Challenges of the Occupational Health Physician

The International Commission on Occupational Health (ICOH) has now functioned for 100 years. The Finnish Association of Occupational Health Physicians participates in celebrating this 100th anniversary by publishing a brief international supplement. The aim of this publication is to shed light on the challenges that physicians nowadays are tackling in the field of occupational health, and to describe some current activities and projects, especially in Europe. As representatives of the Finnish Association, we want to bring up some special features and aspects of the occupational health care system of our country.

The changing world around us requires that the concepts and definitions related to occupational health and medicine need to be discussed thoroughly by occupational health professionals, as well as by the clients, who form a network of employers, employees and the authorities. Nicholson (2001) believes that we need to ask less often ‘what do we do?', and more often ‘what can we add?' or ‘what is our unique contribution?' The needs and expectations of clients should be listened to with respect and sensitivity. At the junction point where the client and the producer of services meet, the principles of our professional independence need to be combined with the demand for good services. The recognition of ‘weak signals' from the society and sensitive reacting to the changing world of work using relevant methods helps ensure good cooperation between employers, employees, and occupational health professionals. Preventive measures and improvements in working conditions can be carried out with the sincere efforts of all partners in the tri-partite collaboration.

In the management of work-related diseases, occupational medicine still forms the essential core of occupational health. A few years ago a Delphi study showed that our academic colleagues held traditional disease-focused views the competence requirements of training in occupational medicine (Macdonald et al. 2000). Hazards to health, occupational diseases and work-related ill health were given high priority. On the other hand, the traditional methods of occupational medicine are today being challenged by an increasing demand for evidence-based thinking. Activities such as health examinations and work place interventions should be considered evidence-based, if possible. This evidence-based approach will be emphasized increasingly also in the education and training of occupational physicians.

The changing definition of occupational health has increased the importance of health promotion. Ill health due to work-related symptoms lowers the employees' quality of life and the productivity of the enterprise. This should be remembered especially as regards aging workers, whose share in the work force is growing everywhere. The European Network of Workplace Health Promotion is an ambitious joint project of the countries of the European Union, inspiring a vision of successful future activities.

Prevention has always been a central goal in the occupational health context. Occupational health services (OHS) vary in different countries according to the national legislation or health care system in the respective countries. The national system in Finland is based on a law and on collaborative practices following specific guidelines. Curative treatment, although voluntary in the legislation, plays an important role in our OHS system. The consumer-focused definition of occupational health gives high priority to the quality of the services. New ways to assess quality have to be developed. The OHS of global enterprises is facing many challenges, because both the surveillance of the activities and the statistics are not comparable in different countries. A corporate-level occupational health and safety coordination team has to create common guidelines for the whole enterprise. In addition, every worker of the world should have access to occupational health services, which should be as ‘natural' as public health care. By complementing the health care system with basic occupational health services it is possible to achieve a great impact on the level of public health, especially in countries where traditional exposures to e.g. asbestos, quartz, lead, pesticides and other toxic chemicals are still overwhelming occupational health hazards (Rantanen 2005).

We hope that this theme supplement of the Occupational Health Physician provokes thoughts and discussion concerning topical occupational health and safety issues, and will increase enthusiasm for this fascinating and at the same time extremely challenging area.

Kirjallisuutta

1. Nicholson P. Occupational Medicine: New world, new definition. Editorial. Occup Med 2001;51:423-4.
2. Macdonald EB, Ritchie KA, Murray KJ, Gilmour WH. Requirements for occupational medicine training in Europe: a Delphi study. Occup Environ Med 2000;57:98-105.
3. Rantanen J. Basic Occupational Health Services. The Joint ILO/WHO Committee on Occupational Health priority for ILO/WHO/ICOH collaboration, with the support of the Finnish Institute of Occupational Health (FIOH), 2nd revised ed., Helsinki 2005 (available from: Suvi Lehtinen, Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, FI-00250 Helsinki, Finland)