Friday, March 20, 2009

Occupational Health Schemes for Organization. Essential Elements of Occupational Health Practice.

Many organisations operate occupational health schemes for their employees. Generally, these schemes are managed and implemented by occupational health nurses with, perhaps, an occupational physician available to provide a medical input when required, and embrace some or all of the main areas of occupational health practice. In certain cases, a scheme may be directed at complying with specific health surveillance requirements laid down in regulations, such as the
MHSWR and the COSHH Regulations.

Occupational health practice incorporates the following aspects:
1. Placing people in suitable work
This entails the assessment of current and mental and physical capability and identification of pre-existing ill-health conditions. It generally takes the form of pre-employment medical examinations and/or pre-employment health screening.

2. Health surveillance
The provision of health surveillance for certain employees may be one of the outcomes of a risk assessment under the MHSWR, COSHH Regulations or Noise at Work Regulations. It entails specific health examinations at a predetermined frequency for:
a. those at risk of developing further ill health or disability, such as employees who may be occasionally exposed to excessive noise levels or hazardous dusts; and
b. those actually or potentially at risk by virtue of the type of work they undertake during their employment, such as radiation workers.

3. Providing a treatment service
This involves the efficient and speedy treatment of injuries, acute poisonings and minor ailments at work. This service is important in terms of keeping people at work, thereby reducing lost time associated with attendance at local doctors’ surgeries and accident and emergency departments.

4. Primary and secondary monitoring
Primary monitoring is principally concerned with the clinical observation of sick persons who may seek treatment or advice on their condition.
Secondary monitoring, on the other hand, is directed at controlling the hazards to health which have already been recognised, for example, regular audiometry for employees exposed to noise.

5. Avoiding potential risks
This is an important aspect of occupational health practice with the principal emphasis on prevention, in preference to treatment, for a known condition.
This may entail, for example, making recommendations with respect to the substitution of certain hazardous substances with less hazardous substances.

6. Supervision of vulnerable groups
Vulnerable workers include young persons, pregnant women, the aged, the disabled and persons who may have had long periods of sickness absence, perhaps as a result of surgery. New and expectant mothers and young persons are two groups singled out in the MHSWR with respect to risk assessment requirements. Regular health examinations to assess continuing fitness for work may be necessary for people in these groups.

7. Monitoring for evidence of non-occupational disease
This is a form of routine monitoring of employees not exposed to health risks with the principal objective of controlling diseases and conditions prevalent in certain communities, such as mining, with a view to their eventual eradication.

8. Counselling
Counselling employees on a range of health-related issues, and on personal, social and emotional problems, is an important feature of an occupational health service.

9. Health education
This is primarily concerned with the education of employees towards a healthier lifestyle. It can also include the training of management and employees in various areas of health and safety at work, in healthy working techniques and in the avoidance of health hazards, such as those arising from manual handling and the use of hazardous substances.

10. First aid and emergency services
Occupational health services commonly supervise first aid arrangements, train first aid staff and prepare specific aspects of contingency arrangements in the event of fire or other disaster situations, such as a major chemical spillage or an explosion.

11. Occupational hygiene
Occupational hygiene is an area of occupational health practice concerned with the identification, measurement, evaluation and control of contaminants, and other physical phenomena, such as noise and radiation, which could have adverse effects on the health of people exposed to such contaminants. Occupational health services frequently employ occupational hygienists to concentrate specifically on this area of risk.

12. Environmental control
This area is mainly concerned with ensuring compliance with environmental protection legislation, such as the Environmental Protection Act, and covers measures for the prevention and control, in particular, of airborne contaminants, such as dusts, gases and fumes, together with noise, which could be a nuisance to the inhabitants of the neighbourhood.

13. Health records
The completion and maintenance of health records required under certain regulations, such as the COSHH Regulations, Noise at Work Regulations and Control of Lead at Work Regulations, is commonly undertaken by occupational health services. These records may further be necessary on an internal basis for ensuring health surveillance procedures are maintained and may feature in epidemiological studies of certain groups of employees.

14. Liaison
It is standard practice for occupational health practitioners to liaise with enforcement agencies, in particular the Employment Medical Advisory Service (EMAS) of the HSE.



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