Understanding Occupational
Health: Myth & Legislations
Dr Obadiah Lulu Elekima,MPH, M.Sc(Tox.), M.Sc
M.Sc(Occ Med), MBA, AFOM, MRCOG (1), MFOM, Ph.D, FRSPH
Lead Consultant Occupational Physician,
Worcester Acute Hospitals NHS Trust, UK
Senior Lecturer & Consultant Public Health Physician,
University of Port Harcourt, Nigeria
Content (1)
• What is Occupational Medicine (OM)?
• Work-related Ill –health (WRI)/Occupational Diseases-Burden & MortalityOverview
• Training in OM
• What are Occupational Health Services (OHS)?
• Who is an Occupational Health Physician (OHP)?
• Problems with Occupational Health Practise in Nigeria
• OH Legislations in the UK
Content (2)
• Recommendations
• Federal, State & Local Governments
• Medical & Dental Council of Nigeria (MDCN)
• Organisations (Public & Private) & Individuals
• Conclusions
Occupational Health…. What is it?
“..the promotion and maintenance of the highest degree
of physical, mental and social well being of workers in
all occupations.” (ILO/WHO 1950)
Oc
Principal role of Occupational Medicinecupational
Health…. What is it?
……. is the provision of health advice to organisations
and individuals to ensure that the highest standards of
Health and Safety at Work can be achieved and
maintained (Fac of Occup Med, UK).
Work-Related Disease/occupational disease Burden &
Morality-Overview(1)cupational
• When prevention and control measures at work fail,
occupational diseases (OD) can occur.
• OD cause huge suffering and losses to workers, businesses,
social security funds and societies at large.
• Diseases caused by work kill six times more workers than
work-related accidents (ILO, 2014).
Work-Related Disease/occupational disease Burden &
Morality-Overview(2)cupational
• estimated that there are globally about 2.02 million deaths
annually caused by disease due to work13,
• annual global number of cases of non-fatal work-related
disease is estimated to be 160 million.
• OD cause immeasurable human suffering to victims and their
families, & entail major economic losses for enterprises and
societies as a whole
Work-Related Disease/occupational disease Burden
& Morality-Overview(3)cupational
• OD also results in lost productivity and reduced work capacity.
• Globally, ILO estimates that around 4 per cent of the world’s gross
domestic product (GDP), or about US$2.8 trillion, is lost owing to
work-related accidents and diseases in direct and indirect costs .
• Identification and reporting of OD or work-related ill-health (WRI)posed a huge challenge in most countries.
• OD can be invisible in public policy discussion, since in most countries,
especially developing countries, there is very limited reporting of such
diseases.
• Identification & reporting made worse by lack of OH legislations.
Training in Occupational Medicine (OM)? (1)
 A clinical specialty -just as surgery, general/internal medicine, paediatrics,
obstetrics & gynaecology etc
 A faculty of the royal college of physicians (UK), American College of
Occupational & Environmental Medicine (USA) and other equivalents.
 Need broad clinical knowledge of the different specialties of medicine to be
able to train and qualify in OM
 In the UK, needs a Minimum of 4 years of postgrad training after Senior
House Officer (SHO) or at least 3 years post graduation. Similarly in Australia
and some EU countries.
Training in Occupational Medicine (OM)? (2)
 Satisfactorily completion of competencies, pass the prescribed
Board or Faculty of the Appropriate College Examinations (2
parts-I & II), Complete a Dissertation, awarded MFOM
(equivalent to Fellowship awarded in different specialties in
Nigeria following the exit exams) & put on the Specialist
Register.
 Slight Variation in the USA but still requires regulated period of
training and board certification
What OH Services involve? (1)
A. Clinical Occupational health activities
• Pre-employment assessments-Health screening
• Periodic medical examinations (including health
surveillance)
• Post sickness absence review
• Immunisations including Travel Advice
• Health Promotion, education and counselling
(Health Promotion)-Good Health is Good Business
What OH Services involve (2)
• Treatment
• Rehabilitation of employees back into the workplace
B. Workplace assessments
= Evaluation of workplace to reduce or eliminate
exposure
• Recognition
• Evaluation
• Control
What OH Services involve (3)
C. General advice and support
• Advice on compensation
• Disaster planning including advice on managing
chemical incidents
• Food hygiene (Food industry)
• Advice on environmental issues
What OH Services involve (4)
D. Other activities
• Audit, quality assurance and evaluation
• Worker protection and business protection
What is not Occupational Medicine? (1)
• All other medical Specialties other than OM i.e. Family Medicine (FM)/
General Practitioner (GP), surgery, Obstetrics & Gynaecology (O&G),
Paediatrics, General Public Health.
• A medical doctor who does Appendicectomy or herniorraphy- Not surgeon
• Performing Caesarian Section (C/S) or “TOP” –does not make the doctor an
Obstetrician or Gynaecologist.
• In a similar way, having retainerships or just working in an industry or
company without training in OM does not make the doctor a Specialist
Occupational Physician.
Who is an Occupational Physician (OHP) /Occupational Health
Practitioners (OHP)?
Doctor-Specialises in Occupational Medicine after a regulated period of training
by a recognised professional body, acquired competences, passed the
prescribed examinations, and on the Specialist Register e.g. MFOM, FFOM (UK),
FACOEM (USA).= Consultant/Specialist Occupational Physician
Doctors in the USA-generally, start training in Public Health but specialised in
Occupational Medicine (Board Certified)
Doctors- in active OH practise + AFOM or AFOM-recognised as Specialist in
Occupational Medicine
Doctors whose primary employment is in an occupational setting and have
acquired at least 10 years of experience should be described as OHP with or
without the Diploma in OH/M.Sc in Occupational Medicine*
Who is not an Occupational Health Specialist?
• Any doctors who do not fall under the definitions above & Not trained in OH
including *(General Public Health Physicians), Professionals-Surgeons,
Paediatricians, Internists, Obstetricians & Gynaecologists, Medical Officers,
Family Physicians (FP)/General Practitioners (GPs)
• Other Nurses other than trained Occupational Health Specialist Nurses
• Allied Health Professionals-Environmental Health Officers, Physiotherapists,
• Just doing a dissertation in work-related topic or among workers or in a
work-environment DOES NOT MAKE YOU AN OH PHYSICIAN/Specialist. E.g.
some of our colleagues in General Public Health.
Who is an Occupational Health Specialist Nurse (SOHN)?
• Nurse -Specialises in Occupational Health Nursing after a regulated period of
training by a recognised professional body, acquired competences, passed
the prescribed examinations, and on the Specialist Register e.g. on
Occupational Health/Public Health section of the Specialist Register of
Royal College of Nursing (RCN, UK)) or the American College of Nursing
Who is NOT an Occupational Health Specialist Nurse (SOHN)?
Any nurse or midwife or general public health nurse who
does not meet the above criteria.
Problems with OH Practise in Nigeria? (1)
Lack of the folowing:
 regulated OH practice-open to Abuse
 Appropriate regulations to govern/guide OH Practice
 Appropriate Professional Body to standardise the
registration and
regulation of OH practitioners doctors, Nurses and other HCWs
 Enforcement
 Appropriate Health & Safety regulatory body independent of the Ministry
of Labour/Ministry of Health e.g. HSE (UK) , OSHA (USA)
 Understanding the of OM Specialty
 understanding of the requirement for OH practice
 understanding of the Occupational Medicine Specialty by the MDCN
(Medical and Dental Council of Nigeria)
Problems with OH Practise in Nigeria? (2)
Lack of the folowing:
 recognition of the Faculty of Occupational Medicine as a Specialty and or as
a Subspecialty by the Medical and Dental Council of Nigeria.
 clarity in the understanding of the differences between the practises of
Occupational Medicine/Health specialists and Health & Safety officers or
Environmental Officers
 respect and ignorance on the part of our medical colleagues in other
specialties about Occupational Health/Medicine and its practises.
 understanding of the relationship between health and work i.e. the impact
of Health on Work and the Impact of Work on Health. Need to be Healthy to
work efficiently & effectively. To work safely such that your work does not
make you become unwell.
 Non-existence of an Employment Tribunal-look specifically at employment
Problems with OH Practise in Nigeria? (3)
Lack of the folowing:
 Of recognition that workers need to be Healthy to work efficiently &
effectively. To work safely such that your work does not make you
become unwell.
 Non-existence of an Employment Tribunal or equivalent courts -dealing
specifically with employment laws & Work-related issues
Encouragement
I understand:
• the Faculty of Public Health of the Nigeria Medical Postgraduate
College- recently approved
subspecialty training in Occup &
Environmental medicine but still early days.
• the Faculty of Community Medicine of the West African College of
Physicians (WACP) is also considering
training in Occup &
Environmental medicine as a Subspecialty. Already has Draft document
for Approval by College (Delayed by EBOLA CRISIS!!!)
Occupational Health Legislations (1)
• OH or Work-related legislations in Nigeria are still very rudimentary and
limited to what had existed since the Factory Act. Even when claims are
made that the Acts or Regulations have been updated, they are either
NOT enforced, Ambiguous, Not Clear or Not Effective.
• It would be difficult to effectively practise OH without clear,
unambiguous and Effective legislations.
• Difficult to practise OH without enforcing the regulations
• However, we can borrow a leaf from the UK or USA or other countries
with more advanced OH legislations. Typical Example of some of the
Regulations in the UK that we may be able to adapt are as follows:
Occupational Health Legislations (2)
Major Sources of Law in the UK:
• Statute- Acts of Parliament compromising primary legislation
• Common law- the principles of law accumulated from the decisions of
judges in cases presented to them in courts over the years;
• European Directives & Regulations
Occupational Health Legislations (3)
Types of OH related laws
• Criminal law:
• Primarily deters & punishes offenders through prosecutions by the
State and its Public Officials-Crown Courts or criminal courts
(Magistrates Courts).
• Successful convictions requires ‘beyond reasonable doubt’ & results
in a penalty for the offender e.g. fines or prison sentences.
• Breaches of health & Safety legislation, HSE & local authorities (local
governments) bring about criminal prosecutions.
Occupational Health Legislations (4)
• Civil law:
• Primarily compensates for injury or loss proved to be resulting from a
failure to carry out a duty of care owed to the wronged party.
• Successful claim requires a proof on ‘balance of probabilities’ and
results in awarding of damages or compensation to the plaintiff
(Complainant).
• Health & Safety cases in civil courts arise mainly from either breach of
statutory duty or negligence, where the claimant must prove that he
was owed a duty of care by the defendant and that his injuries or losses
were a foreseeable consequence of failure by the defendant to take
reasonable care.
Occupational Health Legislations (5)
What are Regulations?
• Regulations are laws made by Parliament and usually made under the
Health & Safety at Work Act (legally binding as the parent Act).
• Approved Codes of Practice (ACoP)-provide guidance on how to apply the
law and have a special legal status. Following them is not compulsory.
However, in practice not following an ACoP could be difficult to defend
and could lead to successful prosecution.
 1974-The Health & Safety (H & S) at work Act (HASWA) enacted: Underpins
occupational H & S practice in the UK. Enables all other H & S legislations.
Imposes statutory duties on employers in the UK to take reasonable care of
their employee’s health and safety
Occupational Health Legislations (6)
The Health & Safety (H & S) at work Act (HASWA), 1974 states:
 employers’ statutory duties
 employees’ statutory duties to comply with all health and safety at
matters at work
 successful prosecution could lead to fine or prison terms
 Act covers everyone at work, including independent contractors and
their employees, the self-employed, visitors, but excludes domestic
servants in private households.
 Act is the parent of many other
statutory regulations, e.g.
Management of Health & safety at Work Regulations 1999,
Occupational Health Legislations (7)
The Health & Safety (H & S) at work Act (HASWA), 1974 states:
 Manual Handling Regulations, & Control of Substances Hazardous
to Health Regulations 2002.
 Employers’ Statutory Duties Include:
•
to ensure so far as reasonably practicable that:
• There is a safe system of work
• There is a safe place of work
• Staff are given information, instruction and training on matters of
health and safety and are adequately supervised
Occupational Health Legislations (8)
The Health & Safety (H & S) at work Act (HASWA), 1974 states:
 There is a safe system for the handling, storage & transport
of substances & materials
 There is a safe working environment-may include preemployment medical exam & Equality Act, 2010 or Disability
Discrimination Act (DDA), 2005. Although, these were NOT
specified under the act.
Occupational Health Legislations (9)
The Health & Safety (H & S) at work Act (HASWA), 1974 states:
 Employees’ Statutory Duties:
 Do nothing to endanger their health
 Duty to inform the employer truthfully when requested for
information on matters concerning medical history.
 Failing to disclose , when requested, material information about
previous or current medical conditions may result in fair
dismissal.
Occupational Health Legislations (10)
Regulations from the Health & Safety at Work Act, 1974
 1992-Display Screen Equipment (DSE) Regulations
 1999-Management of Health at work Regulations
 COSHH 2004
 Control of Asbestos at work regulations-2012
 Control of lead at work regualtions-2004
 Equality Act, 2010 (replaced Disability Discrimination Act (DDA),
2005) (UK)
Occupational Health Legislations (11)
Institutions that Enforce the Act and Regulations
 The Health & Safety Commission (HSC) –responsible for Policy
 The Health & Safety Executive (HSE) responsible for enforcing the Act for
all public services, agriculture, construction & manufacturing industries.
 The Employment Medical Advisory Service (EMAS)- a division of the HSEissues notices to companies or Individuals for breaches of health &
safety law.
 Environmental Health Officers employed by the local authorities (local
govt) –enforce the act in relation to shops, restaurants, hotels, offices
Occupational Health Legislations (12)
The ‘Six pack’ -came into force in 1993 under HASWA: include






Management of Health & safety at Work Regulations 1999
Workplace (Health, Safety & Welfare) Regulations 1992;
Provision and Use of Work Equipment Regulations (PUWER) 1998;
Personal Protective Equipment Regulations (PPEs) 192;
Manual Handling Regulations 1992;
Display Screen Equipment (DSE) Regulations 1992
Occupational Health Legislations (13)
Management of Health & safety at Work Regulations 1999-Employer’s
duties:







Suitable & sufficient’ assessment of the health & Safety risks
employees & others in the workplace
Implement measures identified by the risk assessment
Training must be provided to all employees
Appropriate Health Surveillance
Further risk assessment for women of childbearing age
Record findings
Emergency procedures set up
‘
of
Occupational Health Legislations (14)
Workplace (Health, Safety & Welfare) Regulations 1992-covers
The work environment-ventilation, cleanliness,
waste, lighting,
temperature, room dimensions & space, workstations and seating,
floors, surfaces, lavatories, facilities for washing, rest & eating.
Occupational Health Legislations (15)
Provision and Use of Work Equipment Regulations (PUWER) 1998:
 Ensures equipment for work is suitable, complies with standards, safe,
maintained safely, regularly inspected, safety measures in place e.g.
warning signs.
 Risk assessment of equipment
 Risks controlled as far as reasonably practicable
 Provide information, training, instructions to all employees
Occupational Health Legislations (16)
Personal Protective Equipment Regulations (PPEs) 1992
(amended 2002)
 Suitable PPEs e.g. masks, gloves, apron, goggles, overall
 Provide information, training, instructions to all employees
 Maintained, regularly inspected, safety measures in place
Occupational Health Legislations (17)
Manual Handling Regulations 1992
Applied in Transporting or supporting of a load (include: lifting,
putting down, pulling, pushing, carrying or moving)






Eliminate risk, where possible
If not, carry out Manual handling risk assessment
Implement measures to reduce risks
Employees under duty to use safe systems e.g. use of hoist,
attend manual handling training,
follow instructions
Occupational Health Legislations (18)
Display Screen Equipment (DSE) Regulations 1992 :
Covers computers, laptops, CCTVs, or any other equipment used for the
display of text or graphics used ‘habitually’ (about 30-50% of time at
work) at work
 Regular breaks
 DSE workplace assessment
 Workstations-has appropriate lighting, noise, temperature, avoid
glare, enough legroom, adjustable chairs (back and height),
appropriate software
 Provide regular eye tests
Occupational Health Legislations (19)
Control of substances Hazardous to Health (COSHH) Regulations 2002
(Amended 2004)
 Risk assessment of exposure to hazardous substances at work
 Prevent exposure if reasonably practicable
 If not, exposure adequately controlled




Not exceeding any applicable Workplace Exposure Limits (WEL)
Health Surveillance
Provide instructions, training & supervision of employees
Control measures to follow hierarchy of control measures: elimination,
substitution, isolation/enclosures, engineering controls, PPEs
Occupational Health Legislations (20)
The Control of Vibration at Work Regulations 2005-employers’ duties:
 Risk assessment of exposure to vibration (individuals using vibrating
tools: drills, hammer drills, sanders, breakers, hedge cutters, strimmers)
Dentists, Dental Technicians, construction workers, carpenters, farmers,
oil workers, workers in most industries, mechanics , miners etc)
 Health surveillance
 Control measures
 Provide instructions, training & supervision of employees
 Provisions appropriate PPEs-anti-vibration gloves, water-resistant
clothing, warm clothing
 Exposure Action Value-2.5m/s2
 Daily Exposure Limit value (ELV) 5.0ms/s2
Occupational Health Legislations (21)
Reporting of Injuries, Diseases and Dangerous Occurrences Regulations
(RIDDOR) 1995:
Employer must report to HSE or local authority via the incident contact
centre, any of the following arising out of, or in connection with work:
 Death or major injuries from accident
 Minor injuries causing the individual to be off work or unable to
perform the full range of their normal duties for over 3 days
 Reportable industrial diseases when confirmed in writing by a
doctor
 Dangerous occurrences, including needlestick injuries
Occupational Health Legislations (22)
The Control of Noise at Work Regulations 2005
 Risk assessment of exposure to noise (Workers affected: Dentists, Dental
Technicians, construction workers, carpenters, farmers, oil workers,
workers in most industries, mechanics , miners etc)
 Health surveillance
 Control measures
 Provide instructions, training & supervision of employees
 Provisions appropriate PPEs-hearing protection
 At or above 80dB(A) hearing protection must be worn. Hearing checks
regularly
 At or above 85dB(A) a programme control measures must be implemented
to reduce the risk of exposure to a minimum
Occupational Health Legislations (23)
The Control of Asbestos at Work Regulations 2012
• Avoid exposure to asbestos at work
Equality Act, 2010 (Disability Discrimination Act, 1995 (Amended 2005)
• Employers: to make reasonable adjustments to be able to
accommodate employees with disability.
Disability: Physical or Mental impairment with substantial adverse effect,
long-term (likely to last or lasted 12 months or more), requires regular
treatment, tendency to relapse e.g. mental health anxiety & depression,
bipolar disorders, cancers, HIV, multiple sclerosis, diabetes, hypertension,
NOT Disabled: personality disorders, Alcohol, drug or nicotine addiction
unless complications of their addictions i.e. liver failure, mental illness
Occupational Health Legislations (24)
Medical Assessment of Oil & Gas UK (OGUK) & UK offshore operations
association (UKOOA)
Regulates Oil & Gas Workers in the UK
 Pre-employment/pre-placement medical
 Minimum age for employment: 18 yrs
 Periodic medical- 3 yearly up to age 39 yrs, 2 yrly between 40 and 50 yrs, &
annually.
 more frequent medical after significant absence due to injury or illness.
 measurements-height, weight, body mass index (BMI), visual acuity, colour
vision, systematic physical exams
 BMI> 35 (Unacceptable)
Occupational Health Legislations (25)
 Investigations: urinalysis, pulmonary function, audiometric testing
 Certification of dental fitness; routine dental surveillance
 Catering staff to have at least one stool sample cultured for pathogens
 HIV does NOT debar from employment BUT symptoms and signs of AIDS
related Complex debars
 Malignancy (unfit) but decided case by case basis
 Alcohol & substance abuse-positive test=exclusion But companies ready
to assist
 Medications: cytotoxics, anticoagulants, immunosuppressants, insulin,
anticonvulsants, oral steroids, routine use of psychotropic agents,
tranquillizers, narcotics, hypnotics are unfit to work offshore
Occupational Health Legislations (26)
Medical conditions Unfit/unacceptable for Offshore work:
 Chronic ear disease or vertigo, significant symptomatic nasal airway
obstruction, recurrent or chronic sinus infection
 Hearing loss in better ear greater than 35dBA for lower frequencies
or 60dBA for higher frequencies
 Neurological disorders e.g. epilepsy, cerebral disorders-unacceptable
 Peripheral vascular disease.eg. varicose veins with ulceration, varicose
eczema or active deep vein thrombosis-unacceptable
• CVS, chronic lung dis, Mental disorders, chronic kidney dis, liver dis, GI
disorders (active peptic ulceration, IBD, symptomatic hiatus hernia,
haemorrhoids, fistulae, anal fissures, cholelithiasis,
pancreatitis,
abdominal herniae)
Recommendations (1)
Federal Government, State & Local Governments Actions
 Enact Laws/Legislations- regulations to govern/guide OH Practice
 Appoint appropriate body/Committee
consisting of Occupational
Professionals to assist with drafting the legislations and advising the
government.
 Establishment of Health & Safety regulatory body similar to HSE (UK) &
OSHA (USA) independent of the Ministry of Labour/Ministry of Health –
Headed by Occupational Physician but with membership from other health
professional groups
 Establishment of
Employment Tribunals to address specifically
employment cases & employment laws
Recommendations (2)
Federal Government, State & Local Governments Actions
 Monitoring & Regulatory system
 Better understanding of the relationship between health and work i.e. the
impact of Health on Work and the Impact of Work on Health.
 To raise the profile of Occupational Medicine
 To make Occupational services mandatory for all organisations-small,
medium and large organisations, both private and public-through
legislations.
 Equality Act or Disability Discrimination Act Law MUST be Established:
Avoid wrongful dismissals, rejection for employment, retired too early,
discrimination against disabled people e.g. air crew with HIV
Recommendations (3)
 Mandatory for organisations to employ OH physician with the right
OH qualifications-ensure appropriate advice & correct OH Practise.
 Environmental laws to stop pollution especially work-related by
companies, individuals or organisations.
Medical & Dental Council of Nigeria
 Better understanding of the OH Specialty
 Establishment of the Faculty of Occupational Medicine
 Registration of Accredited Specialist qualifications acquired from
Reputable medical bodies e.g. American Board Certification, MFOM &
other equivalents under category A of the Specialist Register- as there
are currently OH specific training programmes in Nigeria.
Recommendations (4)
Medical & Dental Council of Nigeria
 Recognition of medical Doctors with over 10 yrs experience practising OM
full time as their primary assignment as Specialist in some capacity.
 Establishment -appropriate pathways with various bodies such as the
WACP, the Nat. Postgrad. Med. College of Nigeria, the American College of
Occupational & Environmental Medicine, The Faculty of Occupational
Medicine of the Royal College of Physicians, UK and others for the
recognition of Medical Doctors without OH qualifications but with at least
10 years of continuous OH practice as Specialist in Category B of the
Specialist Register for the first 2 yrs of registering the Specialty.
 Set up regulations for Occupational Health Practice
Recommendations (5)
Medical & Dental Council of Nigeria
 to standardise the registration and regulation of OH practise by doctors
and other HCWs
 Enforcement of professional registrations & Restriction of OH Practices
to qualified OH Specialists only
Recommendations (6)
Postgraduate Medical Colleges
 Time both the Nigeria Medical Postgraduate College & the West African
College of Physicians (WACP) gave recognition to Specialist OH
Physicians trained outside from reputable accredited bodies & support
their registrations under Category A of the Additional Registration.
 Time both Faculties of Public Health & Community Medicine of the
Nigeria Postgrad. Med. College & WACP considered the benefits to the
colleges & the Nation of having trained OH consultants & award
Fellowships of the colleges to OM Specialists/consultants who trained
outside Nigeria from reputable accredited bodies to boost training &
development of future specialists in OM.
Recommendations (7)
Postgraduate Medical Colleges
 Establish genuine pathways for recognising Medical Doctors
without formal training but practising OM full time as their primary
assignment for at least 10 yrs as Specialists in some capacity during
the first 2yrs of establishment of OM Specialty/Subspecialty.
 To stand shoulder to shoulder to clarity the friction between
Occupational Medicine/Health specialists and Health & Safety
officers or Environmental Officers.
 Faculties of Public Health of the 2 colleges to build better
relationships with external faculties of Occupational Medicine,
FOM (UK) or ACOEM (USA)-effective & Robust dev. OM in Nigeria.
Recommendations (8)
Postgraduate Medical Colleges
• Work towards closer integration & Reciprocal Recognition with
external faculties of Occupational Medicine i.e. FOM (UK) & ACOEM)
(USA) & others.
 Both Colleges to offer appropriate advice to both the MDCN & Fed Govt
to ensure the growth & development of OM in Nigeria.
 Both Colleges to stop the dirty Politics & Cold War and work together for
the growth of OM, the medical profession and the greater benefit of
Nigeria & Nigerians.
Recommendations (9)
Organisations –Public & Private & Individuals
 To recognise the distinct role of OH Physicians & Nurses and the value
they add to the organisation
 To re-configure services such that OH services will be made distinct and
separate from Family Medicine/GP practices, Paed., O & G, Surgery and
other clinical services.
 To stop confusing other clinical services especially family medicine/GP
practices as OH services. The diagnosis, investigations & treatment of
various medical conditions except work-related are not part of OH role.
 Families and dependents of employees should be seeing Family
Physicians or other clinicians for their medical problems and not OH.
Recommendations (10)
Organisations –Public & Private & Individuals
• OH services are purely for workers, - it is about adjustments that could
be made to make individuals work safely.
 OH services are about ensuring that the work environment & the
systems of work are safe
 Ensure recruit individuals with specialist OH qualifications and not
confuse it with fellowships/memberships
from other clinical
specialities-as you will give you better value for money.
Recommendations (11)
Organisations –Public & Private & Individuals
By employing a well trained OH physician (Not Imitations) & appropriate
OH legislations, you will get the following benefits:
 Reduction in work-related Disease burden, injuries & mortality
 Less Litigations & payment for compensations
 Increased Productivity as sicknesses absences will be brought to a
minimum
 Appropriate advice and adjustments to work will cut down the
duration of sickness absences.
 A Healthier workforce will by far be more productive
 Cut down a lot of unnecessary overheads
Conclusions
 Establishment of OH laws that are enforceable with appropriate
support structures is paramount to the future development of OH in
Nigeria.
 Thank you for lending me your ears & your time.