1 Overcoming Diagnostic Issues and Training Program for Doctors in Hong Kong and China Dr. Ignatius Yu Clinical Professor and Head, Division of Occupational and Environmental Health Associate Director (Research), School of Public Health and Primary Care The Chinese University of Hong Kong

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3 WORK AND HEALTH

4 Occupational Medicine The effects of work on health The effects of health on work A clinical specialty Dealing with individual patients A specialty in preventive medicine (public health) Dealing with groups of working people

5 Prescribed Occupational Diseases in Hong Kong Compensation Legislation Employees’ Compensation Ordinance (48) Pneumoconiosis Compensation Ordinance (3) Occupational Deafness Compensation Ordinance (1) Preventive Legislation Occupational Safety and Health Ordinance - Notification of Occupational Diseases

Diagnosis Employees’ Compensation Ordinance The process for confirming the diagnosis of occupational disease is unclear Pneumoconiosis Compensation Ordinance Diagnosis and assessment by a designated Pneumoconiosis Medical Board with specialists in occupational medicine and respiratory medicine Occupational Deafness Compensation Ordinance Diagnosis and assessment by a statutory Occupational Deafness Medical Committee with representatives from all related disciplines (Occupational Medicine, ENT, Audiology) Designated hearing test centers for medical examination and hearing assessment 6

7 Occupational Physicians Medical specialists in Occupational Medicine Medical practitioners trained in Occupational Medicine but have not achieved specialist status Medical practitioners offering medical services to companies and factories but without formal training in OM

8 3 Levels of Formal Training Diploma in Occupational Medicine Master in Occupational Medicine Specialist in Occupational Medicine

9 Hong Kong Academy of Medicine Hong Kong College of Community Medicine Occupational Medicine Subspecialty Board 3 years basic training an academic course with the taught component in occupational medicine/ occupational health equivalent to that of a master course Part I Examination (8 hours of written examination) 3 years higher specialist training Part II Examination Written Papers (6 hours) Practical/Clinical Examination (5 stations) Part III (Exit) Examination

10 Occupational Physicians in Hong Kong Currently, there are only about 20 fully qualified occupational physicians in Hong Kong (most are in universities and the government) but unfortunately, not all of them are actively involved in occupational health programs for various reasons.

11 Occupational Physicians in Hong Kong the missing block  most occupational safety and health programs at company level are without any input from occupational physicians company doctors/'contract doctors'  curative treatment,  pre-employment examinations (to screen out unfit applicants),  controlling sick leave  may not have received training in OM

12 Value-Adding Contributions From Occupational Physicians At the territory-wide level, advice on appropriate legislation and policy health information systems for occupational accidents and diseases (with their skills in epidemiology and biostatistics) strategies and the practical aspects of dealing with major occupational and environmental incidents

13 Value-Adding Contributions From Occupational Physicians At the company level, the engagement of an occupational physician will enable the company to adopt a more pro-active approach than the current one that places too much emphasis on screening out unfit workers and on curative treatment. a comprehensive occupational health program may benefit from the contributions from an occupational physician

14 What Are We Doing in Hong Kong treatment placement maintenance prevention protection promotion

15 Where Do We Stand Where Should We Stand protect workers health prevent diseases and injuries promoting occupational health  good health is good business  good matching improves production efficiency and leads to better physical and mental health

Division of Occupational and Environmental Health Thank you for your kind attention! Hope you have enough food for thought …