Occupational Health Risk and Health Impact Assessment: Necessary Information Facilitating Correct Medical Fitness Assessment for Work
Abstract
Framework Directive on Health and Safety at Work 89/391/EEC is concentrated on three main issues: the risk evaluation, the protective and preventive services and the consultation and participation of workers. Protective and preventive services called occupational health services (OHSs) should be represented by multidisciplinary expert team; medical part of this service is realized by occupational medical service (OMS) providers.
One of the crucial medicolegal activity of occupational medical service providers is the certication of medical fitness for work issued by examining physician and based on knowledge of working conditions/health risks at work and on results of occupational medical examinations of workers/employees. Working conditions are generally assessed by specific health risk assessment (so called System of categorization of work operations) established in the Czech Republic on monitoring 13 harmful factors in the workplace.
Working operations are divided into four categories: category 1 is the safest, category 4 is the worst according to the extent of risk. The prediction of occupational disease (OD) in correlation to the risk category based on number of persons working in risk categories is 5/100.000 in risk category 1 (12.3 % of OD), 1/10.000 in risk category 2 (24.7% of OD), 9/10.000 in risk category 3 (46.6% of OD) and 9/1000 in risk category 4 (12.0% od OD).
A keystone of quality performance by an examining physician is the familiarity with specific working conditions and demands of the respective job and the knowledge of the state of health of individual workers. The simplified approach when only health examinations of workers are realized, may have serious consequences, particularly in incorrect medical fitness assessment for work especially for vulnerable workers (f.e. pregnant women, older workers).