14.10.2020 – From the FOM
Occupational Health Records of deceased persons – ethical considerations relating to confidentiality and disclosure
Although the topic of confidential OH records is well covered in the 8th Edition of the FOM Ethics Guidance, the recent pandemic events have seen a number of similar contacts seeking ethical advice from the Faculty in relation to requests for release of OH clinical records without informed consent.
Most such requests relate to OH records of deceased NHS workers where the concern of interested parties is centred on COVID-19 as the potential causal agent. In some cases, the records are being requested by non-clinical staff (HR or lawyers) to consider issues relating to the possible legal liability of the employer. In others, a Medical Director or Caldicott Guardian has been the origin of a request to support an internal investigation and, in some cases, the request has come directly from HSE.
OH staff have been placed under considerable duress for urgent release, and senior staff in the employing organisations have argued that they are the owners of the records and have the right to access as Data Controllers.
Ethically, it would be usual to require informed consent from the next of kin to release a confidential clinical OH record. Legally, the Access to Health Records Act 1990 gives the right of access to the personal representatives of the deceased’s estate and anyone with a claim arising from the death. Neither the GDPR nor the Data Protection Act 2018 applies to the personal data of the deceased.
As the FOM Ethics Guidance makes clear, OH practitioners holding clinical records have duties to protect confidentiality that extend beyond GDPR or Data Protection Regulation. Even where consent is not used as a lawful basis for processing personal data under the GDPR, clinical OH records are also covered by Common Law duties to protect confidentiality and by professional registration requirements, both of which require Informed Consent to release records, except in limited circumstances, where there is a statutory exemption or it is in the public interest to do so.
HSE, as a Regulatory Authority, does have a statutory power to make such requests and, whilst it would be good practice to inform the next of kin of release of a copy, the OH records can be released to enable HSE investigation.
A lawyer or employer does not in most cases have statutory authority to access the contents of OH records, in breach of the common law duty of confidence, without informed consent or a court order. Recent emergency measures to control the pandemic have seen a ministerial statement made in pursuance of Regulation 3 of the Health Service (Control of Patient Information) Regulations 2002 that requires, if a clear public interest argument is made, compliance with a request to enable an investigation. Such a request has been validly made for the release of OH records in relation to a cluster of NHS COVID related morbidity in a single organisation – in this case, the records were released to a senior clinician leading the investigation.
OH staff are advised to question the basis of an authority being cited as a reason for the release of a clinical record. Those requesting records, with appropriate authority, would be expected to be able to cite the relevant legal basis under which the request is being made. It is important to recognise that the GDPR alone is not a sufficient basis. Wherever possible, the informed consent of the next of kin should be sought. Clinicians may also seek advice from their clinical indemnity insurer or Registration Body.
OH staff are advised to make sure that their actions, when releasing OH records are clearly recorded in the employee’s records. It should be apparent who the records were released to, when, and on what legal basis. In doing so the OH professional should be able to demonstrate that they have acted in good faith and in line with expected practice.
These requests have also highlighted concerns about the integrity and protection provided when electronic clinical records are stored on the employer’s IT systems. OH providers should ensure security measures are maintained to limit access as far as reasonably possible to only authorised OH staff (or in the case of general clinical records, appropriate staff) with a genuine legally appropriate need to access and use the record (as defined within Data Privacy notices), just as you would with physical written records filed in appropriately locked storage.
If the OH professional has reason to believe OH records were inappropriately released, they should consider alerting their organisation’s Data Protection Officer as well as seeking advice from their indemnifying organisation. OH professionals can also seek advice from the Office of the National Freedom to Speak Up Guardian as well as the Office of the Information Commissioner.
Acknowledgement
The Faculty of Occupational Medicine acknowledges and is grateful for the work of the FOM Ethics Committee who have provided this clarification.
Dr Anne de Bono Dr Steve Boorman
President Chair, Ethics Committee
References
Ethics Guidance for Occupational Health Practice, Faculty of Occupational Medicine (2018) 8th edition (3. Information)
Notice from the Secretary of State for Health and Social Care under the Health Service (Control of Patient Information) Regulations 2002 requiring NHS England and NHS Improvement to process confidential patient information for purposes related to COVID-19. https://www.england.nhs.uk/wp-content/uploads/2020/06/COPI-notice-to-nhs-england-improvement-covid-19.pdf
Occupational Lung Disease – Keeping up to Date FREE WEBINAR SERIES
Keep up to date online! We are going virtual
Three clinical case-based webinars covering a range of themes in occupational lung disease on three Tuesday evenings in November 7-8pm
- ❖ Tuesday 3 November, 7-8pm: Dr Jo Szram
‘Refreshing your spirometry knowledge – a case-based discussion’ - ❖ Tuesday 10 November, 7-8pm: Professor Paul Cullinan ‘Cases from the clinic, with imaging’
- ❖ Tuesday 17 November, 7-8pm: Dr Johanna Feary & Dr Julia Selby ‘It’s not all asthma: how to pick up and treat other work-related issues’Presentations will be followed by Q&A sessions
These webinars are brought to you free of charge by the department - ❖ Please contact Magda on m.wheatley@imperial.ac.uk for further information
- ❖ Registration link is acceible via the event webpage
- ❖ An attendance certificate will be available on receipt of feedback and on request.
- ❖ Sessions will be recordedYour presenters
Further details:
Magda Wheatley, Group Administrator
National Heart & Lung Institute (Imperial College)
Population Health and Occupational Disease, 1b Manresa Road, London SW3 6LR
Tel: 020 7594 7990 (answerphone); m.wheatley@imperial.ac.uk
Course details: http://www.lungsatwork.org.uk/courses/all
Opt into receiving our events newsletter by e-mail/amend your preferences: https://bit.ly/2wmNd11
Working conditions contribute to poor Nurse Wellbeing – see article here.
As lockdown restrictions relax, employers are considering their return to work strategies for employees. Occupational Health Nurses are instrumental in providing advice and guidance to both employers and individuals to ensure a successful return to work.
The Royal College of Nursing (RCN) and the Society of Occupational Health (SOM) are pleased to continue their successful partnership, following the hugely successful Occupational Health Nursing Conference 2019: Key Issues in Occupational Health.
In this exclusive webinar, they are bringing together two of the most respected figures working in the NHS during the Covid-19 pandemic. On 18th August 2020 at 6.30pm, Professor Anne Harriss, SOM President, will be joined by Dr Shriti Pattani, Chair of NHS Health at Work Network and Susie Singleton, Consultant Nurse Health Protection & IPC Centre’s & Regions National Lead at Public Health England.
To find out more – click here
The RCN and the Society for Occupational Medicine (SOM) are looking at COVID-19 and the return to work agenda.
Join the webinar as we explore the instrumental role of occupational health nurses in ensuring a successful return to work as lockdown restrictions ease.
To find out more – click here
Health and medical surveillance during the coronavirus outbreak
For the guide – click here
Supporting Mental Health during Covid-19 – A Guide
For the guide – click here
The latest advice from Gov.uk with regards Covid-19 tests and testing kits
For the latest advice from Gov.uk – click here
Understanding the provision of occupational health and work-related musculoskeletal services
For the latest advice from Gov.uk – click here
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Click here for the latest news from ICO regarding workplace testing
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Chartered Institute of Ergonomics & Human Factors: USABILITY OF PPE SURVEY
We’d like to know what you think about Personal Protective Equipment (PPE) usability during the Covid-19 pandemic.
Professor Jay Banerjee is a Consultant in Geriatric Emergency Medicine in the East Midlands. He’s finding that working in PPE for Covid-19 for a 12-hour shift is changing the way he works so he is collecting information on whether this is also a problem for other people. He is collaborating with Professor Sue Hignett, a Chartered Ergonomist & Human Factors Specialist (C.ErgHF).
The survey is about use of PPE, not PPE provision and availability. It will take around 5 minutes to complete and all data will be anonymous and only reported in summary tables or anonymised quotes. Your answers will be used to gain a preliminary understanding of the use of PPE for prolonged working and to design a future observational/interview study when appropriate.
Latest News from NHS Employers – Extra Support for Occupational Health Services:
New release from Work Fit – Occupational Medicine Consultancy:
To watch IOSH & WHO’s joint Covid-19 Webinar from last week or to book to join the next IOSH webinar on Covid-19 click below:
Guidance on Coronavirus (Covid-19) tests and testing kits
New personal protective equipment (PPE) guidance for NHS teams
Society of Occupational Medicine Covid-19 summary update 18 March 2020
Message from OH Nurses Connect
NHS OH support
We have been approached by a number of OH doctors and nurses in the last few days, eager to volunteer their support and expertise to help the NHS occupational health community during the coronavirus pandemic. If you are able to support these efforts, please email admin@nhshealthatwork.co.uk detailing:
- your name
- level of OH qualification
- contact email and/or phone number
- the type of support you are able to provide i.e. whether face-to-face (and which town/city/region), online/remote, or both
The NHS Health at Work Network will publish these details on a restricted part of their website, accessible only to NHS OH departments. Individual NHS OH Services will then be responsible for making direct contact with the volunteering OH professional to check availability and make the necessary arrangements.
Thank you for your support.
Dr. Anne de Bono, President FOM
Dr Will Ponsonby, President SOM
Dr. Shriti Pattani, NHS Health at Work Network
Report on Silica from BOHS
BOHS issued yesterday a press release welcoming the B&CE and All Party Parliamentary Group’s joint report on Silica, that was officially launched last week.
http://www.bohs.org/bohs-welcomes-important-new-report-on-silica/
SCPHN survey
We would like to say a big thank you to everyone who completed the recent SCPHN survey. The response rate was excellent with over 500 people responding. We are currently analysing the responses and will publish the results as soon possible. Many thanks also to SOM for assisting with this.
We attended the second meeting of the NMC Post Registration Standards Steering Group last week. Again, Occupational health was well represented with a strong voice. The meeting was very constructive with good progress being made The Steering group will be reporting progress to the NMC Council meeting in the next two weeks.
The NMC have advised that they will be producing a newsletter very shortly with an official update which will be available on their website as well FOHN website. https://www.fohn.org.uk/
We will continue to keep you informed of the updates as they come out so keep watching this space.
CPD section in our Members Portal
We are delighted that the CPD section is now up and running in the members area. The site is a really useful tool to help build and develop skills in OH nursing. There is a wealth of information on CPD requirements for OHNs as well as information on courses and resources. There is also a great mapping tool to keep everything on track. This site has been developed by FOHN member, Janet O’Neill, many thanks for her work on this. This is a “living” site, so new contributions are very welcome to help keep it current and relevant to our practice.
- Making health and wellbeing a core priority for the top level of management in any organisation
- early interventions in long term (i.e. >4 weeks) sickness absence, to facilitate return to work
2. NICE’s focus on:
- The importance of occupational health assessment and advice, linked to commissioning quality OH advice from specialists in occupational medicine and from accredited OH services, with SEQOHS as the key marker of quality OH provision (i.e. the FOM’s accreditation system for Safe Effective Quality Occupational Health Services)
- Research, including into the most effective, and cost effective, interventions in supporting return to work
2–4 October 2019, London
A practical three-day qualification designed to train OH and other professionals in the theory and practice of case management skills – in order to improve absence management, job retention and return-to-work outcomes.
How to prepare concise, well-written OH reports that will provide quality information for managers, be understood by employees, and be defensible if the information contained in them is ever required in legal proceedings.
Occupational Health – A Speciality Worth Fighting For?
Click here to read this great article from Mandy Murphy.
FOHN AGM and Leadership Forum- 1 October, Liverpool
The day will start with a topical discussion then lead into a masterclass on helping you to develop a compelling occupational health and wellbeing strategy (including mental health) and concluding with a thought provoking debate on meeting the challenges of OH in the future.
Social Media and Occupational Health
Social Media is a platform for communication. Its user generated content can be contentious, challenging, or informative. It is an excellent tool to keep in touch with friends and colleagues, and it can be used as a marketing tool to get in touch with prospective clients or connections. It is important to be aware of “Fake News” on these platforms but on the whole they are a useful tool.
There are training courses you can go on to learn the algorithms to get maximum effect, and there are some definite do’s and don’ts. A simple google search looking for LinkedIn or Facebook hints and tips will deliver multiple google links as well as paid for books and courses.
In my view, LinkedIn is the platform to use when wanting to be professional, yet Facebook, the more social family orientated platform, has a very active and professional Occupational Health group page run by Diane Romano Woodward and Carr Barnes. But why mention all of this in today’s blog? Well, this week I have had 2 contacts on LinkedIn which I felt were “inappropriate”.
The first one began with the words “You look pretty…” forgive me, but this is not tinder and I am here to work so why do people think its ok to approach me in this way? Would it be acceptable face to face? Absolutely not, so why do it behind a keyboard?
The second, was a mental health professional, who took umbridge with a statistic my social media team had posted about mental health. Apparently, it was out of date. I approached this person with positivity explaining this and asked for the information to be shared on the original post, after all we all want to know what the evidence shows right? The reply I received was judgemental, opinionated and rude. The poster, although speaking from a place of knowledge (allegedly) immediately lost my respect. How could someone working in Mental Health get it so wrong? Communication is key and talking down to people is not the way to share knowledge, especially on such a sensitive subject. How did I handle this? I blocked the individual. Why? Because I do not want to surround myself with people who are keyboard warriors or trolls, these are what the internet calls people who purposefully go out to cause an argument. I will also use this as a reflective tool to ensure that we use the right statistics.
As I mentioned, there are some do’s and do no’ts on social media, and I plan to share these tips with you on a webinar in the near future. In the meantime, think of these “rules” when posting
- Your comments can be seen by everyone. Even if you post in a closed group, people can still screen shot this and share with others.
- Don’t post something you may regret
- Be professional, if people search for your name, they may also be able to see your Facebook posts. Do you want a peer, colleague or employee reading what you have written?
- Ensure you know how to use the security settings, so you have a closed setting
- Think of the pictures that you may be tagged into; do you want anyone seeing those late night drunken pictures of you? Or maybe the bikini shot your friend took and shared despite you saying no!
- Think of Facebook as being for friends and LinkedIn being for work purposes.
- Don’t just forward posts, it may be fake news. It is always worth checking the source and making sure you are forwarding valid information.
Article by Lyndsey Marchant – FOHN Director
DWP Work and Health Unit consultation – Health is everyone’s business – a public consultation on a range of measures to reduce ill health-related job loss
Seeking views on how employers can best support disabled people and people with long-term health conditions to stay, and thrive, in work.
The consultation is part of the government’s drive to tackle the injustices and barriers in society faced by disabled people, seeking to level the playing field and ensure disabled people have equal life chances.
Please provide your views using the online survey accessed via the links below.
Green Paper link:
Consultation link:
https://getinvolved.dwp.gov.uk/work-and-health/consultation/
FOM – SOM Response to the Government consultation: Health is everyone’s business, proposals to reduce ill-health related job loss.
Coventry University are leading research work on older workers and MSD
Invitation to research:
We are looking for employees over the age of 50 with a chronic musculoskeletal condition (MSD) to take part in a survey. The aim of this research is to identify the strategies that older employees are offered and use to manage their chronic MSDs at the workplace. Your opinion and knowledge as an active member of the ageing workforce can contribute much to the aims of this project.
As a participant in this study, you would be asked to complete an online questionnaire that will last approximately 20 minutes. Your participation is entirely voluntary, and you can opt out at any stage.
To participate or learn more about this study you can follow this link : http://bit.ly/researchMSD and/or contact the principal researcher: Glykeria Skamagki, ab7685@coventry.ac.uk
Note from the National School of Occupational Health
The National School of Occupational Health underwent a review of its activities in late 2018 which resulted in a set of recommendations for the ongoing development the school including focusing attention on improving occupational medical training and reconfiguration of the NSOH Board. Support and influence for multi-professional education and related membership organisations, such as FOHN, will continue as before and revised strategic objectives will be published in the autumn.
Dame Carol Black becomes a Patron for the FOHN
“Since writing my 2008 Review Working for a Healthier Tomorrow I have become convinced of the potential for Occupational Health Nurses to play a fuller part in the Health and Work agenda and have greater standing in the sector. I believe that the Faculty of Occupational Health Nursing can be instrumental in making this happen, and I am delighted to have become a Patron of the Faculty.” Dame Carol Black
Read Dame Carol Black’s profile here
Ototoxicants – what are they how may they worsen hearing loss in the workplace?
By Satish Lakhiani – Acoustic consultant
It’s well known that hearing damage may be caused by exposure to loud noise, and that the degree of damage is more severe the longer the period of exposure is to noise. What may not be common knowledge is that there is strong evidence that some chemicals (known as ototoxicants) including medicinal drugs could cause hearing loss or imbalance when exposed to them. These effects are independent of noise and may be either temporary or permanent.
It therefore follows that exposure to both noise and ototoxic substances elevates the risk of hearing loss, and this needs to be recognised when carrying out a noise risk assessment.
How is the hearing mechanism affected by ototoxic substances?
Ototoxicants may enter the body by inhalation, ingress through the skin, or ingestion, and eventually find its way into the bloodstream. It may then damage the inner ear by either affecting the structures in the ear itself, or by affecting the nervous system. Some of these ototoxicants may damage the hair cells in the cochlea (i.e. the auditory receptor located in the inner ear) where the hair cells are responsible for transmitting signals to the brain along the auditory nerve. These type of ototoxicants may be classified as cochleotoxicants. There are 2 further types of ototoxicants, viz: neurotoxicants which can inflict auditory damage via the central and peripheral nervous system, and vestibulotoxicants which affect the vestibular system and result in imbalance, and may be accompanied by dizziness and vertigo.
The detrimental effect of some ototoxic substances upon hearing is that in addition to sounds needing to be louder for detection, it creates both the inability to localise auditory signals and poor frequency resolution which contribute to further hearing impairment. In environments where hearing protectors are worn, the sufferer’s chances of accidents are heightened.
Which substances are ototoxic?
Current investigative work into the interaction of ototoxic chemicals with noise is limited and is based on epidemiological studies from humans and also animal research. Where data has been taken from animals exclusively and research bodies have considered the test methods to be robust and reliable, there is a high degree of confidence that the tested substances may be regarded as ototoxic.
Ototoxicity may be present in the following groups of substances. Some may not be out of place in industrial type environments. The lists are by no means exhaustive:
Solvents
- Styrene and methylstyrene
- Trichloroethylene
- n-propylbenzene
- Toluene
- Xylene and p-Xylene
- Ethylbenzene
- Carbon disulphide
Asphyxiants
- Hydrogen Cyanide
- Carbon monoxide
Nitriles
- 3 Butenenitrile
- cis-2-pentenenitrile
- acrylonitrile
- cis-crotononitrile
- 3,3 iminodipropionitrile
Metals and compounds
- Lead
- Germanium Dioxide
- Mercury
Medication
- Aminoglysocidic antibiotics (e.g. streptomycin, gentamycin, amikacin)
- Analgesics and antipyretics (e.g. chloroquinine, quinine and salicylates)
- Loop diuretics (e.g. furosemide)
- Chemotherapy agents (e.g. cisplatin, bleomycin, and carboplatin)
Of the medication, ototoxicity may be temporary and mild in small doses but the effect may be more pronounced with consumption of some of the chemotherapy agents used in managing cancer. Staff could still be at the workplace when under such medication regimes.
Which are the high risk industries?
These are some examples of industries where ototoxic substances are used, and where noise levels can be high, therefore increasing hearing loss risks.
- Fabricated metal manufacture
- Aircraft refuelling
- Textile manufacture
- Furniture building
- Printing
- Paint manufacture
- Construction
- Boat/Ship building
- Chemical production
- Firefighting
- Paint production
- Defence (weapon discharge)
- Leather production
- Solar cell manufacture
- Mining
How can ototoxicants be identified in the workplace?
Research bodies have concluded that current studies do not provide enough robust evidence to be able to publish a dose-effect combined relationship of noise with ototoxicants. Neither The Control of Substances Hazardous to Health Regulations (CoSHH) 2002 nor the Workplace Exposure Limits (EH40/2005) refer to ototoxicity. It’s therefore highly unlikely, for commercial reasons, that manufacturers will warn of ototoxicity on their products. This makes ototoxicants difficult to identify and therefore applying methods of risk control. The best clue for ototoxicity would be to look out for the word neurotoxic on the product labelling or the safety data sheets.
How do you reduce the aggravation of hearing loss with ototoxicants present?
Some suggested risk mitigative actions employers should consider carrying out in a noisy workplace where staff are in contact with ototoxic substances are listed below.
- Replacing ototoxic chemicals by less ototoxic ones or ones that are not ototoxic.
- Isolating the process from the noisy environment if use of the ototoxicant cannot be avoided.
- Providing information in the risks, hazards, and effects of ototoxic chemicals with noise to employees.
- Increasing the frequency of health surveillance for staff exposed to noise and ototoxicants.
- Providing adequate ventilation and effective PPE in areas where ototoxicants are used.
- Raising staff awareness in the effect of ototoxicant medication upon hearing, and for them to inform their doctors/pharmacist of any concerns.
- Introducing any noise control measures against slightly reduced regulatory exposure limits.
Phone: 07710 356663
Email: satish@esselacoustics.com
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Chartered Institute of Ergonomics & Human Factors: USABILITY OF PPE SURVEY
We’d like to know what you think about Personal Protective Equipment (PPE) usability during the Covid-19 pandemic.
Professor Jay Banerjee is a Consultant in Geriatric Emergency Medicine in the East Midlands. He’s finding that working in PPE for Covid-19 for a 12-hour shift is changing the way he works so he is collecting information on whether this is also a problem for other people. He is collaborating with Professor Sue Hignett, a Chartered Ergonomist & Human Factors Specialist (C.ErgHF).
The survey is about use of PPE, not PPE provision and availability. It will take around 5 minutes to complete and all data will be anonymous and only reported in summary tables or anonymised quotes. Your answers will be used to gain a preliminary understanding of the use of PPE for prolonged working and to design a future observational/interview study when appropriate.
Latest News from NHS Employers – Extra Support for Occupational Health Services:
New release from Work Fit – Occupational Medicine Consultancy:
To watch IOSH & WHO’s joint Covid-19 Webinar from last week or to book to join the next IOSH webinar on Covid-19 click below:
Guidance on Coronavirus (Covid-19) tests and testing kits
New personal protective equipment (PPE) guidance for NHS teams
Society of Occupational Medicine Covid-19 summary update 18 March 2020
Message from OH Nurses Connect
NHS OH support
We have been approached by a number of OH doctors and nurses in the last few days, eager to volunteer their support and expertise to help the NHS occupational health community during the coronavirus pandemic. If you are able to support these efforts, please email admin@nhshealthatwork.co.uk detailing:
- your name
- level of OH qualification
- contact email and/or phone number
- the type of support you are able to provide i.e. whether face-to-face (and which town/city/region), online/remote, or both
The NHS Health at Work Network will publish these details on a restricted part of their website, accessible only to NHS OH departments. Individual NHS OH Services will then be responsible for making direct contact with the volunteering OH professional to check availability and make the necessary arrangements.
Thank you for your support.
Dr. Anne de Bono, President FOM
Dr Will Ponsonby, President SOM
Dr. Shriti Pattani, NHS Health at Work Network
Report on Silica from BOHS
BOHS issued yesterday a press release welcoming the B&CE and All Party Parliamentary Group’s joint report on Silica, that was officially launched last week.
http://www.bohs.org/bohs-welcomes-important-new-report-on-silica/
SCPHN survey
We would like to say a big thank you to everyone who completed the recent SCPHN survey. The response rate was excellent with over 500 people responding. We are currently analysing the responses and will publish the results as soon possible. Many thanks also to SOM for assisting with this.
We attended the second meeting of the NMC Post Registration Standards Steering Group last week. Again, Occupational health was well represented with a strong voice. The meeting was very constructive with good progress being made The Steering group will be reporting progress to the NMC Council meeting in the next two weeks.
The NMC have advised that they will be producing a newsletter very shortly with an official update which will be available on their website as well FOHN website. https://www.fohn.org.uk/
We will continue to keep you informed of the updates as they come out so keep watching this space.
CPD section in our Members Portal
We are delighted that the CPD section is now up and running in the members area. The site is a really useful tool to help build and develop skills in OH nursing. There is a wealth of information on CPD requirements for OHNs as well as information on courses and resources. There is also a great mapping tool to keep everything on track. This site has been developed by FOHN member, Janet O’Neill, many thanks for her work on this. This is a “living” site, so new contributions are very welcome to help keep it current and relevant to our practice.
- Making health and wellbeing a core priority for the top level of management in any organisation
- early interventions in long term (i.e. >4 weeks) sickness absence, to facilitate return to work
2. NICE’s focus on:
- The importance of occupational health assessment and advice, linked to commissioning quality OH advice from specialists in occupational medicine and from accredited OH services, with SEQOHS as the key marker of quality OH provision (i.e. the FOM’s accreditation system for Safe Effective Quality Occupational Health Services)
- Research, including into the most effective, and cost effective, interventions in supporting return to work
2–4 October 2019, London
A practical three-day qualification designed to train OH and other professionals in the theory and practice of case management skills – in order to improve absence management, job retention and return-to-work outcomes.
How to prepare concise, well-written OH reports that will provide quality information for managers, be understood by employees, and be defensible if the information contained in them is ever required in legal proceedings.
Occupational Health – A Speciality Worth Fighting For?
Click here to read this great article from Mandy Murphy.
FOHN AGM and Leadership Forum- 1 October, Liverpool
The day will start with a topical discussion then lead into a masterclass on helping you to develop a compelling occupational health and wellbeing strategy (including mental health) and concluding with a thought provoking debate on meeting the challenges of OH in the future.
Social Media and Occupational Health
Social Media is a platform for communication. Its user generated content can be contentious, challenging, or informative. It is an excellent tool to keep in touch with friends and colleagues, and it can be used as a marketing tool to get in touch with prospective clients or connections. It is important to be aware of “Fake News” on these platforms but on the whole they are a useful tool.
There are training courses you can go on to learn the algorithms to get maximum effect, and there are some definite do’s and don’ts. A simple google search looking for LinkedIn or Facebook hints and tips will deliver multiple google links as well as paid for books and courses.
In my view, LinkedIn is the platform to use when wanting to be professional, yet Facebook, the more social family orientated platform, has a very active and professional Occupational Health group page run by Diane Romano Woodward and Carr Barnes. But why mention all of this in today’s blog? Well, this week I have had 2 contacts on LinkedIn which I felt were “inappropriate”.
The first one began with the words “You look pretty…” forgive me, but this is not tinder and I am here to work so why do people think its ok to approach me in this way? Would it be acceptable face to face? Absolutely not, so why do it behind a keyboard?
The second, was a mental health professional, who took umbridge with a statistic my social media team had posted about mental health. Apparently, it was out of date. I approached this person with positivity explaining this and asked for the information to be shared on the original post, after all we all want to know what the evidence shows right? The reply I received was judgemental, opinionated and rude. The poster, although speaking from a place of knowledge (allegedly) immediately lost my respect. How could someone working in Mental Health get it so wrong? Communication is key and talking down to people is not the way to share knowledge, especially on such a sensitive subject. How did I handle this? I blocked the individual. Why? Because I do not want to surround myself with people who are keyboard warriors or trolls, these are what the internet calls people who purposefully go out to cause an argument. I will also use this as a reflective tool to ensure that we use the right statistics.
As I mentioned, there are some do’s and do no’ts on social media, and I plan to share these tips with you on a webinar in the near future. In the meantime, think of these “rules” when posting
- Your comments can be seen by everyone. Even if you post in a closed group, people can still screen shot this and share with others.
- Don’t post something you may regret
- Be professional, if people search for your name, they may also be able to see your Facebook posts. Do you want a peer, colleague or employee reading what you have written?
- Ensure you know how to use the security settings, so you have a closed setting
- Think of the pictures that you may be tagged into; do you want anyone seeing those late night drunken pictures of you? Or maybe the bikini shot your friend took and shared despite you saying no!
- Think of Facebook as being for friends and LinkedIn being for work purposes.
- Don’t just forward posts, it may be fake news. It is always worth checking the source and making sure you are forwarding valid information.
Article by Lyndsey Marchant – FOHN Director
DWP Work and Health Unit consultation – Health is everyone’s business – a public consultation on a range of measures to reduce ill health-related job loss
Seeking views on how employers can best support disabled people and people with long-term health conditions to stay, and thrive, in work.
The consultation is part of the government’s drive to tackle the injustices and barriers in society faced by disabled people, seeking to level the playing field and ensure disabled people have equal life chances.
Please provide your views using the online survey accessed via the links below.
Green Paper link:
Consultation link:
https://getinvolved.dwp.gov.uk/work-and-health/consultation/
FOM – SOM Response to the Government consultation: Health is everyone’s business, proposals to reduce ill-health related job loss.
Coventry University are leading research work on older workers and MSD
Invitation to research:
We are looking for employees over the age of 50 with a chronic musculoskeletal condition (MSD) to take part in a survey. The aim of this research is to identify the strategies that older employees are offered and use to manage their chronic MSDs at the workplace. Your opinion and knowledge as an active member of the ageing workforce can contribute much to the aims of this project.
As a participant in this study, you would be asked to complete an online questionnaire that will last approximately 20 minutes. Your participation is entirely voluntary, and you can opt out at any stage.
To participate or learn more about this study you can follow this link : http://bit.ly/researchMSD and/or contact the principal researcher: Glykeria Skamagki, ab7685@coventry.ac.uk
Note from the National School of Occupational Health
The National School of Occupational Health underwent a review of its activities in late 2018 which resulted in a set of recommendations for the ongoing development the school including focusing attention on improving occupational medical training and reconfiguration of the NSOH Board. Support and influence for multi-professional education and related membership organisations, such as FOHN, will continue as before and revised strategic objectives will be published in the autumn.
Dame Carol Black becomes a Patron for the FOHN
“Since writing my 2008 Review Working for a Healthier Tomorrow I have become convinced of the potential for Occupational Health Nurses to play a fuller part in the Health and Work agenda and have greater standing in the sector. I believe that the Faculty of Occupational Health Nursing can be instrumental in making this happen, and I am delighted to have become a Patron of the Faculty.” Dame Carol Black
Read Dame Carol Black’s profile here
Ototoxicants – what are they how may they worsen hearing loss in the workplace?
By Satish Lakhiani – Acoustic consultant
It’s well known that hearing damage may be caused by exposure to loud noise, and that the degree of damage is more severe the longer the period of exposure is to noise. What may not be common knowledge is that there is strong evidence that some chemicals (known as ototoxicants) including medicinal drugs could cause hearing loss or imbalance when exposed to them. These effects are independent of noise and may be either temporary or permanent.
It therefore follows that exposure to both noise and ototoxic substances elevates the risk of hearing loss, and this needs to be recognised when carrying out a noise risk assessment.
How is the hearing mechanism affected by ototoxic substances?
Ototoxicants may enter the body by inhalation, ingress through the skin, or ingestion, and eventually find its way into the bloodstream. It may then damage the inner ear by either affecting the structures in the ear itself, or by affecting the nervous system. Some of these ototoxicants may damage the hair cells in the cochlea (i.e. the auditory receptor located in the inner ear) where the hair cells are responsible for transmitting signals to the brain along the auditory nerve. These type of ototoxicants may be classified as cochleotoxicants. There are 2 further types of ototoxicants, viz: neurotoxicants which can inflict auditory damage via the central and peripheral nervous system, and vestibulotoxicants which affect the vestibular system and result in imbalance, and may be accompanied by dizziness and vertigo.
The detrimental effect of some ototoxic substances upon hearing is that in addition to sounds needing to be louder for detection, it creates both the inability to localise auditory signals and poor frequency resolution which contribute to further hearing impairment. In environments where hearing protectors are worn, the sufferer’s chances of accidents are heightened.
Which substances are ototoxic?
Current investigative work into the interaction of ototoxic chemicals with noise is limited and is based on epidemiological studies from humans and also animal research. Where data has been taken from animals exclusively and research bodies have considered the test methods to be robust and reliable, there is a high degree of confidence that the tested substances may be regarded as ototoxic.
Ototoxicity may be present in the following groups of substances. Some may not be out of place in industrial type environments. The lists are by no means exhaustive:
Solvents
- Styrene and methylstyrene
- Trichloroethylene
- n-propylbenzene
- Toluene
- Xylene and p-Xylene
- Ethylbenzene
- Carbon disulphide
Asphyxiants
- Hydrogen Cyanide
- Carbon monoxide
Nitriles
- 3 Butenenitrile
- cis-2-pentenenitrile
- acrylonitrile
- cis-crotononitrile
- 3,3 iminodipropionitrile
Metals and compounds
- Lead
- Germanium Dioxide
- Mercury
Medication
- Aminoglysocidic antibiotics (e.g. streptomycin, gentamycin, amikacin)
- Analgesics and antipyretics (e.g. chloroquinine, quinine and salicylates)
- Loop diuretics (e.g. furosemide)
- Chemotherapy agents (e.g. cisplatin, bleomycin, and carboplatin)
Of the medication, ototoxicity may be temporary and mild in small doses but the effect may be more pronounced with consumption of some of the chemotherapy agents used in managing cancer. Staff could still be at the workplace when under such medication regimes.
Which are the high risk industries?
These are some examples of industries where ototoxic substances are used, and where noise levels can be high, therefore increasing hearing loss risks.
- Fabricated metal manufacture
- Aircraft refuelling
- Textile manufacture
- Furniture building
- Printing
- Paint manufacture
- Construction
- Boat/Ship building
- Chemical production
- Firefighting
- Paint production
- Defence (weapon discharge)
- Leather production
- Solar cell manufacture
- Mining
How can ototoxicants be identified in the workplace?
Research bodies have concluded that current studies do not provide enough robust evidence to be able to publish a dose-effect combined relationship of noise with ototoxicants. Neither The Control of Substances Hazardous to Health Regulations (CoSHH) 2002 nor the Workplace Exposure Limits (EH40/2005) refer to ototoxicity. It’s therefore highly unlikely, for commercial reasons, that manufacturers will warn of ototoxicity on their products. This makes ototoxicants difficult to identify and therefore applying methods of risk control. The best clue for ototoxicity would be to look out for the word neurotoxic on the product labelling or the safety data sheets.
How do you reduce the aggravation of hearing loss with ototoxicants present?
Some suggested risk mitigative actions employers should consider carrying out in a noisy workplace where staff are in contact with ototoxic substances are listed below.
- Replacing ototoxic chemicals by less ototoxic ones or ones that are not ototoxic.
- Isolating the process from the noisy environment if use of the ototoxicant cannot be avoided.
- Providing information in the risks, hazards, and effects of ototoxic chemicals with noise to employees.
- Increasing the frequency of health surveillance for staff exposed to noise and ototoxicants.
- Providing adequate ventilation and effective PPE in areas where ototoxicants are used.
- Raising staff awareness in the effect of ototoxicant medication upon hearing, and for them to inform their doctors/pharmacist of any concerns.
- Introducing any noise control measures against slightly reduced regulatory exposure limits.
Phone: 07710 356663
Email: satish@esselacoustics.com
- Making health and wellbeing a core priority for the top level of management in any organisation
- early interventions in long term (i.e. >4 weeks) sickness absence, to facilitate return to work
2. NICE’s focus on:
- The importance of occupational health assessment and advice, linked to commissioning quality OH advice from specialists in occupational medicine and from accredited OH services, with SEQOHS as the key marker of quality OH provision (i.e. the FOM’s accreditation system for Safe Effective Quality Occupational Health Services)
- Research, including into the most effective, and cost effective, interventions in supporting return to work
2–4 October 2019, London
A practical three-day qualification designed to train OH and other professionals in the theory and practice of case management skills – in order to improve absence management, job retention and return-to-work outcomes.
How to prepare concise, well-written OH reports that will provide quality information for managers, be understood by employees, and be defensible if the information contained in them is ever required in legal proceedings.
Occupational Health – A Speciality Worth Fighting For?
Click here to read this great article from Mandy Murphy.
FOHN AGM and Leadership Forum- 1 October, Liverpool
The day will start with a topical discussion then lead into a masterclass on helping you to develop a compelling occupational health and wellbeing strategy (including mental health) and concluding with a thought provoking debate on meeting the challenges of OH in the future.
Social Media and Occupational Health
Social Media is a platform for communication. Its user generated content can be contentious, challenging, or informative. It is an excellent tool to keep in touch with friends and colleagues, and it can be used as a marketing tool to get in touch with prospective clients or connections. It is important to be aware of “Fake News” on these platforms but on the whole they are a useful tool.
There are training courses you can go on to learn the algorithms to get maximum effect, and there are some definite do’s and don’ts. A simple google search looking for LinkedIn or Facebook hints and tips will deliver multiple google links as well as paid for books and courses.
In my view, LinkedIn is the platform to use when wanting to be professional, yet Facebook, the more social family orientated platform, has a very active and professional Occupational Health group page run by Diane Romano Woodward and Carr Barnes. But why mention all of this in today’s blog? Well, this week I have had 2 contacts on LinkedIn which I felt were “inappropriate”.
The first one began with the words “You look pretty…” forgive me, but this is not tinder and I am here to work so why do people think its ok to approach me in this way? Would it be acceptable face to face? Absolutely not, so why do it behind a keyboard?
The second, was a mental health professional, who took umbridge with a statistic my social media team had posted about mental health. Apparently, it was out of date. I approached this person with positivity explaining this and asked for the information to be shared on the original post, after all we all want to know what the evidence shows right? The reply I received was judgemental, opinionated and rude. The poster, although speaking from a place of knowledge (allegedly) immediately lost my respect. How could someone working in Mental Health get it so wrong? Communication is key and talking down to people is not the way to share knowledge, especially on such a sensitive subject. How did I handle this? I blocked the individual. Why? Because I do not want to surround myself with people who are keyboard warriors or trolls, these are what the internet calls people who purposefully go out to cause an argument. I will also use this as a reflective tool to ensure that we use the right statistics.
As I mentioned, there are some do’s and do no’ts on social media, and I plan to share these tips with you on a webinar in the near future. In the meantime, think of these “rules” when posting
- Your comments can be seen by everyone. Even if you post in a closed group, people can still screen shot this and share with others.
- Don’t post something you may regret
- Be professional, if people search for your name, they may also be able to see your Facebook posts. Do you want a peer, colleague or employee reading what you have written?
- Ensure you know how to use the security settings, so you have a closed setting
- Think of the pictures that you may be tagged into; do you want anyone seeing those late night drunken pictures of you? Or maybe the bikini shot your friend took and shared despite you saying no!
- Think of Facebook as being for friends and LinkedIn being for work purposes.
- Don’t just forward posts, it may be fake news. It is always worth checking the source and making sure you are forwarding valid information.
Article by Lyndsey Marchant – FOHN Director
DWP Work and Health Unit consultation – Health is everyone’s business – a public consultation on a range of measures to reduce ill health-related job loss
Seeking views on how employers can best support disabled people and people with long-term health conditions to stay, and thrive, in work.
The consultation is part of the government’s drive to tackle the injustices and barriers in society faced by disabled people, seeking to level the playing field and ensure disabled people have equal life chances.
Please provide your views using the online survey accessed via the links below.
Green Paper link:
Consultation link:
https://getinvolved.dwp.gov.uk/work-and-health/consultation/
FOM – SOM Response to the Government consultation: Health is everyone’s business, proposals to reduce ill-health related job loss.
Coventry University are leading research work on older workers and MSD
Invitation to research:
We are looking for employees over the age of 50 with a chronic musculoskeletal condition (MSD) to take part in a survey. The aim of this research is to identify the strategies that older employees are offered and use to manage their chronic MSDs at the workplace. Your opinion and knowledge as an active member of the ageing workforce can contribute much to the aims of this project.
As a participant in this study, you would be asked to complete an online questionnaire that will last approximately 20 minutes. Your participation is entirely voluntary, and you can opt out at any stage.
To participate or learn more about this study you can follow this link : http://bit.ly/researchMSD and/or contact the principal researcher: Glykeria Skamagki, ab7685@coventry.ac.uk
Note from the National School of Occupational Health
The National School of Occupational Health underwent a review of its activities in late 2018 which resulted in a set of recommendations for the ongoing development the school including focusing attention on improving occupational medical training and reconfiguration of the NSOH Board. Support and influence for multi-professional education and related membership organisations, such as FOHN, will continue as before and revised strategic objectives will be published in the autumn.
Dame Carol Black becomes a Patron for the FOHN
“Since writing my 2008 Review Working for a Healthier Tomorrow I have become convinced of the potential for Occupational Health Nurses to play a fuller part in the Health and Work agenda and have greater standing in the sector. I believe that the Faculty of Occupational Health Nursing can be instrumental in making this happen, and I am delighted to have become a Patron of the Faculty.” Dame Carol Black
Read Dame Carol Black’s profile here
Ototoxicants – what are they how may they worsen hearing loss in the workplace?
By Satish Lakhiani – Acoustic consultant
It’s well known that hearing damage may be caused by exposure to loud noise, and that the degree of damage is more severe the longer the period of exposure is to noise. What may not be common knowledge is that there is strong evidence that some chemicals (known as ototoxicants) including medicinal drugs could cause hearing loss or imbalance when exposed to them. These effects are independent of noise and may be either temporary or permanent.
It therefore follows that exposure to both noise and ototoxic substances elevates the risk of hearing loss, and this needs to be recognised when carrying out a noise risk assessment.
How is the hearing mechanism affected by ototoxic substances?
Ototoxicants may enter the body by inhalation, ingress through the skin, or ingestion, and eventually find its way into the bloodstream. It may then damage the inner ear by either affecting the structures in the ear itself, or by affecting the nervous system. Some of these ototoxicants may damage the hair cells in the cochlea (i.e. the auditory receptor located in the inner ear) where the hair cells are responsible for transmitting signals to the brain along the auditory nerve. These type of ototoxicants may be classified as cochleotoxicants. There are 2 further types of ototoxicants, viz: neurotoxicants which can inflict auditory damage via the central and peripheral nervous system, and vestibulotoxicants which affect the vestibular system and result in imbalance, and may be accompanied by dizziness and vertigo.
The detrimental effect of some ototoxic substances upon hearing is that in addition to sounds needing to be louder for detection, it creates both the inability to localise auditory signals and poor frequency resolution which contribute to further hearing impairment. In environments where hearing protectors are worn, the sufferer’s chances of accidents are heightened.
Which substances are ototoxic?
Current investigative work into the interaction of ototoxic chemicals with noise is limited and is based on epidemiological studies from humans and also animal research. Where data has been taken from animals exclusively and research bodies have considered the test methods to be robust and reliable, there is a high degree of confidence that the tested substances may be regarded as ototoxic.
Ototoxicity may be present in the following groups of substances. Some may not be out of place in industrial type environments. The lists are by no means exhaustive:
Solvents
- Styrene and methylstyrene
- Trichloroethylene
- n-propylbenzene
- Toluene
- Xylene and p-Xylene
- Ethylbenzene
- Carbon disulphide
Asphyxiants
- Hydrogen Cyanide
- Carbon monoxide
Nitriles
- 3 Butenenitrile
- cis-2-pentenenitrile
- acrylonitrile
- cis-crotononitrile
- 3,3 iminodipropionitrile
Metals and compounds
- Lead
- Germanium Dioxide
- Mercury
Medication
- Aminoglysocidic antibiotics (e.g. streptomycin, gentamycin, amikacin)
- Analgesics and antipyretics (e.g. chloroquinine, quinine and salicylates)
- Loop diuretics (e.g. furosemide)
- Chemotherapy agents (e.g. cisplatin, bleomycin, and carboplatin)
Of the medication, ototoxicity may be temporary and mild in small doses but the effect may be more pronounced with consumption of some of the chemotherapy agents used in managing cancer. Staff could still be at the workplace when under such medication regimes.
Which are the high risk industries?
These are some examples of industries where ototoxic substances are used, and where noise levels can be high, therefore increasing hearing loss risks.
- Fabricated metal manufacture
- Aircraft refuelling
- Textile manufacture
- Furniture building
- Printing
- Paint manufacture
- Construction
- Boat/Ship building
- Chemical production
- Firefighting
- Paint production
- Defence (weapon discharge)
- Leather production
- Solar cell manufacture
- Mining
How can ototoxicants be identified in the workplace?
Research bodies have concluded that current studies do not provide enough robust evidence to be able to publish a dose-effect combined relationship of noise with ototoxicants. Neither The Control of Substances Hazardous to Health Regulations (CoSHH) 2002 nor the Workplace Exposure Limits (EH40/2005) refer to ototoxicity. It’s therefore highly unlikely, for commercial reasons, that manufacturers will warn of ototoxicity on their products. This makes ototoxicants difficult to identify and therefore applying methods of risk control. The best clue for ototoxicity would be to look out for the word neurotoxic on the product labelling or the safety data sheets.
How do you reduce the aggravation of hearing loss with ototoxicants present?
Some suggested risk mitigative actions employers should consider carrying out in a noisy workplace where staff are in contact with ototoxic substances are listed below.
- Replacing ototoxic chemicals by less ototoxic ones or ones that are not ototoxic.
- Isolating the process from the noisy environment if use of the ototoxicant cannot be avoided.
- Providing information in the risks, hazards, and effects of ototoxic chemicals with noise to employees.
- Increasing the frequency of health surveillance for staff exposed to noise and ototoxicants.
- Providing adequate ventilation and effective PPE in areas where ototoxicants are used.
- Raising staff awareness in the effect of ototoxicant medication upon hearing, and for them to inform their doctors/pharmacist of any concerns.
- Introducing any noise control measures against slightly reduced regulatory exposure limits.
Phone: 07710 356663
Email: satish@esselacoustics.com
Chief Operating Officer and President
Faculty of Occupational Health Nursing
Voluntary role
Part time, two year initial term
After many years of dedication to the recognition and continuous improvement of occupational health nursing, Christina Butterworth is stepping down from her leadership role at the FOHN, creating an opportunity for others to step forward and take on one of these stretching but rewarding roles.
This is an exciting time for the Faculty of Occupational Nursing (FOHN), as we establish ourselves as the ‘go to’ organisation for occupational health nursing. Providing the standards, information and support required to take the profession forward.
We are looking for two exceptional leaders who can maximise this opportunity; a Chief Operating Officer who works closely with the Executive Committee to deliver the business plan and maintain operational excellence, and a President who works closely with the Board of Trustees to define the strategy and act as the figurehead for the organisation.
It is important to emphasise that FOHN is a membership organisation that aims to empower its members to do their best.
The COO/President will work closely with the Registrar, Executive Directors and other team members in delivering the mission, vision and values of The FOHN.
How to apply
- Before you apply for this role, please download and read the accompanying recruitment pack
- For an informal discussion about this role or more information please contact us
- Please send your CV and Supporting Statement, explaining why you are interested in this post, your suitability for the position and how you feel you can support the ethos and values of FOHN to info@fohn.org.uk
- Please supply the contact details of 2 referees (one should be your current line manager/clinical supervisor). We will not approach referees without your prior agreement
- Please also indicate your ability to start the role
- Interviews and related activities will take place via teleconference.
For more information, a welcome from our Chair of Trustees and job description, please click on this link: FOHN President_COO Applicants information.
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