Health Information - Occupational Health

• Help employers select job applicants who were physically qualified for a job
• Treat injured workers so they could return to work quickly.

Eventually, industrial medicine expanded to include a broader range of services and created the foundation for the medical specialty known today as occupational medicine.

Occupational Medicine
A major focus of occupational medicine is employee health assessments. Medical personnel in this field help ensure that assessments …

• Are competent and appropriate to an employee's occupation and type of work.
• Occur at the proper time and at proper intervals.
• Take place on an ongoing basis, as necessary, to assure that employees maintain medical qualifications and do not encounter adverse health effects because of worksite exposures.

Examples include pre-employment physical exams; medical surveillance of workers exposed or potentially exposed to substances such as radiation, beryllium, and numerous industrial chemicals; and medical qualification exams for pilots, drivers of commercial vehicles, commercial nuclear reactor operators, and others.

As a group, many of these assessments are mandated by federal and state statutes and are often referred to as health and safety regulatory compliance requirements.

When workers are injured or exposed to potentially harmful substances on the job, occupational medicine health care providers conduct evaluations and frequently provide treatment. As such, they are part of the Workers' Compensation team.

Early and aggressive clinical management is vitally important in minimizing the consequences of an injury or exposure. It also is important that the medical personnel who provide care have a clear and thorough understanding of the worker's essential job functions and working conditions, as well as the appropriate clinical protocols.

Economics
From an economic standpoint, the need for effective management of work-related injury or illness is readily apparent. In one recent year, the total cost associated with occupational injuries and illness in the United States was $171 billion ($65 billion direct and $106 billion indirect). This was 3 percent of our gross domestic product!

Direct costs are easily identifiable and include medical, hospital and physician services, physical therapy, and medicine. Indirect costs are less visible and include lost productivity and work time, replacement workers, disability payments, legal expenses, and Workers' Compensation insurance premiums. Direct costs make up about one third and indirect costs contribute about two thirds of the total cost for Workers' Compensation. To effectively manage these costs, occupational medicine providers, employers, and employees must work together.

Prevention
The critical goal is prevention, especially at the worksite while work is being performed. Implementation of modern work practices, engineering safeguards, health and safety laws, and improvements in worker training have made worksites progressively less dangerous. Risk management also has become predictable, and worker injuries have declined.

At the same time, the cost of acquiring, training, maintaining, and retaining a qualified workforce has become recognized as a critical factor for American business. Competition in today's global markets is fierce, and productivity, quality and customer responsiveness have become vital in the overall competitive environment.

Some employers have begun to look beyond traditional regulatory compliance requirements and employer-sponsored health insurance plans in order to enhance productivity. They are encouraging and helping employees embrace healthy lifestyles. These types of efforts routinely and repeatedly result in significantly better employee health, higher productivity, and less need for traditional medical services. This, in turn, reduces health care costs for both the employee and the employer.

Studies have consistently shown a return on investment ranging from 300-800 percent. That means for each dollar invested in health programs for clinical prevention, wellness promotion, enhancement of physical conditioning, and targeted disease management, there has been a total overall savings of $3-$8.

Routine Care
Occupational medicine providers not only provide preventive medicine services, but also treat acute minor conditions. The care usually involves "walk-in" or same day service and may be especially important in highly technical or highly regulated industries where certain types of treatments may affect a worker's ability to function safely. Employees receive the care they need, and time away from work is minimized.

Occupational medicine providers also may offer employees routine immunizations, including annual flu shots. They may work with primary care providers and specialists to monitor and treat workers who have chronic, potentially complex health conditions such as diabetes, asthma or metabolic syndrome.

Looking Ahead
Most experts expect that occupational medicine will continue to refine delivery methods for traditional services and incorporate:

• Health management
• Disease management
• Absence management
• Pharmaceutical benefits
• Health benefits management
• Care quality and cost management

Occupational medicine may also become more involved in non-traditional roles to improve worker health and productivity.