Effects of Work on Health Work on Health Jeremy Owen Army Professor of Occupational Medicine Royal...
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Transcript of Effects of Work on Health Work on Health Jeremy Owen Army Professor of Occupational Medicine Royal...
Effects ofEffects of Work on HealthWork on Health
Jeremy OwenJeremy OwenArmy Professor of Occupational MedicineArmy Professor of Occupational Medicine
Royal Centre for Defence Medicineand
Institute of Occupational Health, University of Birmingham
February 2006
HEALTH >>>> HEALTH >>>> WORKWORK >>>> >>>> HEALTHHEALTH
To ignore the two way interactions between work and health is to risk To ignore the two way interactions between work and health is to risk misdiagnosis, mismanagement and overall failure to do your best for your misdiagnosis, mismanagement and overall failure to do your best for your patients and society at large.patients and society at large.
Learning PointsLearning Points Pluses and minuses of work on healthPluses and minuses of work on health
Revisit concepts of hazard and riskRevisit concepts of hazard and risk
Major UK occupational health problemsMajor UK occupational health problems
Revisit occupational historyRevisit occupational history
Supplemented by small group seminarsSupplemented by small group seminars
Effects of Work Effects of Work (On the Worker)(On the Worker)
Work provides:Work provides:• IncomeIncome• StatusStatus• PurposePurpose• InfluenceInfluence• SecuritySecurity
Work imposes:Work imposes:• CostsCosts• ConstraintsConstraints• HassleHassle• DisempowermentDisempowerment• Hazards &Hazards &• Risks to health & safetyRisks to health & safety
HazardHazard
Any exposure that might cause harmAny exposure that might cause harm
RiskRisk
The chance of that harm actually occurringThe chance of that harm actually occurring in given circumstances.in given circumstances.
HAZARDS/EXPOSURESHAZARDS/EXPOSURES
ChemicalChemical
PhysicalPhysical
Mechanical (ergonomic)Mechanical (ergonomic)
BiologicalBiological
Psycho-social/organisationalPsycho-social/organisational
EXAMPLESEXAMPLES
ChemicalChemical
PhysicalPhysical
Mechanical (ergonomic)Mechanical (ergonomic)
BiologicalBiological
Psycho-social/organisationalPsycho-social/organisational
Work-Related Ill-Health in UK
Changing nature of ‘work’Manufacturing Service IndustriesPhysical SedentaryFixed products VarietyLarge firms SMEsPaternalistic DetachedStrong Unions Reduced
Membership‘Job for Life’ Portfolio Careers
Work-Related Ill-Health in UK
Changing nature of ‘work’Long Contracts Mobile WorkforceJob Security Target DependentFull Time Part Time, ‘Flexitime’Male Workforce Diverse WorkforceRetire at 65yrs Work beyond 65yrsCultural strata More social
flexibilityWomen at home Women at Work
Work-Related Ill-Health in UK
• The Changing Workforce:– Significantly altered perceptions
• Expectations to be ‘healthy’• Lack of acceptance of ‘risk’• Insecure• Isolated• Pressurised
Work-Related Ill-Health in UK
• ‘Traditional’ Work Related Ill-Health:– Musculoskeletal– Trauma– Toxicological manifestations– …..
• ‘Modern’ Work Related Ill-Health:– Stress– PTSD– CFS– WRULD
The Scale of the Problem
• The Cost?
• The Numbers?
• The Effects?
• The Duration?
WRI costs £10 billion/yr in UK
2+ million believe they have a WRI
Cost of £434 per employee/yr
7.8 days absent per employee/yr
Top Four Illnesses/Diseases?
Musculoskeletal,
Stress,
Respiratory,
Skin Problems.
Musculoskeletal Diseases
Most common problem:
– 1.1 million people/yr
– Cost = £5.7 billion/yr
Musculoskeletal Diseases
Most frequent causes include:Most frequent causes include:
• Repetitive and heavy liftingRepetitive and heavy lifting• Bending and twistingBending and twisting• Repeating an action too frequentlyRepeating an action too frequently• Uncomfortable working positionUncomfortable working position• Exerting too much forceExerting too much force• Working too long without breaksWorking too long without breaks
Occupational Stress
Close second!
9.1 million UK workdays lost each year are 9.1 million UK workdays lost each year are attributed to stress related illnessesattributed to stress related illnesses
Cost to industry is £3.7 billionCost to industry is £3.7 billion
Costs for Govt Sick Pay + NHS is £7 billionCosts for Govt Sick Pay + NHS is £7 billion
20% of workers report high or very high levels of stress at work
Respiratory
Work related death due to lung disease (2000):
– Mesothelioma 1628– Asbestosis without meso 186– Other pneumoconiosis 279– Byssinosis 4– Allergic alveolitis 7– TOTAL 2104
OCCUPATIONAL ASTHMAOCCUPATIONAL ASTHMA
Most frequently reported occupational Most frequently reported occupational respiratory disease in Great Britainrespiratory disease in Great Britain
1500-3000 new cases a year1500-3000 new cases a year
7000 cases of work related asthma when 7000 cases of work related asthma when those whose asthma is made worse by work those whose asthma is made worse by work are addedare added
Cost Cost £1.1 billion£1.1 billion each year each year
SWORD reported cases/year SWORD reported cases/year
isocyanatesisocyanates 128128 flour or grain dustflour or grain dust 80 80 glutaraldehydeglutaraldehyde 49 49 wood dustwood dust 49 49
natural rubber latex natural rubber latex 38 38 solder/colophony 35solder/colophony 35
laboratory animals 32laboratory animals 32 glues and resinsglues and resins 30 30
OCCUPATIONAL ASTHMAOCCUPATIONAL ASTHMA
Who develops hypersensitivity is unpredictableWho develops hypersensitivity is unpredictable
The dose of exposure needed is unpredictableThe dose of exposure needed is unpredictable
Hypersensitivity is irreversibleHypersensitivity is irreversible
Removal from exposure immediately warning Removal from exposure immediately warning symptoms start may allow complete recoverysymptoms start may allow complete recovery
Cases must be reported under RIDDOR SchemeCases must be reported under RIDDOR Scheme
Skin
Work-related skin diseases:
– Self-reported prevalence
= approx 39,000
– Annual incidence reported by specialist doctors = approx 3,900
How Do You Make a Difference?How Do You Make a Difference? Prevention (Better than Cure)Prevention (Better than Cure)
Health & Safety PoliciesHealth & Safety Policies
ScreeningScreening
SurveillanceSurveillance
TreatmentTreatment
Workplace AdjustmentWorkplace Adjustment
Redeployment (Change of Work)Redeployment (Change of Work)
An occupational history is a chronological list of all the patient’s employment, expanded as necessary to detail any evidence of occupational exposure to potentially hazardous agents and resulting effects on health.
What is an Occupational History?
Why take an Occupational History?
To determine if there is evidence that:
• work is a likely cause of ill health.• work has aggravated existing ill health.• health or ill health has an effect on the
capacity for work.
The Occupational HistoryThe Occupational History
What do you do for a living?What do you do for a living?
What do you What do you actuallyactually do at work? do at work?
What do you work with?What do you work with?
How long have you been doing this type of work?How long have you been doing this type of work?
Do you have more than one job?Do you have more than one job?
Have you done any different kinds of work in the past?Have you done any different kinds of work in the past?
Have you been told that anything you use at work may make you ill?Have you been told that anything you use at work may make you ill?
Has anyone at work had the same symptoms?Has anyone at work had the same symptoms?
Do you have hobbies e.g. DIY or gardening, that may bring you intoDo you have hobbies e.g. DIY or gardening, that may bring you into contact with chemicals?contact with chemicals?
Is there an occupational health doctor or nurse at your workplace?Is there an occupational health doctor or nurse at your workplace?
OH Stakeholders
Individual
- Employee
- Patient
Work - Colleagues- Employer- Customers- Investors
- Public
Society- Community- Health Service- Country - Legislators- Media?
And don’t forget ….. YOU and I!