His Occupation: Safety and Fulfillment

Abstract

Work is a central feature of adult life and may contribute to overall well-being or may cause disease, injury, or death. Recognizing its importance facilitates communication, helps to establish rapport, gives the clinician a sense of what matters to the patient, and offers the chance to reinforce safety and health. For some common health outcomes—low back pain and asthma—work may play an etiologic role or may exacerbate an underlying condition, and workplace modification may offer relief. In other instances, underlying conditions like obesity, diabetes, chronic obstructive pulmonary disease, or chronic renal failure may impact how your patient would approach shift work or hot environments, as examples. Understanding the particular stressors of the workplace can help you provide your patient with the tools to address these and other risk factors. This chapter is a brief introduction to occupational safety and health, a neglected area of medical practice, and offers information about a variety of resources.

1.11 Resources

The Occupational Safety and Health Administration (OSHA) [http://www.osha.gov/] is charged with creating and enforcing regulations for safe and healthy workplaces. OSHA has a webpage for workers, detailing their rights for a safe and healthy workplace: http://www.osha.gov/workers/index.html. Employers can learn about their responsibilities and how to obtain assistance from OSHA at this link: http://www.osha.gov/employers/index.html

• Occupational Safety and Health Administration (OSHA). Heat Campaign: Water Rest Shade. Accessed at: http://www.osha.gov/SLTC/heatillness/index.html. It has many resources for employers and workers, including low-literacy information and a smartphone app that calculates the heat index and provides reminders about workplace protective measures.

• OSHA’s Clinicians’ webpage: http://www.osha.gov/dts/oom/clinicians/index.html. It provides information, resources, and links to help clinicians navigate OSHA’s web site and aid clinicians in caring for workers. Key sections of the Clinicians’ webpage include:

  • Ethics and Confidentiality in Occupational Health

  • Evaluating Occupational Exposures and Injuries

  • Medical Records—Laws and Confidentiality

  • Reporting a Dangerous Workplace

  • Setting up a Safe Outpatient Office

  • Workers’ Compensation

The National Institute for Occupational Safety and Health (NIOSH) [http://www.cdc.gov/NIOSH/] is the US federal agency that conducts research, provides education, and makes recommendations to prevent worker injury and illness. NIOSH webpages of particular interest:

• Men’s Reproductive Health in the Workplace: http://www.cdc.gov/niosh/topics/repro/mensWorkplace.html.

• NIOSH’s Education and Research Centers [http://www.cdc.gov/niosh/oep/erc.html] are university-based programs located around the country. The centers provide clinical services, train occupational health professionals, and do research.

• NIOSH Health Hazard Evaluation [http://www.cdc.gov/niosh/hhe/ ] is a worksite evaluation that can be obtained through a request by an employer or three or more employees.

• NIOSHTIC-2 [http://www2a.cdc.gov/nioshtic-2/] is a searchable bibliographic database of occupational safety and health publications, documents, grant reports, and journal articles supported in whole or in part by NIOSH.

The Agency for Toxic Substances and Disease Registry (ATSDR) is a federal public health agency of the US Department of Health and Human Services tasked with providing evaluation and education regarding environmental health hazards. ATSDR’s Case Studies in Environmental Medicine include “Taking an Environmental History”: http://www.atsdr.cdc.gov/csem/exphistory/docs/exposure_history.pdf.

The Association of Occupational and Environmental Clinics (AOEC) [http://www.aoec.org/] is a nonprofit organization committed to improving the practice of occupational and environmental health through information sharing and collaborative research. AOEC has a network of over 60 clinics and 250 individual members across the United States and in some other countries. AOEC’s clinic directory is a helpful resource: http://www.aoec.org/directory.htm.

The American College of Occupational and Environmental Medicine (ACOEM) [http://www.acoem.org/] is the professional organization of physicians specializing in the field of occupational and environmental medicine. ACOEM conducts continuing educational training for physicians, produces clinical guidelines and policies, and is a source for locating an occupational medicine specialist.

The American Public Health Association (APHA) [https://www.apha.org/] is the largest organization of public health professionals in the United States. APHA is comprised of multiple interest groups, including an Occupational Safety and Health section [https://www.apha.org/apha-communities/member-sections/occupational-health-and-safety] and a Men’s Health Caucus [https://www.apha.org/apha-communities/caucuses/mens-health-caucus].