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Occupational
medicine
Occupational medicine is
the branch of clinical medicine most active in the field of occupational
health. Occupational health physicians work closely with the occupational
health team which consists of Occupational Health Nursing Professional,
Industrial Hygienists, Biostatisticians, Public Health Specialists, and
Biomedical Engineers (namely those specializing in Ergonomics). In the
United States it is one of the three medical specialties (also including
aerospace medicine and public health and general preventive medicine)
encompassed by the American Board of Medical Specialties recognized
specialty of preventive medicine. Its principal role is the provision of
health advice to organisations and individuals to ensure that the highest
standards of health and safety at work can be achieved and maintained.
Occupational physicians must have a wide knowledge of clinical medicine
and be competent in a number of important areas.
Occupational health should aim at: the promotion and maintenance of the
highest degree of physical, mental and social well-being of workers in all
occupations; the prevention among workers of departures from health caused
by their working conditions; the protection of workers in their employment
from risks resulting from factors adverse to health; placing and
maintenance of a worker in an occupational environment adapted to his
physiological and psychological equipment and, to summarise, the adaption
of work to man and of each man to his job.
Areas of focus
Occupational hazards to health
Occupationally related disease and ill-health are an important cause of
morbidity and mortality in the world. The occupational health team must be
aware of the work hazards, understand how to assess the risks in a
particular workplace and how these should be controlled, as well as be
able to recognise, treat and control occupational disease should it occur.
Categories of Work Hazards (also called "Work Factors")
Work hazards can be classified as the following: physical work hazards,
chemical work hazards, biological work hazards, ergonomic work hazards,
and psychosocial work hazards.
In many countries the need of Occupational Health involvement in
employment is backed up by legislation.
Examples of Occupational Health Hazards:
Physical work hazards
Car accidents, Motor-vehicular accidents (MVA's)
Ionizing radiation
Sun Exposure (UVA and UVB rays)
Heat Stress and dehydration
Noise
Chemical work hazards
Tobacco Smoke, smog, indoor air pollution
Benzene
Work-related carcinogens
Aerosols, fumes, smoke
Silicosis
Asbestosis
Biological work hazards
HIV/AIDS
Tuberculosis
Hepatitis A
Hepatitis B
Hepatitis C
Ergonomic work hazards
Lifting
Pushing
Pulling
Materials management
Musculoskeletal Disorders
Repetitive Motion
Vibration white finger
Psychosocial work hazards
Work stress/strain
Workload
Autonomy
Decision Lattitude
Work safety climate
Coping (psychology)
Personality (also called personality preference or typology)
Power (sociology) or power politics
Gender
Discrimination
References: Plog, B.A., Niland, J., & Quinlan, P.J. (2002). Fundamentals
of Industrial Hygiene (5th ed.). Itasca, IL: National Safety Council.
Levy, B.S. & Wegman, D.H. (2000). Occupational Health: Recognizing and
Preventing Work-Related Disease and Injury (4th ed). Philadephia:
Lippincott, Williams & Wilkins.
LaDou, J. (2004). Current Occupational & Environmental Medicine (3rd ed.).
New York: Lange/McGraw-Hill.
Rogers, B. (1994). Occupational Health Nursing: Concepts and Practice.
Philadelphia, PA: W. B. Saunders.
Assessment of disability and fitness for work
No matter how good an individual's clinical treatment may be, if employees
end up losing their job it has in part failed them. Assessment of an
individual's fitness to carry out specific jobs, and their rehabilitation
and return to work after illness is an important role of occupational
physicians. These tasks can only be carried out by practitioners who have
a detailed knowledge not only of human health, but also of the specific
work situation.
Communications
The occupational physician is required to communicate with clinical
colleagues responsible for the primary care of the workers, with other
health professionals such as occupational hygienist (also called
industrial hygienists), ergonomists and occupational health Nurses, active
in the multi-disciplinary practice of occupational health, as well as with
management, trade unions and staff representatives in the workplace.
Research
The workforce is the principal customer of occupational health research,
carried out to increase knowledge on particular aspects of health hazards
at work, or to ascertain the safety or otherwise of specific employment in
a specific situation.
Occupational health law and ethics
Occupational physicians must be aware of the extensive health and safety
legislation in some countries as it affects their practice, as well as
ensuring that they maintain accepted ethical standards, particularly in
relation to the medical confidentiality of data regarding individual
workers.
Health promotion
The workplace can provide an ideal opportunity and environment to promote
good health. The occupational physician must be able to organise, provide
and evaluate health promotion programmes which meet the health needs of
the specific workplace where they are being undertaken.
Management
Occupational physicians are doctors - yet their role demands more. As well
as demonstrating competence in related issues, they must also be well
versed in the principles and practice of business and financial
management.
The environment
The environment protection act defines pollution in terms of harm to
health. The occupational physician's role as health adviser to industry
inevitably involves the doctor in the consideration of any environmental
hazards emanating from the workplace. Of course there is great variation
in the emphasis given to these aspects according to the nature of work,
for example in the chemical field consideration of hazards to health may
predominate, whereas say in the transport field fitness to work may be a
more important concern. Modern employment patterns demand consideration of
new employment hazards such as occupational stress, or health concerns
like sedentary work.
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