BASIC OCCUPATIONAL HEALTH FOR MEDICAL                 OFFICERS            Training course for regional medical officers   ...
TARGET GROUPRegional and district medical officers in NamibiaASSUMPTIONSParticipants- are medical officers from public hea...
FIRST WEEK: INTRODUCTION TO OCCUPATIONAL MEDICINE                                      DAY 1, MONDAY, 14 FEBRUARY 2011Star...
Start   End     Durati                           Activity/Content                      Training   Trainee      Aids      L...
DAY 2, TUESDAY, 15 FEBRUARY 2011Start   End     Durati                          Activity/Content                          ...
Start   End       Durati                                   Activity/Content                                         Traini...
DAY 3, WEDNESDAY, 16 FEBRUARY 2011Start   End     Duration                           Activity/Content                     ...
Start   End     Duration                          Activity/Content                             Training    Trainee        ...
DAY 4, THURSDAY, 17 FEBRUARY 2011Start   End     Durati                         Activity/Content                         T...
11.00   12.00       45        Example: MUSCULOSKELETAL DISORDERS                                                    Lectur...
DAY 5, FRIDAY, 18 FEBURARY 2011Start   End     Duratio                         Activity/Content                      Train...
SECOND WEEK: BASICS OF OCCUPATIONAL HYGIENE                                        DAY 6, MONDAY, 21 FEBRUARY 2011Start   ...
DAY 7, TUESDAY, 22 FEBRUARY 2011Start   End     Duratio                        Activity/Content                       Trai...
Start   End     Duratio                      Activity/Content                        Training   Trainee      Aids      Lec...
DAY 8, WEDNESDAY, 23 FEBRUARY 2011Start   End     Duratio                       Activity/Content                      Trai...
Start   End     Duratio                      Activity/Content                     Training   Trainee      Aids      Lectur...
DAY 10, FRIDAY, 25 FEBRUARY 2011Start   End     Duratio                        Activity/Content                       Trai...
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Lesson plan basic occupatiuonal health for medical officers in namibia full

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Lesson plan basic occupatiuonal health for medical officers in namibia full

  1. 1. BASIC OCCUPATIONAL HEALTH FOR MEDICAL OFFICERS Training course for regional medical officers organized by the World Health Organizationat the request of the Ministry of Health and Social Services of Namibia LESSON PLAN Swakopmund, 14 - 25 February, 2011
  2. 2. TARGET GROUPRegional and district medical officers in NamibiaASSUMPTIONSParticipants- are medical officers from public healthcare facilities in Namibia. They have excellent clinical skillsand experience, but no previous training in occupational healthGOALS and OBJECTIVES  Introduce participants to concepts, paradigms and approaches in Occ Health  Explain foundations on the important and common occupational and work-related diseases  Underline importance of multi-disciplinary approaches to diagnosis, exposure and preventive action  Underline the role and importance of long-term, sub-acute exposures in disease and disability development  Enable participants to reconstruct historic exposures in disease cases  Enable participants to understand reports on occupational health risk assessmentTEACHING METHODS  Use participants experience and stories as much as possible to keep content concrete and relevant  Visualize a lot, work with films clips, and photos as much as possible  Keep lectures open for discussions and questionsTRAINING TEAMDr Ali El Sherif - Chief Medical Officer for Occupational Health, Ministry of Health and Social Services- course coordinatorMr Thebe Pule - Regional Adviser, WHO Regional Office for Africa, Brazzaville - occupatiuonalhygieneDr Norbert Wagner, Program Director "International Program in Occupational Health Practice",School of Public Health, University of Illinois at Chicago (UIC), United States - occupatiuonalmedicineProfessor Tony Cantrell - former head of Information Section, National Institute of OccupationalHealth, Johannesburg, South Africa - occupèational hygieneDr Ivan D. Ivanov, Scientist, Occupational Health, World Health Organization, Headquarters, Geneva,occupational medicine 2
  3. 3. FIRST WEEK: INTRODUCTION TO OCCUPATIONAL MEDICINE DAY 1, MONDAY, 14 FEBRUARY 2011Start End Durati Activity/Content Training Trainee Aids LecturerTime Time on Topic techniqu activity required (min) e8.30 9.30 60 Introduction and Course Overview Describe Whiteboard Dr Ali and Introduction of lecturers known or flipchart T. Pule Introduction of participants: cases of Introduction to Course Objectives, Format, and Materials occ diseases9.30 10.15 45 Introduction to occupational health lecture Copies of Dr Ali and Occupational Health - scope, issues and challenges timetable T. Pule Occupational health in Namibia - main problems and list of Legislation and regulations for occupational health in Namibia topics (???)10.15 10.45 30 BREAK10.45 11.15 30 The role of the medical officer in occupational health Lecture Ivanov (Ivan) and Role discussio Responsibilities n Skill mix Collaboration with occupational health experts11.15 12.00 45 Health surveillance of workers lecture Ivanov Screening Medical and exposure tests Health examinations12.00 13.30 90 LUNCH BREAK13.30 14.15 45 Occupational health problems in major sectors Lecture Ivanov Mining Agriculture Healthcare Small business, artisans 3
  4. 4. Start End Durati Activity/Content Training Trainee Aids LecturerTime Time on Topic techniqu activity required (min) e14.15 15.00 45 Introduction to occupational medicine (part 1) Lecture Wagner - How important are occupational diseases? - Occurrence, incidence, global burden of disease - Disease vs. accidents - Challenges in describing past and present and mixed exposures - consequences for preventive action, hierarchy of controls15.00 15.30 30 BREAK15.30 16.30 30 Principles of Toxicology Lecture Wagner - exposure pathways - uptake dynamics - Metabolism and excretion - distribution, organ-specific affinity and storage 4
  5. 5. DAY 2, TUESDAY, 15 FEBRUARY 2011Start End Durati Activity/Content Training Trainee Aids LecturerTime Time on Topic techniqu activity required (min) e8.00 8.15 15 Introduction to Day 2: Lecture Wagner Common Occupational Diseases8.15 9.00 45 LUNG DISEASES Lecture Guided Wagner - Physiology of respiratory tract discussion - Overview, classification - Occurrence, incidence & prevalence9.00 9.45 45 Occupational Asthma Lecture Guided Wagner - pathomechanisms and discussion - occurrence, prevalence discussio - causes, irritant vs allergic n - dilemma of exposure assessment for allergic lung diseases - preventive action and control technologies9.45 10.15 30 Participants presentation on lung diseases Presentatio LCD Wagner - Mapp 2001 agents old & new causing asthma OEM 354.pdf n - Microorganisms in grain handling 9851_7.pdf10.15 10.45 30 BREAK10.45 11.30 45 Dust-related lung diseases: Lecture Wagner Inert dusts: COPD and - pathomechanisms film on - occurrence, prevalence dust - occupations exposure s Irritant dust/fumes: example Alveolitis - pathomechanisms, - inert vs., irritant vs biological substances triggering immune reaction - occupations, examples, - occurrence, prevalence11.30 12.00 30 Respiratory protection with PPE Lecture Discussion Pule - selection and use - limits and challenges12.00 13.30 90 LUNCH BREAK 5
  6. 6. Start End Durati Activity/Content Training Trainee Aids LecturerTime Time on Topic techniqu activity required (min) e13.30 14.30 60 Mineral dust-related lung diseases Lecture Wagner Asbestosis and Silicosis - Causes, pathomechanisms and natural course - Occurrence and occupations - dilemmas in exposure assessment and exposure reconstruction for compensation cases (TLVs, "exposure years" concept)14.30 14.45 15 BREAK14.45 15.45 60 Participants presentation on lung diseases Student Wagner - COPD presentatio - USA risk assess death certif silica 122.pdf n and - Silica exposure assessment concepts discussion - Asbestos exposure assessment concepts - Asbestos risk in industry15.45 16.15 30 Medical assessment of lung function and Fitness-to-work Lecture Discussion Wagner - Purpose and limits - Ethical considerations, conflicts of interest and challenges16.15 17.00 45 Discussion of short cases Open full Discussion Fitness-to-work for employees with lung diseases, case class discussions, dilemmas discussio n ------------------------------------------------------------------------------------------------------------------------------------------------------------ 6
  7. 7. DAY 3, WEDNESDAY, 16 FEBRUARY 2011Start End Duration Activity/Content Training Trainee Aids LecturerTime Time (min) Topic techniqu activity required e8.00 8.15 15 Introduction to Day 3: Lecture Common Occupational Diseases8.15 9.00 45 Reconstructing a occupational exposure history in Lecture Guided Exposure Wagner Occupational Health discussion history - challenge of reconstructing exposure questionnai - Mixed exposures: a challenge re - Known facts about mixed exposure scenarios and their health effects, cases, literature - Challenges to measurement, description and interpretation9.00 9.30 30 Presentations of participants: SKIN DISEASES Presentatio - skin diseases & infections & metal fluids 35.pdf ns - other article9.30 10.00 30 BREAK10.00 10.45 45 SKIN DISEASES Lecture Wagner - skin physiology with - common work-related skin-diseases pictures - irritation vs allergy, definition of exposure - typical occupations - preventive action and control technologies - challenges in rehabilitation and reintegration10.45 11.00 15 OCCUPATIONAL INFECTIONS Group work Case Case discussions on typical occupations in working sheets and groups scenarios Exercise, discussion groups11.00 11.30 30 Presentation of group work Presentatio - presentation of results, discussion on occupational infections ns and discussions 7
  8. 8. Start End Duration Activity/Content Training Trainee Aids LecturerTime Time (min) Topic techniqu activity required e11.30 12.00 30 Summary: Occupational Infections Lecture Wagner - typical occupations - prevention strategies, vaccination programs, - control measures, exposure pathway control (airborne, droplet, contact) - Health Care Workers12.00 13.30 LUNCH13.30 14.00 30 Long-term Cumulative Effects of Selected Exposures Lecture Wagner (part 1) Health Effects of Physical Hazards Example: Noise - noise-induced hearing loss - non-aural effects of noise14.00 14.30 30 Example: Vibration Lecture Wagner - vibration-induced disorders and diseases - challenges in reconstructing past exposures14.30 15.00 30 Medical Surveillance Techniques reg Physical Hazards Lecture Wagner - role of audiometric testing vs. prevention - neurological testing, limits and value15.00 15.30 BREAK15.30 16.15 45 Long-term Cumulative Effects of Selected Exposures Presentatio (part 2) ns and discussions Example: SOLVENTS Presentations of Participants: - Case study toluene.pdf - Case study trichlorethylene.pdf - Encephalopathy overview - NEJM425.pdf16.15 17.00 45 Summary of Health Effects of Solvents Lecture Wagner - health effects nervous system - other organs: reproductive system, cancer, liver, kidney, heart - Medical Surveillance: biomarkers, reliability, limits and use 8
  9. 9. DAY 4, THURSDAY, 17 FEBRUARY 2011Start End Durati Activity/Content Training Trainee Aids LecturerTime Time on Topic techniqu activity required (min) e8.00 8.15 15 Introduction to Day 4: Lecture Long-term Cumulative Effects of Selected Exposures (part 3)8.15 9.00 45 Example: OCCUPATIONAL CANCER Lecture Copies of Wagner - theories of effect categories - assumptions and orders of magnitude of effects (Global burden of disease, WHO) - Typical occupational cancers and occupations - Challenges to prevention, concepts of risk and risk assessment - Classification of carcinogenicity of substances9.00 9.30 30 Presentation of participants on Occup Cancer Presentatio Two Articles TBD ns and discussions9.30 10.00 30 CLINICAL OCCUPATIONAL HEALTH Lecture Examples Wagner of Heavy Metals Guidelines - clinical picture, symptoms for medical - Occurrence, importance surveillance - Prevention and treatment options10.00 10.30 BREAK10.30 11.00 30 Long-term Cumulative Effects of Selected Guided Guided Exposures (part 4) discussio discussion n ERGONOMIC WORK DESIGN Introduction: Discussion on qualitative and semi-qualitative exposure assessment challenges of work load 9
  10. 10. 11.00 12.00 45 Example: MUSCULOSKELETAL DISORDERS Lecture Wagner - occurrence and importance - common causes, genetic, environmental/home and occupational - upper limb disorders, carpal tunnel, shoulder, elbow - back disorders12.00 13.30 LUNCH13.30 14.15 45 MENTAL HEALTH Lecture Discussion Wagner Stress and Work Organization - Stress concepts, effects and strain, - demand & control, social support systems - consequences for work organisation - employee support systems in companies - effect of management & organisation styles14.15 15.00 45 CHRONICALLY ILL EMPLOYEES AT WORK Case Discussion presentati Example: The mental health patient as employee on - occurrence and importance - fitness-for-work considerations and ethical dilemmas - consequences for organisations - roles & responsibilities in the supervising and care team15.00 15.30 30 BREAK16.00 17.00 60 Case Studies on chronically ill or performance-reduced Case Open employees (rehabilitation and re-employment) presentati discussion - diabetes on - epilepsy - vision impairment - old age (medical aspects, ethical and social aspects, case management options in company) ----------------------------------------------------------------------------------------------------------------------------- ------------------------------- 10
  11. 11. DAY 5, FRIDAY, 18 FEBURARY 2011Start End Duratio Activity/Content Training Trainee Aids LecturerTime Time n (min) Topic techniqu activity required e8.00 9.00 60 ??????? requested ??????? Lecture Discussion TEST on Day 1 through 4 MCQs and essay questions9.00 9.30 30 BREAK Lecture9.30 10.30 60 Occupational health information on the Internet Wagner Introduction, presentation of websites10.30 12.00 90 Practical Exercises in Information Sources CD copies IF internet access is available on site: work on internet If NOT: work with CDs from NIOSH and ATSDR12.00 12.30 30 Feedback and Questions12.30 14.00 90 LUNCH14.00 END 11
  12. 12. SECOND WEEK: BASICS OF OCCUPATIONAL HYGIENE DAY 6, MONDAY, 21 FEBRUARY 2011Start End Duratio Activity/Content Training Trainee Aids LecturerTime Time n (min) Topic technique activity required8.00 9.00 60 Introduction to occupational hygiene - Lecture Discussion Cantrell assessment and control of occupational health risks9.00 9.30 30 BREAK9.30 10.30 60 Physical hazards - health effects, assessment and Lecture Cantrell prevention  Noise  Vibration  Atmospheric pressure (diving)10.30 12.00 90 Physical hazards - health effects, assessment and Cantrell prevention (contd) a. ionizing and non-ionizing radiation b. thermal conditions c. illumination12.00 13.30 30 LUNCH13.30 15.00 90 Discussion - how to use exposure data on physical Discussion Ali and risks for medical surveillance Cantrell  noise  vibration  ionizing radiation15.00 15.30 30 BREAK15.30 17.00 90 Practical exercises Discussion Cantrell 12
  13. 13. DAY 7, TUESDAY, 22 FEBRUARY 2011Start End Duratio Activity/Content Training Trainee Aids LecturerTime Time n (min) Topic technique activity required8.00 9.30 90 Chemical hazards - health effects, assessment and Lecture Cantrell prevention  Classification of chemicals  Labelling of chemicals  Chemical safety data cards  Occupational exposure limits9.30 10.00 30 BREAK10:00 12:00 120 Practical Ali, Cantrell Practical exercise exercise  reading chemical labels  reading material safety data sheets  obtaining toxicological information about chemicals  using international chemical safety data cards12.00 13.30 60 LUNCH13:30 15:00 90 Chemical hazards - health effects, assessment and Lecture Cantrel prevention  Carcinogens  Allergens  mutagens15.00 15:30 30 BREAK15.30 16.30 60 Chemical hazards - health effects, assessment and Cantrell prevention  pesticides 13
  14. 14. Start End Duratio Activity/Content Training Trainee Aids LecturerTime Time n (min) Topic technique activity required16:30 17:00 30 Discussion Ali, Cantrell Sound management of chemicals at the workplaces15.00 16.30 60 Lecture Cantrell Airborne particulates - health effects, assessment and prevention  Silica  Asbestos  Coal ???  Organic dust16.30 17:00 30 Discussion - how to use exposure data on airborne Discussion Ali and particles for medical surveillance Cantrell  Silica  Asbestos 14
  15. 15. DAY 8, WEDNESDAY, 23 FEBRUARY 2011Start End Duratio Activity/Content Training Trainee Aids LecturerTime Time n (min) Topic technique activity required8:00 9:30 90 Lecture Cantrell Airborne particulates - health effects, assessment and prevention  Silica  Asbestos  Coal ???  Organic dust9.30 10.00 30 BREAK10.30 11:30 60 Discussion - how to use exposure data on airborne Discussion Ali and particles for medical surveillance Cantrell  Silica  Asbestos11:30 12:00 30 lecture Cantrell Overview of silicosis in South Africa12.00 13.30 60 LUNCH13:30 15:00 90 Lecture Cantrell Ergonomic stressors - health effects, assessment and prevention  Posture  Movements  Organization of the workplace  Handling of loads  Eye strain15:00 15:30 30 Break 15
  16. 16. Start End Duratio Activity/Content Training Trainee Aids LecturerTime Time n (min) Topic technique activity required15:30 17:00 90 lecture Cantrell Workplace health risk assessment - strategies and practical techniques  Walk through surveys  Use of practical tools and checklists  Preparing reports DAY 9, THURSDAY, 24 FEBRUARY 2011 FIELD VISIT TO WALVIS BAY FISHING COMPANY SANDBLASTING STATION 16
  17. 17. DAY 10, FRIDAY, 25 FEBRUARY 2011Start End Duratio Activity/Content Training Trainee Aids LecturerTime Time n (min) Topic techniqu activity required e8.00 10:00 120 TEST on Day 6 through 9 test Cantrell MCQs and essay questions10:00 11:00 30 BREAK11:00 12:00 60 questionn Ali Course evaluation aires  Evaluation of progress  Evaluation of course content, structure, lectures12:00 12:30 30 Award of certificates and closure Ali12.30 14.00 30 Lunch 17

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