Training of Polish Occupational Physicians in Risk Communication

Jacek Michalak

Nofer Institute of Occupational Medicine

Lodz, POLAND

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

Occupational Health Service in Poland

• Labor Code Amendment 1991

• Occupational Health Service Act 1996

– Covering all employees– Obligatory measurements and examinations– Costs covered by employers and State

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

The most important legal regulations in Polish OHS Health Care Facilities Act (1991) General Health Insurance Act (1997) Occupational Health Services Act (1996) Minister of Health and Welfare rule on the methods of

determination the harmful factors at the work place (1993)

Minister of Health and Welfare Instruction on the prophylactic examinations of employees (1996) guidelines

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

The standards for prophylactic examinations:minimum extend of medical examinationminimum set of laboratory testsminimum set of specialist consultationsThis can be broadened by a doctorminimum frequency of prophylactic

examinationsThis can be shortened by a doctor

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

The list of harmful factors:14 groups of physical factors (e.g. noise,

vibration)9 groups of industrial dusts (e.g. silica,

asbestos)53 groups of toxic compounds 6 groups of biological factors (e.g. HBV)8 groups of other factors (e.g. stress, shift work)

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

The measurements of harmful factors may be performed:

either by Sanitary Inspection laboratory or by a laboratory authorized by sanitary

inspection

Doctor receives only the results

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

Supervisory system in Occupational Health Service:

national consultant (specialist) appointed by the government

regional consultants (specialists) appointed by local authorities - Voivodes

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

System of physicians’ specialist education 6 years of medical studies1 year of postgraduate stages

Now you can start to cure, but not to be an occupational physician!

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

Former system of specialists’ training:2 years of training– I0 specialtyNext 3 years - II0 specialty

Present system:4 years of specialty training

Individual supervision of a specialist – tutor or MASTER

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

Current curricula

• For graduate of Medical University (MB)

• For I0 specialist in occupational medicine

• For I0 specialist in general medicine (GP)

• For I0 specialist in internal medicine

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

AIMS (1)• Working conditions and workers health status• Occupational hazards• Prophylactic examinations• Occupational diseases – prophylaxis, diagnosis

and treatment• Stating working ability at a given workplace• Rehabilitation of disabled workers• Health promotion at the workplace

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

AIMS (2)• Risk assessment• Co-operation with employers• Individual protection devices• Biological monitoring• Advising in occupational safety and health• Analysis of accidents at work and occupational

diseases

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

Knowledge and capacities (items in curriculum)• Health care organization (25)• Occupational hygiene (36)• Physiology and ergonomics (14)• Occupational psychology (7) – communication

with patients• Epidemiology (8)• Statistics (5)

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

Occupational medicine – clinical issues

• General issues (10)

• Occupational pathology (risks) (28)

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

• Management of Occupational Health Services

• Health economics

• Internal medicine

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

• Cardiology

• Angiology

• Pulmonology

• Hematology

• Nephrology

• Gastroenterology

• Endocrinology

• Allergology

• Rheumatology

• Oncology

• Infectious diseases

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

Courses• Introductory (1 week)• Advanced (8 weeks)• Special (each 10 h to 3 weeks): occupational pathology, pneumoconioses,

allergy, occupational psychology (communication),

occupational diseases – dermatology, larygnology, acute poisoning and reanimation,

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

Stages• Internal medicine – 12 months• Infectious diseases – 4 weeks• Orthopedics 2 weeks• Occupational hygiene and epidemiology 8 w. • Health care organization – 4 weeks• Occupational pathology – 4 months• OHS primary unit– 24 months• Pulmonology 5 weeks

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

• 11 examinations

• Active participation in Polish Association of Occupational Medicine

• 1 published report

• 1 foreign language (English, French or German)

Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

However, it is a lot to be done in risk communication