Occupational Health Flashcards
Define occupational medicine
Clinical component of occupational health
It is concerned with the effects of work in health and the influence of pre existing health problems on the capacity to work
Occupational health
Promotion and maintenance of the highest degree of physical, mental social wellbeing of all workers in all occupations by preventing departures from health, controlling risks and the adaptation of work to people and people to their jobs
OH core services
Prevention - ill health caused/ exacerbated by work
Timely intervention
Rehabilitation - help to stay in work and return to work
Health assessment for work
Promotion of health and wellbeing
Teaching and training - staff to support health and wellbeing
Fitness for work, work place safety and the prevention of occupational injuries and disease
Appropriate adjustments at work and to help people continue working
Policies to maintain a safe and healthy work place
Research into work related health issues
Advise on mental health and ill health retirement
OH team
Occupational physician GP OH nurse O Hygienist O psychologist Physio Ergonomists Engineers Safety practitioners Employee Employer Safety rep Lawyers
Role of OH
Help people get back into work if they have been unemployed or maintain their current job
Such as changing a full time role to a part time role
Physical works to sedentary
Advantages of working
Income Status - self esteem Purpose/ identity Social connectedness Security Work is good for health
Unemployment harm to health
Families without a working member more likely to suffer low income and poverty
Inc risk of psychiatric disorders in children 5-15 in those whose parents have never worked
Nature of working is changing
Becoming more sedentary not as physical Not long term jobs shorter contracted Flexible that long working hours Not manufacturers any more to a service industry Working to a master age
Define hazard
Substance agent or physical situation with potential for harm in terms of injury or ill health
Define risk
Is the likelihood of harm or an undesired event occurring - probability that the substance or agent will cause adverse effect under the conditions of use and or exposure and the possible extent of harm
Role of governments
Safety legislation
Enforced by HSE
H and S at work at 1974 breach can lead to criminal prosecution
OH services
No legal obligation for all employers to provide OHS but they must meet legislation
Professional bodies
- faculty of O medicine
- society of O medicine
Fit for work assessment.
Free in England and Wales part of NHS
Accept referrals after 4 weeks sickness absence
Referral from GP or employer
Aim to facilitate earlier return to work
Provides an OH assessment and general health and work advice to employers, employees and GP
Benefits of OH
Improve work place safety - identifying hazards and controlling risks Keep workforce fit for task Reduce sickness absence Rehabilitation and assisting RTW Improve workability - identifying work place adjustments to accommodate individuals Maximise productivity and profit Retain skilled workers in employment Comply with the law
Occupational disease
Disease caused by work or the environment
Work related disease
Disease initiated, hampered or easy to get by working
Why is there interest in identifying occupational disease
Because work related ill health costs money
Work place health and welfare systems exists to improve health, wellbeing and productivity of the work force
What can cause occupational disease
Physical
Chemical
Biological
Psychosocial factors in the workplace
Impact of illness at work
Increased risk to the individual
Increased risk to colleagues
Increased risk to the public
Damage to reputation
Most common work related illness
Musculoskeletal
Mental health
Respiratory condition.
Skin
Illness at work
Coincidental
Index cases
Exacerbated by work
Caused by work
Recognising work related ill health
History
Examination
Investigations
Occupational history
What you do for a living What do you actually do at work Tools do you use to work Have more than one job Any different kinds of work in the past Symptoms do you get at work Are they absent at home Don't ask for job name need to ask exact take cos can be different
Reporting systems for ill health
Voluntary
Statutory
Periodic
RIDDOR - reporting injuries, disease or dangerous occurs dead regulations
When is a fitness to work assessment required
Pre employment - occupational health advisor
After sickness - OH advisor or GP
Interval assessment dependent on job requirements.
After an incident at work
Possible retirement on grounds of ill health
Job change
GP rarely involved up to employer to hire an OH advisors
Return to work
Gp assessment.
Does the patient want to return to work Does the patient need to be 100% before returning to work ? Aim of assessment Effects of health on work Effects of work on health Workplace adjustments/adaptations required for employee to work safely Communicate outcome and recommendations Equality act
Who can refer for fitness to work?
Self referral
Management referral
HR
Management referral - questions from employer
Likely date of RTW
Residual disability on RTW
Will it be permanent or temporary
Will employee be able to work regularly and efficiently
What duties can to patient do and for how long before normal work
Will they require continued treatment or medication upon RTW
Summary of fitness factors:
S stamina - can you work full time and meet the demands of the job
M mobility - walking bending stooping is that possible
A agility - dexterity posture coordination
R rational - mental state mood
T treatment - side effects duration
I intellectual - cognitive abilities
E essentials for job - food handlers, driving
S sensory aspects - safety self and others
Fitness to drive role of doctors
Advise individual on the impact iPod their medical condition for safe driving
Advise on legal requirements to notify the DVLA
Notify the DVLA when fitness to drive requires notification when indivisible cannot or will not notify them themselves - driver is legally responsible for notifying them
Summary of fitness factors - DETTOL
Demands of the job Environment Temporal Travel Organisational Layout
The medial condition
Nature - temporary/ permanent. Progressive relapsing, treatment available?
Appropriate clinical guidelines for management of the condition
Work factors which may aggravate it
Complications
Patients needs and expectations at work
Fitness for work report
Fit
Unfit
Fit with restrictions/ adjustments
Cannot make assessment without further info
Advice to employer by OHP
Written recommendations to manger/ HR Discuss content with employee Offer to show employee content before sent to employer Copy to employer Copy to GP Arrange a follow up assessment
Fitness for work prognosis
Can be difficult to ascertain - depends on patients condition, willingness to rehabilitate, employer to provide options
If you don’t know it’s better to say so
Work place modification
Encourage patients to keep in touch with work Reduce hours Change pattern of work - shifts Change tasks or work content Adapt work place - alter layouts Reduce pace of work
Adapt equipment
Provide training
Provide mobility and transport
Redeployment - temporary or permanent
Medical certification
4 days absence - SC2 form
7 days absence - employer may ask fit medical certificate
Fit note - emphasis on positives of work
Advise employee on tasks they can and can’t do
RTW considerations
Key clinical outcomes
Success measurement
Pre work assessment
Fitness for work
Job requirements
Health status and influencing factors
Restrictions
Work place exposure
Hazard types, exposure assessment, risk management
Risk communication
Prevention and control
Health outcome
Ill health Work related Early retirement Compensation Reporting Latency
Work place risk assessment HSE
Step 1 identify the hazards
Step 2 decide who might be harmed and how
Step 3 evaluate the risks and decide on the precautions
Step 4 record your findings and implement them
Step 5 review your assessment and update if necessary
