Fitness for Safety Critical Work

Safety critical work can be defined as a task where the ill health of an individual may compromise their ability to do that task, therefore posing a significant risk to the health and safety of others, as well as plant, premises and the environment. Types of safety critical roles involve operating machinery such as cranes, or driving passenger vehicles such as trains or planes. Other safety critical roles include managing safety critical control systems such as air traffic controllers, working within the railway industry or nuclear industry.

Medical fitness standards apply to certain safety critical roles and there are specific industry standards for certain industry groups, such as the railway, airline and construction industries. Safety critical roles rely on the employee being medically fit for that role as well as technically competent. It is therefore important that safety critical workers are not suffering from medical conditions or undergoing any medical treatment which is likely to cause sudden loss of consciousness or incapacity, impairment of awareness, concentration, balance or coordination, or significant limitation of mobility.

A safety critical medical will need to be conducted prior to any individual starting in a safety critical role.  The occupational health provider will work with the employer to understand the specific nature of safety critical roles of their staff and identify appropriate industry standards. A medical assessment is likely to include a detailed questionnaire to understand the health history and current conditions and treatment, as well as a number of tests including eyesight, hearing test, urinalysis, blood pressure and any other industry specific tests. Medical requirements may vary in frequency depending on the industry and as an individual’s health may change over time, a reassessment is recommended for any significant change in health status or for sickness absence due to a condition that may affect fitness for safety critical work. To understand the occupational health assessment requirements for your industry and organisation, please get in touch today, for more information.

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OnMarch 22, 2015, posted in: Occupational Health Posts by

Are you doing enough to manage stress at work?

stress at workAn individual who feels stressed at work may feel stressed solely due to work issues, but in many instances there is likely to be a combination of home and work pressures. Sometimes the home pressures are the main issue, which then cause the individual to struggle with the normal work pressures, which can lead them to believe that the pressures are mainly work-related.

Regardless of the cause of stress, undertaking an individual stress risk assessment will help identify the work issues or concerns the individual has with coping with certain work factors (even if they are not the main cause of the stress). Once the work factors have been identified, actions need to be identified to help reduce those pressures, until the individual’s symptoms have improved. Having a documented conversation with the employee will ensure that a record is kept of the issues/concerns from the individual’s perspective, along with actions the Organisation has taken to address the concerns.  The HSE have a number of useful tools to help shape the conversation, including the return to work questionnaire, which is a useful template that lists a number of questions to help the manager identify the specific areas which are causing the individual concern.

Work-related stress is a complex issue. It may be due to inherent factors in the work or job design, or may just be that tan individual has reduced resilience, or the job is not a good fit for that person.  If there is any double about what support an individual needs, then an occupational health assessment is recommended. Sometimes feel more comfortable having a more frank conversation with an occupational health professional than their manager, and the real issues can often be more easily identified.

As with general risk assessments, Organisations need to be doing an Organisational stress risk assessment, looking at each job or role, or each department, to identify potential areas of stress so that control measures can be put in place to ensure that their staff are not exposed to unacceptable levels of pressure. The HSE have produced a stress indicator tool that can be done with groups of people to identify the key stressors, which managers can use as a starting point to help manage pressures at work. The HSE also have a number of other really useful tools and templates which can help tackle work-related stress, as well as information on how to secure management commitment for dealing with stress at work.  For help in tackling stress at your workplace or general advice on how to use the HSE tools, please call us today.

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OnMarch 15, 2015, posted in: Occupational Health Posts by

Supporting Employees with Chronic Fatigue Syndrome (CFS) at work fatigue syndrome (CFS) is also known as Myalgic Encephalomyelitis (ME), and is a condition where you have long-term disabling tiredness (fatigue). Most people with CFS also have one or more other symptoms such as muscular pains, joint pains, disturbed sleep patterns, poor concentration, headaches, low mood. The cause is not known. Treatments that may help in some cases (but not all), include a programme of graded exercise therapy (GET) and cognitive behavioural therapy (CBT).

CFS is a condition that causes marked long-term tiredness (fatigue) and other symptoms which are not caused by any other known medical condition. A diagnosis of CFS is generally made once other medical conditions have been ruled out.

The following factors are thought to make CFS worse: recurring infections with viral or bacterial germs; not being active enough, or even being too active, stress, poor diet, being socially isolated and/or feeling frustrated and depressed; and environmental pollution.

There is no cure for CFS and treatment is aimed at managing the symptoms as well as possible. It may take an individual a number of months to learn how to pace themselves and find out what works for them. Fatigue is the main symptom, which is often described at an overwhelming feeling of mental and physical exhaustion that is not relieved by rest. In order to support someone at work with fatigue, a rehabilitation plan needs to be set out with a very gradual increase in hours over a number of weeks or months. There will be times when the symptoms fluctuate in severity and may flare up for a period of time. In this case, an individual may need to reduce their hours temporarily before they can get up to thier full hours.

Managing symptoms can involve medication to ease joint pains, anti-depressants to lift the mood, pacing activities by managing sleep, rest and relaxation time, as well as a good diet and good stress management strategies. Graded Exercise therapy (a rehabilitation programme of progressively increasing exercise) can help in some cases. Cognitive behavioural therapy (CBT) can help develop effective coping strategies and lift mood.

The severity varies, and for some individuals the symptoms resolve, for others they can have long periods with no or mild symptoms followed by flare ups where the symptoms are worse for a number of weeks or months. Following a setback the individual should usually be able gradually to return to their previous activity level. Each individual varies in their reponse to the condition and the longer-term outlook is variable.

In order to support an individual at work with CFS, a number of temporary or permanent adjustments could be considered. These would include reduced hours, a later start time or earlier finish time, and a reduction in the time spent on the more physical aspects of the role or remove these aspects completely. For tailored adjustments to suit the specific individual and the specific Organisation/working environment, an occupational health assessment is recommended. Pick up the phone to call us for advice on how to manage CFS or similar conditions in your workplace.




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OnMarch 8, 2015, posted in: Occupational Health Posts by

Fit for night work?

The UK Working Time Regulations (1998) states that night time working hours are usually between 11pm and 6am. It states that the night time period must be 7 hours long and include the period between midnight and 5am. Staff who regularly work for at least 3 hours during this period are usually deemed night workers.

Night work can have an adverse effect on health in some cases, and can aggravate some underlying health conditions. Fatigue is one of the main symptoms of working night shifts, especially if the individual finds it difficult to sleep during the day. This can lead to difficulty in concentrating, slower reaction times and slower mental processing. Studies have shown that there is an increased risk of injury or accidents on night shifts as opposed to day shifts. Digestive problems, such as heartburn or a change in bowel habit, are also commonly described by night workers. This may be due to the change in eating patterns and may be aggravated by unsuitable food taken in unsuitable quantities at unsuitable times.

There are some medical conditions, which for some individuals, may be aggravated by night work. There are very few, if any, health conditions that absolutely rule out night work. It is more often the treatment for a medical condition which needs consideration, especially if it needs to be taken at a certain time or has significant side effects such as drowsiness. Where there is a medical problem, it is often possible for the person to work during night hours with suitable modifications to their treatment regime for example. Some health conditions that may be affected by night work include diabetes; epilepsy; some respiratory conditions; depression and anxiety; and conditions where medication needs to be taken at strict intervals to avoid destablising the condition or causing other problems.

The Regulations state that night workers should be offered a free health assessment prior to working nights and at regular intervals after that. This can be done initially by questionnaire, and if any concerns are identified, a more detailed occupational health assessment can be conducted by an occupational health nurse. If an employee’s health is significantly affected by night work, employees may need to be offered adjustments or suitable other work where possible.

There are a number of actions that can be taken to reduce the risks to health associated with night work. The BBC Health website has very comprehensive information, assessment tools and interactive activities to enable you to better understand the science of sleep, your personal needs and strategies for good sleep. For an informal chat about your night workers, please call us today


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OnMarch 1, 2015, posted in: Occupational Health Posts by

Skin hazards at work materials used in the working environment can affect the skin, or pass through the skin and cause diseases in other parts of the body. Therefore, as an employer, you have a legal duty to assess the health risks that could arise through skin exposure to hazardous substances at work. The skin is the largest organ in the body and it’s main functions include providing a protective barrier against harmful substances and injuries, restrict the loss of moisture, reduce the effects of UV radiation, acts as a sensory organ (e.g touch, temperature), helps regulate body temperature and detect and protect against infections.

If the moisture content in the skin is too high or too low, it can significantly affect the skin’s barrier properties, which can increase the risk of developing skin disease. the four main groups of substances that can cause skin problems are corrosive substances that can lead to burns at the site of contact; irritant substances that can cause irritant contact dermatitis at the site of contact; sensitising substances that can lead to allergic contact dermatitis, and substances that cause other diseases, such as urticaria, acne or skin cancer.

In order to reduce the risk of work-related skin disease, you will need to assess the risks, put in place measures to control the risks (such as avoid or reduce contact with hazardous materials) , ensure workers protect their skin (with gloves and appropriate skin hygiene techniques) and then monitor for early signs of skin disease. Depending on the outcome of the risk assessment, health surveillance may be required. An occupational health specialist can work with you to identify if health surveillance is required and the most appropriate health surveillance programme to adopt at your workplace. If any of your employees work with skin hazards and are reporting symptoms indicative of skin disease (rash, itchiness, dryness, cracking, bleeding, scaling, redness) then an occupational health assessment would be required in order to identify any possible contributory workplace factors, advise on fitness for work and any temporary or permanent adjustments that may be required for that individual. For an informal discussion on skin hazards in your workplace, please call us today.

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OnFebruary 22, 2015, posted in: Occupational Health Posts by

What to expect from an occupational health assessment. purpose of an occupational health referral is for the employer to understand if there is a health condition present that may impact on work, or if there are any work factors that may impact on the employee’s health.  The referral should provide information on the individual’s health condition or symptoms, identify how that condition may impact on their work in the short and long-term, and identify solutions or adjustments to minimise any impact of health on work and vice versa.

A referral is appropriate in the following cases; for frequent short-term absences, long term absences (more than 4 weeks), concerns about an employee’s health at work, concerns about the effect of work on an employee’s health, any stress-related or mental health symptoms or absences, or where a functional assessment or workplace assessment is required to establish fitness to perform specific tasks for their current role.

The occupational health consultation would be either face-to-face, or over the telephone and will be conducted by an occupational health advisor (occupational health nurse) or an occupational health physician (occupational health doctor). The purpose of the consultation is to take a full medical history (including diagnosis, investigations and treatment), to understand how the condition or symptoms affect  normal everyday activities at home and work, and to understand all elements of the job.  In order to get the most from the consultation, it is important that the employee brings all relevant medical details. This includes any diagnosis, a list of any scans or investigations and the results, a list of any treatment , including name and dose of current medication and any copies of relevant letters from the GP or Specialist.

All consultations are strictly confidential,  however, a report will need to be provided to the line manager and/or HR manager. Employees will need to give consent for this report and should be advised on the contents of the report before providing consent. No clinical information (such as diagnosis) can be disclosed without consent. The manager will need to understand how the condition affects functioning at work and hence what the employee is able to do, and not able to do. Employees have the right to withold consent, however, the organisation may not then be aware of the appropriate support that is needed at work.

The occupational health report should include the reason for referral; relevant medical history and response to treatment/interventions; likely timescales for recovery; advice on specialist referrals; likely impact of condition on work in the short and long-term; recommendations and adjustments; likely return to work date; clinical justification for all comments and recommendations; and specific advice on “next steps’ in terms of review. If you would like to discuss whether or not an occupational health assessment is appropriate for your employee, please call us today for further advice.

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OnFebruary 8, 2015, posted in: Occupational Health Posts by

Protecting the health of people who work with Display Screen Equipment (DSE)

Display Screen Equipment is a device or piece of equipment that has an alphanumeric or graphic display screen, which includes conventional desktop computers as well as newer technologies such as laptops, touch screens and other similar devices.

Long periods of computer-based work has been linked with musculo-skeletal symptoms such as aches and pains in the lower back, neck, shoulders wrists and hands, as well as fatigue, headaches and eyestrain. The Health and Safety (Display Screen Equipment) Regulations 1992  were introduced to protect the health of people who work with DSE, especially as this has now become one of the most common kind of work equipment. Making a few small adjustments to workstations and working practices, can make working environments more comfortable and reduces the risk of developing any symptoms relating to this type of work, and  reduce the risk of sickness absence due to developing health conditions.

The Regulations require a DSE risk assessment to be conducted on any workstation where an individual has been identified as a ‘DSE user’ and that users are provided appropriate training and are informed of the risks associated with working with DSE and what steps to take to reduce these risks. Employers also need to provide regular eye tests for their DSE users and corrective appliances (glasses) where the corrective appliances are needed solely for DSE use.

There are times when individuals may still develop musculo-skeletal symptoms, eyestrain or fatigue, even when a workstation risk assessment has been conducted and training been given. In these situations, an occupational health assessment is recommended, which can help identify any work or non-work factors that may be contributing to the symptoms. In many cases, small adjustments to the workstation layout, employee’s posture or taking extra breaks from sitting can reduce the frequency and severity of the symptoms significantly. An occupational health nurse can also advise the employee on whether or not they should see their GP for a diagnosis or possible treatment, as well as provide both the employer and employee on appropriate steps to take to minimise further symptoms.

An occupational health provider can help you organise your workplace to ensure that you are compliant with the DSE Regulations, which can include training your staff to undertake risk assessments, or undertaking them for you. Please get in touch  to discuss the needs of your workplace today.

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OnFebruary 1, 2015, posted in: Occupational Health Posts by

Is your employee likely to be classed as ‘disabled’ under the Equality Act (2010)?  

Determining whether an employee is likely to be considered as disabled under the Equality Act (2010) is important as it means that employers must consider offering reasonable adjustments to that person’s work if there are aspects of their work where they are at a substantial disadvantage, compared to a non-disabled person, due to their health condition or symptoms.

The Equality Act (2010) states that a person has a disability if:

(a)       They have a mental or physical impairment; and

(b)       The impairment has a substantial and long-term adverse effect on their   ability to carry out normal day-to-day activities

In order to be classed as disabled under the Equality act, the individual’s condition must satisfy each of the four parts:

(1)       There must be a mental and/or physical impairment

(2)       The impairment must have a substantial adverse effect

(3)       The impairment must be long-term; and

(4)       There must be an effect on normal day-to-day activities

Although there are some conditions that are automatically classed as a disability.

When determining whether or not the individual satisfies the above criteria, the likely effect of the condition without medication or treatment also needs to be taken into account. Therefore, if an individual’s condition is fully controlled on medication, which allows them to lead a normal life with no effect on normal day-to-day activities, this does not necessarily mean that their condition will not be classed as a disability under the Act.

Although it is only a judge at a Tribunal that can determine legally if an individual has a disability as defined by the Equality Act (2010), an occupational health advisor will be able to give an informed opinion, based on their knowledge and experience, on whether or not an individual is likely to be classed as disabled under the Act. In order for this opinion to be given, an occupational health assessment is required in order to establish the full medical picture, including medical history, current conditions, symptoms, treatment, and the impact of their symptoms on their usual day-to-day activities. If you would like help in understanding your obligations with regards to disability under the Equality Act (2010), please call us today.

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OnJanuary 25, 2015, posted in: Occupational Health Posts by

What are ‘reasonable’ adjustments under the Equality Act (2010) and when do they apply?

The Equality Act (2010) requires employers to offer reasonable adjustments for disabled employees, however, it is down to employers to decide what is reasonable and adjustments should comprise.

Reasonable adjustments are limited to those that prevent a disabled person from being placed at a substantial disadvantage compared with those who are not disabled, and are primarily concerned with enabling the disabled person to remain at work or return to work. Therefore, when trying to decide what is a reasonable adjustment, it is important to identify the disadvantage faced by the employee and whether or not any adjustments would alleviate this.

Possible adjustments include making adjustments to premises (e.g ramps, widening doors), changing hours of work, provision of training, modifying processes such as a grievance process to allow a disabled person to be accompanied, adjusting redundancy criteria by ignoring disability-related sickness, providing modified work equipment or allocating some of the disabled person’s duties to someone else.

One of the factors that needs to be taken into account when deciding whether or not an adjustment is ‘likely’ to be reasonable is the extent to which the adjustment would diminish the disadvantage. Other factors would also include how practical the adjustment is, the financial cost of making the adjustment, the extent of any disruption to the employer’s activities, the availability of financial and other resources available, and the nature of the employer’s activities and the size of the undertaking.

The Equality Act states the employer only has to make reasonable adjustments if it knows the employee is disabled. An occupational health assessment during employment or at the pre-employment by an occupational health professional can help determine whether or not an individual may be classed as disabled under the Act. Occupational health specialists can also help employers in making the decision on whether an adjustment is likely to be reasonable and lawful, however, the ultimate decision on whether or not the organization can accommodate any specific adjustment is down to the organization itself. If you would like to understand how the Equality Act may affect your business, please call us for more information.

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OnJanuary 19, 2015, posted in: Occupational Health Posts by

Supporting individuals who want to work whilst having cancer treatment

Being given a diagnosis of cancer can have a devastating effect on that person and their family. Once the diagnosis has been accepted, many people like to try and keep as much normality in their life as possible, and in some cases want to remain at work if they can.

Treatment for cancer will vary depending on the type, extent and stage of the cancer that they have. Treatment includes surgery, radiotherapy and chemotherapy or a combination of all three. The different treatments can be given for varying lengths of time and affects each individual differently. The physical aspects of a cancer diagnosis and treatment can include pain, nausea, vomiting, severe fatigue, hair loss and joint aches and pains, and mentally some individuals can feel low, depressed or anxious.

Many treatments can last up to one year or more, and over that period of time the symptoms that an individual experiences are likely to fluctuate. There may be times when an individual feels well enough to work, but other times when they don’t. As treatment progresses, the tiredness can get significantly worse, therefore at the start of treatment, an individual may be able to manage most of their usual work, however, as treatment progresses some adjustments may allow the individual to continue working in some capacity if they want to and if the organisation can accommodate some adjustments.

Whether or not an individual remains at work, even in a reduced capacity, is a joint decision that needs to be made taking into account both the individual’s and organisation’s needs. This can be done by utilising an occupational health service to conduct an occupational health assessment. The individual’s wishes and health status will be taken into account, as well as an understanding on what the organisation can accommodate in terms of adjustments. Types of adjustments could include reduced hours, reduced number of working days or working from home. As the individual’s health status is likely to change throughout treatment, a regular occupational health assessment will identify appropriate adjustments at different stages of treatment.

If you want to discuss types of adjustments that you could offer for your employees who are currently undergoing cancer treatment or any other health condition, please call us now.

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OnJanuary 9, 2015, posted in: Occupational Health Posts by