Occupational medicine

Occupational medicine is the branch of clinical medicine most active in the field of occupational health. Occupational health physicians work closely with the occupational health team which consists of Occupational Health Nursing Professional, Industrial Hygienists, Biostatisticians, Public Health Specialists, and Biomedical Engineers (namely those specializing in Ergonomics). In the United States it is one of the three medical specialties (also including aerospace medicine and public health and general preventive medicine) encompassed by the American Board of Medical Specialties recognized specialty of preventive medicine. Its principal role is the provision of health advice to organisations and individuals to ensure that the highest standards of health and safety at work can be achieved and maintained. Occupational physicians must have a wide knowledge of clinical medicine and be competent in a number of important areas.

Occupational health should aim at: the promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations; the prevention among workers of departures from health caused by their working conditions; the protection of workers in their employment from risks resulting from factors adverse to health; placing and maintenance of a worker in an occupational environment adapted to his physiological and psychological equipment and, to summarise, the adaption of work to man and of each man to his job.

Occupational hazards to health
Occupationally related disease and ill-health are an important cause of morbidity and mortality in the world. The occupational health team must be aware of the work hazards, understand how to assess the risks in a particular workplace and how these should be controlled, as well as be able to recognise, treat and control occupational disease should it occur.

Categories of Work Hazards (also called "Work Factors")
Work hazards can be classified as the following: physical work hazards, chemical work hazards, biological work hazards, ergonomic work hazards, and psychosocial work hazards.

In many countries the need of Occupational Health involvement in employment is backed up by legislation.

Examples of Occupational Health Hazards:
Physical work hazards
 * Car accidents, Motor-vehicular accidents (MVA's)
 * Ionizing radiation
 * Sun Exposure (UVA and UVB rays)
 * Heat Stress and dehydration
 * Noise

Chemical work hazards
 * Tobacco Smoke, smog, indoor air pollution
 * Benzene
 * Work-related carcinogens
 * Aerosols, fumes, smoke
 * Silicosis
 * Asbestosis

Biological work hazards
 * HIV/AIDS
 * Tuberculosis
 * Hepatitis A
 * Hepatitis B
 * Hepatitis C

Ergonomic work hazards
 * Lifting
 * Pushing
 * Pulling
 * Materials management
 * Musculoskeletal Disorders
 * Repetitive Motion
 * Vibration white finger

Psychosocial work hazards
 * Work stress/strain
 * Workload
 * Autonomy
 * Decision Lattitude
 * Work safety climate
 * Coping (psychology)
 * Personality (also called personality preference or typology)
 * Power (sociology) or power politics
 * Gender
 * Discrimination

References: Plog, B.A., Niland, J., & Quinlan, P.J. (2002). Fundamentals of Industrial Hygiene (5th ed.). Itasca, IL: National Safety Council.

Levy, B.S. & Wegman, D.H. (2000). Occupational Health: Recognizing and Preventing Work-Related Disease and Injury (4th ed). Philadephia: Lippincott, Williams & Wilkins.

LaDou, J. (2004). Current Occupational & Environmental Medicine (3rd ed.). New York: Lange/McGraw-Hill.

Rogers, B. (1994). Occupational Health Nursing: Concepts and Practice. Philadelphia, PA: W. B. Saunders.

Assessment of disability and fitness for work
No matter how good an individual's clinical treatment may be, if employees end up losing their job it has in part failed them. Assessment of an individual's fitness to carry out specific jobs, and their rehabilitation and return to work after illness is an important role of occupational physicians. These tasks can only be carried out by practitioners who have a detailed knowledge not only of human health, but also of the specific work situation.

Communications
The occupational physician is required to communicate with clinical colleagues responsible for the primary care of the workers, with other health professionals such as occupational hygienist (also called industrial hygienists), ergonomists and occupational health Nurses, active in the multi-disciplinary practice of occupational health, as well as with management, trade unions and staff representatives in the workplace.

Research
The workforce is the principal customer of occupational health research, carried out to increase knowledge on particular aspects of health hazards at work, or to ascertain the safety or otherwise of specific employment in a specific situation.

Occupational health law and ethics
Occupational physicians must be aware of the extensive health and safety legislation in some countries as it affects their practice, as well as ensuring that they maintain accepted ethical standards, particularly in relation to the medical confidentiality of data regarding individual workers.

Health promotion
The workplace can provide an ideal opportunity and environment to promote good health. The occupational physician must be able to organise, provide and evaluate health promotion programmes which meet the health needs of the specific workplace where they are being undertaken.

Management
Occupational physicians are doctors - yet their role demands more. As well as demonstrating competence in related issues, they must also be well versed in the principles and practice of business and financial management.

The environment
The environment protection act defines pollution in terms of harm to health. The occupational physician's role as health adviser to industry inevitably involves the doctor in the consideration of any environmental hazards emanating from the workplace. Of course there is great variation in the emphasis given to these aspects according to the nature of work, for example in the chemical field consideration of hazards to health may predominate, whereas say in the transport field fitness to work may be a more important concern. Modern employment patterns demand consideration of new employment hazards such as occupational stress, or health concerns like sedentary work.