The purposes of occupational medicine are described in terms of its clinical medical, environmental medical, research, and administrative content. Each of these components is essential in different proportions in comprehensive occupational health services for different industries, and can only be satisfactorily provided by occupational physicians and occupational health nurses who are an integral part of their organizations. Two-thirds of the working population in the United Kingdom are without the benefits of occupational medicine. The reorganization of the National Health Service and of local government presents the opportunity to extend occupational health services to many more workers who need them. It is suggested that area health authorities should provide occupational health services for all National Health Service staff and, on an agency basis, for local government and associated services, eventually extending to local industry. Such area health authority based services, merged with the Employment Medical Advisory Service, could conveniently then be part of the National Health Service, as recommended by the British Medical Association, the Society of Occupational Medicine, and the Medical Services Review Committee. (+info)
A training exercise in subjectively estimating inhalation exposures.
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OBJECTIVES: This study examined whether it is possible to train occupational hygienists to estimate inhalation exposures reliably from limited occupational information using a new method and assessed improvements in the quality of the estimate using the aggregate from multiple assessors. METHODS: Five occupational hygienists estimated inhalation exposure for 40 tasks covering a range of chemical hazards using a recently developed subjective modeling technique supplemented by detailed guidance notes. The measured exposure levels were used to determine the validity of the method. The correlation coefficients of the log-transformed data were used to assess the discriminative power of the method, and the ratio of the mean estimate to measured values was used to measure accuracy. RESULTS: There was good-to-excellent agreement between the assessors' estimates and the measured data, the correlation coefficients ranging from 0.73 to 0.85. There was a tendency for assessors to overestimate the exposure levels by, on the average, two- to fourfold. Aggregating the assessors' estimates helped to improve the correlation coefficient to 0.88, the overestimation being 2.6-fold. Using more than three assessors for aggregate estimates did not improve the reliability of the method. CONCLUSIONS: Overall, the assessors found the method to be useful in generating exposure estimates that correlate well with measured levels. The provision of high-quality guidance information is likely to be important in the generation of reliable exposure estimates. The method is likely to be of use in epidemiologic studies in which limited exposure data are available. (+info)
Occupational health nurses' participation in health committee surveyed in Yamaguchi prefecture, Japan.
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This survey was conducted to know the present conditions of occupational health nurses (OHNs) activity related to health committees (HCs) in Japan. Questionnaires that included items related to duties of the OH physician (OHP), those of the OHN, and their mutual duties within the HC, were mailed to 41 companies employing OHNs and questionnaires from 18 companies were analyzed. Comparison of the frequency of OHN attendance at Health Committee Meetings (HCMs) revealed that 33.3% of OHNs attended the HCs when their companies employed full-time OHPs and 83.3% attended when their companies employed part-time OHPs. In a question about the OHN's opportunity to deliver a speech, give a report or make a presentation at their HCMs, 16.7% of OHNs in companies with full-time OHPs and 66.7% of OHNs in companies with part-time OHPs reported they had such opportunity. In companies with part-time OHPs, 50.0% of the OHNs reported that they were asked for their opinions at the HCMs, but OHNs at companies employing full-time OHPs were not asked for their opinions. It was considered that in the future, OHNs, particularly those working with a part-time OHP, will have an important role in the HC and developing OH services for their companies. (+info)
The implementation of occupational health guidelines principles for reducing sickness absence due to musculoskeletal disorders.
(4/31)
BACKGROUND: Occupational health guidelines recommend a biopsychosocial approach to manage sickness absence due to musculoskeletal disorders (MSDs), with a primary focus on early intervention through provision of a supportive network. AIMS: To investigate the implementation of a guidelines-based intervention (early contact of absentees; addressing psychosocial obstacles; offering temporary modified work; communicating among the players), and to determine whether this is effective for reducing return-to-work times and duration of future absence. METHODS: A non-randomized controlled trial was conducted within a UK company. Occupational health nurses at two experimental sites (1,435 workers) were trained to deliver the intervention to workers taking absence due to MSDs (low back and upper limb disorders), while usual care was delivered at three control sites (1,483 workers). Company-recorded absence data were collected over a 12-month follow-up period. RESULTS: The implementation of the experimental intervention was impeded by unforeseen organizational obstacles at one site (policies, procedures and individual approaches) which had a detrimental effect on uptake and delivery. At the site where the intervention was delivered per protocol, absence was significantly less compared with controls; 6.5 and 10.8 days, respectively. However, the duration of future absence was not significantly different (13.0 and 25.1 days, respectively). CONCLUSIONS: An early intervention addressing psychosocial obstacles to recovery can be effective for reducing absence due to MSDs. Successful implementation, where the key players are onside and organizational obstacles are overcome, is difficult to achieve. (+info)
Development and process evaluation of the participatory and action-oriented empowerment model facilitated by occupational health nurses for workplace health promotion in small and medium-sized enterprises.
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The objective of this study is to develop an available empowerment model for workplace health promotion (WHP) in small and medium-sized enterprises (SMEs) and to evaluate its applicability and feasibility. Semi-structured interviews with employers and workers in SMEs were conducted to assess their actual requirements for support. The structure of our new empowerment model was discussed and established through several rounds of focus group meetings with occupational safety and health researchers and practitioners on the basis of results of our interviews. We developed a new participatory and action-oriented empowerment model based on needs for support of employers and workers in SMEs. This new model consists of three originally developed tools: an action checklist, an information guidebook, and a book of good practices. As the facilitators, occupational health nurses (OHNs) from health insurance associations were trained to empower employers and workers using these tools. Approximately 80 SMEs (with less than 300 employees) were invited to participate in the model project. With these tools and continued empowerment by OHNs, employers and workers were able to smoothly work on WHP. This newly developed participatory and action-oriented empowerment model that was facilitated by trained OHNs appears to be both applicable and feasible for WHP in SMEs in Japan. (+info)
Occupational health nurses' activity after general health examination for workers.
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In this study, the present condition of occupational health nurse's role after performing general health examination was surveyed. Questionnaires were mailed to 41 companies, and returned questionnaires from 24 of them were analyzed. Although general health examination results were reported to all workers individually in 100% of companies, physician's opinion regarding the examination results were obtained in 86% of companies with part-time physicians comparing with 100% of those with full-time physicians. Health care support related to the examination results were performed by 90% of occupational health nurses and 70% of physicians in companies which employed full-time physicians, but by 100% of occupational health nurses and 50% of physicians in those which employed part-time physicians. In companies with part-time physicians, 64% of occupational health nurses played roles in submitting reports to Labor Standard Inspection Office, but only 30% of occupational health nurses did it in those with full-time physicians. These results show that occupational health nurses working in companies with part-time occupational health physicians were more active in providing health care for workers after general health examination than occupational health nurses working in those with full-time occupational health physicians. (+info)
Health promoting behaviors and factors related to lifestyle among Turkish workers and occupational health nurses' responsibilities in their health promoting activities.
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The purposes of this study were to describe health-promotion lifestyle profile of 264 Turkish workers, to determine the factors which affect their lifestyle and to describe occupational health nurses' responsibilities in their health promoting activities to compare their profile with those published from other studies using Health-Promoting Lifestyle Profile. This is a descriptive study. Study was conducted in a food industry. 530 workers are working in this workplace. Approximately fifty percent of the workers participated in this study. The convenience sample composed of 264 workers. Data were collected using a questionnaire about socio-demographic features developed by the investigators and Health Promoting Lifestyle Profile developed by Walker et al. Subscales with the highest means in this study were interpersonal support and self-actualization. Compared to workers reported from other studies, Turkish workers got low scores of self-actualization, nutrition, interpersonal support and stress management. There was no statistically significant difference between total scores and gender, marital status and education. However, there was a statistically significant difference between age and exercise and nutrition. Moreover, as income increased, so did health promoting behaviors. There was a statistically significant difference between perceived health status and importance placed on health and overall health promoting life style and each health promoting behavior. It is important that occupational health nurses identify health behaviors, perceived health status and cultural aspects likely to affect health behaviors among workers. Thus, they may develop effective tools to protect and promote workers' health. (+info)
Sensitivity towards patient needs in the occupational health consultation.
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BACKGROUND: Many employers in Finland provide not only preventive health care but also primary care for their employees. This puts occupational health professionals (OHPs) in a dual role, which in turn raises questions about patient privacy. AIM: To investigate occupational health nurses' (n = 140) and physicians' (n = 94) perceptions of privacy in caring relationships. METHODS: A self-administered questionnaire was sent to 183 occupational health (OH) physicians and 183 OH nurses. Descriptive statistics and frequency tables were used to characterize the variables. The differences between nurses and physicians were determined with Pearson's chi-square tests and Fisher's exact tests. RESULTS: Both nurses and physicians felt that physical, social, psychological and informational privacy was important in the OH setting. The duration of work experience did affect perceptions of privacy. One-third of respondents considered it good practice to take a full medical history from prospective employees as part of the pre-employment assessment. Over half of the OHPs found the currently valid requirements concerning patients' information privacy too strict in that they may in certain cases complicate the provision of care and treatment. CONCLUSIONS: Tact and sensitivity are paramount when dealing with patient privacy. The aim of privacy, however, should not be to conceal information, but rather to prevent any harmful disclosure. (+info)