Training of Polish Occupational Physicians in Risk Communication

1. Training of Polish Occupational Physicians in Risk Communication Jacek Michalak Nofer Institute of Occupational Medicine Lodz, POLAND

2. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Occupational Health Service in Poland • Labor Code Amendment 1991 • Occupational Health Service Act 1996 • Covering all employees • Obligatory measurements and examinations • Costs covered by employers and State

3. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 The most important legal regulations in Polish OHS • Health Care Facilities Act (1991) • General Health Insurance Act (1997) • Occupational Health Services Act (1996) • Minister of Health and Welfare rule on the methods of determination the harmful factors at the work place (1993) • Minister of Health and Welfare Instruction on the prophylactic examinations of employees (1996) guidelines

4. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 The standards for prophylactic examinations: • minimum extend of medical examination • minimum set of laboratory tests • minimum set of specialist consultations This can be broadened by a doctor • minimum frequency of prophylactic examinations This can be shortened by a doctor

5. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 The list of harmful factors: • 14 groups of physical factors (e.g. noise, vibration) • 9 groups of industrial dusts (e.g. silica, asbestos) • 53 groups of toxic compounds • 6 groups of biological factors (e.g. HBV) • 8 groups of other factors (e.g. stress, shift work)

6. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 The measurements of harmful factors may be performed: • either by Sanitary Inspection laboratory • or by a laboratory authorized by sanitary inspection Doctor receives only the results

7. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Supervisory system in Occupational Health Service: • national consultant (specialist) appointed by the government • regional consultants (specialists) appointed by local authorities - Voivodes

8. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 System of physicians’ specialist education • 6 years of medical studies • 1 year of postgraduate stages Now you can start to cure, but not to be an occupational physician!

9. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Former system of specialists’ training: • 2 years of training– I0 specialty • Next 3 years - II0 specialty Present system: • 4 years of specialty training Individual supervision of a specialist – tutor or MASTER

10. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Current curricula • For graduate of Medical University (MB) • For I0 specialist in occupational medicine • For I0 specialist in general medicine (GP) • For I0 specialist in internal medicine

11. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 AIMS (1) • Working conditions and workers health status • Occupational hazards • Prophylactic examinations • Occupational diseases – prophylaxis, diagnosis and treatment • Stating working ability at a given workplace • Rehabilitation of disabled workers • Health promotion at the workplace

12. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 AIMS (2) • Risk assessment • Co-operation with employers • Individual protection devices • Biological monitoring • Advising in occupational safety and health • Analysis of accidents at work and occupational diseases

13. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Knowledge and capacities (items in curriculum) • Health care organization (25) • Occupational hygiene (36) • Physiology and ergonomics (14) • Occupational psychology (7) – communication with patients • Epidemiology (8) • Statistics (5)

14. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Occupational medicine – clinical issues • General issues (10) • Occupational pathology (risks) (28)

15. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 • Management of Occupational Health Services • Health economics • Internal medicine

16. Cardiology Angiology Pulmonology Hematology Nephrology Gastroenterology Endocrinology Allergology Rheumatology Oncology Infectious diseases Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001

17. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Courses • Introductory (1 week) • Advanced (8 weeks) • Special (each 10 h to 3 weeks): • occupational pathology, pneumoconioses, allergy, occupational psychology (communication), • occupational diseases – dermatology, larygnology, acute poisoning and reanimation,

18. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 Stages • Internal medicine – 12 months • Infectious diseases – 4 weeks • Orthopedics 2 weeks • Occupational hygiene and epidemiology 8 w. • Health care organization – 4 weeks • Occupational pathology – 4 months • OHS primary unit– 24 months • Pulmonology 5 weeks

19. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 • 11 examinations • Active participation in Polish Association of Occupational Medicine • 1 published report • 1 foreign language (English, French or German)

20. Training of Polish Occupational Physicians in Risk Communication EASOM Dresden 2001 However, it is a lot to be done in risk communication