1.0 - Give the definition of “Health” as defined by the WHO
“a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.”
1.0 - Give the definition of “Occupational Health” as defined by the ILO
Promote and maintain the highest degree of health for all workers;
to prevent loss of health caused by wor conditions;
to protect workers from health risks in work;
to place and maintain workers in a work environment adapted to their capabilities and needs;
in summary, to adapt work to the workers and each worker to his or her job.”
1.0 - Give the definition of “Wellbeing” as according to the Economic and Social Research Council (ESRC)
“Wellbeing is a state of being with others, where human needs are met, where one can act meaningfully to pursue one’s goals, and where one enjoys a satisfactory quality of life.”
1.1 - List the key categories of occupational health hazards and give examples
Chemical: Acids, alkalis, metals (lead and mercury), gases (carbon monoxide), dusts (silica) and fibres (asbestos).
Biological: Bacteria, viruses, fungi, and protozoa. Biological hazards can be found in humans, animals, and the environment.
Physical: Heat, lighting, noise, vibration, and radiation.
Psychosocial: Mental ill-health, stress, violence, and aggression.
Ergonomic: Repetitive movement activities, manual handling, poor job design, uncomfortable work station height, and poor body positioning.
1.2 The Prevalence of Work-related Sickness and Ill-health.
- Data unreliable.
- Reasonably reliable information by a third of its 174 members.
- Many countries, reporting is very poor, or non-existent.
- Most work-related deaths occur from disease.
The main groups of work-related diseases are:
- cancers (29%)
- circulatory diseases (21%)
- infectious diseases (25%)
- Infectious diseases more common in Sub-Saharan Africa and India
- Circulatory diseases more common in the Former Socialist Economies and the Middle East
- Cancer main killer in the Established Market Economies and China
Musculo-skeletal conditions are the biggest cost outside of fatal accidents. Account for 40% of the total costs incurred.
Back pain can cause long absences from work, major financial burden for society.
1.3 Links between Occupational Health and General/Public Health
Public health concerned with greater populations.
The UK National Institute for Health and Clinical Excellence (NICE) develop guidance on how to improve populations and individuals health.
May focus on a particular topic, population or setting.
Socio-economic inequalities major factor in health.
Unemployed people and those in unskilled work have a shorter life expectancy and experience more ill-health.
Integration of occupational health within framework of public health would allow for better undersanding of health inequalities.
1.4 - Describe the Difference between a Disease Outbreak and an Epidemic?
A disease outbreak happens when a disease occurs in greater numbers than expected.
A single case can be considered an outbreak. If disease is unknown, new to a community, or has been absent for a long time.
An epidemic occurs when an infectious disease spreads rapidly to many people.
1.4 - Describe National Arrangements for Tackling Epidemics
When an epidemic is identified, Public health takes priority over all other considerations.
National infection control has two parts:
- The identification of a health problem - Identify the source, infectious control teams
- take actions to control it - treatment, quarantine, hygiene, physical distancing
Most countries have legislation covering:
- Continual surveillance of infectious diseases
- Agencies to deal with problems observed
1.4 - Describe Organisational Arrangements for Tackling Epidemics.
Change work so source of infection not needed.
Modify work to avoid creating hazardous by-products or waste.
Physical barriers.
Engineering controls such as exhaust ventilation systems.
PPE, clothing, gloves, footwear, and RPE.
Good hygiene, hand washing, avoiding hand to mouth contact, safe disposal of waste, decontamination methods.
Effective vaccines for infectious agents. Vaccination not a substitute for precautions above.
1.4 - Outline Disease Risks and Controls for Healthcare Workers
Healthcare:
Main risk from contact with patients, or through handling contaminated body fluids or clinical waste.
Influenza, Norovirus.
Viral haemorrhagic fever such as Ebola virus, dengue fever, and Crimean-Congo haemorrhagic fever by contact with body fluids.
Mode of transmission and how contagious will affect types of controls.
For example:
- Isolation in a negative pressure suite.
- Isolation in a standard side room.
- PPE e.g. apron, gloves, surgical face mask, RPE’s.
1.4 - Outline Disease Risks and Controls for Agriculture Workers
Risk of zoonotic infection.
Avian influenza, swine influenza, Q fever, E. coli, and TB.
Controls include:
- Gloves and good hand hygiene.
- RPE if animals are positive for infection.
- Vehicles have air filters to reduce the micro-organisms entering the cabs.
- The vaccination of animals.
- Utilising Salmonella-free pigs and poultry.
1.4 - Outline Disease Risks and Controls for Office Workers
Risk of infection from their colleagues.
Open plan offices may dilute aerosols by sneezing colleagues. However, also increase exposure to infectious worker.
Controls Include:
- Good hand hygiene.
- Office cleaning procedures.
- Preventing staff from coming into work when symptomatic.
1.4 - Outline Disease Risks and Controls for Transportation Workers
Risk of infection from other transport users.
Influenza.
Potential for spread may be greater as controls less likely to be in place.
Controls include:
- good hand hygiene
- surgical face masks
- Physical distancing
2.0 - Describe The Basic Principles of the Bio-Psychosocial Model
The bio-psychosocial model of health and illness states that the interplay between:
- Biology: genetic makeup
- Psychology: mental health and behaviour
- Social World: socio-cultural environment
that determines people’s health-related outcomes.
Health promotion must address all three factors.
Health status, perceptions of health, and socio-cultural barriers all impact participation in health-promoting behaviours. (Diet, exercise, medical treatment)
2.1 - Outline The Standards of Fitness to Work
Medical assessment done to determine if a worker can safely do a job or task.
Can handle work conditions
- After an illness or injury.
- After employment has been offered.
- As requested by the employer.
- As a condition of a job transfer or pre-placement
Clinical focus and clinical medical opinions. In some jurisdictions is illegal if used to exclude someone from job.
Assessment of the risk should be done before medical assessment, and any decisions about individuals should be objective and fair.
Well designed process will reduce risk and liability, avoid waste, discrimination, and exclusion.
2.1 - Outline The Principles for a Fitness to Work Programme
Based on a risk assessment.
Aimed to match requirements worker to carry out that task.
Any tests and examinations should relate to an assessment of fitness for that task.
Should produce repeatable and consistent results.
Should apply equally to all who are required to do the work.
Must be safe and legal.
2.2 - Outline The Role of Pre-Placement Assessment
- Ensures all new workers are fit for the job.
- May need to consider adjustments to assist the person in the role.
- Assess if the job may affect the new worker’s health, and if precautions are needed.
- Provides a starting point/baseline for future health comparisons.
The pre-placement assessment also offers the opportunity for new workers to:
- Understand their role more fully and be made aware of necessary precautions.
- Receive training on PPE.
- Introduction to the organisations H&S philosophy.
2.2 - Outline The Benefits of Pre-Placement Assessment
- Pairing of applicant to the task.
- Discovery of health condition(s).
- Determines if any aids or adjustments that are needed (for example, sensory aids, special work stations, additional devices, relocation of a workstation, and/or special parking).
- A baseline for future measurements.
- Knowledge of family health problems lifestyle changes can be provided.
- Supervisors can be made aware of health conditions (for example, insulin-dependent diabetes, convulsive disorders).
- Compliance with local legal requirements for certain job categories.
- Measurement of psychological status.
2.3 - Define Long-Term and Short-Term Frequent Sickness Absence
No common definition of long or short-term absence.
The UK National Institute for Health and Care Excellence (NICE) guidance defines:
- Short-term sickness absence less than four weeks.
- Recurring short-term absence is several episodes of absence, all less than four weeks.
- Long-term sickness absence more than four weeks.
- Recurring long-term absence is several episodes of absence, all more than four weeks.
2.3 - Describe how Initial Enquiries should be made by the Employer.
Before 12 weeks (ideally after 2 to 6 weeks)
A suitably trained person should contact the worker:
- Reasons sickness absence.
- Have they received appropriate treatment?
- Will they return to work and when.
- Any barriers for returning to work.
- Do they need any adjustments made to accommodate their return.
Consider:
- worker’s age
- gender
- type of work they do.
- Incentives or financial issues which may encourage or discourage return to work.
- If a detailed assessment is needed to determine what interventions or services are required.
- Developing a return-to-work plan.
2.3 - Describe Steps How a Detailed Assessment by the Employer Should be Carried Out.
The detailed assessment could include one or more of the following:
Getting specialist advice on diagnosis - more treatment, sick leave.
Use of a screening tool to assess likeliness of return.
A combined interview and work assessment.
Whether interventions or services are needed.
Developing a return-to-work plan.
2.3 Outline the Steps to Taken in a Combined Interview and Work Assessment.
- Involve one or more specialists and the line manager.
- The worker’s health and social and employment situation: Organisational structure and culture (such as work relationships)
- How confident they feel about overcoming these problems.
- Previous experience of rehabilitation.
- Ability to carry out tasks.
- Any workplace or work equipment modifications needed.
2.3 - Describe the Basic Principles of a Return-to-Work Plan.
Should identify the type and level of interventions and services needed (including psychological) and how frequently they are required.
It could also specify whether any of the following is required:
- A gradual return to the original job.
- A return to some of the duties of the original job.
- A move to another job within the organisation (on a temporary or permanent basis).
2.4 - Define Vocational Rehabilitation
- Vocational rehabilitation is “a process that enables people with functional, psychological, developmental, cognitive, and emotional impairments or health conditions to overcome barriers to accessing, maintaining, or returning to employment or other useful occupation.”
- It’s whatever helps someone with a health problem to stay at, return to, and remain in work.
- Early intervention is central to vocational rehabilitation.
- Stepped/gradual approach - low cost, low intensity interventions
