Occupational Health. A nurse specialist Perspective

Transcription

1 Occupational Health A nurse specialist Perspective

2 Learning Outcomes o A bit about (yourself) o A bit of history o Some occupational health stats o Occupational Health Nursing in NZ o Health Monitoring/Well Health Programmes: Insert photo of yourself or other here o Standards for occupational health monitoring o Legislation, guidelines and advisory groups o Occupational disease reporting

3 A bit of history o Bernado Ramazzini o Published first the first study of trade diseases in 1700 o Showed an unusual sympathy for the less fortunate members of society o First to recommended that physicians should inquire about a patients occupation o Acclaimed as the father of occupational medicine

4 A bit of history o Thomas Morrison Legg o First Medical Inspector of Factories o Outstanding contribution to occupational medicine developing crude pathways o The factory system of production grew exponentially in this era worldwide

5 Some Occupational Health stats 500 to 900 deaths per year from Work related illness Predominant causes Occupational cancer, including asbestos related; Cardiovascular and other respiratory disease 80% are men ~ 30,000 cases per year: non fatal disease; hearing loss; musculoskeletal issues; cancer; cardiovascular disease; respiratory ~ 6000 more serious (entitlement paid, and/or hospitalisation) > ~ ~ Injury Stats: In 2014, ACC approved 226,100 claims for injuries incurred while working Manufacturing; construction and agriculture = 45% of claims; 72% males, most were in the age group (23%); 30% related to upper (ACC 2014 stats work related) limbs and 17% to lower limbs.

6 Occupational health nursing in NZ The first Industrial Health Clinic 1948 at Glasgow Wharf in Wellington manned by nurses fist aid orientated The NZOHNA was registered with the Incorporated Societies in July of 1973

7 Occupational Health Nurses Todays occupational Health Nurses (OHN) are Registered Nurses who independently: Observe, assess and report with respect to job tasks and risk of exposure to hazards. Focus more on education and prevention

8 What is Occupational Health Nursing? To provide health monitoring programmes to : o detect adverse health effects resulting from occupational exposures at as early a stage as possible o indicate the absence of a significant hazard o monitor the adequacy of control measures o determine individuals at increased risk o provide baseline medical data for comparative analysis o provide benchmarking for preventative action o provide opportunity for health education o work collaboratively with management teams and health professionals

9 Occupational Health Nursing HSE Act; Providing health surveillance grounded in health monitoring for exposure to hazards. Takes the form of o pre-employment o annual monitoring o exit of employment health assessments.

10 Occupational health nurses work in several ways: For themselves contracting services Own a company of consulting occupational health nurses Employed by DHBs Employed by Ministry of Business, Innovation and Employment (Worksafe) Or employed by a large company in an Occ health unit e.g meatworks, factories (production), mining

11 Hazard Exposures Noise; NIHL chemicals/fumes - Neurotoxicity respiratory hazards - occupational Asthma moving loads (manual handling) - musculoskeletal disorders prolonged sitting at computers/static work - (DPI) new chemical preparations solvent neurotoxicity; organ disorders; Occupational cancers Stress mental health - depression

12 The changing working environment Increasing numbers of older workers Women and migrant workers NZ industry is moving away from primary industries Changing work arrangements: Increase in temporary staff, casual and seasonally employed workers More working part time and job sharing; working from home Significant people working more than 40 hours per week/irregular hours/shiftwork An increase in the use of various forms of contracting, outsourcing, franchising and self employment.

13 Health Monitoring What are the hazards? o What are the requirements by law or regulation or standards o What do we know about the monitoring the hazard?? o Is there good base line health information o Are there changes over time o Accurate recording of histories and symptom changes? o Reporting to the organisation Your Health and Safety Partner Employers Association

14 Health hazard monitoring: How we monitor health o Hearing/audiometry o Spirometry o Vision assessment o Musculoskeletal review o Workspace assessments/task analysis o Return to work planning and programming Well Health programs: o Height; weight; body fat %/BMI; Blood pressure; random BSL o total cholesterol o Some OHNs are also Quit Coaches o Vaccinations

15 Wellness Programmes How do these programs work Corporate vs the New Zealand context Do they???

16 Standards for health monitoring Career pathways Nursing registration Our equipment HASANZ

17 The New Zealand Occupational Health Nurses Association - NZOHNA Our Vision: Healthier workplaces with healthier people in Aotearoa New Zealand Mission: We work together to make the work environment a healthier place by helping employees take care of themselves and by reducing health risks in the workplace.

18 NZOHNA Aim: Provide leadership High standards of professionalism. Work collaboratively with employers and other health providers Provide quality advice and service Build and maintain trust and competence Participate in the wider community of health and safety professions in New Zealand

19 The big picture

20 Legislative Guidelines and Codes of Practice Health and Safety in Employment Act 1992 & Amendments 2003; SAW Act (2105) Broad duties, mandatory compliance H&S Regulations 1995; other legislated Regs Prescriptive and mandatory Approved Codes of Practice; MBIE; Industry Codes Recommended compliance Standards Often industry specific; best practice guides Guidelines Often industry specific; best practice guides SMOU = safe method of use SOP = standard perating procedure

21 Workforce Development- WorkSafe NZ There are major capacity and capability constraints among workers, managers, health & safety practitioners, business leaders and the regulators that contribute significantly to New Zealand s poor workplace health & safety record

22 Groups Professional Bodies NZOHNA NZISM NZSC NZOHS Industry Groups Unions HASANZ Education System Tertiary Institutions Training Research Surveillance PTO s Training Professional Development H&S Regulatory System MBIE HSE Act to HSW Act and Reg s/worksafe EPA MNZ Police Territorial Authorities NZTA ACC Health Care System Primary Care GP s Physicians Nurses Allied Health Care Occupational Health Nurses Occupational Health Physicians Occupational Hygienists Ergonomists Toxicologists Injury Prevention advisors Physiotherapists Occupational Therapists Chiropractors Health protection/promotion officers Other Agencies Ministry for Environment Statistics NZ Department of Internal Affairs

23 Advisory Groups Protecting people at work is not just about reducing the risk of accidents. It is also about ensuring that the long-term health effects of the workplace environment are well managed. Chair of WorkSafe NZ Board, Professor Gregor Coster OHAG - Occupational Health Advisory Group NOHSAC The National Occupational Health and Safety Advisory Committee.

24 HASANZ: Health and Safety Assn NZ o An association of associations o Ensuring professional standards across all H&S specialist groups o Professional excellence o Industry advocacy o Health and safety leadership o Stakeholder engagement

25 Occupational Disease Reporting ANZSOM Role of ANZSOM - anzsom.org.nz NODS notifiable occupational disease system o o o How does it work Is it effective Who can use it

26 Occupational Health Nurses Delivering health targets? The Ministry of Health understands that current health target activity undertaken by Occupational Health Nurses could be shared and recorded with the patients PHO. A brief guidance document was developed at MoH level for PHOs to use in establishing/formalising relationships between Occupational Health Nurses and PHOs. Preliminary meetings have taken place to attempt to address this

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