May 15, 2014
Medical surveillance in occupational health
The term surveillance generally refers to “keeping a watchful eye over someone or something.” In the workplace, surveillance programs have been used to screen individuals for potential over-exposures (such as to lead) or disease development (such as asbestosis). In a more broad sense, programs can be used to observe the health of populations for the development of work-related problems such as hearing loss from noise exposure or allergic reactions from dusts or dander. The keys to success and effectiveness of these types of programs are to identify problems early and take appropriate corrective actions.
While there are nearly 100,000 chemicals in use in industry today, the Occupational Safety and Health Administration (OSHA) only regulates exposure to 30 materials. It is apparent that the initial regulatory processes will never be able to effectively address the safety of the volume of materials in use in industry. The OSHA General Duty clause does require employers to provide “employment and a place of employment which are free from recognized hazards” although does not specifically indicate how this is done. This is clearly an opportunity for employers and occupational health professionals to design and implement methodical medical surveillance programs to protect and promote employee health.
Examples of recent outbreaks of occupational disease highlight the complexity of the issues we are facing: workers in automotive machining operations developing inflammatory lung disease related to unknown contaminants in water based coolants; workers in a microwave popcorn plant also developing severe lung impairment related to aerosolized powders of butter flavoring. In both instances the initial cases were identified by community physicians and the lack of pre-existing workplace medical programs led to confusion and miscommunication in diagnosis and management – costing millions of dollars in medical costs and lost productivity.
But a workplace does not need to be hazardous to realize benefit from periodic medical surveillance of the workforce. Providing employees with access to knowledgeable health professionals demonstrates the value that the company places on health and safety. This allows employees to have questions or concerns addressed and potential problems identified and corrected. The importance of safety procedures and use of personal protection can also be emphasized. In addition, these provide occupational health professionals with a chance to promote personal health and safety and healthy lifestyle habits. The end result can be a safer, healthier, and more engaged workforce.
In summary, an integrated approach to assessing and protecting worker health, while at the same time promoting personal health and safety, is a real value for employers today. To locate occupational health professionals visit the American College of Occupational Medicine website (http://www.acoem.org/).
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