1. Introducing occupational health Part 1 Grant McMillan Hon Senior Clinical Lecturer Institute of Occupational and Environmental Health University of Birmingham Number 1 of a series of lectures and tutorials for medical undergraduates

2. Learning Points Scope of occupational health Scope of occupational health Why bother? Why bother? Interactions between work and health Interactions between work and health Extent of work-related ill health and deaths Extent of work-related ill health and deaths Basic tasks of an occupational health service Basic tasks of an occupational health service Additional handouts electronic and hard copy handouts are available on taking and using an occupational history

3. QUESTIONS TO BURN INTO YOUR MIND DO YOU GO OUT TO WORK?DO YOU GO OUT TO WORK? WHAT DO YOU DO AT WORK?WHAT DO YOU DO AT WORK? WHAT WORK DO YOU DO AT HOME?WHAT WORK DO YOU DO AT HOME?

4. Scope of Occupational Health The promotion and maintenance of the highest degree of physical, mental and social well being of workers in all occupations by preventing departures from health, especially those due to work, and promoting good health through activities at the workplace.

5. Key activities in Occupational Health Preventing departures from health, especially those due to work Promoting good health through activities at the workplace

6. Why bother ? Have fitter, healthier workers - at work Return ill and injured workers sooner Retain trained workers longer Gain economic advantage Comply with legislation Increase productivity and profitability

7. Interactions between work and health To ignore the two way interactions between work and health is to risk misdiagnosis, mismanagement and overall failure to do your best for your patients and society at large.

8. Interactions between work and health Work can improve health Work can improve health Work can harm health Work can harm health (Bad) Health can harm ability to work (Bad) Health can harm ability to work

9. Interactions between work and health Work can improve health Work can improve health Work can harm health Work can harm health (Bad) Health can harm ability to work (Bad) Health can harm ability to work Is your patient fit for work? Is your patient fit for work?

10. Extent and effects of work-related ill-health 2.3 million people in UK believe their ill-health has been caused or aggravated by work 700,000 new cases of work-related disorders a year 23,000 seen by specialist doctors

11. Descending order of new cases of work-related illnesses seen by specialist doctors Musculoskeletal disorders Mental ill health Skin diseases Respiratory diseases incl asthma Infections

12. Extent and effects of work-related ill-health 39 million working days lost Cost of £10 billion Plus deaths

13. Work-related deaths 235 fatal injuries at work in 2003/04235 fatal injuries at work in 2003/04 Estimated 6000 cancer deathsEstimated 6000 cancer deaths related to work related to work Latency of effects – as in mesotheliomaLatency of effects – as in mesothelioma

14. Work-related deaths 235 fatal injuries at work in 2003/04235 fatal injuries at work in 2003/04 Estimated 6000 cancer deathsEstimated 6000 cancer deaths related to work related to work Latency of effects – as in mesotheliomaLatency of effects – as in mesothelioma

15. Latency of work-related diseases Occupational exposure to asbestos started to cease in late 1960s in UKOccupational exposure to asbestos started to cease in late 1960s in UK UK Mesothelioma deaths still rising because of latency of effect. 1968 = 153 2002 = 1862UK Mesothelioma deaths still rising because of latency of effect. 1968 = 153 2002 = 1862 Mesothelioma death rates in males under 45 now steadily decreasing. Why?Mesothelioma death rates in males under 45 now steadily decreasing. Why?

16. Basic tasks of an Occupational Health Service of an Occupational Health Service Hazard identification and risk assessment Risk control or management Matching people to jobs & jobs to people eping patients at work Keeping patients at work Assisting return to work of sick and injured Promoting wellbeing at work

17. Learning Points Scope of occupational health Scope of occupational health Why bother? Why bother? Interactions between work and health Interactions between work and health Extent of work-related ill health and deaths Extent of work-related ill health and deaths Basic tasks of an occupational health service Basic tasks of an occupational health service Additional handouts electronic and hard copy handouts are available on taking and using an occupational history

18. QUESTIONS TO BURN INTO YOUR MIND DO YOU GO OUT TO WORK? WHAT DO YOU DO AT WORK? WHAT WORK DO YOU DO AT HOME?

19. Introducing occupational health Part 1 Grant McMillan Hon Senior Clinical Lecturer Thank you for your attention