1. Training of Polish Occupational Physicians in Risk Communication Jacek Michalak Nofer Institute of Occupational Medicine Lodz, POLAND

2. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Occupational Health Service in Poland Labor Code Amendment 1991 Occupational Health Service Act 1996 –Covering all employees –Obligatory measurements and examinations –Costs covered by employers and State

3. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 The most important legal regulations in Polish OHS ÔHealth Care Facilities Act (1991) ÔGeneral Health Insurance Act (1997) ÔOccupational Health Services Act (1996) ÔMinister of Health and Welfare rule on the methods of determination the harmful factors at the work place (1993) ÔMinister of Health and Welfare Instruction on the prophylactic examinations of employees (1996) guidelines

4. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 The standards for prophylactic examinations: èminimum extend of medical examination èminimum set of laboratory tests èminimum set of specialist consultations This can be broadened by a doctor èminimum frequency of prophylactic examinations This can be shortened by a doctor

5. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 The list of harmful factors: è14 groups of physical factors (e.g. noise, vibration) è9 groups of industrial dusts (e.g. silica, asbestos) è53 groups of toxic compounds è6 groups of biological factors (e.g. HBV) è8 groups of other factors (e.g. stress, shift work)

6. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 The measurements of harmful factors may be performed: èeither by Sanitary Inspection laboratory èor by a laboratory authorized by sanitary inspection Doctor receives only the results

7. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Supervisory system in Occupational Health Service: ènational consultant (specialist) appointed by the government èregional consultants (specialists) appointed by local authorities - Voivodes

8. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 System of physicians’ specialist education è6 years of medical studies è1 year of postgraduate stages Now you can start to cure, but not to be an occupational physician!

9. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Former system of specialists’ training: è2 years of training– I 0 specialty èNext 3 years - II 0 specialty Present system: è4 years of specialty training Individual supervision of a specialist – tutor or MASTER

10. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Current curricula For graduate of Medical University (MB) For I 0 specialist in occupational medicine For I 0 specialist in general medicine (GP) For I 0 specialist in internal medicine

11. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 AIMS (1) Working conditions and workers health status Occupational hazards Prophylactic examinations Occupational diseases – prophylaxis, diagnosis and treatment Stating working ability at a given workplace Rehabilitation of disabled workers Health promotion at the workplace

12. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 AIMS (2) Risk assessment Co-operation with employers Individual protection devices Biological monitoring Advising in occupational safety and health Analysis of accidents at work and occupational diseases

13. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Knowledge and capacities (items in curriculum) Health care organization (25) Occupational hygiene (36) Physiology and ergonomics (14) Occupational psychology (7) – communication with patients Epidemiology (8) Statistics (5)

14. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Occupational medicine – clinical issues General issues (10) Occupational pathology (risks) (28)

15. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Management of Occupational Health Services Health economics Internal medicine

16. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Cardiology Angiology Pulmonology Hematology Nephrology Gastroenterology Endocrinology Allergology Rheumatology Oncology Infectious diseases

17. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Courses Introductory (1 week) Advanced (8 weeks) Special (each 10 h to 3 weeks): occupational pathology, pneumoconioses, allergy, occupational psychology (communication), occupational diseases – dermatology, larygnology, acute poisoning and reanimation,

18. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Stages Internal medicine – 12 months Infectious diseases – 4 weeks Orthopedics 2 weeks Occupational hygiene and epidemiology 8 w. Health care organization – 4 weeks Occupational pathology – 4 months OHS primary unit– 24 months Pulmonology 5 weeks

19. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 11 examinations Active participation in Polish Association of Occupational Medicine 1 published report 1 foreign language (English, French or German)

20. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 However, it is a lot to be done in risk communication