Member countries

UEMS Section of Occupational Medicine do not have participants from all the European countries, but hope in the future to get repræsentatives from all the UEMS memberstates.

Occupational medicine in Austria

History

 

General practitioners are working as company physicians in big companies since the beginning of the 20th century. During the sixties the preventive character becomes more and more important.

1973: Austria obligates large companies to employ company physicians, the first academy of OM was founded.

2000: Every employer has the right for occupational medicine.

Science:

In the end of 19th and beginning of 20th century especially hygienic specialists did research on occupational health issues.

1969: The first chair for occupational medicine was established at the University of Vienna

1979: University Hospital of OM in Vienna, now Institute of OM as a part of University Hospital

 

 

ORGANISATION

 

Inhabitants

 ca. 8.000.000

Employees

ca. 3.000.000

Physicians in Austria

ca. 39.500

Occupational physicians

ca. 1.600

Specialists of occupational health

ca. 110

Full time occupational physicians

ca. 300

Full time specialists of occupational health

ca. 50

 

 NATURE OF OCCUPATIONAL HEALTH SERVICES

 

Private, companies, outsource

Companies have the possibility to employ occupational physicians, to

enter into contracts with freelance occupational physicians or

to hire an occupational health centre.

 

PROFFESIONS

There are two possibilities in Austria to practice the occupational health profession. After three years of clinical training to become general practitioner, the doctor has to attend a 12 weeks program (360 lessions) at the academy for occupational health. Upon completion the doctor can start working as an occupational physician in companies.

The second possibility is to complete a training to become a specialist for occupational health. This lasts for six years. Four out of these six years have to be done for example in a centre for occupational health. The remaining two years have to be spent in the diverse clinical departments of a hospital.

TASKS

The occupational physician has to do several examinations if employees are exposed to substances that are damaging one´s health, for which the legislation has specified the need for examinations. The occupational physicianhas to be called in cases of health protection, determining different dangers, planning of place of work and workspace, reintegration of diseased employees. The occupational physician is working closely with the safety engineers.

HOT TOPICS

Training of specialists of occupational health

Scientific research

Occupational health at universities for medicine

ASSOCIATION

Österreichische Gesellschaft für Arbeitsmedizin

President ÖGA: Erich Pospischil
Vice presidents: Christine Klien, Reinhard Jäger

www.gamed.at

Office:

Arbeitsmedizinischer Dienst Linz

Kaplanhofstrasse 1

4020 Linz

Austria

Email: office@amd.at

T 0043 732 781560-0

Arbeitsmedizin in Österreich   VDDWAKTUEL Ausgabe ok tober 2010

F 0043 732 784594

Occupational medicine in Belgium

 

History

 

Till 1968, occupational health was mostly for large companies.
In 1968 every company had to ensure itself the support of an occupational physician and this through a service for occupational health. This service could be internal or intercompany. This was the start of a big number of external services around groups of employers.
In 1996 the law on ‘Wellbeing at work’ appeared. This was the start of multidisciplinary services, with obligatory prevention advisors in safety, ergonomics, industrial hygiene and psycho-social factors. Occupational medicine in Belgium stays essentially preventive.
This was the start of fusions of services. In 2014 there are only 12 external services left that cover > 90 % of the working population of Belgium. Less than 10 % of the occupational physicians still work for internal services.
In 1996 occupational medicine became an official medical specialty with 4 years of training. Since there are few students, training became interuniversity, at least in the Flanders region. In the French region, discussion is still going on.

 

Population of Belgium

 

Total: 11.036.000 (2012)
Workforce 4.450.000

 

 

 

Physicians in Belgium

 

46.751 physicians (2010)
Around 1000 physicians work in occupational medicine. Since 1996, only doctors that followed the 4-year specialty can work in the field. Before it was only a one year university training. Most of the physicians are exclusively working in the specialty and they work on average 80 % of their working time.

 

Profession

 

Training

 

Postgraduate training takes four years after becoming a licenced physician. Two years are mainly theoretical academic training. Two years are training on the field in a service. A number of activities have to be executed by the trainee. Besides the requirements in medical surveillance of individual workers they have to perform a number of visits on workplaces, performing risk assessments, having the basics of ergonomics and industrial hygiene, participation in committees of well being at work…  The four year study is completed by a scientific thesis.
After completion of the study, the trainee can apply to be recognised as a specialist in Occupational Medicine.
Continuing Medical Education is not to be licenced by the authorities, but there is much focus on it in the specialty.

Tasks

 

Hot Topics

 

• Ability to work and sickness absence
• Ageing workforce
• Financing of the system
• Stress, burnout and all the range of psychological and psychiatric problems

 

 

    • Collaborating in multidisciplinary prevention

 

    •  Medical exams

 

    •  Risk assessment

 

    •  Work place visits

 

    •  Counselling to the employers and employees

 

    •  Participation in the dialogue of the social partners

 

    •  Research in Occupational Health

 

  •  Diagnosis of Occupational Diseases

 

Association

 

We have one association of occupational physicians working in Belgium
In Dutch: BBvAG: Belgische Beroepsvereniging voor ArbeidsGeneesheren
http://www.bbvag.be/
In French: APBMT: Association Professionelle Belge des Médecins du Travail
www.apbmt.be/

 

We have two scientific associations:
Flanders: WVVA: Vlaamse Wetenschappelijke Vereniging voor Arbeidsgezondheidskunde
http://www.vwva.be/

 

French: SSSTR Societé Scientifique de Santé au Travail
www.ssstr.be

 

Information
Contact person:
Dr. Simon Bulterys
Interleuvenlaan 58
3001 Heverlee
Belgium
Tel. 00.32.16.39.05.00

Information is to come

ORGANISATION

    1. 168 full time specialists in Occupational Medicine registered by Health Manpower Registry
    2. Coverage about 80% of the employed population
    3. Total population 4,28 million
    4. Total workforce 1,8 million (employed 1,4 million)

According to Croatian legislation occupational health is covered by compulsory health insurance.

Information is to come

Further information (PDF)

History

Population

Physicians

Nature of Occupational Health services

Profession

Training

Tasks

Hot Topics

Association

 

Society of Occupational Medicine of the Czech Medical Association

Occupational medicine in Denmark

History

Beginning: The doctor C.J.E Hornemann, was one of the first, which in 1872 investigated child labour in Danish factories.  Two percent of the workers were children and several of them were under 10 years.

In 1873 the first steps taken towards the establishment of  The Danish Working Environment Authority

The countries first occupational phycician was Skuli Gudjonsson, who in 1939 became the first professor of Hygiene, University of Aarhus. The focus was on lung diseases and toxicology.

In 1946 the first Department of Occupational medicine at the Rigshospitalet in Kopenhagen was established.

In 1982 the specialty was recognized and the training organized.

Population of Denmark

Total: 5.511.451

Workforce 2.800 000

Physicians in Denmark

19.840 physicians

65 working in the specialty (129 total) Specialists of occupational medicine

Nature of Occupational Health Services

  • Public health care (Hospitals)
  • Very few in private companies (5-6)

Profession

Training

Postgraduate training takes five years after the basic training (1 year), Tree years in a hospitaldepartment of Occupational Medicine, two years in, rehabilitation, lungdiseases, neurology, dermatology). Workplace knowledge and visits on workplaces with the Danish Working Environment Authority. Theoretical training in epidemiology and statistics, professional diseases, risk assesment, industrial hygienics, heath promotion and a scientifik thesis or article.

Continuing Medical Education is not to be licenced by the authorities, but there is much focus on it in the specialty..

Tasks

  • Diagnosis of Occupational Diseases
  • Risk assesment
  • Councelling to the employers and employees.
  • Research in preventing Occupational disease

Hot Topics

  • Work related metal diseases
  • Ability to work and sickness absence
  • Professional diseases

Association

Dansk Selskab for Arbejds- og miljømedicin

The Danish scientific association for environmental and occupational medicine

Information

President: Ole Carstensen

Address: Department of Occupational Medicine, Regional Hospital Vest  Tlf: +45 78 43 35 00  Website: www.dasam.dk

Information is on its way

Occupational Health in Finland

 

HISTORY

Finland’s occupational medicine activities begun to grow actively after the second world war. The ‘Labour safety act’ from 1958 stated that the employer is responsible for the health of the workers and health surveys became obligatory in hazardous workplaces. The ‘Supervision of the Labour Protection act’ in 1973 stated that workplaces with 20 or more employees must have an elected work safety committee, and workplaces with 10 workers or more have an elected work safety responsible. The ‘act on Occupational Health Services’ in 1978 finally opened the door for real preventive occupational health. The law was modified in 2001, when the maintenance of working ability became a new task for occupational health.

The specificity of occupational health in Finland is that employers can also offer curative services. More then 90 % of  employers offer these services. It means that every worker uses the occupational health services almost 2 times per year. Ththis gives This gives to occupational health the possibility of reacting rapidly in case of problems, and opens the possibilities to curative and vocational rehabilitation.

The coverage of occupational health is over 90% in big work places and over 60% in small workplaces (1-9 workers).

ORGANISATION

Population: 5,4million (2010), 68% employed (09.2009) ie. 2,4 million people

Number of doctors: 19 000 (283 inhabitants/doctor)

Number of doctors specialized in occupational health: 767 at age of work, (436 women). About 2,400 doctors in total are working in the field of occupational health, including those who work part time, are on the way to specialization, or work in curative care only.

In Finland we work in multidisciplinary teams: we have 2600 nurses, 700 physiotherapists, 300 psychologists, and 800 aides.

Nature of services:

Communal health services have the obligation to provide occupational health services for the employers in the community. This guarantees the distribution of services all over the country. Communal health services tend to work together with each other, creating bigger centres. The communal system takes care of about 29% of overall occupational health services.

The employer can have its own occupational health service. The tendency now is to use private services, however in-house services still make up 26% of the services.

The employers together collectively organize 6 % of all occupational health services.

The role of private occupational health centres is growing, they take care of 39% of occupational health services.

PROFESSIONS

Training

The minimum requirement for working in occupational health for under 20 hours per week is completion of a 7 weeks’ course organized by the Institute of Occupational Health, during the two first years of practice.

All others working in the field of occupational health for over 20 hours per week must have the specialization. A trainee doctor can begin to specialize in occupational health after completion of the 2 years of common education with all medical students (after 6 years theoretical medical studies). Specialization demands 2 years of occupational health work mentored by a specialized occupational doctor nominated by the university. Additionally 1 year in hospital is required in three different specialities, followed by ½ year training at the Institute of Occupational Health, and ½ year in a practice of assessment of work ability.

200 accredited points or hours of extra training are also required.

Tasks

  • Prevention and Diagnosis of occupational diseases
  • Workplace visits and Risk Assessments
  • Counseling to the employers and employees
  •  Preventive and curative health care of employees, especially related to their work ability

HOT TOPICS

  • Prevention and early treatment of mental diseases.
  • Sickness absence
  • Curative care in occupational health

Association: Finnish Society of Occupational Doctors
Suomen Työterveyslääkäriyhdistys ry
Kalevankatu 11 A, 00100 HELSINKI
Tel: 09 6188 5211
Fax: 09 6188 5260
stly@stly.fimnet.fi

The Finnish Society of Occupational Phycisians www.stly.fi

or contact:
Satu Vaihkonen e-mail: satu.vaihkonen@tyoterveyswellamo.fi
Kari Reijula Kari.Reijula@ttl.fi

OCCUPATIONAL HEALTH SYSTEM IN FRANCE – DR/M.D. ELISABETH ISNARD

Organisation des services de sante au travail en France – Dr. Martine Leonard

Information on its way

 

Presentation 2013 Occupational Medicine i Germany, Dr. Thomas Kraus

OCCUPATIONAL MEDICINE IN GREECE (update JULY 2016)

POPULATION
[Definitions: Employed are persons aged 15 years or older, who during the reference period worked, even for just one hour, for pay or profit or they were
working in the family business, or they were not at work but had a job or business from which they were temporarily absent. Unemployed are persons aged 15-74 who
were without work during the reference period (they were not classified as employed), were currently available for work and were either actively seeking work in
the past four weeks or had already found a job to start within the next three months.
Inactive are those persons who are neither classified as employed nor as unemployed. Economically active population (labour force) are persons either
employed or unemployed. Unemployment Rate is the ratio of unemployed divided by total labour force.]
According to the Hellenic Statistical Authority (ELSTAT), the total population of Greece in the latest census of 2011 was 10.816.286 and the projection for 2016 was
11.533.492. In February 2016, the total population aged 15 years and over, was 9,226,300, of whom 3,603,300 was employed and 1,195,100 was
unemployed (i.e. the economically active population [“labour force”] was 4,798,400). The official unemployment rate (as recorded and calculated in accordance with the
above definitions) was circa 24%. The inactive persons aged 15 years and over were 4,424,900.
OCCUPATIONAL PHYSICIANS (OPs) AND COVERAGE OF WORKING POPULATION BY OCCUPATIONAL MEDICINE (OM) SERVICES
The large majority of the working population (estimated to be circa 85%) is employed either in enterprises with less than 50 workers, or are self-employed.
The Greek occupational health and safety law pertaining to occupational health and safety (which, at least on paper, fully conforms with European Union Law) stipulates
that OM services should be provided only to public and private enterprises with fifty or more workers, or workers employed in smaller enterprises who are exposed to
certain noxious substances such as carcinogens and harmful biological agents. This means that only circa 24% of the employed population (i.e. only the 0.8 million
workers employed in such enterprises) must receive occupational medicine services. It is noted that, virtually, no other enterprises (i.e. none of those which are not obliged
to do so by law) receives OM services.
In reality, occupational medicine services are provided to an as yet unknown fraction of the aforementioned 0.8 million workers by 135 specialists in occupational
medicine, 125 of whom are members of the Hellenic Society of Occupational and Environmental Medicine [HSOEM], and by another, estimated 500 – 800 physicians
legally having the job title “occupational physician”, who, however, hold titles in various medical specialties other than occupational medicine. The law does not
stipulate provision of any occupational medicine services to the self employed working population.
It is noted that, according to the latest EUROSTAT statistics, in 2013, in Greece, licensed practicing physicians (holding any medical specialty or no specialty) were
62,000, which entails a ratio of 627 physicians per 100,00 inhabitants, which is by far the highest number of physicians per 100,000 inhabitants among any other country in
the European Union.
NATURE OF OCCUPATIONAL HEALTH SERVICES
Private and public enterprises and organizations receive OM services by OPs as follows:
By employing individual OPs (i.e. including them among their staff), on a whole time basis, as is the case only in very few large-size companies, or
2. by contracting individual self-employed OPs on a part time basis , or
3. by receiving OM services on a part time or on a whole time basis from a private external Health and Safety Protection and Prevention Service
(EXYPP), which provides occupational medicine and safety services to several enterprises.
PROFESSION
1. TRAINING
Specialisation training in OM fully conforms to current existing European Union Legislation. Following six years of training in a medical school and earning a degree
in medicine, one becomes a qualified physician and is automatically licensed to practice. A physician, immediately after his qualification (i.e. as soon as he earns his
university degree in medicine) may start specialisation training in OM, according to Greek law. This is completed after four years in training in total, which includes the
following parts: 28 months training in clinical specialties in training posts approved by the Ministry of Health (in internal medicine, chest medicine [pneumology],
dermatology, ophthalmology, Ear Nose Throat (ENT) medicine, orthopedics and emergency medicine (including traumatology), 12 months of academic training, and 8
months of practical training, of which 6 months in an organized occupational medicine Service in a private or public enterprise or organization (approved for this
training purpose by the Ministry of Health), and two months in the Center for Occupational Hygiene and Safety (K.Y.A.E.) of the Ministry of Labour. Physicians
specializing in OM may attend academic training either in Athens, organised at the National School of Public Health (ESDY), or in Thessaloniki, co-organized jointly by
the Laboratory of Primary Health Care, General Practice and Health Services Research of the Medical School of the (State) Aristotle University of Thessaloniki, the
Laboratory of Hygiene of the Medical School of the (State) Democritus University of Thrace, and the Department of Occupational and Industrial Health of ESDY.
2. DIFFICULTIES AND DEFICIENCIES IN TRAINING
There are no structured and approved (by an appropriate medical authority) specialization training programs for physicians attending the practical part of their
specialization training in an enterprise. The OPs (specialists in occupational medicine) in the enterprises approved for such training by the Ministry of Health, are
not accredited trainers themselves.
The OPs in hospitals provide OM services to hospital staff only. These are individual OPs. There is an Occupational Medicine Service at one State Hospital only. There
are no occupational medicine outpatient clinics or clinical occupational medicine Departments or Services in hospitals, providing services to employees of enterprises
or to the public in general. Consequently, trainees in OM have fewer chances to deal with and learn from many cases of possible or diagnosed occupational diseases,
during their training.
As allowed by law, the physician (“Registrar”) having the task to manage, to do a large part of the teaching and to coordinate the 12 month long academic training at
the National School of Public Health [ESDY] (during the total four year specialization training period) has not been for many years (and still he is not) a specialist in
occupational medicine himself (because no law specifies that he has to be). ESDY is not a University School. It is decentralized part of the Ministry of Health. Its
professors, however, have the standing of University professors. The post of Professor in Occupational Medicine of this School has remained vacant for several
years and remains so almost every time an incumbent retires.
There has never been and there is not even one Department of Occupational Medicine or one post of full Professor in Occupational Medicine in any Medical
School at a University in Greece. There are only two (two year long) part time postgraduate courses in occupational health, which are also attended by physicians:
One (entitled “Program of Postgraduate Studies in Workplace Health”) is organized by the Medical School of the (State) Democritus University of Thrace, in
Alexandroupolis (capital city of the Thrace Region in North East Greece), and the other (entitled “Occupational and Environmental Health”) is organized by the Medical
School and the Department of Political Science and Public Administration of the (State) National and Kapodistrian University of Athens. The Hellenic Institute for
Occupational Health and Safety (“EL.IN.Y.A.E.”) provides short, continuing education courses on occupational health and safety, which are also attended by physicians
holding specialties other than occupational medicine.
Assessment for the acquisition of the title of specialist in occupational medicine is effected by an Examination Committee of the Ministry of Health only by an oral exam
on completion of specialization training. Neither clinical, nor practical, nor written exams are conducted to that end. As allowed by law, some examiners are not
specialists in occupational medicine themselves.
OCCUPATIONAL MEDICINE PRACTICE
1. MAIN DUTIES OF OCCUPATIONAL PHYSICIANS ACCORDING TO GREEK LAW
a. ADVISORY RESPONSIBILITIES OF OCCUPATIONAL PHYSICIANS (OPs)
1. The OPs make suggestions and recommendations and provide advice to the employer, the employees and to their representatives, in writing or verbally, with
respect to measures that must be taken to protect the physical and the mental health of employees.
2. The OPs provide advice on subjects regarding:
A. The planning, programming, modification of the production process, construction and maintenance of work installations and premises, in accordance with rules of
occupational health and safety,
B. The adoption of measures when new materials are introduced and used in the production process, and on procurement of equipment,
C. a. Matters of work physiology and work psychology, ergonomics and occupational health and hygiene, b. the arrangement and shaping of working posts, c. the working
environment, and d. the organization of the production process,
D. The organisation of a service for the provision of first aid at work,
E. The initial placement and change of working post on account of health reasons, temporarily or permanently, as well as the integration and re-integration of handicapped people into the production process, also by making recommendations
for reforming the working posts.
3. The OPs are not allowed to be used for confirming whether an employee is justifiably (or not) off sick.
b. WORKERS HEALTH SURVEILLANCE BY OPs
1. The OPs carry out medical checks of the employees in relation to their working posts, after they are employed or on changing working posts, as well as periodic medical checks according to the judgment of the Work Inspectors of the Ministry of Labor pursuant to requests by the Occupational Health and Safety Committee (a committee the establishment of which in any enterprise is provided for by Law, when workers in a public or private firm wish to
establish it), whenever the above is not stipulated by law. The OPs take care of the execution of medical examinations and of the measurements of hazardous agents of the working environment in conformity with specific laws
and regulations applicable in each case. The OPs assess the medical fitness of workers to work for specific posts, evaluate and register the examination results, issues certificates concerning the above assessments and
communicates them to the employer. The content of these certificates must secure medical confidentiality.
2. The Ops supervise the implementation of measures for the protection of the health of employees and for accident prevention. To this end:
A. They regularly inspect the working posts and report on any omission and negligence, suggest measures to cope with these omissions and supervise their implementation,
B. They explain to workers the necessity for the correct use of personal protective equipment,
C. They investigate the causes of diseases brought about by work, analyse and evaluate the investigation results and propose measures for the prevention of diseases,
D. They supervise the conformity of the employees with the occupational health and safety rules, inform the employees about occupational health hazards and the means used for their protection.
E. They provide emergency medical care in cases of accidents or sudden illness. Carry out vaccination programmes for the employees at the instruction of the responsible Health Directorate of the
Prefecture in which the enterprise is located.
3. The OPs are obliged to keep the medical confidentiality and the commercial confidentiality.
4. The OPs announce the cases of work related diseases suffered by employees to the Work Inspectorate (to the Centres for Prevention of Occupational health and Safety Risks [KE.P.E.K]) of the Ministry of Labour
through the management of the enterprise in which they work,
5. The OPs are ethically independent in relation to the employer and to the employees.
6. If specific enterprises do not have the necessary infrastructure the OPs are obliged to refer employees elsewhere to have certain necessary complementary examinations as appropriately. Thereafter they are informed
about the examination results and evaluate them.
7. The OPs keep a medical file for each employee. The results of any medical, laboratory and para-clinical tests following examination of an employee are also kept in this file, and they are recorded in the employee’s “Occupational
Health Risk Book”. The OPs also keep securely the medical files of employees exposed to certain noxious (hazardous) agents. These employees must have certain medical examinations and tests in relation to their
occupational exposure by law, whilst medical confidentiality must be kept at all times.
8. The OPs examine any employee (working in the same enterprise where the OPs provide occupational medicine services) who seeks the OPs’ advice with respect to his/her occupational health.
9. The employer is obliged to ask either the Safety Officer (see below) or the OPs , or a private external Health and Safety Protection and Prevention Service (EXYPP), which provides occupational medicine and safety services,
and written occupational health risks assessments of all parts of his/her enterprise.
10. The OPs providing occupational medicine services to Local Government (to Local Authorities, i.e. Municipalities, which are the equivalent of Borough Councils in the UK) can, at their discretion, stipulate any kind of appropriate
medical examinations, tests and vaccinations they deem useful, in addition to those provided for by law for workers in certain high risk jobs.
c. COLLABORATION BETWEEN OCCUPATIONAL PHYSICIANS AND SAFETY OFFICERS (“SAFETY TECHNICIANS”)
The OP and the Safety Officer of an enterprise are obliged to collaborate between themselves and also with the Occupational Health and Safety Committee of the enterprise, where such Committee has been established.
2. DIFFICULTIES AND DEFICIENCIES IN OCCUPATIONAL MEDICINE PRACTICE
Not all Occupational Physicians carry out all the tasks mentioned above, which are provided for by law. The extent to which their responsibilities are dispensed varies, depending on the size, prosperity, management and occupational health and safety culture of each enterprise. As primary health care is not properly and fully developed in Greece (e.g. there are not enough Family Doctors – the equivalent of “General Practitioners” in the UK), occupational physicians perform certain primary health care duties, partly substituting for family doctors. Specialists in OM, for the purpose of diagnosing (or excluding) an occupational disease, or for assessing medical fitness to work, may refer a worker for certain laboratoty tests, only for the purpose of initial diagnosis (according to a very recent Ministerial Decree). By contrast, several employers expect the OP to regularly prescribe medicines and make referrals for tests, as if he were the family physician of a worker. Also, not many occupational physicians carry out written assessments of occupational health risks or initial occupational hygiene measurements. OPs do the best they can, within the limitations imposed on them by the lack of preventive culture, the scarcity of appropriate laboratory facilities, the low status of occupational medicine in relation to other medical specialties, and the current economic crisis in Greece.
There is no structured career for occupational physicians. Process protocols for use in occupational health practice by occupational physicians have very recently been introduced, following the work of a Scientific Committee of the Hellenic Society of Occupational and Environmental Health (HSOEH) and are now implemented in a few private and public enterprises and organizations. Extension of their application in enterprises all over Greece proceeds at a slow pace. There are very few nurses
collaborating with occupational physicians in private or public enterprises and organizations. There is no recognized specialty of occupational health nursing. In many enterprises secretarial, logistical and other necessary support to the work of
the OP is inadequate, or appropriate enterprise surgery premises (and also facilities and equipment) may be absent. There are not enough laboratories for measuring or testing agents related to occupational hazards. Among the few major such
laboratories are those of the Center for Occupational Hygiene and Safety (K.Y.A.E.)  of the Ministry of Labour and of the Hellenic Institute for Occupational Health and Safety (“EL.IN.Y.A.E.”).
3. ISSUES RELATED TO DIAGNOSING AND REPORTING OCCUPATIONAL DISEASES
No cases of diagnosed occupational diseases have been reported to date by employers (who should report them, according to law) to the Regional Centres for the Prevention of Occupational health and Safety Risks (“KE.P.E.K.”) of the Ministry of
Labour (which should record them, according to law) since 2009. The employer, according to law, is responsible for reporting such cases, following diagnosis by occupational physicians. More often than not, appropriate past or current
measurements and testing of noxious occupational agents are not available to enterprise OPs, to enable them to diagnose, beyond any reasonable doubt, whether a disease is occupational or not. No sufficient occupational history of patients is
taken or recorded in clinical departments in hospitals. Collaboration between occupational physicians and physicians holding other specialties treating sick workers is scarce.
Another contributory factor for non-diagnosis is probably that many Greek occupational physicians might not have dealt with enough cases of occupational diseases during their specialization training. Furthermore, definite diagnosis of
occupational diseases is pursued by workers only when they wish to claim disability pension. If they do so, a Committee of the Centre for Certifying Disability (KE.P.A.) of the National Insurance Administration (I.KA.) examines the worker who claims it and may disagree with the diagnosis and prognosis of the enterprise OP. As regards workers compensation for occupational injury, the law of tort exists in Greece. Thus, in some circumstances employer and employee might agree on non- reporting a case of an occupational disease. This may happen when the employer benefits the worker (in certain instances, possibly also at the workers’ suggestion) by permanently and unnecessarily assigning unduly lighter or restricted duties to him after he recovers and returns to work (following absence owing to a diagnosed occupational disease). At the same time, the employer does not appear to admit to negligence, i.e. he does not risk to be shown to have been negligent in his duty to provide a healthy and safe working environment, because he avoids having the case taken by the worker to court. This may, however, delay remedial, preventive measures which ought to be taken by the employer to make work healthier. In
Greece, there is not a separate, specific public “Insurance Fund against Occupational Health Risk”, (into which each employer would pay in premiums, the magnitude of which would depend on his firm’s occupational health and safety risk record) which would cover health care and disability pension of workers afflicted by an occupational disease or work accident, as appropriately.
DEFICIENCIES IN LEGISLATION AND ITS ENFORCEMENT
In Greece, the term “Occupational Physician” (OP) is used to signify a specialist in occupational medicine. However, it is used also as a job title for physicians who are not necessarily specialists in occupational medicine; i.e. they may be specialists in
other medical specialties providing certain OM services as best as they can. This anomaly allowed by law has been rectified for the most part by law amendment, following action taken also by the Hellenic Society of Occupational and
Environmental Health ( HSOEH), but it is still partly accepted and allowed by law (even though, by and large, priority must be given by law to specialists in OM when an employer is seeking an OP):
A. for physicians who had been providing OM services as enterprise physicians in various firms without holding the specialty title of OMF for over seven years up until 2009,
B. for physicians who are recruited for the first time after a job in a private or public enterprise was advertised but for which no specialist in OM applied. and
C. in cases where an EXYPP an “external” (i.e. not in-house) private occupational health and safety company, after unsuccessfully advertising to employ a specialist in OM to work for itself, cosigns a contract with a private
or a public enterprise for providing OM services and then assigns this task of providing OM services to a physician who is employed by the EXYPP, but holds a specialty other than OM.
There is no legal obligation for private companies to advertise a post for an occupational physician.
The responsibilities of occupational physicians working in enterprises (either in the public or in the private sector of the economy) are provided for by law. However it may be further specified in their contracts of work, which may vary between
enterprises. Some of these contracts, in certain private or public enterprises and organizations, may not be adequate or even appropriate for a physician, insofar as they may not promote the provision of high quality OM services. A case in point are
posts for OPs offered to the applicant who claims or accepts the lowest remuneration.
Furthermore, none of the Health Work Inspectors of the Ministry of Labour is a specialist in OM (as there is no relevant legal provision for it). These Inspectors are either physicians holding specialties other than OM, or are other health professionals, e.g. chemists. They merely attend a six months long course in occupational health and safety, before they start exercising their duties. Consequently, a paradox occurs: Whenever an enterprise OP makes a written recommendation recorded in the official register “Book of Written Recommendations by the OP” (held, according to law, in every enterprise ) and the employer decides not to conform with it, the Health Work Inspector of the Ministry of Labour must arbitrate, even though he is much less of an expert than the specialist in OM, who has made the recommendation to the employer.
COMMUNICATION ISSUES
Communicating the value of OEM, to employers, educators, workers, and physicians is inadequate. There have been hardly any Congresses on OM in Greece, and very few papers reporting on studies on OM subjects are published in medical journals or presented at Medical Congresses (as compared with the number of papers on subjects of other specialties). On a positive note, the Hellenic Society of Occupational and Environmental Medicine publishes a peer reviewed scientific
journal of occupational medicine. The [bi-partite – established by the Employers and the Employees Associations] Hellenic Institute for Occupational Health and Safety (“EL.IN.Y.A.E.”) publishes a professional journal addressed to employers, managers employees, and all occupational health and safety professionals, including occupational physicians.
There is inadequate collaboration between the Ministries of 1.Health, 2. Labour, and 3. Education, on occupational medicine and occupational health matters. There is virtually no education on issues of occupational workplace hazards and protection against them in primary and in general secondary education. The economic advantages and value of OM cannot be appreciated sufficiently by many employers during the economic crisis currently plaguing Greece. Generally, public opinion does not recognize that OM is a high priority, or that OPs have the same standing as physicians holding other clinical medical specialties. It is noted that OM was recognized and established as a medical specialty in Greece, in 1987.
HOT TOPICS REGARDING OM
The main issues are:
1. Communicating the value of OEM,
2. Improving related legislation and its enforcement,
3. Improving training in OM, and
4. Improving OM practice
5. Improving the diagnosing and reporting cases of occupational diseases.
Tackling these issues is a challenge, whilst unemployment rate is at 24% and Greece has many infrastructural, manpower (e.g. currently, shortage of staff teaching OM) and economic difficulties to overcome.
Dr Theodore Bazas, MD, PhD, FFOM(RCP, London), MSc(London), DIH(Engl)
Specialist in Occupational Medicine (JCHMT, UK),
Current Member (and former Vice-President) of the Hellenic Society of Occupational and Environmental Health, Delegate to the UEMS Section on Occupational Medicine nominated by the Panhellenic Medical Association
Athens, Greece, 22 July 2016

1. HISTORY

 

Hungarian occupational medicine roots in ancient organisational (mine hospitals, railway physician system) and professional (M. Huszár, L. Markusovszky, J. Fodor, I. Tóth, V. Friedrich) traditions. In 1946, amid the hunger and dire humanitarian, social and financial situation that followed the WWII, physicians laid down the fundamental structures of occupational health by organising occupational medical care for workers in order to promote their health (foundation of the Hungarian Scientific Society for Occupational Health and Medicine). Hungary was the 3rd European country to ratify ILO C161. Industrial medicine that had significant curative roles was predominant in the era of state owned companies until 1994. Modernised prevention focused approach emerged after the privatisation. Occupational safety and health legislation was among the first that was harmonised with the European Union law.

 

2. ORGANISATION

 

POPULATION (in 2011)

 

Total: 9,938 thousand; active: 4,511 thousand

 

No. of doctors: 34,736; No. of occupational physicians 2,340

 

No. of doctors in occupational medical services: full-time: 951; part-time: 1,735

 

NATURE OF OCCUPATIONAL HEALTH SERVICES

 

Accident insurance system is not introduced to occupational safety and health. Provision of occupational medical care to employees is mandatory for employers (but not for self-employed). Compliance is predominantly achieved by direct contracting with external (private, for-profit) medical services. Employers may provide the service themselves by employing the required health care professionals (internal service). Necessary material and human resources are strictly set in the legislation. Regional occupational medical centres provide second level care. The third level of the Hungarian occupational medical system is in the Occupational Health Department of the National Labour Office (formerly OMFI).

 

3. PROFESSIONS

 

TRAINING

 

Occupational medicine is available as main specialisation after graduating at the medical faculty. It takes two years of foundation programme (emergency medicine, internal medicine, occupational medicine of various sectors) run by a university, and two years work at an accredited occupational medical service, under specialist supervision.

 

Occupational medicine used to be available as secondary specialisation between 1996 and 2008. Several occupational physicians acquired their specialisation that way.

 

Subsidiary specialisation to occupational medicine is occupational hygiene.

 

There is no credit system in the postgraduate training.

 

Specialists must participate in continuing medical education (five year cycles).

 

 

 

TASKS / TASK DISTRIBUTION

 

The occupational medical service is the primary consultant for employees and employers concerning health at work. Duties include: informing workers, carrying out fitness-for-job and health surveillance examinations, investigation and reporting of occupational diseases, surveillance of the working environment, giving advice on personal protective equipment, chemical safety, administering vaccination to workers, preventative care of chronically ill workers, examination of professional drivers. Furthermore, the service participates in risk identification and management, the organisation of workplace first aid, occupational rehabilitation, the setting up of the company emergency rescue plan.

 

4. HOT TOPICS

 

 

    • discrepancies between national OSH legislation and the everyday practice

 

    • ethics and independence of occupational medicine on micro and macro levels (finance, politics)

 

    • occupational health for non-organised workers (self-employed)

 

  • aging workforce

 

5. ASSOCIATION

 

Magyar Üzemegészségügyi Tudományos Társaság (MÜTT)

 

Hungarian Scientific Society for Occupational Health and Medicine

 

http://www.mutt.hu/

 

The Society is the only Hungarian professional association that consists solely of occupational physicians and nurses. It aims to defend the interest of occupational medicine by informing and discussing with stakeholders and decision makers, and providing networking opportunities for the membership. The annual conference is taking place in autumn.

 

Communication means

 

Address:
Nagyvárad tér 2.
Budapest
H-1097
EU

 

Postal address:
Pf. 67.
Budapest
H-1507
EU

 

Telephone/fax: int+36-1-216 6942

 

E-mail: mutt@omfi.hu

Occupational Medicine in Italy

History

The origins of Occupational Medicine in Italy date back to the publication of “De Morbis Artificum Diatriba”, the first comprehensive treatise on the diseases of workers written by Bernardino Ramazzini in 1700. However, the modern era of Occupational Medicine in Italy officially began on 12th October 1929 when the Italian Society of Occupational Medicine – Europe’s oldest and largest Association of this kind – was set up during the eighth national Occupational Health Congress held in Naples.  Although this Society was officially founded in 1929, we should not forget that the first national Congress of Occupational Health took place in Palermo as early as 1907.

The first President of the Italian Society of Occupational Medicine was Luigi Devoto who also founded the Milan “Work Clinic” on 20th March 1910. This institution was the first clinic in the world that was specifically designed to study health and disease in the workplace.

In the 1970s, the Italian Society of Occupational Medicine changed its name to the Italian Society of Occupational Medicine and Industrial Hygiene.

 

Population

Italy has a population of 59.4 million inhabitants. The active working population is about 22.7 million, comprising 56.4 % of the total population. There are approx. 330,000 doctors in Italy and approx. 10,000 occupational physicians. Currently, the Italian Society of Occupational Medicine and Industrial Hygiene has approx. 2,000 members.

Occupational Health Services

  • Public Health Care Centres;
  • Private Occupational Health Centres;
  • Private practice.

In Italy, employers and companies can engage freelance occupational physicians or enter into a contract with a private occupational health centre.

 

Professional Training

In the Schools of Medicine in Italy, Occupational Medicine is taught as a separate, mandatory subject.

In order to become an occupational physician and practise this profession in Italy, medical graduates must undergo a 5-year postgraduate training course that consists of practical and theoretical training in the health care of workers, risk assessment and management, industrial hygiene, epidemiology and statistics, industrial toxicology and health promotion. At the end of this postgraduate training period, to obtain a specialization in occupational medicine, trainee physicians must present and discuss a scientific thesis.

Furthermore, in compliance with laws 502/1992 and 229/1999, occupational physicians must complete their Continuing Medical Education (Credits System) obligations in order to be enrolled on the national register of occupational physicians.

 

Tasks

The specific tasks of the Italian Society of Occupational Medicine and Industrial Hygiene are (i) to contribute to the advancement, development and dissemination of knowledge in the field of Occupational Medicine and Industrial Hygiene, (ii) to promote, encourage, inspire and support the implementation of measures aimed at the diagnosis and prevention of occupational accidents and diseases, (iii) to contribute to informing, training and updating occupational physicians. These objectives are mainly achieved through the development, implementation and evaluation of specific guidelines and the promotion of annual training programs (Continuing Medical Education).

 

Hot topics

  • Ability to work and sickness absence;
  • Alcoholism and drug addiction and work;
  • Atypical jobs and work shift;
  • Biological and environmental monitoring;
  • Biological risk;
  • Carcinogens;
  • First aid in the workplaces;
  • Health surveillance;
  • Musculoskeletal disorders;
  • Nanoparticles;
  • Noise and vibrations;
  • Non-ionizing radiation and optic radiation;
  • Occupational skin diseases;
  • Risk assessment and management;
  • Toxicology of organic compounds and metals;
  • Transport workers;
  • Vaccinations;
  • Working hours and sleep disorders;
  • Working with VDUs;
  • Work-related mental illness;
  • Work-related stress.

 

Association

The Italian Society of Occupational Medicine and Industrial Hygiene (http://www.simlii.it/)

President: Prof. Francesco Saverio Violante

 

Contacts:

SIMLII secretariat- c/o Meneghini & Associati srl

Viale Trento, 56/f – 36100 Vicenza

Phone +39-0444-578845

Mobile +39-348-6430909

Fax +39-0444-320321

e-mail: events@meneghinieassociati.it

Occupational Medicine in Latvia

 

 

History:  

 

Society was established in December of 1994.

 

 

Organisation:

 

Occupational medicine in Latvia is independent speciality;

 

Presently there are 412 occupational physicians in Latvia (01.01.2014.) – 1 per 2.030 employees;

 

50 occupational physicians working full time in ocupational medicine. The most of occupational
physicians work in private sector (private medical centres);
15 occupational physicians are working in Occupational medicine center of University Hospital.
362 family doctors have the Certificate of occupational physician and are working part time job in occupational medicine;

 

 

Adress: Latvian association of occupational physicians, 16 Dzirciema street, Riga, LV 1067,phone +0037167409127, +003767409127,

president of association Maija Eglite, professor, Dr. habil. med.

e-mail: Maija.Eglite@rsu.lv

Information is to come

History

 

The ALSAT (Association Luxembourgeoise de Santé au Travail) was founded in 1996 and is a member of the AMMMD (Association des médecins et médecins dentistes). Occupational health was introduced in 1994 and the occupational health services started their work in January 1995.

 

By law, every private company has to organize occupational health for all their employees and there are 3 possibilities to fulfill this obligation:

 

 

    1. Have an in-house occupational health service ( possible for companies with more than 3000 workers)

 

    1. Create an occupational health service  for a sector of activities

 

  1. Affiliate to the Service the Santé au Travail Multisectoriel (STM) which is a public occupational health service created by law and financed by the companies, asking for his service

 

 

 

The public sector has a different regulation for occupational health and its own occupational health service .

 

 

 

Organization

 

Luxembourg has a population of 500 000. The active working population is approximately 320 000 in the private sector and 27 600 in the public sector. The active population is high because of a large part of workers from our neighbor countries.

 

Actually there are 4 in-house occupational services, 3 sector-organized services and the STM for the private sector  and one service for public employees.

 

 

 

The law requires an occupational health physician for 5000 workers. Or actually all the services occupy only 55 occupational health physicians.

 

Professions

 

The training for occupational health physicians took place in the Universities of our Neighbor countries mostly in Belgium and Germany.

 

You have the possibilities to become an occupational health physician specialist (4 years training) or to ask after a specific program requiring 450 hours training over 2 years including at least 2 months of practical training in an occupational health service for an authorization to work as an occupational health physician.

 

 

 

Tasks

 

 

 

 

    • Clinical examinations (pre- employment, risk related health survey, on employers or workers demand, after sickness absence over 6 weeks, employees during pregnancy,  for rehabilitation  )

 

    • Risk assessment

 

  • Prevention at work

 

Hot topics

 

 

 

In 2012 the Ministry of Health has initiated an audit of occupational health where the following hot topics were issued

 

 

 

 

    1. Lack of occupational health physicians

 

    1. Multidisciplinary staff  in occupational health

 

    1. Mental health issues

 

    1. Occupational health in SME’s

 

  1. Promotion of collaboration with stakeholders

 

Association

 

 

 

Association luxembourgeoise de santé au travail a.s.b.l (ALSAT)

 

 

 

President : Marc Jacoby

 

Vice president : Nicole Majery

 

 

 

www.alsat.lu

 

 

 

Office :

 

Rue de Vianden, 29

 

L-2680 Luxembourg

Information is to come

History

The Netherlands Society of Occupational Medicine (NVAB) started in 1946 as a separate section of the Association of Public Health and was officially founded in 1953. Nowadays about 90% of the occupational physicians in The Netherlands , i.c. more than 2000, is NVAB-member. One of NVAB’s goals is enhancement of the scientific basis of occupational health practice and improvement of the professional quality of occupational physicians. One of the tools in a quality-improving strategy is the development, implementation and evaluation of evidence-based clinical practice guidelines. Therefore in 1998, the NVAB started a programme for the development and implementation of evidence-based practice guidelines. To professionalize these activities, NVAB set up a Centre of Excellence in 2003.
Centre of Excellence
One of our main tasks is to develop evidence based practice guidelines in occupational health. In addition to this, NVAB is also involved in the development and implementation of multidisciplinary clinical guidelines for the integration of work-related aspects. Another important issue in NVAB’s quality policy is medical audit. Development and organization of medical audits is a key activity of NVAB’s Centre of Excellence.
Organisation
The Netherlands have a population of 16.5 million people. The active working population is approx. 7 million people. There are approx. 60000 doctors in the Netherlands and 2100 occupational physicians of whom 90 % is a member of the society. There is a growing number of self employed occupational physicians. 190 is a member of an organisation of self employed OPs.
OPs can be part of a private occupational health service, an in-house company service or can work as self employed physicians.
Professions
There is a 4 year postgraduate training for occupational physicians. After that OPs have to fulfil their CPD and CME obligations to keep their registration of 5 years. (credit system)
Tasks
In the Netherlands OPs play an important role in the management of absence behaviour. Maintaining functional capacity of employees is of paramount importance in this respect.
Another important task is the execution of health surveillance programmes, based on risk assessment and evaluation.
Finally, the occupational physician has an important role in prevention. Due to time spent on managing absenteeism insufficient attention can be given to prevention.
Hot topics
  1. lack of independent position due to priority on the management of absence behaviour
  2. Too little time spent on prevention
  3. Companies find other programmes to improve health (without OP)
E-mail Address: nvab.artsennet.nl
 
Communication: Journal of occupational and insurance medicine and newsletter on website

Occupational Medicine in Norway

 

 

 

 

 

History

 

1659 – The mining industry physician – ”Berg Medicus”
1893 – First legislation for workers’ protection. Focus on child labour.
1910 – and onwards – increasing concern in social factors, working conditions and health

 

Nature of occupational Medicine in Norway

 

Occupational Medicine in Hospitals

 

1946- Outpatient clinic at the National Hospital in Norway. Organized by the Norwegian Labour Inspection Authority.
1960s and onwards- Out-patient clinic at the National Institute of Occupational Health     (STAMI)
1978- Department of Occupational Medicine at the Regional Hospital in Telemark, localised in a primary industrial area.
1990-1995- Departments of Occupational Medicine established at six regional hospitals in Norway

 

Occupational Health Services (OHS)

 

1917:  Industrial physician promotes preventive health care
1943:  40 OHS in factories
1945:  OHS organised in cooperation between Medical association, Trade Unions and
Employers organisation.
1977:  New Working Environment Act.
1979:  OHS 3.300 enterprises with 450.000 employees covered by OHS.
1990:  New Act defining enterprises that should have compulsory OHS.
2010:  Extension of the Act of 1990.
2010:  Compulsory approval for all OHS

 

Occupational Health Personnel both employed by the individual company and in independent enterprises offering OHS.

 

Population in Norway

 

5,0 million
Workforce approx. 2,5 mill.

 

Physicians

 

Nearly 28.000 in total
447 members of the combined Association and Society of Occupational Medicine
281 approved specialists of Occupational Medicine

 

Training

 

Postgraduate training of Occupational Medicine Specialists lasts five years. At least one year in OHS or in a Department of Occupational Medicine. Comprehensive program of supervision and theoretical training is mandatory.

 

No compulsory program for continuing medical education.

 

Tasks

 

 

    • Risk assessment at the workplace

 

    • Counselling to the employers and the employees

 

    • Individual health screening

 

    • Cooperation Agreement regarding a More Inclusive Working Life

 

    • Diagnosis of occupational diseases

 

  • Research

 

Hot topics

 

Health Prevention based on Knowledge of Occupational Medicine in a Global Perspective
Strengthen the education in Occupational Medicine at the Universities
Strengthen Occupational Medicine – improve the physicians’ position in OHS

 

www.arbeidsmedisin.no

OCCUPATIONAL MEDICINE IN POLAND
History

Polish Society of Occupational Medicine (PTMP) was set up in 1969 and it gathers about 2000 members, mainly physicians specialized in occupational medicine. It is supported regionally by a group structure arranged in geographical regions. The main goals of the Society are:

  • enhancement of the scientific basis of occupational medicine and harmful effects of work environment
  • co-participation in creating employees’ health prophylaxis strategies
  • development of the Society members’ professional and scientific qualifications
  • co-participation in designing of the postgraduate training in occupational medicine programs
  • development and implementation of evidence-based clinical practice guidelines.

Main data

Poland has a population of 38.5 million people of which 24.2 million are in the working age (15-64).  The active working population is approx. 16 million people.

From a legal point of view, the main stakeholders for health and safety at work in Poland are:

  • Ministry of Labour and Social Affairs responsible for issues related to occupational safety and hygiene (including the transposition of the majority of the EU OSH directives).
  • The Ministry of Health responsible for issues related to occupational health (medicine) and the monitoring of the occupational medicine service.
  • The State Labour Inspection plays a significant surveillance role by checking whether or not the employers fulfil their OSH obligations. The Inspection also conducts awareness-raising campaigns on OSH.

 

According to the Polish legislation, every employment must be preceded by the performance of a compulsory medical examination. Following such an examination, a certified physician issues a certificate, which states whether or not there are any contraindications for one to perform work at a particular post. This rule applies to all workers and workplaces, irrespective of the working conditions. The costs of medical examinations are borne by the employers.

There are approx. 6700 physicians entitled to perform employees’ periodical health screening in Poland. Only 48,4% of them are physicians specialized in occupational medicine.

Some of them work in joined occupational medicine services and some of them as self-employed occupational medicine physicians. They can also work in an in-house company service.

Profession

There is a 5-year postgraduate training for occupational medicine physicians (3-year elementary module – common for various specializations and 2-year specialist training). One becomes a specialist in occupational medicine after passing a national exam.

Contact details

Polskie Towarzystwo Medycyny Pracy

ul. sw. Teresy od Dzieciatka Jezus 8

91-348 Lodz, Poland

e-mail: Jolanta.Walusiak-Skorupa@imp.lodz.pl

www.ptmp.org.pl

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

Total                           10.341.330 (as of 31 Dec 2015)

Workforce                      5 182.000 (as of 1st T 2017)

PHYSICIANS IN PORTUGAL(2016)

50.927 medical doctors

1014 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 provision is seldom exploited

 

PROFFESION

Training

The internship requires practical and theoretical modules, distributed through 4 years, in a major Hospital with an OHS, as well as specialized organisms that deals with Occupational Health, in particular Labour Inspectorates (ACT) and the one in charge for the recognition of OD (DPRP-ISS). A final exam concludes the evaluation process.

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

Rua Delfim Maia, 405, 4200-256 Porto

TLF: (351) 225070180

FAX: (351) 225070179

TM: (351) 935570107

antonio.pinheiro@nortemedico.pt

 

Ferreira Leal, MD – President of the College

je.ferreira.leal@gmail.com

TM: (351) 961748197

Pedro Gustavo Reis, MD – Representative in UEMS

pedrogreis@netcabo.pt

TM. (351) 965 059 968

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

History

1654- Royal College of Physicians of Ireland (RCPI) established

 

1976- Faculty of Occupational Medicine established at RCPI, now has Malaysia / New Zealand / United Arab Emirates Committees

 

2000- 4 Year Specialist Training Scheme in Occupational Medicine established

 

Organisation

Population : Republic of Ireland 4.2 Million /Northern Ireland 1.8 Million (Faculty is all Ireland)

 

Workforce:  1,8 mill
Doctors :     8,000 Republic of Ireland
Occ Physicians :86 full-time Occupational Physicians, app. 250 part time non specialists GPs with an interest in Occupational Medicine
Three Bodies  :

 

 

    • Faculty of Occupational Medicine (All Ireland& International)

 

    • Irish Society of Occupational Medicine (Republic of Ireland)

 

  • Northern Ireland Society of Occupational Medicine (Northern Ireland)

 

Nature of Occupational Health Services

Roughly 50% of Full Time Occupational Physicians are in the public sector and 50% are in the private sector. Large public sector organisations like the Civil Service, Health Service, Police (“Garda Siochana”) , Postal Service and Transport Service have inhouse ocupational halth services. Private sector organisations have either inhouse or outsourced occupational health services.

 

There are also approximately 25-30 doctors employed by the Department of Social Protection who work in disability assessment medicine.

Periodic medicals for all workers (like in France etc) are not a feature of Irish Occupational Health Services. Periodic health surveillance for noise exposure / hand-arm vibration etc & immunisation against biological hazards are required on a statutory basis.
Professional Training

 

Four Year Specialist Training Programme in Occupational Medicine, currently 7 trainees, funded by the public sector and training provided by the Faculty of Occupational Medicine, exit exam is Membership of the Faculty of Occupational Medicine (MFOM). Also training provided to generalists via Irish College of General Practitioners in conjunction with Faculty of Occupational Medicine, exit exam is Licentiate of the Faculty of Occupational Medicine (LFOM)

 

Hot Topics

New Medical Practitioners Act requires all doctors to undergo compulsory CME and Audit, 360 degree feedback may be introduced at a later date. Doctors who are not involved in specialist training or who are not on a specialist registrar are required to “align” themselves with a specialist training body who will provide non-specialist competance assurance for their area(s) of work. This will be a major body of work for the Faculty going foward with limited financial and doctor resources, all of whom are unpaid “volunteers”.

Weblinks

www.rcpi.ie/Faculties/Pages/FacultyofOccupationalMedicine.aspx

www.isomirl.com

OCCUPATIONAL MEDICINE IN SLOVENIA

 

 

HISTORY
Beginning: 18th century in mercury-mine Idrija (west Slovenia) – the medical and social care for the miners and their families was assured by world famous doctors like Giovanni Antonio Scopoli (1723 – 1788), Balthasar Hacquet (1739 – 1815).

During 1963 and 1967 the Dispensaries of occupational medicine were founded to take preventive and active heath care for all the workers in Slovenia.

On 9th September 1971 the Clinical Institute of Occupational Medicine in Ljubljana was founded.

 

POPULATION OF SLOVENIA

Total: 2 046 976
Workforce 821 965
ACTIVE PHYSICIANS IN SLOVENIA
5015 physicians
194 Specialists of occupational medicine

 

NATURE OF OCCUPATIONAL HEALTH SERVICES

  • Private practice
  • Public health care centres

 

PROFESSION
TRAINING
  • Postgraduate training takes four years (active health care of workers, epidemiology and statistics, professional diseases, risk assesment, industrial hygienics, heath promotion)
  • Continuing Medical Education is required to be licenced by the Medical Chamber of Slovenia.

TASKS

  • Preventive assesments of employees as required by the legislation
  • Risk assesment
  • Councelling to the employers

HOT TOPICS

  • Ability to work and sickness absence
  • Professional diseases
  • Changes of legislation
ASSOCIATION
ZDRUŽENJE MEDICINE DELA, PROMETA IN ŠPORTA
 

 

ASSOCIATION OF OCCUPATIONAL, TRAFFIC AND SPORTS MEDICINE OF SLOVENIA
Address: Dalmatinova ulica 10  SI-1000 LJUBLJANA
Website: www.zmd.si
Contact person: alenka.skerjanc@siol.com

OCCUPATIONAL MEDICINE IN SLOVAKIA

 

 

 

 

HISTORY

  • 1932 – first outdoor patient department and few years later clinical department in Prague, Czechoslovakia – prof. Dr. J. Teisinger
  • 1949 outdoor patient department and clinical department in Bratislava – prof. Dr. M.Nosáľ
  • 1951 – outdoor patient department in Martin, 1956 – clinical department in Martin – Dr. B.Geryk
  • 1952 – outdoor patient department in Košice, 1960 – clinical department in Košice – assoc. Prof. Dr. B.Gomboš
  • 1953 – Research Institute of Occupational Hygiene and Occupational Diseses in Bratislava – Dr. I Klucik

 

ORGANISATION

 

POPULATION OF SLOVAKIA

 

Total: 5 412 254
Active: 2 056 656

 

 

ACTIVE PHYSICIANS IN SLOVAKIA

 

All: 20578 Specialists of occupational medicine: 127

 

NATURE OF OCCUPATIONAL HEALTH SERVICES

 

Non governmental health facilities
Private practice
Public health centres (advice and state health inspection)

PROFESSION

 

TRAINING

 

Postgraduate training for a doctors is possible in 4 specialization/subspecialization:

  • Occupational Medicine (specialization – 4 years study) after basic specialization in Internal medicine, or GP, or Hygiene and Epidemiology subspecializations:
  • Clinical Occupational Medicine and Clinical Toxicology (subspecialization – 3 years study)
  • Preventive Occupational Medicine and Toxicology (subspecialization – 3 years study)
  • Occupational Health Services (subspecialization – 2 years study)

 

Continuing Medical Education is required to be licensed by the Slovak Medical Chamber.

 

HOT TOPICS

Occupational health-prevention of professional and work related diseases, health promotion
Professional diseases

  • One time compensation: awarding points scale depends up to disease (240 – 8000 points)
  • 1point = 2% of average earns in Slovakia (2010: 1p.=14,89€)
  • plus monthly accident pension

Occupational Health Services

  • changes of legislation
  • tasks in team of OHS

TASKS

  • Occupational health risk assessment
  • Preventive examinations of employees – evaluation of work ability
  • Advising to employers and emploees
  • Health education
  • Evaluation of health status of emploees in relation to the changing work conditions
  • Diagnostics ,notification and prophylaxis of occupational diseses

ASSOCIATION

 

 

Slovenská spolocnos‘ pracovného lekárstva SLS – SLOVAK ASSOCIATION OF OCCUPATIONAL MEDICINE

 

Address:
Rastislavova str. 43
04190 Košice
Slovakia

 

Contact person: marek.varga@upjs.sk

HISTORY

1900 First law legislating work accidents. This law originated the development of a treatment and compensation system for workers.

1955 Occupational Medicine officially recognised as a medical specialty.

1956 Spanish Society of Occupational Health and Safety at Work founded as a federation of regional societies.

1989 Access to 3 year formal training in OM through national examination.

2005 Four year Specialist Training Scheme in Occupational Medicine established.

ORGANISATION

POPULATION

Total population:                         46.072.834

Active population:                       23.122.300

Registered doctors:                          219.031 (476 doctors / 100.000 inhabitants)

Occupational Physicians:                   10.500 doctors with title of specialist in OM (5.500 doctors actually working in OM (estimated))

 

NATURE OF OCCUPATIONAL HEALTH SERVICES

 

In-house OHS: mainly public sector and large private enterprises.

Outsourced OHS: most medium and small sized enterprises (a very high number of private companies in Spain are medium or small) and many large companies.

 

 

PROFFESION

TRAINING 

After medical school, access to a 4 year specialist training programme in Occupational Medicine through national examination. Training includes a 6 month theoretical course, 20 months hospital rotations and 20 months rotation in an Occupational Health Service. Training is funded mainly by private sector (unlike other specialties) which is causing a worrying decline in number of trainees.

 

TASKS / TASK DISTRIBUTION

 

– Preventive: Most OH Physicians work in this modality. Health surveillance and fitness for work evaluation. Periodical medical examinations for workers. It can be done in an in-house OHS or in an outsourced private OHS.  
– Clinical: diagnosis and treatment of work accidents and occupational diseases in a “mutual insurance company”. This system is parallel to the National Health System, which covers not work related pathology.
– Others: Evaluation of work disability for compensation schemes. Sickness absence. Advice/support Units for General Practitioners. Civil Service. University.

 

HOT TOPICS
– Decreasing number of trainees.

– Communication between the two systems of social security (occupational and not occupational) and the preventive system (OHS).

– Occupational diseases.

– Changes in legislation.

– Concern about the position and the future of the specialty.

 

ASSOCIATION AND WEBLINKS

 

SOCIEDAD ESPAÑOLA DE MEDICINA Y SEGURIDAD DEL TRABAJO (SEMST)

Spanish Society of Medicine and Safety at Work is a federation of 12 regional societies with an autonomous regional scope and a total of over 3000 professionals associated.

Address: C/ Santa Isabel, 51. 28012 Madrid. Tel 91 792 13 65. (Fax 91 500 20 75)

Website: http://www.semst.org

President:        Francisco Vicente FORNES UBEDA

SOCIETAT CATALANA DE SALUT LABORAL (SCSL)

Catalan Society of Occupational Health is the biggest of the 12 regional societies with 800 professionals associated.

 

Address: Carrer Major de Can Caralleu 1-7. 08017 Barcelona. Tel: 93 203 27 97 (Fax: 93 203 14 85)

Website:http://webs.academia.cat/societats/laboral/

President:           Jordi Carles Schlaghecke Gras

Contact person:  Mari Cruz Rodríguez Jareño     (scsl@academia.cat )

 

Presentation 2012

Information is to come

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

Prevention – Insurance – Rehabilitation  SUVA, Klaus Stadtmueller

OCCUPATIONAL MEDICINE IN UNITED KINGDOM
There are two main bodies for Occupational Medicine in UK:

 

    1. The Faculty of Occupational Medicine
    2. The Society of Occupational Medicine.

 

The Faculty of Occupational Medicine was set up in 1978 to provide a professional and academic body of doctors empowered to develop and maintain high standards of training, competence and professional integrity in occupational medicine. Its objectives are to:

 

○   act as an authoritative body for consultation in matters of education and public interest concerning occupational medicine
○   promote for the public benefit the advancement of education and knowledge in the field of occupational medicine
○   develop and maintain for the public benefit the good practice of occupational medicine, providing for the protection of people at work by ensuring the highest professional standards of competence and ethical integrity.

 

The Faculty is a registered charity. Its policies and general direction are determined by the Board, which is elected by the membership.  It is supported by committees, working groups and including regional forums.  It is also responsible for the publication of Occupational and Environmental Medicine.

 

The Society is also a registered charity and was founded in 1935 as the Association of Industrial Medical Officers; it changed its name to the Society of Occupational Medicine in 1965. It provides education and support to its members through a national and regional programme of continuing medical education and a quality assured appraisal scheme in support of the requirements for medical revalidation in the UK. It has 1800 members and is open to doctors outside of UK with an interest in occupational medicine as well as nationally.  Membership includes general practitioners as well as occupational physicians. It is supported regionally by a group structure arranged in geographical regions.

 

It has a board, which is elected by the membership determining policies and strategic direct with both national and regional membership.

 

The Society is concerned with:

 

○   the protection of the health of people in the workplace
○   the prevention of occupational injuries and disease
○   related environmental issues

 

SOM is a forum for its membership and aims to stimulate interest, research and education in Occupational Medicine. It has wide-ranging contacts with government departments and professional bodies and responds with the Society’s view to consultative documents and topics of interest and concern affecting the speciality.

 

ORGANISATION

 

Population: 60 million (2012), 26 million people at work.

 

Number of doctors specialized in occupational health: 1000

 

Training and Membership
The Faculty is responsible for post-graduate training within the speciality and admits Diplomates who satisfy the Regulations and pass the diploma examination; Associates which is a qualification awarded to those medical practitioners who have a sufficiently broad clinical experience and full or part-time experience in occupational medicine to satisfy the Regulations and who pass the examination for Associateship (an examination which has been replaced as part of the new specialist training requirements for UK dictated by PMETB), and Members who are registered medical practitioners who wish to specialise in occupational medicine.  Members will have satisfactorily completed a prescribed period of supervised training in one or more approved posts (minimum of 4 years) and have passed both Part 1 and Part 2 of the Faculty examinations (previously Associateship examination and Membership assessment of thesis, dissertation or other published work). There are also Fellows who are elected by the Board.

 

The Society works closely with the faculty in providing relevant CPD/CME for its members and as well as having a pivotal role in supporting members with its appraisal scheme.

 

The nature of occupational health services in UK
Occupational health services in some organizations in UK are integral to the organization in particular large organizations e.g. NHS, Armed Forces, Police and other large industrial based organizations. There are also a number of OHS providers, which are contracted by different organizations to provide services.  Service provision is a mixture of nurse-led and doctor-led services depending on the organisation’s needs.  There is currently no statutory requirement for occupational health provision in UK although certain medical services have to be provided in the more hazardous industries in line with European legislation.

 

Hot Topics

 

○   Health of the potentially working population including those currently out of work
○   Managing sickness absence

 

Contact Details

Society of Occupational Medicine
Hamilton House
Mabledon Place
London WC1H 9BB
Tel: 020 7554 8628
admin@som.org.uk
www.som.org.uk
Faculty of Occupational Medicine
3rd Floor, New Derwent House
69-73 Theobalds Road
LONDON
WC1X 8TA
Tel: 020 7242 8698
Fax: 020 3116 6900
www.facoccmed.ac.uk