Portugal

 


Occupational Health in Portugal


 HISTORY



By the late decade of the century due to social and political events, the first laws regarding conditions at work are published (minimum age, working time, restricted activities)


After the fall of the monarchy in 1910, the new republican regime enacted laws that defined the criteria for repairing work-related diseases and accidents. Up to world war two, private enterprises created their own systems that in some cases also provided assistance for work related accidents by building their own hospitals.



In 1950 a joint Commission of the International Labour Organization and of the World Health Organization establishes the definition of Occupational Health.


In April of 1962 a decree, based upon Recommendation 112 of the ILO, establishes the obligation of Occupational Health Services in the enterprises with the risk of silicosis. A year later a post-graduation course in Occupational Health begins at the Instituto Superior de Higiene (nowadays Instituto Nacional de Saúde - National Institute of Health - INSA) Dr. Ricardo Jorge.


By January of 1967 further decrees are published that enlarge the scope of the Occupational Health Services that are to cover industries that present risks of work-related diseases, but its effectiveness is still limited to those that employ over 200 workers. However its basic concepts remain at the core of the present day regulations.


In 1974, the path for adhesion to the EEC was opened and following it in 1986, the Directives begin to be adopted including the ones that regulate this field


The extension to all fields of activity, apart from the Armed Forces, Polices and Civil Protection Services, is established in 1991 through the adoption of Directive 89/391/EEC. 


In 2009 a new Law has been enacted, which includes the adoption of several Directives. In this Law it is specified that the Occupational Health physician must have a graduation in this area and be registered in the respective College of the Portuguese Medical Association (Ordem dos Médicos). It is also recognized as legal practitioners in this field those doctors that fulfil some criteria specified in the law, but actually either they are about to cease its activities due to ageing or its practice is limited to the duration of its post-graduation process.


The College of Occupational Health was established in 1978 and currently has around 900 members.


After the creation of the National Health Service, post-graduation in the different specialities have mainly been provided through internships of 4 or 5 years. Although the proposal for an internship in Occupational Health has already been delivered to the proper authorities in early 2008 to replace the current transitional plan, unfortunately this is still the process that was adopted in 2002.


Further information. Document from dr Pedro Reis


POPULATION OF PORTUGAL (2009)


Total                                     10 627 000 


Workforce                                 5 594 800 


PHYSICIANS IN PORTUGAL(2010)


41 933  physicians


892 specialists in occupational medicine


 


NATURE OF OCCUPATIONAL HEALTH SERVICES


 


 


Occupational Health Services are mainly provided either by internal (civil services or major enterprises) or external (outsource) services. Although the law also admits the possibility of common services, this form of providing is seldom exploited.


  


 


PROFFESION


Training


The current process requires 2 years of theoretical apprenticeship provided by an accredited Institution, followed by 2 years of practical activities supervised by a specialist in Occupational Health. A final exam concludes the evaluation process.


Post-graduation in the different specialities have mainly been provided through internships of 4 or 5 years. Although the proposal for an internship in Occupational Health has already been delivered to the proper authorities in early 2008 to replace the current transitional plan, unfortunately this is still the process that was adopted in 2002.


Continous medical education:


 


No credit system has been implemented as the Portuguese Medical Association defends a method of evaluation based upon Careers with a continuous process throughout the active life of medical doctors.


 


ASSOCIATION


 


Colégio de Medicina do Trabalho - Ordem dos Médicos


      colegios@omcentro.com


      Av. Afonso Henriques, 39


      3000-011 Coimbra


      Tel. (351) 239 792 920


      Fax (351) 239 702 788


 


      Lopes Pires, MD – President of the College


      lopespires@mail.telepac.pt


      Tel. (351) 966 780 250


 


      Pedro Gustavo Reis; MD – Representative in UEMS


      pedrogreis@netcabo.pt


      Tel. (351) 965 059 968


Presentation from The Portuguese Medical Association at the meeting i Lisboa october 2009