Med Lav
-
In 2005, 52% of workers in the Veneto Region reported one or more sick leave spells in the previous 12 months, compared with 16% reported in the European Survey on Working Condition in 2000 (ESWC), although health conditions were better in the Veneto Region than in the ESWC. ⋯ The choice of measurements influences the results; duration of absence could be used to detect areas of suspected work-related diseases, while cumulative incidence might be more helpful to detect areas of suspected absenteeism/presenteeism.
-
Headache is reported as one of the most frequent causes of lost work time and reduced work efficiency. ⋯ Data regarding the prevalence of migraine were similar to the results reported in other studies. The vast majority of the individuals reported no absenteeism over the previous three months. The study confirmed that we should continue to manage the presumed job-related trigger factors in the best possible manner, counselling should be made available to health care workers during the periodic health examinations or upon request, and if needed, the patient should be sent to a neurology specialist for a free examination and appropriate pharmacological treatment.
-
Health and medical knowledge are essential to the resolution of disputes in law and administrative applications (such as workers' compensation) and provide essential input into public policy decisions. There are no socially agreed-upon rules for the application of this knowledge except in the law. On a practical level, the legal system lacks the capacity to evaluate the validity of knowledge as evidence and therefore relies heavily on expert opinion. ⋯ Another is how the generalizations drawn from epidemiology and population-based sciences are interpreted and individualized, as they must be, for the case at hand. A related issue is how risk is interpreted for an individual after the fact, when conventional probability treats risk before the fact and conventional biostatistics applies primarily to a population. This emerging approach is called "evidence-based medical dispute resolution".
-
Occupational asthma (OA) is one of the most common forms of occupational lung disease in many industrialized countries, having been implicated in 9 to 15% of adult-onset asthma. Work-related asthma includes: 1. immunologic OA, characterized by a latency period before the onset of symptoms; 2. nonimmunologic OA, which occurs after single or multiple exposures to high concentrations of irritants; 3. work-aggravated asthma, which is pre-existing or concurrent asthma exacerbated by workplace exposures; and 4. variant syndromes. OA is important to recognize clinically, because it has serious medical and socioeconomic consequences. ⋯ Removal of the worker from exposure to the causal agent and early treatment with anti-inflammatory drugs lead to a better outcome. Assessment of the work environment and identification of host factors may provide us with useful information about the mechanisms involved in OA. Another issue concerns strategies for preventing OA which should be implemented.
-
Western populations are in the middle of the epidemiological transition of chronic diseases. Care of patients with chronic disease is directed at optimising life expectancy and quality of life. Daily and social functioning, including paid work are part of the treatment objectives. Yet, advice for and support in work related coping with chronic diseases, and collaboration with occupational health are not--yet--part of routine curative medical care procedures. This is also the case in general practice, where most patients with chronic conditions are treated. This 'blind spot' signals a generic lost opportunity in optimizing the care of patients with chronic disease. This paper analyses from empirical data the importance of integrating work-related advice and support in general practice and explores potential evidence of the benefits this provides for patients: the opportunities that can be capitalised through better interaction between occupational physicians (OP) and general practitioners (GP). ⋯ All consultations with employees with a chronic (respiratory) disease can be considered as opportunities to supervise work-related implications of the disease. Patients value their ability to work but frequently apply inefficient coping through ignoring the implications of their circumstances for their disease. A more efficient coping can probably be achieved through a more active involvement of patients in managing their own disease. Guidelines--like the Dutch College of General Practitioners'--have developed into a sophisticated and generally respected system of guidance of patient care. Explicit emphasis of management in relation to the workplace may present a logical opportunity to capitalise on.