ma. gia baquiran- sison, md moh dpcom diplomate, philippine college of occupational medicine...
TRANSCRIPT
Ma. Gia Baquiran- Sison, MD MOH DPCOM
Diplomate, Philippine College of Occupational Medicine
Consultant, World Health Organization, Western Pacific Region
Medical Director, Meralco Corporate Wellness Center
Consultant, Makati Medical Center
Masters in Occupational Health, University of the Philippines Manila
Masters in Occupational Medicine, University of Illinois Chicago
Outline of Presentation Definition of the practice of Occupational
Medical The Role of Emergency Medicine in
Occupational Medicine Global trends and Conditions that affect
Occupational Medical Practice Local trends in Occupational Medicine in the
Philippines Emerging health trends in the workplace Conclusion and Recommendations
What is the practice of Occupational Medicine? Occupational Medicine is a medical
discipline that emphasizes prevention and deals clinically and administratively with the health needs of both individuals and groups with respect to their working environment and includes recognition, evaluation, control, management and rehabilitation of occupationally-related diseases and injuries.
Role of ER Medicine in Occupational Medicine
1985: ACEP established the Occupational Medicine Committee to evaluate and develop the role of the ER physician in Occupational Medicine.
1986: ACEP defined 6 areas of Emergency Medicine which is inclusive of an area in Occupational Medicine
Role of ER Medicine in Occupational Medicine ACEP statement: “ The ER physician
with additional qualifications and/or special competencies may engage in the provision of initial care and continuing Occupational Medicine services including illness and injury prevention, case management and patient rehabilitation.
Initial Management of Patients at the ER presenting with a Work-related Injury or Illness
Established policy of ACEP last 1998 Delineates ER physicians’
responsibilities in the following areas:Provision of emergency evaluation and
treatmentDetermination of medical causationEstablishment of physical limitationsCommunication with the employerArrangement of appropriate follow-up care
Global Trends and Conditions Affecting Occupational Medical Practice Migration of Industry to developing countries Migration of workers – OFW’s, seamen Increase in the Business process outsourcing ( BPO)
business Demographic changes in nearby countries Emerging new diseases and conditions Increased Travel
Top Outsourced Industries in the Philippines Manufacturing Industry – microchips, cars,
telecommunication equipment Agricultural Industry – pineapple, vegetable oil,
biofuels Service Industry – BPO (call centers), medical
transcription and coding, accounting/billing Health Services – medical tourism Retirement Industry
Local Trends in Occupational Medicine in the Philippines
Increase in BPO companies (call centers) – SHIFT WORK problems
Computer chip industry relocations Heavy industries (shipbuilding, oil refineries) to Export
processing zones Outsourcing of health services by companies Growth of HMO’s and health plans Enforcement of Occupational Health Laws as mandated
by the Department of Labor and Employment
Philippine Labor Standards in the Occupational Health Practice• Based on Rule 1960 of the DOLE-BWC Standards in
Occupational Health and Safety and the Philippine Labor Code
• In all workplaces where there is more than 1 work shift in a day, the employer shall in addition to the requirements of the rule, provide the services of a fulltime first-aider for each work shift.• Workers 10-50: first aider• 50-200: full time registered nurse • 201-300: full time RN, parttime MD, parttime dentist• 301 above: full time RN, full time MD, full time dentist
General Features Work as one of the causes. Both workers and non-workers are affected. Increase in the NCDs (diabetes,
hypertension, coronary artery disease in the young)
Has impact in health cost utilization Emphasis must always be towards the
preventive side and fitness to work should be highly considered.
Top Occupational Health Issues in the Workplace Infectious diseases Bronchial asthma Skin diseases Cardiovascular diseases Gastrointestinal-related diseases Cataract, deafness Acute poisoning
Based on the Philippine National OSH Profile, Sept. 2010
Occupational Health Issues in the Business Process Outsourcing Increasing number in NCDs (diabetes, hypertension in the
young) Shift work related health issues Ergonomic-related health issues such as Repetitive Strain
Injuries (RSI) Psychosocial factors (job satisfaction, personality traits,
perception of intensified workload, job control)
Sample Shift Schedules in the BPO Industry
8 hour shift/ 37.3 hours per week/ 6 days on, 3 days off
10 hour shift/ 40 hours per week/ 6 days on, 1 day off
24 hours shift/ 56 hours on the average per week/ 7 days on but rotated every 9 days
Re-Emerging Health Issues in the Workplace Increase in HIV-AIDS Increase in Respiratory diseases, UTI,
Gastrointestinal-related diseases, Cardiovascular diseases
Persistence of Obesity as number one in annual physical examinations
Resurgence of PTB Substance abuse
Demographics: Population
Demographics: Gender
Demographics: Marital Status
Demographics: Age
Demographics: Body Mass Index (BMI)
Demographics: BMI by Gender
Demographics: BMI by Age
Smoking History
Smoking History by Age
Drinking History
Drinking History by Gender
Drinking History by Age
Prevalent Illnesses based on Annual Physical Examination
Medical Conditions by Gender
Medical Conditions by Age
Medical Conditions by Drinking History
Medical Conditions based on Smoking History
Top Illnesses based on Doctors’ Diagnosis Acute Tonsillopharyngitis Upper Respiratory Illness Gastrointestinal-related Disorders Tension Headache/ Migraine UTI Hypertension Conjunctivitis Musculoskeletal strain Systemic Viral Illness OB-related
Top Reasons for ER Conduction
Gastrointestinal-related disorders Cardiovascular-related disorders Respiratory-related Pregnancy-related Asthma Accidents Anaphylaxis
Top Reasons for Sent Home Cases Conjunctivitis ATP GI-related Disorders URTI Tension Headache/ Migraine Systemic Viral Illness Hypertension Musculoskeletal disorders Dental-related disorders UTI
Occupational-related Contributing Factors Repetitive activities Shiftwork-related Forceful exertion Awkward/static posture Temperature extremes Localized mechanical stress Lifestyle-related factors such as eating
habits, smoking and drinking
New Trends in Occupational Health To predict individual susceptibility to a
substance/ certain disorders To estimate internal exposure or early
biological effects by molecular bio- markers or biological monitoring
Monitor exposure especially for carcinogens like toluene and pesticides
New Trends in Occupational Health Introduction of Medical Case Management Fitness for Work specialty Enforcement of health and wellness
programs in the workplace
References in Occupational and Environmental Health Medline via PubMed:
www.ncbi.nlm.nih.gov/entrez/query.fcgi TOXLINE and Hazardous Substances
Data Bank: http://toxnet.nlm.nih.gov/index.html
IRIS (Integrated Risk Information System): toxic doses of substances in the environment
NIOSHTIC-2: www.2a.cdc.gov/nioshtic-2
CONCLUSION
Knowledgeable in global trends and their effects on Occupational Medical Practice
Recent trends and developments in Occupational and Environmental health
Managed care and its tools to ensure quality of care and cost-effectiveness
Medical professionals should be advocates of change in the workplace and be of GOOD influence to patients/workers