GUIDELINES FOR EMPLOYEE S HEALTH - AN USEFUL TOOL FOR WORKPLACE HEALTH PROTECTION Adriana Todea, MD Senior Occupational Health Physician - Institute of Public Health Bucharest, Romania I designed this guide having in mind the desire to build an useful tool of communication, both for employer and employee, with regard to the workplace health protection. Health at the workplace, in Romania, has to be ascertained by the employer as an important problem in all its aspects and should not be perceived only as a mandatory isssue. Having in mind these considerations, these guidelines constitute an invitation for debate between the employee, the employer and the occupational health physician, so as to prevent illnesses, to create healthy and secure jobs and to increase employees work performances. 1
EMPLOYEE S GUIDE FOR HEALTH What we need to know about the periodical check up when considering workplace exposure to health hazards? 2
Why is it important for you to know? You will find qualified support provided by the physician who takes care of yourself when you need this! But you are the first responsible for your own status of the health! Finally, you ll have to apply the physician s recommendations, but you ll be the one to act in order to change something in your behavior at the workplace. You can learn how to prevent workplace injuries and occupational diseases, how to obtain the maximum of satisfaction from the decisions you are taking together with your colleagues. The aim of this guide is to support you to know more - in comparison with your colleagues about health and safety at work when exposure to dangerous substances in the working environment is involved. We wish you to be aware about your role, as an employee, in protecting your health. You ll find out that often, your own health and income, no matter if you are employer or employee is in your hands and you can do a lot to keep them in a good shape. This guide will help you to understand: What information the occupational health physician needs from you? What kind of information you need about workplace and health hazards in order to prevent work injuries and occupational diseases? How can you collaborate with the occupational health physician in order to act together for your own health? How the physician could support you when you have questions referring to workplace health issues and you cannot find answers for these questions or you have signs and symptoms which you consider to be related to work? If you don t understand some of the questions, advice or answers given by the occupational medicine physician, do not restrain yourself to ask until everything it s been clarified. It s more useful to exactly understand what this is about, in order to clarify yourself and to transmit useful information to your work colleagues. They will listen to you and your prestige will increase becoming (why not?) yourself a good health adviser. Speaking with your physician can be part of the process of taking decisions regarding your well-being at the workplace because: You are the only one which truly lives and knows what happens there, at the workplace You are the only one who will apply physician s advise and benefit of its utility 3
Defend our health! HOW? Through the periodical check-up What the periodical check-up means? Is a complex medical consultation, performed while being healthy, which has to be done by each employee on regular basis, annually or even often, if the health risks involved by the workplace are bigger It is compulsory performed by an occupational health physician It is foreseen as mandatory in the Romanian legislation, The General Norms for Labour Protection, 2002 Edition This check up has a complex approach, it s being correlated with the working conditions, being specific to these conditions and is composed of a package of medical services which differ from one workplace to another according to the documented health risks. For each noxious chemical it is performed a complex clinical examination consisting of clinical examination and laboratory investigations, specific for each exposure (according to the record cards from the Chemical Agents Chapter, annex 7, from General Norms for Labour Protection. 4
WHO IS RESPONSIBLE FOR THE PERIODICAL CHECK-UPS? THE SPECIALIST IN OCCUPATIONAL HEALTH which has a postgraduate training/specialization of 5 years in a Residency Program for Occupational Medicine The Specialist knows: If the exposure to chemical agents may influence your health in a negative way; If your health status allows you to work many years without getting any disease. If you can get an occupational disease because of the peculiarities of your work and because of the working conditions. Why do you need a periodical check-up when you are healthy and you are working? All the employees, no matter where are they working, have to undergo, at least on annually basis, a periodical check up. What is the importance of this check up? To prevent occupational diseases, work injuries but also the lack of comfort during the working processes; To discover on going illnesses e.g. professional poisoning when these are in an early stage, can be easily treated and consequently your life could be saved; To contribute to the identification of the diseases caused by workplace related factors, named occupational diseases or, which are related to the working conditions named work related diseases; The periodical check-up will help you to work better, you will be healthier and earn more money while bringing benefits to the company you work for! 5
If you have headaches, if you make more mistakes than usual, You will loose time and money! But the worst thing is that you could loose your job! You are an employee: when should you go to visit the physician? YOU MUST GO FOR THE PERIODICAL CHECK UP! Even if you are feeling healthy and you have no pain When some signs appear at the workplace and you do not know how to interpret them (headaches, premature tiredness, lack of appetite, spots on the skin etc.): -the headaches appear shortly after you have started the work, when you are working with chemical volatile substances (as organic solvents); -you can hardly breathe and you feel a lack of air when you enter in the working room where there are mineral dusts or vegetal fibers; -you noticed that your skin is red, or there appeared modifications of the skin while you work with a toxic substance; -you feel tired and weak all the time, without being able to pinpoint a specific reason, in such a way that you can not solve the work tasks assigned, as you did before. 6
It is cheaper to prevent than to treat! When you go for a treatment it happens often that it is too late! You are the most important: as an employer, as an employee but also as the support for your family. As an active person you have the following rights: To receive good quality medical care. Only the occupational specialist can provide this care. Is your right to discuss with the physician responsible for the medical care; You have the right to be treated with politeness, consideration and respect; You have the right to the confidentiality of the diagnosis; is a right of all the employees at international level. The consultation is confidential, no information from your file should be communicated to other person without your expressed consent; You have the right to receive complete and up to date information; the physician must explain to you all the tests you ll go through, the risks you are exposed to and the side effects of the drugs you take, in such a way to enable YOU to decide about your health; You have the right to ask questions whenever you do not understand something. The physician has the obligation to respond to your questions in an user friendly language and must assure that you understood what was explained to you; You have the right to be informed how you could protect yourself against the occupational diseases or how you can work in safety to prevent occupational accidents. 7
If you ll loose your work capacity, you ll loose not only money, but also the quality of life! If you help yourself, you will be helping your work colleagues! Teach them how to have a healthy lifestyle! You should be an example! In order to achieve the objectives of the medical consultation, as an employee you have also RESPONSIBILITIES: To answer to all the questions of the physician, concerning the health problems you have, in an honest, correct and complete way. The physician needs these information to exactly assess which is the relation between these ones and the conditions in which you are working in order to better advice and proper treat the disease you have, or to see what should be done in order to prevent other symptoms; To express your thoughts clearly; the occupational health physician has to know how you are working, what is bothering you, what habits (health risks) do you have: smoking, alcohol drinking and lifestyle, if there are any drugs that make you sick; To ask the physician if you don t understand something; To follow physician s advises, such as: to wear your working equipment as well as the personal protective one, to make sure that when you work the ventilation system is on, to respect the labor protection regulations, to take the drugs prescribed for you, to have time off etc; To report the physician honestly if you didn t follow the medical advises given during the periodical check ups; 8
WHAT TO EXPECT? The occupational health physician manages the periodical check up What does the physician need to know about you? What you tell to the physician is very important because it helps him understand what is going on with your health, and if the symptoms you are talking about are related to your work. You must be ready to answer questions regarding: your medical history : what diseases have you had, surgical interventions, alimentary or drug induced allergies, etc. the medical history of your family: what diseases did your parents, brothers/sisters and grandparents have? what drugs are you on at the moment? is there any drug that made/is making you sick? do you have aliments or drug induced allergies? your professional history : to remember all your workplaces, the working conditions you worked in, if you had any work related accidents last years, if you ever suffered a toxic chemical poisoning at your workplace, or any other occupational disease. have you noticed any symptoms that appear while being at your workplace? Why is it important for the physician to know your medical past (previous medical records): These records will give him information regarding: Your previous health problems: childhood diseases, surgical events, chronicle diseases (diabetes, high blood pressure, liver diseases, anemia), if you ever needed to get into an in-patient medical institution for treatment; Previous medical examinations you did undergo (ECG, radiology, blood tests); it would be helpful to have them with you when you go to the physician; Your lifestyle; you have to answer in an honest manner if you smoke, drink alcohol, use drugs and how do you spend your spare time. Why do you have to answer honestly? Because all these information are useful for the physician to better evaluate your health status. Eventually is it you that decides regarding your health, the physician only guides you; Your period, pregnancy, number of abortions; STD s (sexually transmitted diseases); 9
A premature diagnose of a diseases during the periodical check up, can save your life! What is a medical check up? The occupational health physician does a complete medical exam: Skin, ganglions, lungs, heart, internal organs, sight, hearing; Blood pressure, pulse, height and weight measurements; Lab exams, depending on the general exam s results; All your answers will be registered in a MEDICAL FILE. YOU HAVE TO KNOW: The medical file is a judicial document describing in great detail your health status; It helps you: the medical file allows you to see how evolves your health status in time, and to compare the present medical results with the past ones; The more detailed the medical file is, more useful is! It doesn t belong to your physician or to your employer, it belongs only to you, it is personal and confidential! 10
Occupational disease (1) What do you need to know? What is an occupational disease? The occupational diseases are diseases caused by physical, chemical or biological factors, linked to work processes, and leading to the exhaustion of different organs and systems of the human body during work, regardless the type of the employment contract. Occupational diseases include also the ones suffered by students, pupils and apprentices during their practical activities and by the employees in their trial period. The occupational diseases that need to be declared, investigated and registered are described in the second Annex of the General Norms for Labor Protection, 2002 Edition; here are ascertained 73 diseases and the working environment conditions that determine them. What is a work related disease? Beside the occupational diseases there are work related diseases, which are caused by the working conditions as well as by other conditions not related to work (for example the back pains can be determined by the strenuous effort at the workplace as well as by the physical effort out of the working hours). For the evaluation of employees health status as well as for the implementation of effective prevention measures is of paramount importance to understand very well the occupational diseases and the work related diseases. 11
You can save yours but also the health of your work colleagues! Occupational disease (2) What do you have to do? If you are an employer, you have to take care of the health of your employees, taking into account the general prevention principles: Avoiding risks Risks assessment; Control risks at the source Adapting the work by designing the workplaces, choosing the working equipment and the work methods so as to reduce the monotony and to establish predetermined working rhythms/patterns and to reduce their impact on health; Adapting to the technical progress; The replacement of the hazards with diminished ones; Developing a coherent prevention policy taking into account new technologies, work organization, working conditions, social relations and the impact of the workplace environment factors; According priority to the collective prevention measures ; Proper instructions for the employees. If you are an employee, you have to take care of yourself and of your colleagues by: Respecting the labor protection regulations Wearing personal protective equipment Doing periodical medical check ups Adopting a healthy lifestyle 12
IF YOU ARE AN EMPLOYER: DON T FORGET! The biggest reward is the health of the employees! Investing for health is very important; it will increase the working capacity of the employees, and the profit of your company! DON T FORGET! Use the advises of the occupational medicine physician They will guide so as you to avoid material losses due to occupational accidents and diseases IF YOU ARE AN EMPLOYEE DON T FORGET! Go to the periodical medical check up! Give the physician all the information he/she needs! Don t forget, this information is valuable! DON T FORGET! You are handling chemical substances that you don t know how will affect your body. Be informed and protect yourself! Keep in mind that many of these substances affect your liver, kidney, blood and many of them cause cancer. If you didn t know about it, asks your physician, he owes you an answer! DON T FORGET! The exposure to biological agents, like hepatic viruses, can cause you acute viral hepatitis type B, chronic hepatitis type B, hepatic cancer and cirrhosis! DON T FORGET! The employer provides the personal protective equipment but is your duty to wear it! DON T FORGET! Do you have any problems with your personal protective equipment? Inform your employer! He/she has to protect you! 13
Take care of your body! What is a healthy diet? It represents more than the fuel that gets you in motion, it is the building material of your cells and the chemical elements that will regulate the processes of your body. No single aliment provides you all that you need, and when you handle toxic substances at your workplace it is important that you eat a variety of aliments every day, such as: Fruits and vegetables Bread, cereals and other wheat products Yoghurt, milk, cheese Meat, eggs and proteins Don t eat too much salt, sugar and fats. Eat lean meat. Don t forget that alcoholic drinks don t have any nutritive value and they are bad for your health. Try to maintain an ideal weight. You can improve your eating habits by chewing slow and well. Prepare smaller portions. To maintain your weight it is necessary to have physical activity, to eat lean meat, less sugar and to avoid the alcohol. Is the alcohol bad for your health? The alcohol is a strong drug that may create dependence and affect your health. Drinking for a long time affects badly your liver, brain, nervous system and heart. The alcohol decreases the level of the hormones in your body, reduces the sexual ability for the men and for the women as well. The alcohol affects your capacity to take good decisions, to think and control your impulses. If you are a leader and you need to make decisions, drinking alcohol can make you lose your job. If you work in an environment with toxic substances such as solvents, the effects of the alcohol combined with the solvent can cause poisoning with severe effects, and premature death. 14
References 1. The Law for Labour Protection, no. 90/1996 2. General Norms for Labour Protection, Edition 2002 3. The Law no. 100/1998, regarding the public health assistance, published in the Romanian Official Journal no.204/1 June 1998 4. The Ministry of Health Order no. 803 for approval of the exposure indicators and/or biological effect which are relevant for the specific body response to the risks factors for occupational diseases, published in the Romanian Official Journal no. 811/18 December 2001 5. The Law no.346/2002, regarding the insurance for occupational accidents and diseases, published in the Romanian Official Journal no.454 din 27 June 2002 6. The leaflet: The Guide for Women s Health. The Reproductive Health Campaign. 15