Transcript No Slide Title

Introducing
occupational health
Grant McMillan
Hon Senior Clinical Lecturer
Institute of Occupational and Environmental Health
University of Birmingham
Number 3 of a series of lectures and tutorials
for medical undergraduates - handout
Learning Points
• Scope of occupational health
• Interactions between work and health
• Extent of work-related ill health and deaths in GB
• Basic tasks of an occupational health service
• Concept of hazard and risk
• Hazards of some specific occupations
• Matching people to jobs & jobs to people
• Assisting return to work of sick and injured
• Keeping patients at work during treatment
• Promoting health at work
Additional handouts on taking and using an occupational
history
What is Occupational Health ?
The promotion and maintenance of the
highest degree of physical, mental and social
well being of workers in all occupations by
preventing departures from health, especially
those due to work, and promoting good
health through activities at the workplace
Why bother?
• Have fitter, healthier workers who are happy - and at work
• Return ill and injured workers sooner
• Increase productivity and profitability
• Retain trained workers longer
• Gain economic advantage
• Comply with legislation
Interactions between work and health
To ignore the two way interactions between work and health is to risk
misdiagnosis, mismanagement and overall failure to do your best for your
patients and society at large.
Interactions between work and health
• Work can improve health
• Work can harm health
• Health can adversely effect work.
Interactions between work and health
• Work can improve health
• Work can harm health
• Health can adversely effect work.
“Is your patient fit for work?”
Extent and effects of work-related ill-health
• 2.3 million people in UK believe their ill-health
has been caused or aggravated by work
• 700,000 new cases a year
• 23,000 seen by specialist doctors
Descending order of new cases of
work-related illnesses seen by
specialist doctors
•
•
•
•
•
Musculoskeletal disorders
Mental ill health
Skin diseases
Respiratory diseases incl asthma
Infections
Extent and effects of work-related ill-health
• 39 million working days lost
• Cost of £10 billion
• Plus deaths
Work-related deaths
• 235 fatal injuries at work in 2003/04
• Estimated 6000 cancer deaths
related to work
• Latency of effects – as in mesothelioma
Latency of work-related diseases
Asbestos exposure causally linked to mesothelioma
Latency of work-related diseases
• Occupational exposure to asbestos started to
cease in late 1960s ub UK
• UK Mesothelioma deaths still rising because of
latency of effect. 1968 = 153
2002 = 1862
• Mesothelioma death rates in males under 45 now
steadily decreasing. Why?
Basic tasks
of an Occupational Health Service
• Hazard identification and risk assessment
• Risk control or management
• Matching people to jobs & jobs to people
• Assist return to work of sick and injured
• Promote wellbeing at work
Risk assessment and management
• Identify hazards
• Assess risks to health in the circumstances
• Consider workers and general population
• Control risks to an acceptable level
Hazard
Any exposure that might cause harm
Risk
The chance of that harm occurring
in given circumstances
Classes of hazards

Chemical

Physical

Mechanical and ergonomic

Biological

Psycho-social/organisational
Where can exposure to a hazard occur?

Confined within workplace

Vented from workplace

Carried from workplace

Domestic

Leisure
Chemical exposures at work

Hairdressers

Farmers

Cleaners

Builders

Healthcare workers
Physical exposures at work

Heat
welders, soldiers, ex-pats

Cold
fishermen, storemen

Noise
airport workers, road repairs

Vibration
construction workers

Radiation radiographers, welders

Lifting
nurses
What hazards a medical
student might meet at work ?


Sources of hazards
patients,
investigations,
therapeutic agents
environment
Most important include infectious agents
anaesthetic agents
antineoplastic drugs
ionising radiation
violence
Matching jobs and people
• People: health, fitness/disability, susceptibilities
: use evidence-based fitness standards
• Jobs: Ergonomics + minimising risks
• Psychosocial: work organisation
: work-life balance
• Common sense
Should you be assisting your patient
to stay at or return to work?
• What work does the patient do?
• Are there patient factors which might
impede remaining or returning?
• Do you have a meaningful measurement
of performance?
• Work factors?
• What useful interventions may be made?
• Can you utilise occupational health staff?
Help workers to be fit
• Promote healthy lifestyle
•smoking cessation
•diet and obesity control
•exercise
•reduce stress-causing pressures
• Improve self-perception of health and fitness
• Encourage leisure exercise
• Encourage exercise at work - stairs vs lifts,
changing rooms and showers, gym
Learning Points Check
• Scope of occupational health
• Interactions between work and health
• Extent of work-related ill health and deaths in GB
• Basic tasks of an occupational health service
• Concept of hazard and risk
• Hazards of some specific occupations
• Matching people to jobs & jobs to people
• Assisting return to work of sick and injured
• Keeping patients at work during treatment
• Promoting health at work
Additional handouts on taking and using an occupational
history