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Nursing in Occupational Health
Occupational Health Nurses (OHN)s are registered nurses who independently observe and assess the worker's health status with respect to job tasks and hazards. Using their specialized experience and education, these registered nurses recognize and prevent health effects from hazardous exposures and treat workers' injuries/illnesses. Occupational health nursing is a field within the nursing profession which is focused on the prevention and management of workplace injuries. Occupational health nurses can work for companies which want to provide nursing services to their employees, and for government agencies concerned with occupational and public health issues. Many are registered nurses, and some hold master's degrees in topics such as public health. Occupational Health Nursing History in the Philippines Occupational Health Nursing in the Philippines traces its roots to Ms. Magdalena Valenzuela of the Department of Health who founded the Industrial Nursing Unit (INU) of the Philippine Nurses Association on Nov. 11, 1950. INU is an organization of Nurses working in the industry as company nurse. The Industrial Nursing Unit was changed to Occupational Health Nurses Association of the Philippines, Inc. (OHNAP) on Sept. 10, 1960 and on Sept. 25, 1979, the Constitution and By-Laws created a Specialty Board that granted its first Certified Occupational Health Nurse Title to its first graduate.
Functions of occupational health team 1. Work with the occupational health team to lead the sanitary and industrial hygiene of all industrial establishments including hospitals to determine their compliance with the sanitation code and its implementing rules and regulations. 2. Recommends to local health authority the issuance if license/business permits and suspensions or revocation of the same for any violation of the condition upon which licenses or permits had been issued, pursuant to existing rules and regulations. 3. Coordinates with other government agencies relative to the implementation of the implementing rules and regulations. 4. Attends to the complaints of all establishments in the area of assignment related to industrial hygiene and recommends appropriate measures for immediate compliance. 5. Informs all affected workers regarding the nature of hazards and the reasons for the control measures and protective equipment. 6. Participates to provide, install and maintains in good condition all control facilities and protective barriers for potential and actual hazards. 7. Makes a periodic testing for physical examination of the workers and other health examinations related to worker¶s exposure to potential or actual hazards in the workplace. 8. Provides control measures to reduce noise, dust, health, and other hazards. 9. Ensure strict compliance on the regular use and proper maintenance of personal protective equipment. 10. Provide employees/workers an occupational health services and facilities.
11. Refers or elevates to higher authority all unsolved issues in relation to occupational and
environmental health problems 12. Prepares and submit yearly reports to the local and national government. Scope Educationally prepared to recognize adverse health effects of occupational exposure and address methods for hazard abatement and control, OHNs bring their nursing expertise to all industries such as meat packing, manufacturing, construction as well as the health care industry.
OHNs:
Have special knowledge of workplace hazards and the relationship to the employee health status. Understand industrial hygiene principles of engineering controls, administrative controls, and personal protective equipment. Have knowledge of toxicology and epidemiology as related to the employee and the work site.
Typical OHN Activities:
Observation and assessment of both the worker and the work environment Interpretation and evaluation of the worker's medical and occupational history, subjective complaints, and physical examination, along with any laboratory values or other diagnostic screening tests, industrial hygiene and personal exposure monitoring values Interpretation of medical diagnosis to workers and their employers Appraisal of the work environment for potential exposures Identification of abnormalities Description of the worker's response to the exposures Management of occupational and non-occupational illness and injury Documentation of the injury or illness
Types of occupational health nurse ~ Industrial nurse ~ Company nurse ~ Plant nurse SCOPE OF RESPONSIBILITIES Assess work environments to identify potential or actual health problems Render first-aid treatment , especially during emergency cases, from simple wound dressing to wound suturing. Refer emergency cases to the nearest hospital requiring more extensive medical aid of surgical care in the absence of company physician. Active involvement in the Safety & Health Committee of the company. Monitor and record all medicines issued to employees
Conduct home visit to employees who were on prolonged sick leave and those who went on leave without permission no notifications for verification purposes. Assist the company physician during consultation and treatment. Monitor, record and prepare industrial accident reports, assist in filing and processing for SSS/ PH benefits Maintain accurate records of sick, vacation and other leaves. Prepare summary reports on industrial accident cases, injuries and sickness. Prepare and monitor request for medical supplies, sterilizing equipment, medicines and linen, among others, for daily use in the clinic as well as maintain stock cards for inventory. Perform liason tasks with SSS, Pag-ibig,Philhealth and accredited hospitals.
Hazards in Occupational Health Nursing A. Physical hazards: 1. Physical hazards are agents within the work environment that may cause tissue damage or other physical harm. 2. Physical hazards include radiation, temperature extremes, noise, electric and magnetic fields, lasers, microwaves, and vibration. 3. Health effects may be acute or chronic, depending on the dose and the body part affected. Examples: a. Acute: acoustic trauma from excessive noise; heat stress or stroke; skin rashes; eye injuries from infrared radiation; skin burns, cuts, or contusions. b. Chronic: Noise-induced hearing loss (NIHL); multiple myeloma and leukemias from exposure to ionizing radiation; teratogenic or genetic effects induced by certain types of radiation.
B. Chemical hazards: 1. Various forms of either synthetic or naturally occurring chemicals in the work environment may be potentially toxic or irritating to the body system through inhalation, skin absorption, ingestion, or accidental injection. 2. Chemical hazards include solution, mists, vapors, aerosols, gases, medications, particulate matter (fumes and dust), solvents, metals, oils synthetic textiles, pesticides, explosives, and pharmaceuticals. Specifically, health care workers are exposed to chemical hazards such as anesthetic gases, chemotherapeutic and antineoplastic agents, tissue fixatives and reagents, disinfectants and detergents, sterilizing agents, solvents, latex, and mercury. 3. Health effects may be acute or chronic and can affect the pulmonary, reproductive, urologic, cardiovascular, neurologic, and immune systems.
Examples: a. Acute: respiratory irritation due to smoke, poisoning from accidental ingestion; metal-fume fever; chemical burns; contact dermatitis and other dermatoses b. Chronic: cancers (e.g. mesothelioma, bronchogenic and gastrointestinal carcinomas); pleural disease; occupational asthma; hypertensitivity pneumonitis; birth defects; neurological disorders C. Biological hazards: 1, Biological agents such as viruses, bacteria, fungi, mold, or parasites may cause infectious disease via direct contact with infected individuals/ animals, contaminated body fluids, or contaminated objects/ surfaces. 2. Workers in certain occupations (e.g., health care, biologic research, animal handling) have a high incidence of infectious disease. 3. Health effects may be acute or chronic, depending on nature of the organism. Examples: a. Acute: self-limiting infections such as colds and influenzas; measles; skin and parasitic infections. b. Chronic: tuberculosis; chronic hepatitis B; HIV infection, progressing to AIDS.
D. Mechanical hazards: 1. Mechanical agents may cause stress on the musculoskeletal or other body systems. 2. Hazards include inadequate work-station and tool design, frequent repetition of a limited movement, repeated awkward movements with hand-held tools, local vibrations. 3. Health effects may be acute or chronic; they may result in a permanently disabling health effect. Examples: a. Acute: neckstrain and other muscular fatigue from forceful exertion or awkward positioning; visual fatigue b. Chronic: Raynaud¶s syndrome from use of vibrating power tools; carpal tunnel syndrome and other work- related musculoskeletal disorders; back injury
E. Psychosocial hazards: 1. Psychosocial hazards are often related to the nature of the job, job content, the organizational structure and culture, insufficient training and education regarding job requirements, and the physical conditions in the workplace; leadership and management styles can also contribute to psychosocial hazards. 2. Psychosocial hazards include interpersonal conflict, unsafe working conditions, overtime, sexual harassment, racial inequality, role conflict, shift work, limited autonomy, poorly defined expectations, and work instructions, and absent or limited job reward. 3. Health effects may be acute or chronic, including temporary and permanent disabilities; the occurrence of accidents and injuries may be a secondary effect of these hazards. Examples: a. Acute: increased heart rate; increased blood pressure; sleep disturbances; fatigue; depression; substance abuse; worksite violence b. Chronic: hypertension; alcoholism; coronary artery disease; mental illness; gastrointestinal disorder.
DOH Occupational Health Program A. The Health of the people is the primordial concern of the Department of Health. By virtue of the Sanitation Code of the Philippines, Chapter VII ± Industrial Hygiene (PD 856) the Department of Health is furthered tasked to take care of the administration and enforcement of sanitary requirements, environmental measures, provision of personal protective equipment and health services applicable to all workplaces. The reorganization of the Department of Health in 2000, left the Occupational Health Program to National Center for Disease Prevention and Control (NCDPC), Environmental and Occupational Health Office (EOHO). B. The objectives of Occupational Health Program in Partnership with the labor or worker groups, Local Government Units, industries and other sectors will integrate occupational health services into basic services in order to: 1. Improve the health status of workers with particular emphasis on the undeserved/small-scale and the high risk group of workers and the affected populace including the vulnerable sector including the children. 2. Provide maximum access to occupational services. 3. Develop the skills and amplitude of health personnel on the anticipation, recognition, evaluation and control of occupational hazards; early recognition and management of occupational poisonings; and other occupational health and safety concerns. 4. Reduce morbidity and mortality rates among workers in the workplace. 5. Reduce disability incidence due to work related illnesses, poisoning and diseases.
6. Establish a monitoring/reporting system for occupational diseases. C. The Program Strategies/Key Result Areas are as follows: 1. Establish/institutionalize Regional Occupation Toxicology (wherein Mercury Surveillance is incorporated) and poison Control Center. 2. Integration of Occupational Health Services as part of the Primary Health Care Approach. 3. Upgrade manpower capability of health personnel and existing facilities/laboratory respond to occupational health and related concerns. 4. Preventive and primitive Occupational Health Strategies. 5. Toxicovigilance activities. 6. Advocacy Campaign thru the ³Healthy Workplace´ Initiative 7. Research 8. Multi-agency Linkages