The role of the occupational health nurse has been revolutionised, more opportunities are presenting themselves and the need for occupational health nurses is increasing. This article is a short history of occupational health and it’s relation to nursing practice today.
Occupational health nursing covers sickness absence management, rehabilitation, health surveillance, health assessment, health screening, health promotion, research and development, policy and procedure and audit.
Occupational Health in the Workplace
Last year in Great Britain, 34 million days were lost due to ill health and work related injury and 2.1 million people suffered from an illness they believed was caused or made worse by work, according to statistics from the Health and Safety Executive (HSE). This clearly suggests that there is a strong financial benefit for considering employee’s health and wellbeing.
Occupational health nurses have the potential to influence the health of a community and improve the general health of the nation through public health initiatives. The World Health Organization propose that occupational health services can make a significant contribution to other government initiatives, such as reducing health inequalities, reducing social exclusion and sickness absence, by protecting and promoting the health of the working population.
The practice of occupational health should be a synthesis of the study of the core values of public health, combined with an in-depth knowledge of occupational health, health and safety and an understanding of the organisational, sociological and psychological factors that affect workplace practice. In practice it is clearly a specialty requiring a distinct body of knowledge and skills, which can be gained by post-registration training.
The development of occupational health education is influenced by the recommendations of the NMC, Royal College of Nursing and Association of Occupational Health Nursing Practitioners. Lending support to the changing pattern of work practices, and the requirements of stakeholders such as employers and managers, are the requirements of educational institutions, government policy and legislation.
In addition to health and safety, and legislation, occupational health is also a major part of Government strategy. There are several documents that focus on the workplace for health. To name but a few, The NHS Plan (2000), A Strategy for Workplace Health and Safety in Great Britain for 2010 and beyond (2004), and Taking a Public Health Approach in the Workplace (2003) which included the Royal College of Nursing, and Occupational Health Professionals, to more current day Dame Carol Blacks, Working for A Healthier Tomorrow (2008). They all identify that Occupational Health can increase the awareness of health benefits at work.
Historical Occupational Health
Interestingly, occupational health is not a new area of specialism. As Thornbory (2008) argues, people have been aware for thousands of years that certain types of work can affect health, giving the slaves who knew that to stop inhaling dust, while cutting stones to build the pyramids in ancient Egypt, they needed to cover their mouths, as an example.
Dr Ramazinni, an 18th Century Professor in Medicine, also regarded as the father of industrial medicine (now known as occupational health), wrote on the diseases of workers – Diseases of Tradesmen and Craftsmen. He wrote about hazards to health, including dusts, chemicals and many other factors. Echoing the changes of today, the Industrial Revolution was a time of great technological, social and economic change, and work. Work practices and workplaces changed rapidly; however there was little regard for the employee, as the emphasis was on productivity.
Charley (1978) still however explores the British history of occupational medicine throughout the Industrial Revolution. And so, Industrial health was born from an industrial age. That is, as discovered by Gregg (1965), until statutory legislation, which addresses health, safety, working hours and working conditions, was introduced in 1802 with The Health and Morals of Apprentices Act. His findings go on to show that other statutory legislation was passed and put into place in the following years, covering, among other things, working hours for children and women, and mining and factory safety.
Occupational Health Legislation
A lot of legislation has since been passed, bringing us to the most relevant of today. The Health and Safety Commission and HSE are the policy and regulatory bodies within the UK. The national independent watchdog for work-related health, safety and illness, the HSE acts as an independent regulator for public interest in order to reduce work-related death and serious injury in Great Britain’s workplaces. This is where Criminal Law would apply, with the potential for severe impositions as punishment for failure to comply with legislation.
The Health and Safety at Work Act (HSE1974) gives principles, rights and responsibilities to both employer and employee. It is the basis upon which most secondary legislation is derived. It is most relevant, from an occupational health perspective, to the requirement for an employer to perform risk assessments in relation to the type of work their employee is carrying out. The concept of risk assessment is central to the operation of the act and many of the regulations made under it.
The Health and Safety at Work Act has since been supplemented by an extensive range of health and safety legislation, including the Management of Health and Safety Regulations (HSE 1999) – where there is again a general requirement to carry out risk assessments in relation to the health and safety of employees, and Approved Codes of Practice (ACOPs), Guidance Notes and Regulations such as Reporting of Injuries, Diseases and Dangerous Occurrences (RIDDOR) (Health and Safety Executive 1995), and control of Substances Hazardous to Health (COSHH) (Health and Safety Executive 2002).
In addition is the Equality Act, previously known as the Disability Discrimination Act (Government Equalities Office 2010), which ensures through its legislation, that employers make reasonable adjustments for disabled people.
Finally, the UK Government have also adopted the European Directives, made under The Health and Safety at Work Act 1974, which set basic laws throughout the European Union, which cover manual handling, visual display screen equipment, management of health and safety, personal protective equipment, work equipment, workplace health, safety and welfare.
The role of the occupational health nurse has been revolutionised; more opportunities are presenting themselves for the development of occupational health services. While maintaining traditional values of nursing, nurses must articulate and demonstrate the benefits of nursing practice to employees and employers.
Yvonne Jones has been an Occupational Health Nurse for the past six years