1. Prevention The MedicalApproachPresented By: Dr. Kalicharan Ramnarine
2. OUTLINEINTRODUCTION/DEFINITIONHEALTH SURVEILLANCEPROGRAMMESTRESS IN THE WORKPLACE(SYMPTOMS)DETERMINANTS OF STRESSMANAGEMENT OFWORKPLACE STRESSCONCLUSION
3. INTRODUCTIONOccupational Health is the promotion and maintenance ofthe highest degree of physical, mental and social well-being of workers in all occupations by preventingdepartures from health, controlling risks and theadaptation of work to people, and people to their jobs.(ILO/WHO 1950)The concept of workplace health surveillance is new toOccupational health and is different from medicalscreening.
4. INTRODUCTION CONTHealth screening refers to the early detection andtreatment of diseases associated with particularoccupations.NIOSH defines occupational health surveillanceas “the tracking of occupational injuries, illnesses,hazards, and exposures.”The National Institute for Occupational Safety and Health (or NIOSH).
5. INTRODUCTION CONT: The Joint ILO/WHO Committee onOccupational Health at its 12th Session in 1995defined an occupational health surveillancesystem as “a system which includes afunctional capacity for data collection,analysis and dissemination linked tooccupational health programmes.This means having a system to look for early signsof ill health caused by hazards at work.
6. INTRODUCTION CONT:It includes health records for individuals andmay involve questionnaires or medicalexaminations to inform the employer.Corrective action may involve referral fortreatment and/or adaptations to work forindividuals affected.Serve as an indication that controls may befailing, review of risk management and action.
7. OCCUPATIONAL HEALTH SURVIELLANCEIt is essential to the planning, implementation andevaluation of occupational health programmes and controlof work-related ill health and injuries and the protectionand promotion of workers’ health.
8. SURVEILLANCE PROGRAMMEYou must decide whether the work you do needshealth surveillance. Ask yourself whether any of yourworkers are at risk from: noise or vibration solvents, fumes, dusts, biological agents and othersubstances hazardous to health asbestos, lead or work in compressed air ionizing radiations or commercial diving – theserequire a particular type of high-level medicalsurveillance.
9. DEVELOPING A HEALTH SURVEILLANCE PROG (HSE)
10. SURVEILLANCE PROGRAMME CONTNIOSH defined three indicators of workplacehealth surveillance programme.Availability of easily obtainable dataPublic health importance of the occupationalhealth effect or exposure to be measuredPotential for intervention activities
11. SURVEILLANCE PROGRAMMESMajor limitations: underreporting of occupational health disorders (verycommon in most of the undeveloped and developingcountries) inability to diagnose the etiology by the occupationalhealth care workers and availability of the data such as death records.
12. WORK STRESS
13. INTRODUCTION/ BURDENHigh job demands and unjust effort-rewardare risk factors for mental and physicalhealth problems.Studies have indicated that work stress isassociated with heart disease, depression,and musculoskeletal disorders .Leads to increased spending on healthcare.Prevention and management of thispsychosocial risk not priority.
14. WORK STRESSDefinition:“Work-related stress is the responsepeople may have when presented withwork demands and pressures that arenot matched to their knowledge andabilities and which challenge theirability to cope.”WHO 2007.
15. IMPACT OF WORK STRESS According to Marmot & Wilkinson, 2006 theworking environment and the nature of work itselfare both important influences on health. Systematic reviews shows stress at work isassociated with heart disease, depression, andMSDs ( Melchoir et al.2007) Leads to absences from work and also presenteeism,(although present at work, the performance is poor andsometimes even hazardous to themselves as well asothers around them).
16. LEGISLATION T&T - OSHA The Occupational Safety and Health Act, 2004 No mention of work stress
17. EFFECTS OF WORK STRESSPhysical symptomsMental health symptomsSocial symptomsEmotional health symptoms
18. SYMPTOMS OF WORK STRESSPHYSICAL BEHAVIOURALUlcers (G. I.)Weight lossHigh blood pressureHeart diseaseMusculoskeletal disordersPain (generalized)An increase in alcoholconsumptiondifficult in the workplaceless co-operative, more accident prone, less sociable. inability to cope withfamily/domestic roles, neglect of personalappearance
19. LOOK OUT FOR THESE SIGNSPSYCHOLOGICALMemory LossDepressionMental ConfusionDifficulty ConcentratingLoss of Sexual DesireIrritabilityInsomniaFeelings of guilt and uselessness
20. DETERMINANTS OF WORK STRESSPSYCHOSOCIAL HAZARDSWorkloadWork Schedule/Pressure (urgency/competing demands)Surveillance (by management)/ controlJob insecurityStructural and Managerial ChangesPhysical conditions (environment)/ Equipment.Job designWork organization/ Work-home interface
21. DETERMINANTS OF WORK STRESSJob contentLack of variety or short work cycles, fragmentedor meaningless work, under use of skills, highuncertainty, continuous exposure to peoplethrough workWorkload & work paceWork overload or under load, machine pacing,high levels of time pressure, continually subject todeadlines
22. DETERMINANTS OF WORK STRESSWork scheduleShift working, night shifts, inflexible workschedules, unpredictable hours, long orunsociable hoursControlLow participation in decision making, lack ofcontrol over workload.
23. DETERMINANTS OF WORK STRESSEnvironment &equipmentInadequate equipment availability, suitability ormaintenance; poor environmental conditionssuch as lack of space, poor lighting, excessivenoiseOrganisational culture& functionPoor communication, low levels of support forproblem solving and personal development .
24. DETERMINANTS OF WORK STRESSInterpersonal relationships at workSocial or physical isolation, poor relationshipswith superiors, interpersonal conflict, lack ofsocial support, bullying, harassmentRole in organizationRole ambiguity, role conflict, and responsibilityfor people
25. DETERMINANTS OF WORK STRESSCareer developmentCareer stagnation and uncertainty, underpromotion or over promotion, poor pay, jobinsecurity, low social value to workHome-work interfaceConflicting demands of work and home, lowsupport at home, dual career problems
26. STRUCTURAL/MANAGERIAL CHANGES INTHE MODERN WORLDPrivatizationGlobalisationMergers/acquisitionsDownsizingGrowing too rapidlyTechnological introductionAll contribute to work stress !
27. Management of WORK STRESSAn effective risk assessment approach isnecessaryMeasure the current situation (using surveysand/or other techniques)Work in partnership with employees and theirrepresentatives to make practical improvementsAgree and share an action plan with employeesand their representativesRegularly review the situation to ensure itcontinues to improve
28. Management of Work stress Medical Management of physical sign /symptoms. Employee Assistance Programme Present in many larger organizations in Trinidadand Tobago. Confidential UK National model for work stress (see slide below)
29. Stress Management cont:HSE developed the Management Standards fordealing with work-related stress in an organizationwhatever the size or type.The Standards identify six factors to be addressed:Demands – including issues such as workload, workpatterns and the work environmentControl – how much say the person has in the way theydo their workSupport – including the encouragement, sponsorshipand resources provided by the organization, linemanagement and colleagues
30. STRESS MANAGEMENT CONTRelationships – including promoting positiveworking to avoid conflict and dealing withunacceptable behaviourRole – whether people understand their role withinthe organisation and whether the organisationensures that they do not have conflicting rolesChange – how organisational change (large or small)is managed and communicated
31. ACTIVITIES THAT CAN IMPROVEEMOTIONAL HEALTHRead something you enjoyListen to soothing musicDo breathing exercisesWalkExperience natureTake a relaxing bathPlay with a petTend to your bodyEngage in a physical activity
32. CONCLUSIONDuring the implementation of a health surveillancesystem, involve your workers and theirrepresentatives at an early stage, so they understandits purpose and their roles and responsibilities in anyresulting health surveillance programme.Ask for advice from a competent occupational healthprofessional in developing a health surveillanceprogrammer
33. CONCLUSION CONT:Work-related stress is the response people mayhave when presented with work demands andpressures that are not matched to their knowledgeand abilities and which challenge their ability tocope. (WHO, 2003)Psychosocial risks (work-related stress ) are majorchallenges to occupational health and safety (EU-OSHA, 2007