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Peligros de vigilancia de la salud en el trabajo [Power Point]
Workplace health hazard surveillance [Power Point]
How to initiate and organize an occupational surveillance program.
Cmo iniciar y organizar un programa de vigilancia profesional.
Safety and health at work
Community Health 2003
t Community Health
1 Workplace Health Hazard Surveillance
2 What is Occupational Surveillance? Systematic monitoring of: Hazardous exposures Adverse health events FOR THE PURPOSE OF Prevention and control of: Occupational hazards Occupational diseases and injuries
3 Types of Prevention Primary Target: those with potential for exposure; no disease yet. Goal: change exposure conditions Secondary Target: those with early stage of disease, no symptoms yet Goal: reverse disease, delay symptom onset Tertiary Target: those with clinical disease Goal: cure or control of disease.
4 Healthy Asymptomatic Symptomatic Worker Disease Disease Primary Secondary Tertiary Prevention Prevention Prevention Opportunities for Prevention time
5 Why might you start an occupational surveillance program? Identify a problem and estimate its magnitude Identify groups at risk Monitor illness/injury trends in time and geography Identify cases, workplaces, and industries for attention Identify new illnesses Identify new hazards
6 How might you use a surveillance program? Prioritize health problems Determine whether you need an intervention program Evaluate progress, success, or failure of an intervention program Provide planning data for cost effectiveness and benefit analysis
7 Surveillance Techniques Keep log of new injuries and illnesses Examine existing databases for specific, sentinel diseases Conduct questionnaire survey of workers Conduct physical examinations Conduct laboratory examinations Conduct job hazard analysis
8 Sentinel Health Event (SHE) Disease, disability, untimely death related to work Occurrence of this event serves as a warning signal that: Preventive efforts are needed Further study may be required
9 SHE Examples Choose a disease or injury that is likely related to work: Search for lung disease in miners Pesticide poisoning in farmers Hepatitis in health care workers Deaths in construction
10 How would you organize surveillance? HAZARD BASED Characterize hazards Observation/checklist Monitor environment Test workers HEALTH BASED Acute or chronic injuries/illnesses List of insurance claims Death certificates Health questionnaire Physical examination Lab testing for disease markers
11 Techniques: Keep Log Name Date of Injury Diagnosis Causative Factors
12 Techniques: Examine existing databases Death certificates Hospital Discharges Laboratory reports Workers compensation reports National surveys Occupational health clinics
13 Techniques: Questionnaire Survey Demographic variables Work history: job tasks, hazards Health history: current, prior Symptoms Social, confounding factors
14 Techniques: Physical examination Respiratory Skin Others
15 Techniques: Laboratory Reports Require labs to report abnormal results above a specific level (e.g., Pb>25mg/dl) May tie lab certification to reporting Set up reporting agency protocol (e.g., health department accepts reports on pre made forms or electronically) Decide what level will trigger an intervention
16 Techniques: Workplace investigation Investigate and record information about fatal injuries (i.e., accident investigation) Visit industries with a particular hazard Require reporting of certain injuries and set up a mechanism for reporting, however do not have to get every event to have an effective surveillance program
17 What are the components of a surveillance system? Gather information on exposure & disease Analyze data Disseminate data in an organized form Use data to target or evaluate an intervention On going
18 Case Studies For each of the cases, ask these questions 1. What is the sentinel health event of interest 2. What is the best way to collect information about it? (consider cost, time it takes to collect, how you will use results) 3. How could you use these results?
19 Case One You have heard about a small, rural community where most of the adults work in agriculture. There is concern about pesticide poisoning among adults and children because housing is located right next to farms.
20 Case One Sentinel event: pesticide poisoning Collect information: Questionnaire of community Blood testing of community Reports from local hospitals/clinics Use results: I.e. Design pre and mid season cholinesterase testing. Remove workers with decrease.
21 Case Two A scaffold fell off the side of a building on a windy day. Two workers were killed.
22 Case Two Sentinel event: death Collect information: accident investigation review logs or medical records of injuries Use results: Policy change to improve enforcement
23 Case Three A group of rubber workers notice that several of their co workers have developed leukemia. They are concerned about the hazards of their industry.
24 Case Three Sentinel event: Leukemia Collect information: medical records of workers, if possible conduct survey of workers compare rates to those expected Use results: If elevated rates, determine related exposure reduce hazard collect ongoing CBCs to follow trend; inform workers of results of study