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OEH Training Summary Thoughts Hong Kong 29 October 2013. Thomas H Gassert MD MSc Harvard School of Public Health. OEH Diagnosis and Causation. Two steps: Medical diagnosis requires quality OEH training Causation (work related, or not) should be an impartial judgment
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OEH Training Summary ThoughtsHong Kong29 October 2013 Thomas H Gassert MD MSc Harvard School of Public Health
OEH Diagnosis and Causation • Two steps: • Medical diagnosis requires quality OEH training • Causation (work related, or not) should be an impartial judgment • Need to use subject and group information • Epidemiology, toxicology, risk assessment • Understanding work place and job imperative • Causation is a judgment (more probable than not): • Strength of association • Consistency • Specificity • Time relationship • Biological gradient • Biological plausibility • Coherence (synthesis of evidence) OEH Summary Thoughts
Obstacles for Parties to OEH OEH Summary Thoughts
OEH Motivation & Advantages OEH Summary Thoughts
Approaches – Two? • Obstacles are serious • Two approaches • Root levels, subtle but strong, holistic, integrated, from bottom-up • Choose motivated partners from all parties • Start with work-site OEH skills (e.g., safety reps) • Empower workers with knowledge of OEH recognition, diagnoses and how to relate with OSH profs and medical • Emphasize training primary care in OEH • Public • Campaigns, expert and grassroots publications, ratings, media, handbooks (Hesperian style), videos • Call out abuses and reward good practices using science and experts (medical and legal) OEH Summary Thoughts
Projects - ? • Signed resolution stating need for training • Identify rapid and practical ways to integrate OEH training locally with existing PHC services • Complete baseline needs assessment, nation-by-nation (publish and post) • Assemble an interim international OE medical panel to assist urgent cases and disasters OEH Summary Thoughts
Possible Solutions • Root work to educate all parties • OEH/OSH prevention skills (1, 2, 3 levels) • Technical skills and knowledge transfer • Shop floor • Medics, hygienists, engineers, managers, gov’t workers • Raise legal (labour and OEH law) and medical standards • OD diagnoses (see WHO handout from Finland) • Access to health care and primary prevention experts • Accreditation/certification of medical teams • Integrate and embed OEH training in primary care service • Consider Taiwan NODIS internet OD reporting system as it has had significant boost to OD diagnosis and compensation (see handout article from IJOEH 2013) • Bring “value-added” achievable projects to funders • Funds will come if payors see value-added (benefits outweigh costs) • Establish new generation of OEH specialists by having national capacity building in OEH training, certification and materials OEH Summary Thoughts
WorkSite Technical Training • Walk-through survey and checklists • OSH committee (labour and management) • Periodic inspections • Access to experts and records/reports • Occupational hygiene, safety manager, consultant • Nursing, Rehab, Medical • Worker has right to his/her medical and exposure records • Hazard Communication tools, access • Barefoot epidemiology • Each case • Group applications OEH Summary Thoughts
Final Thought • Training and Funding • Jump start for OEH at all levels • Eliminate costs and financially support those being trained in OEH skills/knowledge • Use international support to eventually build national competencies/capacity • New Generation Univ – U. British Columbia linked with superior programs for certifications (Harvard, U.I. Chicago, U. Wash., others) • Work with Partners in Health to create Partners in Occupational & Environmental Health • Realize human rights to OEH • Access funding from World Bank for team training OEH Summary Thoughts
17 Ways NextGenU Differs from MOOCs* and Traditional Education • Credit • Free • Financial sustainability • Higher level education • Best available resources • Coordinated curriculum • Competency-based foundation • Multiple languages • Extensive human interactions • Interactive computerized learning • Extensive computer and human assessment • Open use • Customizable • Active educational partnerships • A new way to teach • Open research policy • Warm prestige *MOOCs=Massive Open Online Courses
Seek Free Methods 4 Freedoms • Cost • Barriers • Ads • Carbon New Gen U Partnerships OEH Summary Thoughts
Motivation • Feel impowered • Feel motivated • Try not to feel overwhelmed • Seek global support, partners • Integrate environment with occupational • There’s no turning back! OEH Summary Thoughts