HEALTH CARE

Fostering occupational health

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Occupational healthcare professionals are in high demand at the moment as the importance of health and wellbeing in the workplace receives more attention from employers.

Employee health and wellbeing is receiving more attention in today’s workplace environment as employers realise the implications of risk factors on both their workforce and business. To this end, occupational healthcare practitioners are being recruited to address the issue and are currently in high demand. Dr Jenny Sapire, Occupational Medical Practitioner for Life Occupational Health, spoke to Achiever about the latest trends in this very specialised field.

Could you give us some background on yourself and your career?

I became interested in studying medicine some time after leaving school, having spent a gap year as an American field scholar in the United States and completing a Bachelor of Arts degree majoring in English and Politics at Wits University. I completed my MBBCh at Wits in 1991 and five years after graduating I became involved in occupational medicine. I started working at the National Institute for Occupational Health and completed my diploma in Occupational Health while I was there. After spending some time in private practice as a GP, I joined Life Occupational Health as a full-time occupational medical practitioner (OMP) in 2000, working at clinic factories in and around Gauteng. In 2011, I became the Clinical Standards Manager for Life Occupational Health, based at head office in Johannesburg. Life Occupational Health is one of the larger companies providing occupational health services in South Africa.

What is occupational healthcare, and how does it apply to the work environment?

Occupational health, as defined by the International Labour Organisation, is “the promotion and maintenance of the highest degree of physical, mental and social wellbeing of workers in all occupations by preventing departures from health, controlling risks and the adaptation of work to people, and people to their jobs.” So, in essence, occupational health is concerned with the interrelationship between work and health. It looks at the effects of work on the health of workers and the effect of people’s health on their capacity to work. Occupational health is managed by a team of professionals in a workplace who include the occupational medical practitioner (doctor), the occupational health nursing practitioner (OHNP) and the occupational hygienist, all of whom have specified roles and responsibilities for the provision of occupational health. Technicians and administrators may also form part of the team. Key legislation that governs occupational health in South Africa includes the Occupational Health and Safety Act and the Mine Health and Safety Act. These state that the employer must ensure a healthy and safe working environment for its employees. To do this, workplace risks need to be identified and control measures put in place to minimise exposure and risk. Employees need to be monitored for the effect of workplace exposures on their health. This is called medical surveillance, and may include physical examinations, hearing tests, lung function tests, chest X-rays as well as testing for exposure to hazardous chemical substances in blood or urine—known as biological monitoring. The medical surveillance programme is also there to ensure the employees are fit for various jobs or tasks, for example working at heights, in confined spaces, driving, and operating moving machinery. For these types of jobs, certain minimum standards of fitness are required. If a disease is diagnosed which is thought to be caused by work exposure, it is the responsibility of the OMP to report such diseases to the compensation commissioner. Common occupational diseases include noise-induced hearing loss, dermatitis (skin disease) and occupational lung diseases such as asbestosis, silicosis or coal workers’ pneumoconiosis and occupational asthma. Occupational health is also responsible for the management of injuries on duty, chronic disease management, primary healthcare, emergency medical management, rehabilitation, and health education and promotion.

How much need is there at the moment for occupational healthcare professionals in South Africa?

There is a huge need for occupational health professionals in South Africa. It is one of the scarce resources we have in this country. There is a legal requirement for appointment of qualified OMPs, OHNPs and hygienists in the mining industry. Wherever there is exposure to hazardous chemical substances, noise, heat and other hazards, medical surveillance processes are required to be implemented by law and hence require an occupational health team. Such risks are ubiquitous in industry.

In terms of the skills required in occupational healthcare, what are they and are we currently experiencing any shortage?

The occupational health team consists of the occupational medical practitioner, the occupational health nursing practitioner and the occupational hygienist. In the larger clinics or medical centres, there may be trained technicians, primary healthcare nurses and radiographers and administrative staff. There is a shortage of all three occupational health professionals in the country. The 2013 figures on the SA Nursing Council (SANC) register show there are 2 044 registered nurses with post basic training in occupational health—a number that is insufficient to cover the needs of South African industry and mining. The shortage of occupational health practitioners is felt especially in the more remote areas.

What can schools and higher education institutions do to promote and advance these skills?

They can increase awareness of occupational health as a profession that is desperately needed in this country. Provision of distant learning courses for nurses working in remote areas would definitely assist.

With regard to recruitment, what do employers look for in this field?

Ideally, a combination of the appropriate qualifications and experience in the working environment. Computer literacy, intimate knowledge of the occupational health legislation, passion for occupational health, people skills, good communication skills and good ethical principles are distinct advantages. Registration with the appropriate bodies (SANC, Health Professions Council of SA, Southern African Institute for Occupational Hygiene) is a requirement.

How does South Africa’s occupational healthcare standards compare to international standards?

South Africa has one of the best occupational health legislations in the world, and the standard of occupational health fairs very favourably against international standards. The mining industry for many years has been at the forefront of occupational health and research. Many of the large corporations in South Africa are multinationals that operate according to international best practices.

How can occupational healthcare promote employee empowerment?

Through education and awareness of risks in the workplace, the employee can be in a better position to manage his or her own health risks. The OHSA requires employees to “take reasonable care for the health and safety of himself and of other persons who may be affected by his acts or omissions”. Workplace health programmes empower employees to take control of their own health and to ensure they remain fit for work.

How can occupational healthcare assist in dealing with South Africa’s fight against HIV/Aids? What challenge do we face in this regard?

HIV/Aids is, of course, one of the huge health challenges this country faces and the workforce cannot be seen in isolation of this challenge. Many companies in South Africa have for many years now been offering awareness and education programmes as well as testing for HIV as part of wellness promotion. Some companies, particularly some of the mining houses, started providing antiretroviral treatment to employees long before the government started its general rollout to the public. Occupational health also plays a role in the management of tuberculosis.

How can employers make use of OHPs to fully realise human capital in their businesses, and how do OHPs assist in labour relations?

A comprehensive occupational health programme leads to a healthier workforce, resulting in greater productivity and reduction in absenteeism and medical incapacity. If a company offers a good occupational health service, employees will be more inclined to feel they are being well looked after and cared for, which may improve labour relations.

Health and wellbeing are considered as multi-layered, with physical, mental and relational aspects receiving attention in the pursuit of optimal wellness. How do OHPs address these multi-layered aspects holistically?

Wellness and health promotion is becoming an increasing important offering of many companies that see the benefit a healthy workforce can offer on productivity and the bottom line, as well as the benefit it has for the individual. Occupational health professions are in a perfect position to provide chronic disease monitoring, health promotion in terms of lifestyle disease modification, smoking cessation programmes, dietary advice as well as expertise in occupational health—addressing the health needs of the workforce in a holistic manner.

Sam Mhlongo

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