Aims and functions of occupational health services
The primary concerns of occupational health services remain those specified by the ILO/WHO in 1950, although work-related diseases are now considered as well as purely occupational diseases. The actual services offered are essentially preventive in nature and are summarized below.
Job placement
People with certain preexisting medical conditions may be at a disadvantage in some jobs. A preemployment health questionnaire or medical examination can be of great value in such cases by determining job unsuitability before training time and expense have been incurred. Job suitability may also need to be regularly monitored in order to assure employee health and ability. Airline pilots, for example, undergo regular medical checkups because a pilot with failing vision or one who suffers from an undetected heart condition that can lead to a heart attack could endanger many lives. The health service can also give valuable advice with regard to alternative employment when a worker is found to be unfit for a particular job.
Safety training
An occupational health service has a responsibility to keep all employees informed about hazards in the workplace. The measures taken to protect employee health should be thoroughly explained so that workers understand the necessity of complying with such irksome or unpleasant restrictions as the wearing of protective clothing and face masks. First aid facilities should be organized and employees instructed about first aid procedures in case of accidental injuries or other emergencies.
Supervision of high-risk groups
Exposure levels considered safe for a young male worker may be hazardous for a pregnant woman (the fetus, especially during the first three months of development, is particularly sensitive to environmental toxic agents). Pregnant women, as well as such other vulnerable groups as the very young, the elderly, and the disabled, therefore require appropriate medical surveillance and advice about specific precautionary measures they can take.
Control of recognized hazards
A complex system of environmental and biological monitoring has been developed for the control of known hazards at work. Occupational health practice is concerned with monitoring the concentration of toxic substances in the environment, determining safe exposure levels, suggesting procedures to limit worker exposure, and monitoring workers for signs of overexposure. Occupational health specialists can also contribute to the prevention of health risks by assisting in the planning and design of new equipment and factories.
Identification of unrecognized hazards
Occupational health services can play a major role in the detection of new health hazards of all types. Clinical observation and study may reveal a causal relationship between patterns of sickness or mortality in groups of workers and their occupational exposure. Examples of hazards identified in this manner include lung and nasal cancer among nickel workers, lung cancer in asbestos workers, and coronary heart disease among workers exposed to carbon disulfide (used in the manufacture of rayon).
Treatment
Quick, on-site treatment of work injuries and poisonings can prevent complications and aid recovery. Such treatment can also be economically beneficial by saving traveling and waiting time. Furthermore, physicians and nurses who are unfamiliar with their patients’ working conditions may keep workers with minor injuries away from work longer than necessary. An occupational treatment service offers opportunities for specialized counseling and health education.
General health education and surveillance
Occupational health services may have to provide general medical care for workers and their families in developing countries with inadequate community health services. Even when general health care is provided elsewhere, an occupational health service can offer an effective and often economically advantageous program of health education and counseling. By advising employees on such topics as smoking, alcohol or drug abuse, exercise, and diet, the occupational health service can improve worker health and efficiency and reduce illness and absenteeism. The health service is also in a position to organize employee health surveillance programs for the early diagnosis of disease.