Workplace health surveillance

The concept of workplace health surveillance is new to occupational health and is frequently confused with medical screening. However, the terms are being used interchangeably by many but there are a few basic differences in both. The occupational medical screening is an important part and parcel of workplace health surveillance. In common terms the health screening means the early detection and treatment of the occupational disease while the workplace health surveillance refers to the removal of the causative factors.

In older days of industrialization the diagnosis and treatment were the main components of the occupational health services, which, now has been replaced by workplace health surveillance systems. It is very important to carry out specific tests for the specific hazards which was not practices in older days and thus resulted in non specific outcomes which were difficult to relate with the workplace hazards. The occupational diseases are usually compensated for which costs heavily to the employer. This resulted in development of the workpalce health surveillance which is an integral part of any good occupational health service.

NIOSH defines workplace health surveillance as “Occupational health surveillance can be viewed as the tracking of occupational injuries, illnesses, hazards, and exposures.” The health information is thus collected and is very helpful in assessing the workplace hazards and evaluation of current policies and preventive measures. The workplace health surveillance can be done for individuals and a group of workers. The Joint ILO/WHO Committee on Occupational Health at its 12th Session in 1995 defines Occupational health surveillance system as “a system which includes a functional capacity for data collection, analysis and dissemination linked to occupational health programmes”.

Every industrial organization should have its own workplace health surveillance programme which should be designed specifically for their needs. The organization should follow the procedures recommended in the programme and should a have a close look at the results and observations.

Indicators of workplace health surveillance
The workgroup constituted by CDC and NIOSH defined the three indicators of workplace health surveillance programme.
 * 1) Availability of easily obtainable statewide data
 * 2) Public health importance of the occupational health effect or exposure to be measured
 * 3) Potential for intervention activities
 * These indicators are useful in assessing the ongoing policies and preventive measures but these indicators do have some limitations. Among the major limitations are the underreporting of occupational health disorders (very common in most of the undeveloped and developing countries), inability to diagnose the etiology by the occupational health care workers and availability of the data such as municipal death records.

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Situation worldwide
Different countries have different rules and regulations regarding the workplace health surveillance. Where most of the developed countries have included this process for occupational health and safety of workers especially in hazardous processes, developing and undeveloped countries are yet to include this very important aspect of occupational health. However, it is obligatory on the employer to include medical screening for better production and cost reduction to his organization.

Tools of workplace health surveillance
The most important tools remain the biomonitoring which indicates the total body burden of a hazardous chemical in a worker by means of the laboratory investigations using biological specimen like urine, blood etc. the best practice is to use non invasive procedures as far as possible for this purpose. Other tools for workplace health surveillance include physical examinations and epidemiological cohort and case control studies. The pulmonary function testing is the mainstay of early detection occupational lung diseases. This test gives information about severity and staging of asthma and other restrictive lung diseases. The FEV1 is an important screening test. Pulmonary function testing combined with plathysmography reflects a very clear picture of status of lung functions of the subject. Audiometry remains the mainstay of diagnosis of Noise induced hearing loss which is the most common reported occupational disease in all parts of the world. Hand arm assessment and dermatological assessments are other important tools for workplace health surveillance

Confidentiality of information
Most of the countries have specific regulations for such data and this information should be made available for the purpose of research, assessment and auditing of preventive measures. The worker should be informed while this information if ever shared with any third party. Worker should have a right to assess to this information whenever he wishes to.

Considering the recent developments in occupational health services, it has been found that the workplace health surveillance is a very effective and useful technique to protect the workers from the occupational hazards. It also helps in early detection and treatment of occupational diseases thus contributing to the better worker health. The better is the health of workers, the better would be the growth and efficiency of the organization.

Different practices are existing in different organizations and different parts of the world but the aim of all such activities is to reduce the workplace hazards and a healthy workforce.