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Occupational Health: a 350 years old medical specialty

By Dr Ajay Sati, India Health Manager (Dec 2011 to Feb 2020)


Occupational Health (OH) has been in existence for over 350 years. Ask any employee or corporate honcho about it and the most likely answer might be that it is a form of physiotherapy, confusing OH with Occupational Therapy.


Long ago, an Italian physician by the name Bernardino Ramazzini, while still a medical student at Parma University, was keen on learning more about the diseases suffered by workers. In 1682, when he was appointed chair of theory of medicine at the University of Modena, Ramazzini focused on workers' health problems in a systematic way. He would visit workplaces, observe workers' activities, and discuss their illnesses with them. The medicine courses he taught were dedicated to the diseases of workers. Ramazzini also taught the physicians to ask patients - ‘what is your occupation?’ so that they could correlate if the patient’s disease was due to a particular job, and if so, what correctional steps could be taken.


Today, there may be fewer factories as workplaces and plenty of offices making us falsely feel that there are no work-related diseases or that they have reduced drastically. In fact, it is only the nature of occupational illnesses that has changed. As a medical specialty, OH is essentially practiced in the offices and factories unlike other disciplines that are practiced in a hospital.


The essence of OH as a medical specialty is to prevent and protect worker health from being damaged, harmed or injured. The workplace itself seems to be the best place where this goal can be realized.


Although the OH physician treats patients in the workplace, employers need to understand that the treatment of patients is but one small aspect of it. No workplace may be absolutely safe for good health. It needs to be made so by first identifying potential risks at the workplace, and then taking steps to mitigate those risks in a timely fashion. An OH physician thus, has an important role to play in the timely identification and mitigation of lurking occupational hazards.


To an onlooker for example, working with computers for extended periods of time might appear to be a benign activity devoid of any real dangers. However, as some of us may know, it has its fair share of short and long-term risks. Such a workplace setting should generally prompt an OH physician to ask themselves if they’re doing enough to protect worker health.


The work of an OH physician involves assessing health risks at the workplace, taking steps to mitigate the risks, certifying fitness to work, assisting in quick rehab of the sick, advising personal protective equipment if necessary, promoting wellness, advising on travel vaccinations and prevalent diseases, undertaking medical checks (both required by law and for wellness), preparing SOPs (first-aid, medical emergency response, pandemic response, etc.), participating while deciding workers’ compensation, liaising with hospitals and doctors, ensuring compliance with local health and safety legislation, advising on ill-health retirement, organizing and managing efficient delivery of health services and last but not the least, being an impartial advisor to the organization. The job of an OH physician is no less noble a cause than it was in the earlier centuries and no less important in the 21st! The role of an OH doctor in the industry goes above and beyond the mere act of seeing patients and is far more organizational and prescriptive in nature.


The views expressed here are personal and those of the author.