Employers and workers share work health duties

Medical surveillance programmes is an important part of protecting workers’ health and safety. Emloyers and workers share some occupational health duties.

Employers have to implement a medical surveillance programme if there is the risk that workers may be exposed to hazardous substances that could harm their health and cause disease, in terms of labour legislation, and in terms of chemicals industry best practice.

Surveillance allows employers to gather information about the health of workers, and to implement control mechanisms to make workplaces more safe and healthy.

“Medical surveillance protects workers and saves the company money, by ensuring that the workforce is healthy and fit to work,” says Dr Laurraine Lotter, executive director of the Chemical and Allied Industries Association (CAIA), which runs the Responsible Care programme in South Africa.

Employers have to identify workers at risk of exposure to health hazards, and implement a medical surveillance programme if certain risk levels or legal requirements apply.

Regular health assessments are based on job and exposure specifications. Workers play an important role in medical surveillance programmes. “We encourage workers to take ownership of their surveillance programme, by reporting for annual medical examinations,” said Dr Lotter.

Exposure to hazardous chemicals may be difficult to detect, while levels and effects are difficult to quantify. Diagnosis and treatment may be delayed.

Effects may include lung disease, skin rash, irritation. Medical surveillance aims to detect early signs of disease before symptoms are shown. Appropriate health assessments should be conducted by professional medical personnel that are familiar with conditions at work.

They will conduct periodic employee health assessments, using examinations, questionnaires, lung tests or hearing tests, to determine medical fitness o workers exposed to specific health hazards. Medical data and information are confidential.

“Medical surveillance is an opportunity for workers to learn about their own risks, health and wellbeing”, said Dr Lotter. “Workers should accurately report risk related hazards, incidents and symptoms, on questionnaires and at their own initiative.”

OH awareness toolbox talk

Employers should ensure that workers are aware of, and able to assess, prevent or manage safety, health and environment risks relevant to their own jobs and workplace.

Workers should be informed in induction training, formal training, job training, and toolbox talks about risk management, by using well researched and simply presented training material, toolbox talks, and reminders to sustain risk awareness.

Workers should also have recourse to detailed training material and designated occupational safety, health and environment officials.

Develop your own toolbox talk leaflets and posters on occupational health, occupational diseases, and an occupational hygiene themes.

Basic aspects of occupational health legislation, prevention, management and terminology, are spelled out in the toolbox talk.

The World Health Organisation defines occupational health as promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations.

Mental well-being refers to state of mind of employees. Would a worker be able to concentrate on a task if his or her child were seriously ill, or while getting a divorce?

Social well-being refers to habits and way of life of employees, like alcohol dependency, drug abuse or unbalanced lifestyle.

Several professions and jobs are known for posing a number of health, wellness and social risks, like doctors, nurses, emergency response, construction, mining.

Occupational health professions

Occupational health is the umbrella term for Occupational Medicine, Occupational Hygiene, and Primary Health Care. Occupational Medicine is a branch of preventive medicine with some therapeutic functions. The main responsibilities of occupational medical practitioners are:
• Knowledge of working environment
• Pre-placement, periodic and special medical examinations
• Administrative responsibility for nurses/sisters and first-aiders
• Treatment
• Health education
• Rehabilitation back in workplace
• Teaching and research
• Advice to individuals, management, organized labour and safety representatives on health impacts of jobs and job conditions
• Efficient record keeping, group surveillance of workers at special risk, like canteen staff, drivers and so on
• Liaise with outside organisations like state authorities and researchers.

Occupational Hygiene is an applied science for identification, measurement, appraisal of risk and control to acceptable standards of physical, chemical and biological factors arising from work, that may affect health or well-being of those at work or in the community.

Occupational hygiene functions

Occupational hygiene functions include recognition and assessment of possible factors affecting health and comfort relevant to;
• Materials and processes used
• Products, by-products and waste involved
• Possible points of release or emission of hazardous agents
• Posture and movements of operations
• Nature of protective equipment provided.

Evaluation of the degree of hazards is gauged by:
• Measuring intensity or concentration of hazardous agents
• Comparing results
• Forming a judgment as to the degree of the hazard
• Identifying human physiological effects on workers from tests provided by medical sources like blood, urine, lung function tests.

Design of control measures to improve working performance and conditions may involve:
• Redesign of work process and procedures
• Substitution of safer materials
• Shielding or screening of workers from hazards
• Designing ventilation systems to extract or dilute airborne toxins
• Providing protective clothing as a last resort.

Additional functions may include awareness, education, training, assisting in design of new plant or modifications, record keeping, or research.

Primary Health Care

The World Health Organisation defines primary health care as;
1. Carrying out a therapeutic programme designed by physicians for the ill
2. Maintenance of the physical and psychological environment to facilitate recovery and health
3. Engaging in the patient and his family with regards to recovery and rehabilitation
4. Instructing people, sick and well, in measuring promotional health
5. Carrying out measures for the prevention of diseases
6. Co-ordinating nursing efforts with other members of a health team.

Primary health care may include;
• Health education
• Counseling
• Rehabilitation
• Environmental surveys and controls
• Incident prevention
• Treatment of illness and injury that are job related
• Liaison with other professionals and organisations
• Administration and record keeping.

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