Medical Council of Canada

Medical expert

Work-related Health Issues - 78-8

Rationale

Workplace health and safety hazards can contribute to many different health problems. Physicians play an important role in the prevention and management of occupational injury, illness and disability.

Causal Conditions

(list not exhaustive)
  1. Ergonomic hazards (e.g. awkward postures and movements, poor lighting)
  2. Chemical hazards (e.g. organic solvents, metals, asbestos, toxic gases)
  3. Physical hazards (e.g. noise, vibration, radiation)
  4. Biological hazards (e.g. blood or other body fluids, animal and bird droppings)
  5. Psychological and work organization hazards (e.g. workplace stressors, workplace bullying)

Key Objectives

Given a patient with a health problem, the candidate will evaluate the possible workplace etiological factors, to assess the contribution of occupational exposures for the most common pathologies, to assess the impact of the condition on the ability to work, and develop an appropriate management plan. Particular attention should be paid to the identification of occupational risks for the patient and his/her co-workers.

Enabling Objectives

Given a worker with a health problem, the candidate will

  1. list and interpret critical clinical findings, including:
    1. perform a history and focused physical examination to identify the illness and determine the possible relationship of symptoms to work;
    2. identify hazards in the workplace that could have had an impact on the health problem (work and exposure history);
    3. identify protective equipment being used and environmental controls that are in place;
    4. identify non occupational factors that could influence the condition.
  2. list and interpret critical investigations, including:
    1. appropriate laboratory or radiologic investigations depending on the presenting health problem (e.g. chest radiography, ultrasound);
    2. physiologic and/or functional assessments (e.g. PFTs , audiograms, occupational therapy assessment).
  3. construct an effective initial management plan, including:
    1. initiate specific therapy as required for the health problem;
    2. determine whether the patient should be assigned to a different work, or stop work and advise the patient on this topic;
    3. determine follow up care and whether further consultation, counselling and/or a multi-disciplinary approach to care is needed;
    4. advise the patient on workers compensation;
    5. advise the relevant authorities if necessary (notifiable disease, reporting a dangerous situation).
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