INFORMATION & SERVICES

WHAT IS OCCUPATIONAL HEALTH?

Occupational health has to do with the wellbeing of all employees. It is a service that is wholly dedicated to the minimization and/or prevention of negative health issues relating to hazard exposure in and around the workplace. Occupational health is pivotal in the early detection of job-related illnesses. Job specific health evaluation are carried out and suitability of specific job roles are recommended.

WHO DOES IT CONCERN?

The employer and employee alike are concerned with safety in the workplace and the health and wellbeing of each other.

All employees regardless of their job title or role in a company are at risk of developing work-related injuries or illness. Often the misconception is that only employees tasked with heavy or manual labour are more at risk of occupation injury or disease, however this is not true. Even the sedentary individual that works behind a computer the whole day may develop health complication relating to his/her job; conditions such as high blood pressure, high cholesterol, obesity, Vitamin D deficiencies and musculoskeletal problems, to name just a few. 

How does Occupational health affect a business?

According to The Occupational Health and Safety Act (85 of 1993), Chapters 8 and 9 it is the employer’s responsibility to maintain a safe working environment.

The employer’s role is to “…provide and maintain, as far as is reasonably practicable, a working environment that is safe and without risk to the health of his employee.” Occupational Health and Safety Act (Act 85 of 1993) section chapter 8.

In order for the employee to abide by this regulation it is important then to measure any deviation in the employees’ health so as to detect potential hazards or risks in the workplace that could be affecting an employees’ wellbeing. The best method of ensuring compliance is to carry out medical examinations, medical surveillance and biological monitoring.

IS IT MANDATORY?

YES IT IS. According to the Occupational Health and Safety Act (85 of 1993).

Who governs or enforces adherence of this Act?

Occupational Health and safety checks are carried out by the Department of Labour. Usually these checks are done if:

·      there has been an influx of injuries, illness, accidents or death reported at a specific site. These visits are then conducted on an appointment basis or

·      an unofficial visit is made after receiving a complaint made by an employee regarding an unsafe working environment or unsafe working practices or “procedures”.

Employers found to be non-compliant with measures set out in the OHS Act could potentially face hefty fines or even litigation.

Another aspect to be considered, other than non-compliance is the serious financial ramification relating to employees developing or acquiring occupationally related illness’ or injuries, due to unsafe working conditions or lack of safety measures put in place to minimize hazards.

What does an Occupational health medical examination comprise of?

A health assessment comprising of a physical examination and the compilation of a full health/medical history is carried out to evaluate the health status of an employee.

There are different medicals that are performed at different stages of employment.

1.  Pre-employment: prior to employment to gauge health and existing health status. This serves as a baseline for future medical exams and medical surveillance.

2.  Periodic medicals: medical surveillance done yearly to gauge any variances from the base line. To detect health issues potentially arising from hazards in the workplace or job practice.

3.  Exit medical: a medical performed when the employees’ contract comes to an end. Employees’ health status assessed before exiting the workplace. This medical is helpful in preventing future claims and litigation against the company, in the case of an employee later unjust fully claiming injury or disease.

Medical examination comprises of a nurse practitioner determining the employees’ state of health, identify risk factors for disease, and then devising strategies for the prevention of occupational acquired disease.

Different working environments require different specialized medical investigation. For example, individuals working in the engineering field may require hearing tests to monitor potential hearing damage or loss. Painters may need to undergo biological monitoring to detect exposure to and/or absorption of hazardous substances such as ethyl acetate, formaldehyde and methylene chloride.  Biological monitoring is done through laboratory testing of urine, blood body tissue or exhaled breath samples.

Medical examinations and medical surveillance are both industry and job specific.

In order to be able to understand the special requirements and aspects for monitoring it is of utmost importance that a document known as a “man job specification” be completed by the employer or supervisor.

This document needs to be completed for every different job type in a specific industry, i.e.; an electrician and a plumber both working for a company will obviously have different work exposures and therefore be prone to similar but also different job hazards; therefore two different “man job specification” will be necessary.

In the past it may have easier to conduct a generic type of medical examination for all employees. But this “one size fits all” method will no longer suffice if the employer is to comply with The OHS Act.

Different activities for different jobs may cause or potentiate different risks. Job specific medicals evaluations are also simply considered good practice.

Medical surveillance is the systematic assessment of employees exposed or potentially exposed to occupational hazards. This assessment monitors individuals for adverse health effects and determines the effectiveness of exposure prevention strategies. For example, the effectiveness of a hearing loss programme that was implemented after a hearing problem was detected in the workplace. Surveillance will indicate product and programme effectiveness.

WHO PERFORMS MEDICALS?

Certain industries require that an Occupationally Health trained doctor conduct the examination ie: seafarers, aeronautical professionals and mining employees.

While in other industries, an Occupational Health trained Registered Nurse is suitably qualified to carry out medical exams and medical surveillance.

WHAT DOES THE SERVICE INCLUDE?

For every single employee coming for a medical the following is considered the basic:

·      Medical / personal questionnaire (to establish employee health history and risk factors)

·      Medical examination (listening to heart, lungs, checking reflexes, etc)

·      Weight and height and BMI (body mass index)

·      Blood pressure

·      Urine test (to detect underlying health issues- not to be confused with drug test)

·      Blood glucose test (specifically for known diabetics and where required for job specific reasons)

·      Vision screening (basic)

Job specific extra examinations may include:

·      Audiometry testing (hearing test)

·      Spirometry (lung function test)

·      In depth vison testing - depth perception and colour blindness

·      Urine drug test- 5 panel (Amphetamines, Cocaine, Methamphetamines, Opiates and Marijuana)

·      Working at heights questionnaire and medical

·      Psychological questionnaire

In the case of a potential health issue being detected, the employee will be referred, either to his doctor or a clinic for further treatment and management.

The Occupational Health Nurse does not treat the employees but rather acts as an aid to screen potential health problems, advice the employee and refer, if deemed necessary.

Once the medical has been completed, a fitness certificate is compiled and the employer is provided with a copy.

Please note that no personal details of the employees’ health condition or chronic conditions are shared with any persons including the employer. This is in accordance with The National Health Act (Act No. 61 of 2003) which states that all patients, (in this case, employee) have a right to confidentiality and this is consistent with the right to privacy in the South African Constitution.

However, in the case of drug testing and in accordance with company policy and rules, an employee has to sign consent for testing and is then informed that if the result is positive for narcotics, his/her employer will be notified. In the case of him refusing to sign consent, this matter will then need to be handled by HR or management, and no testing will be carried out.

This fitness certificate is proof that a medical was indeed carried out. Recommendations are made and indicated on the certificate therefore the document also serves as a guiding tool for the employer to either keep the employee in his current position or reconsider possible position/role and change so as to prevent or exacerbate possible harm, disease, injury or death from occurring.

Detection of health issues plays a very important role in correcting, adapting or adopting measures to prevent and/or minimize hazards in the workplace.

Companies that have Health and Safety officers on site may use the information acquired through the medicals, as an early detection tool, to be alerted and then concentrate on unsafe areas in the workplace that may need attention.

WHAT OTHER SERVICES ARE OFFERED TO THE EMPLOYER?

Issues detected such as a potential hearing loss during a periodic medical among employees, may require a hearing conservation program which is a service the Occupational Health nurse could assist the employer with.

Additional support such as weekly or biweekly Blood pressure or Blood sugar monitoring can be arranged too.

Advice and sourcing of PPE’s and PPD’s are an additional service offered to clients.

HOW AND WHERE?

The service is adaptable. In order to prevent as little disruption in the working day and to ensure that production continues unhindered, it is preferred to perform medicals on site.

All that is required is a possible vacant office or quiet corner to ensure privacy and confidentiality. An electricity plug point is also needed.

The medicals are performed and any extra tests that are needed or required by the employer are carried out. The medical certificate is compiled and e-mailed to HR and/or management.

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