Occupational Health

Question 1

Define occupational medicine

Answer 1

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

Question 2

Occupational health

Answer 2

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

Question 3

OH core services

Answer 3

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

Question 4

OH team

Answer 4

Occupational physician 
GP
OH nurse 
O Hygienist 
O psychologist 
Physio
Ergonomists 
Engineers 
Safety practitioners
Employee 
Employer 
Safety rep 
Lawyers

Question 5

Role of OH

Answer 5

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

Question 6

Advantages of working

Answer 6

Income
Status - self esteem 
Purpose/ identity 
Social connectedness 
Security 
Work is good for health

Question 7

Unemployment harm to health

Answer 7

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

Question 8

Nature of working is changing

Answer 8

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

Question 9

Define hazard

Answer 9

Substance agent or physical situation with potential for harm in terms of injury or ill health

Question 10

Define risk

Answer 10

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

Question 11

Role of governments

Answer 11

Safety legislation
Enforced by HSE
H and S at work at 1974 breach can lead to criminal prosecution

Question 12

OH services

Answer 12

No legal obligation for all employers to provide OHS but they must meet legislation
Professional bodies
- faculty of O medicine
- society of O medicine

Question 13

Fit for work assessment.

Answer 13

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

Question 14

Benefits of OH

Answer 14

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

Question 15

Occupational disease

Answer 15

Disease caused by work or the environment

Question 16

Work related disease

Answer 16

Disease initiated, hampered or easy to get by working

Question 17

Why is there interest in identifying occupational disease

Answer 17

Because work related ill health costs money

Work place health and welfare systems exists to improve health, wellbeing and productivity of the work force

Question 18

What can cause occupational disease

Answer 18

Physical
Chemical
Biological
Psychosocial factors in the workplace

Question 19

Impact of illness at work

Answer 19

Increased risk to the individual
Increased risk to colleagues
Increased risk to the public
Damage to reputation

Question 20

Most common work related illness

Answer 20

Musculoskeletal
Mental health
Respiratory condition.
Skin

Question 21

Illness at work

Answer 21

Coincidental
Index cases
Exacerbated by work
Caused by work

Question 22

Recognising work related ill health

Answer 22

History
Examination
Investigations

Question 23

Occupational history

Answer 23

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

Question 24

Reporting systems for ill health

Answer 24

Voluntary
Statutory
Periodic

RIDDOR - reporting injuries, disease or dangerous occurs dead regulations

Question 25

When is a fitness to work assessment required

Answer 25

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

Question 26

Return to work

Answer 26

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

Question 27

Who can refer for fitness to work?

Answer 27

Self referral
Management referral
HR

Question 28

Management referral - questions from employer

Answer 28

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

Question 29

Summary of fitness factors:

Answer 29

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

Question 30

Fitness to drive role of doctors

Answer 30

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

Question 31

Summary of fitness factors - DETTOL

Answer 31

Demands of the job 
Environment 
Temporal 
Travel 
Organisational 
Layout

Question 32

The medial condition

Answer 32

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

Question 33

Fitness for work report

Answer 33

Fit
Unfit
Fit with restrictions/ adjustments
Cannot make assessment without further info

Question 34

Advice to employer by OHP

Answer 34

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

Question 35

Fitness for work prognosis

Answer 35

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

Question 36

Work place modification

Answer 36

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

Question 37

Medical certification

Answer 37

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

Question 38

RTW considerations

Answer 38

Key clinical outcomes

Success measurement

Question 39

Pre work assessment

Answer 39

Fitness for work
Job requirements
Health status and influencing factors
Restrictions

Question 40

Work place exposure

Answer 40

Hazard types, exposure assessment, risk management
Risk communication
Prevention and control

Question 41

Health outcome

Answer 41

Ill health 
Work related 
Early retirement 
Compensation 
Reporting 
Latency

Question 42

Work place risk assessment HSE

Answer 42

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