Occupational Health Services

The primary task of occupational health services (OHS) is to protect workers’ health in relation to the working environment. The main aims are to prevent accidents at the workplace, work-related injuries and diseases, and to improve different aspects of the working environment.

“Emphasizing that in spite of positive developments of occupational safety and health particularly in industrialized countries, over three quarters of workers of the world live and work in developing and transitory countries, often working in high risk occupations in both formal and informal sectors, without adequate protection by occupational health and safety law and lacking social protection and access to occupational health services. Such gaps in prevention lead to 2.3 million deaths among the workers of the world every year”.

This quote comes from the final statement after the 31st International Congress on Occupational Health in 2015. The statement stressed greater recognition of the importance of occupational health services and advancement of the field trough training, education and greater global cooperation.

The ILO Convention on Occupational Health Services (No. 161) and the ILO Recommendations on Occupational Health Services (No. 171) were adopted in 1985. The main tasks for OHS are mentioned in these documents. But what does this mean in practical life? What does this type of health personnel do? In practice this may differ from country to country.

Professions in occupational health services

Occupational health services should be made up of multidisciplinary teams whose composition should be determined by the nature of the duties to be performed. The most common types of professions who work in an OHS are physicians, nurses, physiotherapists, occupational hygienists and safety engineers.

Occupational physicians

Occupational physicians give advise to the enterprise on health related and medical issues, and also has the medical responsibility in the OHS unit. The doctors can participate in health examinations, rehabilitation, supervision and counselling and information work, as well as surveillance of the work places. Some countries have a medical specialty in occupational medicine.

Occupational nurses

Occupational nurses work with primary and secondary preventive measures. They can have tasks related to health examinations of workers, counselling and information work, as well as surveillance of the work places. Some countries have specific courses and special education for these nurses.

An occupational nurse often perform audiometry checking the hearing of the workers. ^{© G. Tjalvin}

Occupational hygienists

Occupational hygienists are involved in surveillance and supervision related to chemical, biological or physical factors at the work places. Occupational hygienists can have different backgrounds, such as chemistry or biology, and some countries have specialized courses to certify occupational hygienists.

Occupational hygienists can plan and perform specialized measurements, such as dust measurements, in the work place. ^{© G. Tjalvin}

Occupational physiotherapists

Occupational physiotherapists work on preventive issues related to musculoskeletal diseases, and often participate in general surveillance and supervision in the work environment. A few countries have a specialty for this profession related to the work places.

Safety engineers

Some OHS units have their own engineers specialized to work on safety issues at the work places. In some countries the safety engineers and the occupational hygienists have a close co-operation.

General tasks in an OHS

The role of OHS should be essentially preventive, and their activity should take into account the particular occupational hazards in the working environment as well as the problems specific to the branches they serve.

Surveillance of the working environment

Surveillance of the working environment is one of the main tasks of the OHS. This can be performed by a walk-through survey of the workplace, different work environment measurements or monitoring as well as interviews with managers, foremen and workers.

Informing employer, enterprise management and workers about occupational health hazards

As information about potential workplace health hazards is obtained, it should be communicated to those responsible for implementing preventive and control measures as well as to the workers exposed to these hazards. The information should describe the hazard and the preventive measures being taken, and explain what the workers should do to ensure their effectiveness.

Assessment of health risks

To assess occupational health risks, information from surveillance of the work environment is combined with information from other sources, such as epidemiological research on particular occupations and exposures, and occupational exposure limits. Qualitative (whether an agents is hazardous) and quantitative (the degree of exposure) data may demonstrate that workers face health risks and indicate a need for preventive and control measures.

Surveillance of workers’ health

Due to limitations of a technological and economic nature, it is often not possible to eliminate all health hazards in the workplace. Under such circumstances, surveillance of workers’ health plays a major role. It comprises many forms of medical evaluation of health effects developed as a result of workers’ exposure to occupational health hazards. For instance, if a work place has high noise levels, the hearing ability of the workers can be examined. The purpose is to be able to tell if any of the workers develop reduced hearing. If they do so, they need specific protection and care to avoid further development of the hearing loss, and the work place must work harder on preventive issues to avoid other workers from developing the same problem.

Pre-employment health examinations

The purpose pre-employment health assessment is to determine whether a person is fit to perform a particular job and to ensure that his or her placement in this job will not represent a danger to his or her health, or to the health of other workers. This work is not always a task for an OHS unit.

Advisory role in decision-making processes

An important task for OHS is to provide advice to the enterprise management, the employers, the workers, and health and safety committees. Such advice needs to be taken into account in any company decision-making processes.

Occupational health care and curative health services

OHS may be involved in the diagnosis, treatment and rehabilitation of occupational injuries and diseases. The knowledge of occupational diseases and injuries combined with the knowledge of the job, the working environment and occupational exposures present in the workplace enable the occupational health professionals to play a key role in the management of work-related health problems. General, curative health services are not normally recommended as a part of the OHS activity, as this work may steal time from the preventive issues.

Rehabilitation

The participation of OHS is crucial in guiding workers’ rehabilitation and their return to work after injuries or diseases. This is becoming more and more important as there are a large number of occupational accidents in developing countries and in terms of the ageing of the working populations in industrialized societies.

Health promotion activities

Many occupational health services participate in “stop smoking” campaigns. ^{© G. Tjalvin}

Many OHS have health promoting programs that aim at changing personal health practices such as smoking, diet and physical exercise, with a view to improving overall health status and reducing absenteeism. These are not usually considered as occupational health programs, but as public health services delivered in the workplace, because they focus attention and resources on personal health habits rather than on protection of workers against occupational hazards.