Occupational Health An exploration of a paradigm

Occupational Health Professor Peter Sims Division of Public Health The School of Medicine, University of Papua New Guinea An exploration of a paradigm Work Thursday, April 10, 2008 HEALTH Peter Sims DISEASE 1 Aim • To show how The workplace can be both a threat to the health of the worker and/or an opportunity for health gain Thursday, April 10, 2008 Peter Sims 2 The Objectives • To determine the changing nature of work in human society and its implications for the health of the people • To appreciate that a healthy workforce is more productive,efficient and effective • To consider “The diseases of occupations” • To examine the role of occupational health services Thursday, April 10, 2008 Peter Sims 3 “In the Sweat of Thy Face Shalt Thou Eat Bread,till Thou Return Unto the Ground ” Genesis Ch.2 V19 • • • • Professor Peter Sims Division of Public Health The School of Medicine, University of Papua New Guinea Thursday, April 10, 2008 Peter Sims 4 Human Happiness requires the fulfillment of three key areas • In our loves • In our friends • In our work Thursday, April 10, 2008 Peter Sims 5 Ideas Around Work-labour As a Commodity,capital Versus Labour,the Control of the Means of Production • • • • • • • Man as a machine Physical strength Repetitious Boredom Long hours Poor reward Expendable Peter Sims • • • • • • • The dignity of labour Skills and trades Pride in craftsmanship Apprenticeship Price,shortage,reward Privilege and power The social bonds 6 Thursday, April 10, 2008 The World of Work In the Past • • • • • • There was work for the unskilled 8-18 hours per day 5-6 days a week 52 weeks a year It was seasonal, sporadic,day labour The worker was used and discarded Peter Sims 7 Thursday, April 10, 2008 Before the Industrial Revolution the Farm Labourer worked long hours for small wages The new factories were built in the towns Men and women found low paid work,with long hours and little security Thursday, April 10, 2008 Peter Sims 8 Work in Transition • The rise of union power and the realisation that a stable and well trained labour force was more effective in delivering a quality product, reliably in a competitive world produced stability of employment and often a • “Job for life” Thursday, April 10, 2008 Peter Sims 9 The World of Work • • • • • Is Changing Shorter hours 6-8 hours per day Shorter weeks 4-5 days More holidays 46 week year Shorter working life-30years Work is more skilled,-more training is needed,-often contract work or part time,we may do several different jobs in a lifetime and work for many employers Peter Sims 10 Thursday, April 10, 2008 The Modern Office The Home Worker Thursday, April 10, 2008 Peter Sims 11 THE CHALLENGE-WORKER VERSUS OWNER Not just for profit or higher wages but for HEALTH Thursday, April 10, 2008 Peter Sims 12 The Healthy Worker • • • • • Is more productive Has less time off Is happier at work Is more likely to stay with that job Is worth training and investment Thursday, April 10, 2008 Peter Sims 13 Is This Person Fit to Do This Work? • The physical and mental requirements of the task • Physical health of worker- vision, hearing, speech, mobility • Mental health- behaviour, motivation,learning ability • Chronic illness or disability • Work/employment record Thursday, April 10, 2008 Peter Sims 14 Pre-employment Screening • Specific requirements • Colour vision • Height/weight • Sex • Age • Fitness test • Iq/personality Thursday, April 10, 2008 • • • • • • • Peter Sims Specific exclusions Epilepsy Diabetes mellitus Hepatitis carrier HIV +ve Alcohol problem Criminal record 15 Can We Keep This Person Fit at Work? • • • • • • • Training Protection Supervision Rewards Facilities Rest and meal breaks Positive health Peter Sims • Monitor the environmentdust,radioactivity etc • Monitor the individual -blood tests,radiation badges, peak flow rate etc • Monitor the workforce -patterns of sickness absence 16 Thursday, April 10, 2008 Occupational Diseases-some Classical Problems • Bladder cancer • Asbestosis Mesothelioma Silicosis • Contact dermatitis Atopic eczema • Farmer’s lung Thursday, April 10, 2008 Occupational asthma Peter Sims 17 Occupational Hazard Work Hazard Risks Prevent Doctors Nurses Miners Needles PM's Needles Resuscitat. Dusts Hygiene Food Workers Thursday, April 10, 2008 HepB StrepInfec HepB/HIV Meningitis COAD /Silicosis Food Poisoning Train Immunize Train Immunize Sprays, Extractors Train Supervise 18 Peter Sims Occupational Hazard Work Hazard Risks Prevention Accident Wound Separation Violence Sex Worker Pregnancy VD Bar man Alcohol 2nd.smoke Injury Postal Workers Infection Army Thursday, April 10, 2008 Injury Train 1st.AID VD Condoms Injury Contracept Abortion Condoms HIV/Hep Immunise. Cirrhosis Educate COAD Ventilate Dog bites Train Anthrax Immunise 19 Peter Sims Accidents at Work • The major cause of Morbidity and Mortality • Largely predictable and preventable • Minor-a cut finger from a paperclip to Major-death from electrocution Thursday, April 10, 2008 Peter Sims 20 An Occupational Health Service • • • • • • Screen new employees Provide 1st AID training Monitor the workplace Review sickness rates Liaise with gp/hospital Health promotion (immunisation/smears/ exercise, smoking ) • Advice to management Thursday, April 10, 2008 Peter Sims 21 The Market place needs some rules-Rights and Duties • • • • • • The Worker Security Sickness cover Pension Fair wages Honest labour • • • • • • The Owner/manager Reliable work force Well trained Minimal sickness Productive Fair conditions Thursday, April 10, 2008 Peter Sims 22 The +ve & -ve Stresses of Work • Shift work Rest periods • Production Demands TeamBuilding • Quality standards Trust Management concern Thursday, April 10, 2008 Peter Sims 23 Output versus Stress Output Plateau Decline Optimal Thursday, April 10, 2008 Peter Sims Stress 24 When things go wrong • • • • • • Strikes………………...Lockouts Process failures…….....Faulty product Design failure………....Staff stress Increased sickness……..Absenteeism Human error……...……Accidents System fault…………....Disaster Peter Sims 25 Thursday, April 10, 2008 Some Special Areas • Women at work • • Children at work Prisoners Thursday, April 10, 2008 Peter Sims 26 • Unemployment Underemployment • Work for men and women • Work that stimulates and enhances • Work that is fairly rewarded and valued • Work that keeps people healthy Thursday, April 10, 2008 Peter Sims 27 The Mental Health of the Worker • Boredom-tedious and repetitious work • Bullyingdiscrimination and harassment • Alcohol-poor performance • Absenteeism Thursday, April 10, 2008 Peter Sims 28 The Disabled Worker • Impaired • Handicapped • Disabled • Debarred Thursday, April 10, 2008 Peter Sims 29 Retraining Rehabilitation Retirement Redundancy Thursday, April 10, 2008 Peter Sims 30 A Workplace Check list • • • • • • The Work Process-what is being done The Work force-who is doing it The hazards-what can go wrong The record-Accident and illness The Services-First aid, Occupational Health The ambience-Men, Management,Machines Peter Sims 31 Thursday, April 10, 2008 Conclusions • Work is an important part of all our lives • Work can endanger health or enhance it • Many problems can be minimized or entirely prevented from existing knowledge • Occupational Health Services can be the key to worker safety and wellbeing Thursday, April 10, 2008 Peter Sims 32 Bernardino Ramazzini 1633-1714 Professor of Medicine at Padua “Medici munus plebios curantis est interrogare quas artes exerceant” “In dealing with the workman the doctor must think of the dangerous trades ” Thursday, April 10, 2008 Peter Sims 33