Occupational Health (4x lectures) Flashcards
What is occupational health?
- the promotion and maintainenst of the highest degree of physical, mental and social wellbeing of workers in all occupations by preventing departures from health, controlling risks and the adaptation of work to people, and people to their jobs
Give 10 roles of OH services
- help prevent work related illness
- advise of fitness for work, workplace safety and the prevention of occupational injuries and disease
- recommend appropriate adjustments
- improve attendance and performance
- provide rehabilitation and provide alternative suitable work
- promote health
- recommend and implement policies to maintain a safe and healthy workplace
- conduct research into work related health issues
- ensure compliance with H&S regulations including minimising and eliminating hazards
- advise of medical health and ill-health retirement
List examples in the following pathway:
Pre-work assessment –> workplace exposure –> health outcome
Prework assessment - fitness for work - adaptations - restrictions - health status - job requirements - functional assessment Workplace Exposure - hazard tpypes - exposure assessment - risk assessment - risk reduction measures - health surveillance - risk communication Health Outcome - ill health - work related ill health - latency - early retirement - compensation - reporting
What are the advantages of work?
- income
- status - self esteem
- purpose/identity
- social connectedness
- security
What are the consequences of unemployment?
- lose all advantages
- physical/mental health conditions
- smoking
- obesity
- higher incidence of psychiatric disorders in children
Define hazard
Define risk
Hazard = substance, agent of physical situation with potential for harm in terms of injury or ill health, damage to property or a combination
Risk = likelihood of the harm or undesired event occurring and the consequence of its occurrence
- the probability that the hazard will cause adverse effect under the conditions of its use
How can occupational hazards be classified?
Give examples of each
Physical = noise, heat, cold, radiation Ergonomic = lifting, carrying, twisting, posture Mechanical = impact injuries Chemical = oils, grease, solvents, paints, diesel fume Psychosocial = working hours, demands, control, bullying, conflicting roles, poor relationships, support, communication, managing change
What is the role of HSE?
- inspection and enforcement
- legislation
- science and research
- statistics
- field operations and investigations
- hazardous installations
- nuclear safety and security
What are the benefits of OH?
- improve workplace safety
- keep the workforce fit for task
- reduce sickness absence
- improve workability
- maximise productivity and profit
- retain skilled workers in employment
- comply with the law
What is the impact of illness at work?
- increased risk to individual
- increased risk to colleagues
- increased risk to public
- damage to reputation
What are the four options for distinguishing between illness at work and work-related illness?
- coincidence
- index case
- exacerbated by work
- caused by work
Describe an occupational history
- What do you do for a living?
- What do you actually do at work?
- What do you use at work? e.g. tools, substances etc.
- How long have you been doing this type of work?
- Do you have more than one job?
- Have you done any different kinds of work in the past?
- What symptoms do you get at work? Are these absent at home?
- Have you been told anything at work that may make you ill?
- Has anyone at work had the same symptoms?
- Do you have hobbies e.g. DIY, gardening, that may bring you into contact with chemicals
- Is there an occupational health doctor or nurse at you r workplace?
Describe the hierarchy of control to manage risk?
- elimination - remove risk
- substitution - use something else
- engineering - remove humans, isolate hazard
- administrative - limit time exposure
- behaviour - follow instructions
- PPE - protect body
What occupational hazards are there for healthcare workers?
- infections
- inoculation injuries
- MSK injuries
- allergy causing substances
- violence
- stress
What are the top 5 categories for work related illness?
- MSK
- mental health
- respiratory
- skin
- hearing loss
What is the aim of fitness for work?
- ensure the individuall is fit to perform the taks for their job effectively and without risk to their own or to others health and safety
In what 5 circumstances is a fitness for work assessment needed?
- patients condition may limit or prevent them for effective performance
- patients condition made worse by the job and work environment
- patients condition make certain job and work environment unsafe to them personally
- the patient condition may make it unsafe for both themselves and others
- patients condition may pose risk to community
What are the 6 oppurtubities to assess fitness for work?
- post offer (pre-placement)
- after sickness absence
- job change - role or work demands
- periodic review
- RTW after injury or illness
- possible retirement of grounds of ill-health
What are the fundamental questions a GP must ask when assessing RTW?
- does the patient want to RTW?
- does a patient need to be symptom free before RTW?
- is (some) work feasible?
What are the aims of the medical assessment?
- effects of health on work
- effects of work on health
- workplace adjustemnt/adapatins
- communicate outcome and recommendations
- equality act 2010, cannot discriminate
What 6 questions from the employer?
- when
- any residual disability
- permanent or temporary
- will employee be able to render regular and efficient service
- what duties would you recommend your patient dose not do and for how long?
- will your patient require continued treatment or medication upon RTW?
What is involved in the medical assessment?
- patient details
- reason for referral
- sickness absence record
- current job
- occupational history
- PC. HPC (mental health screening, functional cacpity, motivation), DHx, SHx, FHx,
- physical examination
What is the role of doctors with regards to fitness to drive?
- advise the individual on impact of their medical condition on safe driving
- advice legal requirements to notify DVLA
- notify DVLA when indival cannot or will not themselves
Give a summary of effects of health on work
SMARTIES
- stamina
- mobility
- agility
- rational
- treatment
- intellectual
- essential for job
- sensory aspects
Give a summary of effects of work on health
DETTOL
- demand of job
- environment
- temporal
- travel
- organisational
- layout
What factors about the medical conditions must be considered?
- the nature of the condtions
- any appropriate clinical guidelines
- work aggregated factors
- stable/progressive/relapsing
- controlled treatment or no available treatment
- complications
- patients expectation and needs
What are the 4 outcomes of the fitness for work report?
- fit
- unfit
- fit with restrictions/adjustments
- cannot make assessment without further information
Give examples of workplace modifications
- encourage patient to keep in touch with work
- reduced hours
- changed patterns/shifts
- change taks or work content
- adapt the workplace
- reduce pact of work - breaks
- adapt equipment
- provide training
- provide for mobility and transport
- redeployment
Medical certifaciton
- after how long an absence must you complete SC2?
- are how long an absence may an employer ask for medical certificate?
4 days
7 days
What are the benefits of returning to work?
- improved general and mental health
- reduce psychosocial distress and minor psyschiatric morbidity
- minimises the harmful physical, mental and social effects of long-term sickness absence
- reduces the risk of longterm incapacity
- improve QoL and wellbeing
What are the 5 steps in the workplace risk assessment?
- identify the hazards
- decide who might be harmed and how
- evaluate the risks and decide on precautions
- record your findings and implement them
- review you assessment and update if necessary
What is involved in hazard analysis?
- type of hazards
- where
- hazard characteristics
- who and how many exposed
- exposure circumstances
- measures used to minimise risks to health
Who might be harmed by workplace hazards?
- operators
- maintaineance
- others in the vicinity
- visitors
What is involved in evaluating the risk of a hazard and precautions?
- Toxicokinetics
- Exposure monitoring
- Setting occupational exposure limits
- Control measures
- Health surveillance
Define health surveillance
- putting in place sustemic, regular and approopatiate procedure to detect healy signs of work-related illness among employees exposed to certain health tools, and acting upon the results
In what 3 circumstances is health surveillance appropriate?
- identifiable disease or effect related to exposure
- reasonalbe likelihood that disease will occur under conditions of exposure
- valid techniques for detecting indications of disease or effects
What 4 findings need to be recorded?
- who is at risk
- risk of what
- likelihood of ill health
- action plan to minimise further risk
