Work related diseases and training element

Helena Taskinen &

Ahe Vilkis

Work related diseases and training: Objectives I-V

I: Training curriculum on work-related and occupational diseases

II: Training of the OHS personnel, family physicians and other specialists on work related and occupational diseases

III: Training for trainers IV: Subnetwork on Occupational Health and

Safety Training Institutions V: Registration of occupational diseases

I: Training curriculum on work-related (WRD) and occupational diseases (OD), 1

AIMS: Training curriculum for OHS physicians,

family physicians, other physicians and trainers of trainers

ACTIVITIES: 3 meetings with CC (AV, EM, RK) and MS

(HT, K-PM) experts

I: Training curriculum, 2

RESULTS: Curriculum for physicians specializing in

Occupational medicine/health services meets the EU/UEMS criteria

Training of OH nurses (physiotherapists etc.) was included only in the Tallinn 2,5 years course

Curriculum for training on WRDs/ODs proposed

I: Training curriculum, 3

EU/ UEMS (European Union of Medical Specialist) requirements for specialist training: 6 years of basic medical training theoretical and practical instruction full time course (or equivalent part-time training)

supervised by the competent authorized bodies in university centre, in a teaching hospital or in a

health establishment approved by the competent authorized bodies

minimum length: 4 years after graduation

I: Training curriculum, 4

Proposal for training on WRDs/ODs in curriculum of graduate students in medicine, in specialists training of family physicians and other relevant specialities 8 credits = 80 h September–May 2004/2005 2 days course in each month Diagnostics of occupational lung, ear, nose and throat,

skin, neurological, eye, musculo-skeletal diseases and prevention

Tartu University, department of Public Health

Recommendations

The additional need of OH physicians is 90-137 Tartu University produces 4 OH physicians a year The estimates for the future need in order to achieve

50% OHS is 150–200 OH physicians Presently there are 63 registered OH physicians in

Estonia More residents (10/year) at TU or Tallinn course

(2,5 yrs) restarted If training is increased, more trainer resources are

needed Training of OH nurses should be established

II: Training of OHS personnel and family physicians

AIMS: training on WRDs/ODs to the OHS personnel, family physicians and other clinical specialists geographical and professional coverage 46 training days for about 20 participants (920 trainee

days) were planned Good practices

RESULTS: 26 training days for 1556 participants, (85 to 146 per course), 2776 trainee days

Activities: Training courses

Skin diseases (3 d) Lung diseases (6 d) Cancer (1 d) Intoxications (2 d) Nose, ear and throat

diseases (2 d) Neurological diseases

(2 d)

Vibrations dis. (1 d) Musculo-skeletal

diseases (3d) Psychiatric dis. (1 d) Work ability ass. (1 d) Reproductive hazards

(2 d) Infectious diseases (2

d)

Participants by profession

occ. health physicians, and residents 77

family physicians 68 physicians 36 lung and nose, throat

spec, allerg. spec. 26 gynecologists 29 neurologists 15 dermatologists 10 radiologists 5

other specialist and residents 42

nurses, midwifes, physiotherapists 79

disability experts 21 others 23

TOTAL 431

Participants from public organisations

Estonian Border Guard 2 Estonian Brodacasting

Company 1 Estonian Civil Aviation

Administration 1 Estonian Defence Forces 11 Estonian Police Board 3 Health Care Board (MoSA) 1 Labour Inspectorate (MoSA) 3 National Institute For Health

Development 8

Occupational Health Centre (MoSA) 3

Social Insurance Board (MoSA) 21

Social Policy Information and Analysis Department (MoSA) 1

Tallinn Pedagogical College 1 Tallinn Prison 2 Tallinn Technical University 3 Tallinn's Children's Hospital 2 Tartu University 18

Participants from private organisations:

East Tallinn Central Hospital 31

Ida-Viru County Central Hospital 1

Jõgeva Hospital 2 Järvamaa Hospital 4 Kallavere Hospital 3 Kohtla-Järve Hospital 2 Narva Hospital 1 North Estonian Regional

Hospital 39 Pärnu Hospital 8 Rakvere Hospital 2

Sillamäe Hospital 1 South-Estonian Hospital 2 Tallinn Emergency Medical

Service 2 Tartu University Hospital 39 Valga Hospital 3 Viljandi Hospital 5 West-Tallinn Central Hospital

28 Limited liability companies 75 Ltd. 69 Self-employed entrepreneurs

33

Results (continued) of obj. II. Training

Visit and training of Estonian 12 experts at FIOH clinics in Finland for 2-4 days

Distribution of the Good Occupational Health Practice guidelines book, introduction of good practices at the courses

Evaluation questionnaire eas used

Please, give your opinion about each course aspect,

by checking the appropriate box and filling the lightly shaded areas of the form.

A. CONTENTS OF THE COURSE

1. The general level of Excellent Good Satisfactory Poor Very poor

the lectures w as:

2. The balance betw een theoretical

presentations and discussions Excellent Good Satisfactory Poor Very poor

group w ork etc. w as in general:

3. The theoretical level of the Far too Far too

course for your specif ic w ork high Too high Just right Too low low

requirements w as:

4. The relevance of the Very Very

hand-outs to the high High Average Low low

subject-matter w as:

III. Training for trainers

AIM: to provide the trainers with skills for adult training

2 courses for trainers ACTIVITIES:

Course 1: training needs were characterized (what is important to train). 8 participants

how to form good chain of treatment for patients with ODs Course 2: the methods for planning training were

lectured and exercised. 21 participants participants from the Network in training (obj.IV) were trained

also (plan for 24 hrs course)

Training for trainers, 2

29 CC trainee days were achieved (18 days were planned)

CONCLUSIONS: The results were used in building the curriculum for the 24

hours’ course and for occupational health curriculum of the specialist training of physicians and for other OHS personnel.

The trainers know how to prioritize the teaching topics (what to teach) and some essential methods for planning and realising the training (how to teach).

Training is likely to improve the recognition of ODs at all levels of health services

IV: Subnetwork on Occupational Health and Safety Training

AIM: to provide an infrastructure for harmonization and development of OH&S training

ACTIVITIES: 2 meetings, where goals/tasks were set and activities were planned

The tasks of the Subnetwork

Web strategy network directory inventory and assessment of training materials development of training packages list of lecturers participation in train-the-trainer events marketing of OHS training

Benchmarks of Subnetwork

All the planned meetings were conducted (the third in the connection with training for trainers)

A subsecretariat for "Improvement of the program of the 24-h course" was nominated

Secretariat organized meetings; next goals: Organizing train-the-trainer education Development of training packages for specific

subjects Network meetings to be continued 1-2 x /year

V: Registration of occupational diseases

AIM: to develop a system for recognizing and registering occupational diseases

Plan: Consultations concerning establishment of registry and systems for follow-up of occupational diseases

ACTIVITIES: Two consultations were coducted, as planned

Benchmarks were achieved

Notification: Two Registries

Estonian Act on Occupational Health and Safety (paragraph 23): the employer notifies the regional office of the

Labour Inspectorate of ODs, on the basis of physician’s notificaton

also notification other work-related diseases can be notified to OHC

Discussions

Problems, e.g. lack of law on insurance for occ. accidents

and ODs handling the cases at court registering ODs in the WRD registry

European Union list of ODs was compared to the Estonian list

Recommendations The number of trained OHS physicians should meet the

needs in the country: increase to 10 residents (now 4) Training of OH nurses and other professionals should be

organised/ stabilised OHS physicians should have a license from the Estonian

Health Insurance Fund to be able to diagnose ODs (be a link of the chain)

Legislation on insurances for occupational accidents and diseases should be framed and launched

Registration of ODs and WRDs should be guided to be done correctly

The position of the OHC should be stabilised and provided with reasonable resources

The Goals Were Exceeded