Occupational Health Flashcards
What can ‘worklessness’ lead to?
Poorer physical health - premature death Poorer mental health More medical care Poorer social integration Loss of self-confidence Less monetary resources Effect on next generation
What’s the cost of ill-health on the economy? Who pays?
Sickness absence to the economy is £28bn
Ill-health costs £100bn
State pay sickness benefits, healthcare costs and loss of tax
Employers pay sick pay
Employees lose earnings
What factors encourage/influence the ‘sick role’?
Culture, beliefs and attitudes - misconceptions about health and work (need to be 100% fit to go to work)
Inadequate systems - no pathways of rapid intervention to keep in work/help return
Lack of primary care involvement - rehab to work not a performance measure for healthcare/lack of occupation health advice
What’s the future of ill-health and employment?
By 2020, 1/3 of the workforce will be over 50 years old
Life expectancy increasing, retirement age increasing but disability free years aren’t changing with this
Early retirement: often ill-health causes early retirement
What is occupational health?
A discipline concerned with the effects of work on health, and the effects of health on work
Promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations
Define Hazard, Risk and Risk Assessment
Hazard = something that might cause harm
Risk = likelihood of that harm actually occurring
Risk assessment: identify the hazard, assess the risks, manage/control risks
What are the current risks to ill-health in the UK?
Mental health - depression/anxiety/stress
Musculoskeletal - skin, respiratory, infection
What are some categories of hazards?
Physical Chemical Mechanical Biological Psycho-social (shift patterns, bullying, workload, stress) Organisational
What are red flags of back pain?
Sphincter disturbance Gait disturbance Saddle anaesthesia Age <20, >50 Thoracic pain Non-mechanical pain
What are some work-related neck and upper limb disorders?
Shoulder pain Epicondylitis Tenosynovitis Non-specific diffuse forearm pain Carpal tunnel syndrome
What are the key elements of a history concerning work-related neck/upper-limb disorders?
Establish anatomical diagnosis
Consider work-related risk factors by asking the patient what they do at work in functional terms
Exclude recreational risk factors
What is an occupational history?
Most effective instrument for the proper diagnosis of occupational disease
What focussed questions are important to ask in an occupational history?
What is your job?
What do you do in your job? What tasks/what do you work with? Eg chemicals
How long have you been doing this job?
Do you have any other jobs?
Have you done any different kinds of work in the past? What were you exposed to?
Do the symptoms improve when away from work? (Eg occupational asthma)
Whose responsibility is it to assess fitness for work?
Normally the employers - with advice from occupational health advisor
What’s the deal with sickness absence certification?
Can self-certify for up to 7 days
Beyond 7 days require medical certificate: the ‘fit note’ which provides certification for statutory sick pay
Includes: advise about period of sickness absence, advises employer about suitable adjustments, facilitates return to work through communication
Fit note may also include: amended duties, altered hours
