Environmental Engineering Reference
In-Depth Information
ous types, and repetitive motion, must also be consid-
ered in protecting employee health.
To ensure that employee health is being protected,
physicians and others engaged in occupational and en-
vironmental medicine conduct medical surveillance
programs that address the types of hazards involved in
the work situation. Occupational physicians may also
use epidemiological studies to assess the effectiveness
of employee health protection programs. Physicians
practicing occupational medicine require appropriate
training, not only in this field, but also in clinical prac-
tice and related fields, such as industrial hygiene, toxi-
cology, and epidemiology; they also work closely with
industrial hygienists, engineers, and health physicists.
Physicians in occupational and environmental medi-
cine must also be aware of applicable laws and regula-
tions.
not specifically included as an essential compo-
nent of an occupational health program by
ACOEM, termination or postemployment exams
establish a record of postemployment health status.
The results of every evaluation should be communi-
cated to the employee whether or not abnormalities
were detected. When appropriate, follow-up evaluation
and/or treatment should be arranged with the employee's
own physician.
Diagnosis and Treatment
Occupational illnesses and injuries should be diag-
nosed and treated promptly. The occupational physi-
cian, who is familiar with workplace hazards, is
uniquely qualified to recognize work-related conditions
and should be able to arrange for prompt treatment and
rehabilitation.
A Generic Program
In 1992, the American College of Occupational and
Environmental Medicine (ACOEM) issued a statement
on the scope of occupational and environmental health
programs and practice (ACOEM, 1992). The essential
components of this detailed statement are summarized
below.
Emergency Treatment of Nonoccupational
Injuries or Illnesses
The occupational medicine program should provide
emergency treatment for employees at work. Treatment
of nonoccupational conditions may be palliative (i.e.,
preventing loss of life and limb and keeping the patient
comfortable) until more definitive care can be obtained.
Health Evaluation of Employees
Health evaluations of employees fall into three gen-
eral categories:
Education of Employees
Employees should be fully informed of the potential
hazards associated with their jobs. Regulations, such
as the Occupational Safety and Health Administration
(OSHA) Hazard Communication Standard, require that
hazard information be communicated not only to em-
ployees, but also to users of manufactured products
(OSHA Standard 29 CFR 1910.1200 Hazard Commu-
nication). Information is communicated partly through
material safety data sheets and labels. Education and
training of employees about health hazards they may
encounter on the job, along with appropriate protective
measures, should be conducted by a multidisciplinary
health team of relevant specialists and trained health
educators.
•
Preassignment.
The health status of new or cur-
rent employees should be determined before rec-
ommending work assignments to ensure that
workers are capable of performing the job safely
and without harming others.
•
Periodic medical surveillance.
The health status
of employees should be reviewed periodically to
ensure that no work-related illnesses have devel-
oped. Reviews may be limited to appropriate
organ(s) or organ system(s). The frequency of
reviews is related to the potential hazard(s).
•
Post-illness or post-injury review.
The health
status of an employee should be reviewed after a
prolonged illness or injury to ensure that the
employee is capable of returning to work safely
and that, if necessary, the work assignment can
be adjusted until recovery is complete.
Programs for Personal Protective Devices
The occupational and environmental health program
should ensure that programs are in place for fitting
•
Termination or postemployment exams.
Although
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