Occupational medicine It is the medical specialty that is dedicated to the study of diseases and accidents that occur due to or as a result of work activity , as well as the prevention measures that must be adopted to avoid them or lessen their consequences. Bernardino Rammazzini is considered the father of Occupational Medicine.
Summary of Occupational medicine
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- 1 Conceptualization
- 2 Health surveillance
- 3 Objectives
- 4 Functions of occupational medicine
- 5 Occupational disease and accident at work
- 1 Areas of occupational health
- 6 Promoting health at work
- 7 Sources
Conceptualization
Occupational Medicine, in addition to being a medical specialty with its own identity, is also part of the spectrum of specialties that make up the Prevention of Occupational Risks, as defined in Law 39/1997 (Regulation of Prevention Services) . However, unlike Safety, Industrial Hygiene and Ergonomics and Applied Psychosociology, which are “technical” specialties, which are aimed at machines or devices, tools , materials, processesand / or environmental conditions that make up the job, Occupational Medicine aims at the person and their state of health in relation to the aforementioned risk factors of the job. Taking into account the definition of health given by the WHO, we can say that any factor that alters the adequate state of physical, mental or social well-being that affects the person in their work will be the object of attention of this medical specialty.
One of the tasks entrusted to Occupational Medicine is Health Promotion in companies, a set of tasks whose purpose is to enhance people’s health and develop programs for the prevention of common diseases. Although these activities are not part of the priority objectives of Occupational Medicine, undoubtedly the doctor who is in charge of the health of a specific group of people, cannot and should not be limited to occupational disease, but his final objective must be the achievement of a good state of health of the personnel under their charge, preventing both professional and common diseases.
Health
The Occupational Risk Prevention Law in its Art. 22 refers to the concept of Health Surveillance, a concept that although for some may still be confusing, it was presented as a regulation of what in the years preceding 1995 as it was He had been working on the medical examinations carried out on the risks inherent to each job, keeping the results of said examinations confidential, and giving the employer full information on the aptitude of the workers.
Protocols
At present there is a general consensus regarding the need to develop protocols for monitoring the health of personnel exposed to certain risks, thus unifying the existing diversity of criteria and allowing the epidemiological assessment of large groups of workers. In this way, it is possible to know to what extent a certain risk is affecting the health of the workers exposed to it, which will make it possible to establish whether the risk assessment and the prevention measures developed were adequate or not. With this information, the employer is able to make the necessary decisions regarding the allocation of new resources to improve prevention.
In this sense, specific protocols are being developed to monitor the health of personnel exposed to specific risks.
Medical examinations
Medical examinations are the main method that exists to evaluate the health status of workers. They involve a personal interview between the doctor and the patient, a physical examination and the corresponding complementary examinations.
Epidemiological reports
Health Surveillance would be lame if it did not include for each professional group exposed to a specific risk a study on the prevalence of pathologies that exposure to said risk could have generated in the population.
goals
Occupational medicine aims to keep the worker in the best health level. For this, it acts in three fundamental lines:
- Occupational preventive medicine. Ensuring that the so-called work pathology does not appear .
- Occupational curative medicine. In charge of the diagnosis and treatment of occupational pathology processes.
- Occupational restorative medicine. Responsible for minimizing the sequelae of occupational disease.
Functions of occupational medicine
- Medical functions. Medical examinations and provision of aid in case of medical emergency.
- Physiological functions. Preventing fatigue, controlling eating , and so on.
- Technical functions. Collaborating with occupational health and safety technicians.
- Advisory functions. Informing the company and its bodies , especially the health and safety committee .
- Training functions. Training of lifeguards and first aid.
- Research functions and relationships. Investigation and relationship with mutual insurance companies for accidents and PE, Labor Inspection and SS, etcetera.
- Administrative functions. Collection and elaboration of statistics regarding occupational and common pathology.
Occupational disease and work accident
Although there are limited and specific situations that can be classified under the two terms as an exact definition of the concepts of occupational accident disease is difficult, the differential characteristics listed below help to make it easy to understand:
Start . The onset of occupational disease is slow, and it is difficult to pinpoint the exact day and time of onset. On the other hand, the work accident occurs abruptly, suddenly, being able to specify exactly the day and time it occurs.
Presentation . While the occupational disease is expected with a causal relationship derived from the jobs that present risk, the accident occurs unexpectedly.
Motivation. The causes of the accident act from outside, it is external to the body in which it causes the harmful effects and it occurs in isolation and without repetition.
Manifestation . While there is no violence in the disease , it is manifested covertly by signs and symptoms that are sometimes difficult to diagnose that can lead to confuse it with common non-professional diseases, the accident is usually violent, sometimes traumatic.
Chance relationship. While the coincidence relationship is clear and evident in work accidents, in occupational disease it is not clear, to the point that most of the pathological manifestations are common to non-occupational diseases. This explains the discrepancies that arise in the labor courts.
Treatment . While the treatment of the disease is generally medical, the accident must be treated surgically.
The human being, due to his professional activity, is exposed to contracting diseases. Some, although they are related to the work carried out, are not due to the fact that it is harmful to health, but to circumstances external to it, while others are a direct consequence of the environmental modifications caused by the work itself, which are the so-called “occupational diseases”. Legally, occupational diseases are only those defined by the law in each country and for each professional safety system.
Occupational health areas
- Occupational Safety is in charge of treating the prevention of work accidents.
- Ergonomics specifically addresses the problem of physical and mental load, tries to facilitate the work of the worker, that he performs the tasks of his job in the most comfortable way. It would be about adapting the job to the worker.
- Industrial Hygiene is fundamentally focused on the issue of pollutants.
- Occupational Medicine has as its most particular aspect, that related to monitoring the health of workers
These areas should not be understood as closed branches, but rather any technician or specialist in any of them can and should collaborate with the rest.
Occupational Medicine is the “medical specialty that enables the doctor to diagnose and prevent health problems related to work”. There is not exactly one medical specialty that develops this discipline, but rather a group of professionals known as Company Doctors. Before, to acquire this title, a short course of about two or three months was usually done. Currently, there is a conflict between the occupational doctors (standard specialty) and the company doctor.
The occupational hygienist focuses on the evaluation and correction of risks in the environment, while the occupational physician attends to the worker’s health problems due to exposures. Both, hygienist and doctor, must collaborate.
Functions of the Prevention Services:
- Preparation of the risk prevention plan.
- Risks evaluation.
- Planning of preventive measures.
- Health surveillance: This function is specific to health personnel, only these personnel can carry it out.
Promoting health at work
The WHO defines Health Promotion as “the process of training the population so that it controls and improves their level of health” (WHO).
[image: logodeoms.jpg | thumb | right | [250px | World Labor Organization]] The basic fundamentals in relation to health promotion would be:
- Actively involve people in the aspects of their daily life related to their health.
- Act on the causes of diseases.
- Use very diverse strategies: information, education, community organization, legal action, etc.
- Community participation, that the general population give their opinion and influence on their working conditions and their health.
On the other hand, health promotion covers a series of areas of action, which would be:
- Development of health policies : This type of problem must be perceived from the scope of all types of policies (health, economic, etc).
- Create favorable environments: air quality , temperature , etc.
- Reinforce community action in relation to the participation of the population in their own health.
- Develop personal skills: This is what is called health education , it is about educating for health, so that people can decide in relation to their health.
- Reorienting and reorganizing healthcare services: It also allows us to address health promotion services.
Health promotion translates into health promotion actions in the workplace. In these places it is relatively easy to put the principles of health promotion into action, mainly for the following three reasons:
- The target population for workplace health promotion is easily accessible.
- The mechanisms for worker participation are already established (prevention delegates and the health and safety committee).
- Healthcare services (prevention services, in this case) are organized in such a way that it is easy to use them as elements of health promotion.
Health Promotion Actions in the workplace:
- Surveillance and prevention activities in occupational health: Control of pollutants and risk of occupational accidents. Attempting to improve the environment of the workplace.
- Medical check-ups: They would not be properly preventive actions, although, sometimes, it is used as it. They can be used as medical advice, that is, to advise the worker about their health care.
- Campaigns for action on behaviors or lifestyles: Many companies carry out campaigns of this type, especially in large companies. These campaigns try to promote certain behaviors and ways of life.
- Models of work organization: Intervention on psychosocial factors, which reduce mental load and stress at work. It would also be influencing the environment at work.
- Social and social welfare programs: These programs would be of the type of: providing housing, sports programs for the worker and their families, vacations, family assistance, etc.
Limitations of Health Promotion in the workplace:
- There are very few companies that carry out health promotion actions outside of what is strictly legislated.
- On the issue of worker participation, information on workers is confused with their participation. The participation of workers implies their active participation in the proposal, design , implementation and evaluation of prevention programs in the workplace.
- Often times, health promotion actions, especially those related to lifestyles, are partially addressed. This means that the problem is not fully addressed, but a message is given to the person, which is not supported by an action that makes it easier for the person to really lead a healthy life, a matter determined to a high degree by the environment in the one that the person moves.
