Different risk factors in the work environment can lead to employees becoming ill. Manual workers have usually an increased risk of developing musculoskeletal disorders. On the other hand, employees whose work is more mental, are at risk of mood disorders and burnout. Because the human mind and body are closely connected, physical ailments contribute to mental exhaustion, and in turn, mental exhaustion can lead to developing a physical illness. For example, an employee with joint pain has to push himself or herself more mentally, his or her concentration of work is disturbed and mood is reduced. Such „pushing forward“ and „whatever it takes“ attitude gradually exhausts the body, which in turn leads to the emergence of new symptoms and health problems.
Because complaining is frowned upon in our culture, an employee who suffers from chronic ailments may be left relatively alone in the workplace. Sometimes the employer does not want to disturb others with his or her worries, sometimes the reason is fear of losing the job. As a last resort, the employer turns to the family physician who usually prescribes painkillers and issues a sick leave. This is not really the correct solution, especially in a situation where the working environment and working conditions play an important role in the illness.
Occupational health care is involved in the treatment and prevention of work-related illnesses. The law even obliges to refer a patient to an occupational health physician (§ 23 (4) of the OHS Act) if there is a suspicion that the illness may be related to work. It is necessary in order to assess and improve employees’ working conditions. Modifying working conditions and working environment with the help of an occupational health specialist (occupational health physician, occupational health nurse, occupational psychologist or occupational physiotherapist) plays a key role in ensuring the employee’s wellbeing and working capacity.
One of the goals of treating work-related illnesses is to prevent further illnesses. In addition, it is important to help the employee return to work as safely and quickly as possible. In order that treatment of work-related illnesses is possible at all, occupational health care services should be able to provide minimally the level of a family physician care to its clients. If an occupational health physician refers a patient with a work-related illness to a family physician and does not coordinate the further treatment of the employee, it contradicts the essence of the Occupational Health and Safety Act.
Of course, it does not mean that working people should exclusively consult an occupational health physician for all kinds of illnesses and health problems. Work-related illnesses are narrowly defined health problems that are caused by risk factors in the working environment, which are not considered occupational diseases. A link between work and illness must be clearly established. As to all general diseases (diabetes, hypertension, heart disease, asthma) and mapping of health risks (high cholesterol, overweight, high blood sugar, urinary tract diseases) the employee receives help primarily from his or her family physician. The national health insurance fund pays the family physician for these services. Occupational health care services are fully paid for by the employer. There is no reasonable justification that the enterprise should pay for tests and analyses which are the responsibility of the family doctor.
Covering costs that are not reasonably connected to occupational health care exploits the employer in several different ways. The reason is that the employer already pays social tax for the employees, for which the employees have guaranteed access to the public health care system. Occupational health care service must strictly stay in its area, i.e help the enterprise to improve the work environment and prevent employees from becoming ill due to work environment risk factors. When occupational health care service starts to duplicate the work of a family physician by inadvertently preventing heart disease, tumors, or obesity, it results in unreasonable spending of the employer’s money. Running analysis in otherwise healthy people or those who have just visited family physicians, also falls under this category. In Medihub clinic, the need for tests and analyses as a part of medical examination is always assessed personally and based on evidence-based medicine. Health check-ups must always be based on the risk factors of the work environment, and on the real needs and possibilities of the employer. The impact of health examinations must reach the working environment, and the employer must receive adequate feedback from the occupational health care service provider.
However, there are a few exceptions where measurement of cholesterol and blood sugar as a part of occupational health care service is reasonable, evidence-based, and related to the prevention of work-related illnesses. For example, health check-ups of rescuers must include prevention and, if necessary, coordinating treatment of high blood pressure and heart diseases, as these disorders increase the risk of losing work capacity. For more information, see the Regulation on “Requirements for the professional qualification of rescue servants, including for their physical preparation, education, and health” and a list of health disorders that prevent the performance of the duties set out in the Annex to the Regulation.
According to studies, nightwork is also linked to a number of general illnesses. Night workers should be screened for sleep disorders, cardiovascular disease, and mental health problems. In addition, studies have established a link between night work and for example, risk of breast cancer. The task of occupational health care is to prevent the development of the abovementioned diseases and, if necessary, recommend changes in working conditions or even switching jobs. If a night shift worker undergoes a medical examination where a disease is detected, then according to good medical practice, the doctor who diagnosed the disease should start the treatment or, if necessary, refer the patient to a specialist. Long-term monitoring and treatment of hypertension can also be done jointly by an occupational health physician and a family physician, i.e all analyses and tests do not have to be performed as a part of occupational health service. If it is the wish of the employer and agreement in the terms of payment has been reached, an occupational health care provider can also provide monitoring and treatment for other illnesses which fall within its competence.
Specialists working at Medihub clinic are ready to offer clients treatment, tests, and analyses in the full scope of general medicine, and if necessary, consult our partners. However, it is important to emphasize once again that the treatment of work-related illnesses is limited and its aim should be the smoother and better operation of the enterprise. According to research conducted in Finland, investing in occupational health care pays itself off three to five times in terms of money. Its requirement is adherence to evidence-based and cost-effective medicine.