substance on an organ system (e.g. pulmonary function tests, LFTs, thyroid function tests)
Biologic Exposure Indices / Threshold Limit Values - how much of a substance one can be exposed to with reasonable amount of risk/harm
temp, radiation, chemical exposure
use animal data for it
