Switzerland

History


The  legal regulation for occupational health goes back as far as to 1864, as the first Swiss "Kanton", Glarus, put the "Fabrikgesetz" into force, it limited the daily maximum working time to 12h maximum. 1878 Switzerland introduced a common federal legislation on matters of working time and liability of the employer in case of an work accident or an occupational disease. After the first world war, the law about diseases and accidents was introduced and a federal insurance fund was created which was competent for industrial working places.


There have been chairs for Occupational Medicine at several universities in the second half of the last century (Geneva, Lausanne, Zürich) with some brilliant and international connected leaders, Prof. Etienne Grandjean for example. But it Occupational Medicine was only a sub-specialty until 1996, the year when Switzerland adopted a legislation, which adopted most of the legislation of the European Union in Occ. Health and Safety for Switzerland.
 


Organization
The society of occupational medicine was founded in 1984 and has today about 200 members, half of them specialists. The society is one of the over 70  Medical Associations which form together with the individual members the Swiss Medical Association FMH.



Population: 8,1 Mio,  23,3% with a non-Swiss passport
Number of doctors (without dentists):  31858 (in 2012)
Specialists in OM: 142 (including non active colleagues)
most of them work in medical organizations which give service to more than one  company or in institutions (insurance, university of LS). There is a growing number of  Occ. Physicians who work full or part time as freelancers in Occupational Medicine.

Nature of service
Employers are obliged to seek professional advice if the have special risks in their organization. Professional advice may com from a technical safety person, an industrial hygienist or an occupational physician. The ideal would be a multidisciplinary team, but this is mostly not the case, so safety experts dominate the business.
There is no obligation for continuous service, for example depending on the risk classification of the company or the headcount or both. Only a very limited number of companies (pharmacy, railway, chemistry)  have their own medical service. There has been a tendency for outsourcing in the 90ies and at the start of the century.



Profession


The postgraduate training in OM needs 2½ years training in medicine outside OM and 2½  years training at an recognized postgraduate post. Ever since there has been a limited number of training possibilities, which means a challenge to the society to seek for ways to increase these. To complete the training, a theoretical course in OM must be completed and there is a final exam to be passed, organized by the society.
The Swiss institute for medical training and continuous education has set guidelines for all specialist's training programs.


E-Logbook, Mini-CEX and DOPS are getting more and more important and are being introduced the coming years.


 


Professional tasks (depending of the post)



  • Workplace visits and risk evaluation

  • Counseling employers and employees and their associations

  • Prevention of professional diseases and work associated health problems

    • Ergonomic problems

    • Work-force with special needs or special regulations (under 18, night workers)

    • Back-to-work, re-integration

  • Insurance medicine and labor inspection

 


 


OM Society Website: http://sgarm-ssmt.ch/ (in German and French)

by: Klaus Stadtmüller  10/2013