Work related diseases and training element

1
Work related diseases and training element

• Helena Taskinen
• Ahe Vilkis

2
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

3
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

4
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

5
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

6
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
• SeptemberMay 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

7
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 150200 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

8
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

9
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)

10
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

11
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

12
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

13
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

14
Evaluation questionnaire eas used
15
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)

16
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

17
IV Subnetwork on Occupational Health and Safety
Training

• AIM to provide an infrastructure for
  harmonization and development of OHS training
• ACTIVITIES 2 meetings, where goals/tasks were
  set and activities were planned

18
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

19
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

20
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

21
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
  physicians notificaton
• also notification other work-related diseases can
  be notified to OHC

22
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

23
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

24
The Goals Were Exceeded