Education of Occupational Health professionals in risk evaluation, analyses and prevention

1. Education of Occupational Health professionals in risk evaluation, analyses and prevention Brigitta Danuser, Angela Ensslin, David Vernez

2. Identifying key factors Society Company: Risk assessment and management OH have do deal with a potential open circle of persons!

3. Identifying key factors:Modes of collaborative work • Multidisciplinary:…..bringing a number of different disciplines together to work discretly on different aspects of a problem • Interdisciplinary:……bringing disciplines together to work on the same problem • Transdisciplinary:…..cutting across disciplines through use of a common conceptual framework to adress a particular problem, blending together concepts and theories (Rosenfield 2003)

4. Identifying key factors Education in risk evaluation and management is basically formation in interdisciplinary work!

5. Identifying key factors Intellectual and institutional factors characterizing disciplines: • Symbolic generalizations • Models • Exemplars

6. Identifying key factors • Establishing an interdisciplinary approach means foremost: • establishing a common language • second establishing common models and requires social competencies

7. Identifying key factors • Interdisciplinary education has to balance: Integration of symbolic disciplinary systems Interdisciplinary model Translation of symbols Proper disciplinary models

8. Identifying key factors • Interdisciplinary work has to have a common goal: FIOH: We promote health and safety at work as part of a good full life!

9. P R OB A B I L I T Y Non acceptable ALARP Acceptable S E V E R i T Y Identifying key factors: Risk assessment and risk management Classical approach: Risk = f(probability and severity) Maximal Threshold: there exists an upper limit above which the risks are not acceptable Mininmal threshold: there exists a lower limit under which no measures have to be taken ALARP = As low as reasonably possible!

10. Identifying key factors: Risk assessment and risk management Measurements of fatality risks (Slovic 2001): • Deaths per million people in the population • Deaths per million people within x miles of the source of exposure • Deaths per unit of concentration • Deaths per facility • Deaths per ton of air toxic released • Deaths per ton of air toxic absorbed by people • Deaths per ton of chemical produced • Deaths per million dollars of product produced • Loss of life expectancy associated with the exposure to the hazard

11. P R OB A B I L I T E Inacceptables Acceptables G R A V I T E Non Acceptable Threshold Uncertainties Principally set for adultes in good health Healthy worker effect New technologies – no experience TLV for 600 substances but 60’000 in use No reliable strategy for mixtures / interactions

12. Non Acceptable Threshold Adultes in good health: but in 2025: females and ageing workers !

13. Acceptable – Non Acceptable Public health threshold: lower than professional threshold: principle of precaution Electromag-netic fields

14. Professionnel exposure • The source is part of the working process • Based on scientific data 500 µT “grey zone” 1 µT • Public exposure • Precaution limit (Swiss) • New installations Acceptable – Non Acceptable Electromagnetic fields of 50 HZ

15. The grey zone The acceptable risk limit is decreasing! According to the Swiss regulations of major hazards: risks in the grey zone are considered acceptable or not acceptable according to the protection required by the population concerned and the environment as well as by public interests! The grey zone is a zone of negotioation!

16. Influences on perception and acceptance of risks • Context • Other risks • Cost-benefice • Equity • Risk distribution • Social groups • Politics-society • Cultural values • Law • Risk category • Individual involvement • severity • Risk measurement • Relative; absolute • «psycho - political» • Communication • repulsion; attraction • authority; experts

17. Individual freedom of choice /control Example Individual acceptable risks total High risk sports 10-2 – 10-3 partial work 10-3 – 10-4 low Collective transportation 10-4 – 10-5 zero Atmospheric pollution 10-5 – 10-6 Influence of individual choice / control

18. OH risk matrix

19. A C B Risk assessment Risk analyses in an emergency departement A: chronic annoyances: stress, fatigue B: mecanic accidents, agressions C: sever accidents, virus contagion

20. Estimatedindividual risk Estimated collective risks • Mecanic accidents • Hepatitis conversion • PC screen work • Organisational risks • Mecanic accidents • Client relationship • HIV conversion • Client relationship • Noise • Noise • HIV conversion • PC screen work Individual – collectiv risks

21. How to deal with the grey zone • 1. reducing the individual risk above the non acceptable threshold! • 2. Applying cost-benefice criteria for the collective – collective wheigted risks, ev. Cost-benefit of measures • 3. Participative approach to set priorities

22. Identifying key factors • To elucidate the subjective nature of risk assessment, OH specialists have to be conscious about their system of values. • To communicate risks and to discuss values • To include our clients and partners (participative approach)

23. FIOH strategy 2006-2010 We promote health and safety at work as a part of a good full life • we create solutions for improving occupational health, safety and well being together with our clients and partners • By applying our solutions, our clients can learn new things, improve their operatons, and succeed in the changing environment • We learn from our clients about their needs in work life.

24. Interdisciplinary Approach in the MAS W+H • Interdisciplinary features in the MAS Work + Health: • -Large common education of Occupational physicians, Occupational Hygienists and Ergonomics Professionals • -Block II dedicated to communication, social competencies, negotiation and company environment • -Large proportion of project oriented learning • -Interdisciplinary group work in a company (2 weeks duration) • -Topic oriented learning

25. Structure of the MAS W+H

26. Block I Block I Professional basics Basics necessary for the understanding of the three disciplines Law and legal issues to find a common language!

27. Block II Block II Management and company environment Managerial aspects of OH Communication, understanding Social competencies Client orientation

28. Block III Block III training in the three disciplines Separately for: Occupational physicians Ergonomics Occupational Hygienists

29. Block IV Block IV Corporate Health Sociology, epidemiology, public health, economics, corporate organisation 2 weeks project work in an interdisciplinary group

30. Ongoing evaluation • Over the last 10 years due to an ongoing evaluation process we have: • Trippled the workplace visits • Doubled the interdisciplinary group work • Added training in mangerial and economic competencies

31. New: Topic oriented learning Goals: • Integration and overview of knowledge • Building of knowledge maps • Identification of missing teaching links

32. Topic orientied learning • Group work • Each group has one theme (Chemistry workplaces, hospital personnel) • At the end of the modules the groupes work one hour on: Which are the relevant aspect for our workplaces learned during the modul? What do they mean, how do the new facts interact with previous learned one’s?

33. From an occupational physiology point of view: This presentation was much too long! Thank you for your attention!