Occupational Medicine Health Screening
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Transcript Occupational Medicine Health Screening
Occupational Medicine
Health Screening
How they can help your business
Dr Mark Feldman
Who am I ?
Senior partner general practice
Trainer in general practice
Petersfield Screening
Health Screening
Occupational Health
Private General Practice
Who am I ?
Stress lecturing
Hypnotherapy
– President of BAMH
– Practice
– Teaching
Customers
Pharmaceuticals
– Aventis Pharma
– Martindale
– Sanofi Winthrop
Biotechnology
– Argenta discovery
– Synexis
Customers
Chemistry
– Rhodia
– Champion Photochemistry
Electrical Generation
– Thames power
Finance
– Mcartney and Dowie
Customers
Education
– Peniel academy
Automotoive
– Axial
Agriculture
– Embrex
Construction
– Noble and Taylor
Occupational Medicine
What is it?
Interface between work and health
– Work affecting employees health
– Health affecting employee’s ability to work
Occupational Medicine
What do we do?
Pre employment questionnaires
– To assess suitability for job
Pre employment examination
– Key workers
– Basis for ongoing screening if required
Medical assessments
– If at risk ie exposure noise, toxins, mechanical
stress
Occupational Medicine
What do we do?
HASAW 1974
– Implies duty to ensure that recruited staff can
perform their work
Occupational Medicine
What do we do?
Review of specific medical problems
– How they affect work
– Second opinion
Referal
– NHS
– Private
Expediting treatment
– Advice to management
Capability
Capacity
– Physical
– Psychological
Occupational Medicine
What is it?
Management of sickness absence
– 40% of employers believe some of their workers
absence is malingering
– 27% of small businesses have a problem
Occupational Medicine
What is it?
Management of sickness absence
10% of workers take > 7 days per yr
9.5% of these take more than 1 episode of 7 days
Bosses average 3.3 dys per year
Workers average 10 days per year
– Most small companies loose on average 31
days due to dubious sickness absence
Occupational Medicine
What is it?
Management of sickness absence
– Bradford factor
100 Warn
140 SSP
– Clear policies
– Early intervention
– Liaison with the NHS
– Making it happen
– Rehabilitation
Occupational Medicine
What is it?
Management of sickness absence
– Different from GP
Quicker back to work
– Knowledge of job
– Knowledge of company requirements
– Knowledge of other work that could be done
Sickness absence
Fair dismissal
– conduct
– capability or qualifications
– Redundancy
– Statutory restriction
– Some other substantial reason justifying dismissal [
withholding of medical data on PEQ, absenteeism]
Sickness absence
Fair dismissal
– Capability
– Evidence of ill health – from Occ physician
Date of return to work
Any residual problems
Permanent or temporary
Will employee render regular efficient service
Sickness absence
Fair dismissal
– Can disagree with GP if
Patient has been examined
Clear report
Risk to others if stay in employment
Specialist report sought if seen consultant
Sickness absence
Fair dismissal if in
– Absenteeism [ frequent short absences ]
Absence records accurate, assessed, investigated
Warnings given sympathetically, problems looked for
OP opinion taken
Employee hearing given
Disability Discrimination Act
May not discriminate on grounds of disability
– Long term > 12 months physical or mental problem , substantial
affect on ability to carry out normal day to day activities
– Make reasonable adjustments to workplace
– BUT can refuse to employ if discrimination is ‘ material to the
circumstances of the case and substantial ie typist with
Rheumatoid.
Disability Discrimination Act
Not allowed to discriminate on recruitment
Includes
– AIDS, MS
– insulin dependant diabetes
Excludes
– Drugs, alcohol, hay fever, voyeurism
– Tendency to steal and set fires
Disability Discrimination Act
Requires reasonable adjustments
– Size of firm
– Amount of resource
– Practicality
All employers covered [ except forces ]
All employees – inc temporary, part time
Disability Discrimination Act
Importance of good written policies
– Eg when will dismiss for absence
– Can dismiss if take time off work due to
disability IF would have dismissed anybody who
took a similar time off work [ Disability related
discrimination ]
Occupational Medicine
What is it?
Legislation
– RIDDOR [ Reportable diseases]
– COSH
– European Directives
– Disability Discrimination Act
Liaison with / provision of occupational
hygiene function
Occupational Medicine
What is it?
RIDDOR
http://www.riddor.gov.uk/info.html
deaths
· major injuries
· accidents resulting in over 3 day injury
· diseases
· dangerous occurrences
. gas incidents
Occupational Medicine
What is it?
COSHH
Occupational Medicine
What is it?
COSHH
http://www.coshhessentials.org.uk/asset
s/live/indg136.pdf
Occupational Medicine
What is it?
COSHH
Cases from practice
50 year old phamaceutical inspector with
wrist pain
28 yr old secretary with CFS
38 yr old woman with Bradford factor of 1000
Occupational Medicine
Who do you need?
Competent person
– As defined by Employment Medical Advisory
Service of HSE
– Diploma in Occupational Medicine
Disease Prevention
Health Screening
– Full History and examination
– Blood pressure
– Exercise stress ECG +cardiac risk assessment
– Liver function tests
– Renal function tests
– Thyroid
– Diabetes
Health Screening
Visual acuity
Glaucoma check – commonest cause of blindness
Grip strength
Hearing
Prostate Specific Antigen for carcinoma prostate
Health Screening
Lung function tests
Cervical Smear
Mammography
Aortic aneurysm > 55 yrs
Health Screening
Faecal Occult blood if family history bowel
cancer
Skin cancers
Cases from practice
45 yr old man with mole 3x3 cm on R calf
47 yr old man with glucose of 18mM
48 yr old man with alcohol problem
40 yr old woman with abnormal
mammogram
Why Petersfield Screening
Better reporting
All of the tests
– Thyroid
– Exercise stress testing
– Abdominal ultrasound
– OKP
Follow through
Ongoing support
The END
Dr Mark Feldman
Petersfield Screening