How Do We Know if it’s Work Related Health Issues or Not?
If you have an occupational health service at your work place their main job is find out if employees have any health problem that may have been caused by the job they are doing and, if found, give advice on how to prevent further health issues.
Sadly some employers stop there as they are more interested in whether the health problem is due to work and no more but this is not so simple as you might think.
The reasons for the difficulty is that most people chose jobs that they like doing – so they carry on in their spare time too or maybe it’s a new hobby.
Take me for example, I spend a lot of my normal working hours working on a computer and my spare time updating my website, blogging and playing games (and I wish I could win more often). I would be unable to blame my employer for all of that.
Other hobbies that cause more concern and confusion involve vibration (motorbiking, gardening, do it yourself), noise (disco’s and listening to loud music, shooting guns), coming into contact with dusts and chemicals (gardeners, housework) to name a few.
Added to that some workers tend to have an underlying resentment of work and blame any health issues on work as their first option.
How many times have I heard that having a cold is down to the air conditioning in the office? One way to investigate this is to call in those who know the workplace and health – an occupational health professional.
Here is the process that occupational health professionals use to come to an opinion.
1. What is the job?
While a written job description is helpful, an on-site visit by occupational health would be invaluable. Seeing the job being performed provides a more complete picture of whether an injury or health problem could result from such activities.
- What exactly is the job?
- What are the physical requirements like lifting, pushing, or pulling?
- What motions are involved, such as bending, kneeling, climbing or crawling?
- What is the work environment — indoors, outdoors or both?
- What tools or machinery are used?
- Is chemical/dust exposure possible?
- Review the risk assessments for each element of the job
- Should the employee need to wear any personal protective equipment?
2. What is the health problem?
A detailed and accurate history should be obtained from the worker:
- What job was the worker doing then and before the health problem (health issues can take many years to occur)?
- What is the health problem and/or details of how health is affected eg can’t sleep, wheezy chest, loss of sensation in fingers etc?
- When did the symptoms start?
- Has he/she been to the Doctor or Hospital?
- Is he/she on any tablets for the health problem?
- Has he/she ever had this before?
- Does this health problem run in the family?
- Does he/she play sports, engage in hobbies or do any intensive physical activity outside work?
- Does h/she have other jobs?
- Does the health problem improve when on different jobs or when away from work (holidays, weekends)
- Current social circumstances
- Other health questions related to job such as smoking history if working with asbestos, drinking alcohol if a safety critical worker etc
3. How is the Job Done?
- What exactly is done on each task and for how long?
- Has the job recently changed in either intensity or type of task?
- Has there been training to do the job?
- Which part of the job is thought to have caused the health problem?
- Do others in the team have the same problem?
- Is the employee enjoying the job?
4. Investigations to Assist Diagnosis/Opinion by Occupational Health
- Questionnaires asking for specific health problems associated with the work being done eg runny nose or watery eyes linked with developing occupational asthma
- Physical examination eg look for skin rashes, restricted movements, strength of grip for objective signs of an injury/illnes
- Clinical tests done by occupational health eg lung function testing, hearing, vibration assessment
- Observe behaviour such as eye contact, engagement, attitude, personality
- Refer to another health professional for a specialist opinion eg dermatologist for patch testing to find the cause of a skin problem
- Request medical records of previous treatment from GP or Specialist to make an informed decision
From the Employer
- Are there performance issues?
- Are there any conflicts with team members or supervisors?
- Relevant hazard data sheets and risk assessments
- An accurate and up to date job description
5. Check Knowledge Base
A lot of health information that people believe are myths and based grown up around some work conditions for example see how repetitive strain injury was first diagnosed , So occupational health professionals need to check the evidence of the about the work and the job – is there likely to be a link?
- What reliable evidence is available on this type of illness?
- What is known about its causation?
- Reference books and papers
- Trade Unions, specialist organisations, help groups, charities
- Other occupational health professionals
- Google scholar
Authors Opinion: Is it Work Related?
Employers always want to know if a health issue “work related,” but this is not a legal term and is often misunderstood.
I have often been asked an opinion on whether a health condition is wholly due to work, partly due to work or not due to work at all; as a health professional I would use all of the steps above to come to an opinion. However, so much of the process is down to subjective information from both the employer and the employee; plus health issues can occur many years after an exposure. So it’s not clear and often a difficult decision to make.
Knowing that opinions of this nature tend to end up in compensation claims or even being read out in court, makes the process even more fraught. The opinion of whether a health problem is work related can have financial implications for both the employer and the employee.
So if you want this sort of decision it is usually a long drawn out process while all the proper steps are taken and even then it may only be a ‘best guess’.
It may be that the final decision will rest with the courts anyway.