33

Working at a great distance from medical services, or in inaccessible

workplaces (such as in mines) requires special arrangements to be
made for transporting patients to hospital, or for bringing medical
assistance to the workplace. Training in, and documentation, of these
procedures is also essential.

Organizations or operations with potential major hazards should have

a documented management plan in place, and personnel trained in
their responsibilities.

Incidents and accidents should be reviewed, to check whether

procedures and provisions are satisfactory, and the effectiveness of the
whole system should be reviewed from time to time.

3.9 Occupational Health and Primary Health

Recent studies indicate that even 25% of diseases can be work-related.

The relation can be strong, for example when an isocyanate causes
occupational asthma or weak or spurious, when blood pressure is
increased by work stress. Although these two conditions have
different medico-legal connotations, both require individual corrective
actions and actions at work and other social factors. Curative care in
OH service differs from common practice by considering how the
patient’s symptoms are related to his work and what are the
underlining processes behind the symptoms. An OH unit is in an
excellent position to do this, because of its know-how about the
effects of work, working conditions and work community on patient’s
condition.

Multidisciplinarity is another strong argument for organizing curative

service in OH. Good results have been achieved by, for example,
combining the expertise of occupational health physician and
physiotherapist in the management of musculo-skeletal disorders.
Evidence from the scientific literature and best practice guidelines
should be used to guide the management of medical conditions. By
using, for example, flow charts, identifying the key actors and the
content and ways of transmitting information between the actors and
other stakeholders the internal and external service processes can be
made explicit and easier to evaluate.